Army Veteran Richard “Dick” Kamerling noticed he was slowing down. When he started feeling some pain in his chest, he knew it was time to see his cardiologist.
That would be Dr. Stephen Waldo, director of Interventional Cardiology at Rocky Mountain Regional VA Medical Center.
Kamerling served two tours in Vietnam as both a pilot and founding member of the elite Delta Force.
Army Veteran Dick Kamerling: “I have absolute confidence in Dr. Waldo and knew he would take care of me.”
“When Dr. Waldo said I needed a stent to open my arteries, it was a done deal. I have absolute confidence in him and knew he would take care of me,” Kamerling said. “He goes the extra mile.”
Over 10,000 Veterans have procedure every year
When Kamerling had his surgery two years ago to place a stent in the artery to his heart, he became one of about 10,000 to 12,000 Veterans a year that have the procedure done at a VA hospital. The procedure, also called Percutaneous Coronary Intervention (PCI), involves expanding a heart artery, often with a tube and metal mesh scaffold to increase blood flow to a restricted or blocked artery.
This is a very common procedure, but it does have some risk. A study was recently published in the Journal of the American Heart Association that evaluated Veterans undergoing this procedure at community or VA hospitals. Over a four-year period (October 2015 – September 2019), 12,962 Veterans underwent this procedure electively to improve their symptoms.
One year after the procedure, those treated at a VA facility had an approximately 25% lower risk of complications compared to those treated at a community hospital.
As one of the authors of the study, Waldo noted that the differences in outcomes were immediate, suggesting differences in procedural techniques. However, the increase in complication rates at community hospitals also expanded over time indicating that the follow-up-care that these patients received was also different.
Biggest differences included intensity of follow-up visits
“Both groups of Veterans had very similar characteristics based on age, race and medical history,” Waldo said. “The biggest differences we found after the procedure were the intensity of follow-up visits and appropriate medication prescriptions. Veterans treated at a VA facility were much more likely to have regular follow-up with their physician and receive appropriate medications afterward. Both factors reduce the risk of a future heart attack.”
Although the study didn’t identify all causes of improved outcomes at VA hospitals, Waldo does have some theories. “The majority of interventional cardiologists at VA are also associated with an academic institution. This gives them access to the latest techniques and best practices in cardiac care,” Waldo said. He is also an Associate Professor at the University of Colorado, School of Medicine in Denver.
“Also, for those who get most of their care at VA, there is a continuity that may allow closer tracking of patient care,” Waldo added. Other studies have indicated that Veterans who receive their health care from the VA generally have better outcomes than those in community care.
Quarterly case conferences keep VA cardiologists updated
To ensure VA cardiologists are knowledgeable of the latest techniques, best practices and medications, they conduct quarterly case conferences and provide updates to the cardiac team, including doctors, nurses and technicians. They also have access to online case reviews to keep their skills current.
These efforts are invisible to Veterans. They just know how they are treated at VA and if they feel valued and well cared for.
“I wish I could get all of my care from VA,” Kamerling said. “I have had some really good doctors and when I go to VA, I have something in common with every single person there.”
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I am a retired Green Beret and started having chest pain about 14 years into my 20 year career. Initially, I had angioplasty but a month later received my first of eight stents over the course of the next 10 years. I have always received quality care when arriving thru the VA ER. I also have had a triple bypass thru the VA – an experience that I am glad I survived. A bypass graft is supposed to last 10 years – two of my three grafts collapsed within 3 months. A civilian cardiologist was able to stent one of the vessels – the other was in salvageable. The VA wasn’t interested in why mine failed and I never saw the same cardiologist at the VA twice – but while I was on active duty the care was excellent – retired not so much.
Where are these supposed VAs with all these cardiologist? I survived emergency ohs for a type A dissection and torn away valve, still have a leaking graft seem another tear remaining new the valve and a aneurysm bleeding slightly. Been over a year and still haven’t been able to see a cardiologist. The VA in Tucson can’t keep any on staff, non in community won’t take me as a patient since no one knows what to do with us that survive and their overwhelmed with all the snowbird seniors here. The on cardio thoracic surgeon this VA has also won’t treat or read my CT’s since my surgeon is some celebrity surgeon no one will question (though he’s not local to us)…
I was feeling good but the VA said I had a blockage and needed a stent put in. I showed up for my appoinment and they put me under and proceeded with the procedure. Long story short the guide wire broke causing me to have a heart attack and I coded. They resusitated me and transported me to a regular hospital, but no one thought I was going to survive. I recovered to some degree but will never be the same, They were not able to recover the guide wire and it is still in my heart and quite often I feel the pain of it. It’s been a year now and I’m still here but I never know when I go to sleep if I will wake up again. All because while installing a stent the guide wire broke and left there.
How about some of us that, like myself that have multiple stents from aneurysms in our arteries form Agent Orange. I sprayed it my self.
Had a Heart attack on 3/25/22 didn’t realize it was a Heart attack until I arrived at St.Louis VA John Cochran at about 2400. They literally sweep me of my feet and next thing I knew I was in Cardiac Cath lab having this exact procedure. The short of it they worked on me for approximately two hours and saved my life! Had two stent’s 70% & 90% blockage. I received the best care in the ER,Cath lab ,ICU that I could have hoped for. Total was in for about 72 hrs . Have been receiving great follow up care . Talking to others that have had the same problems I’m glad I receive all my care through the VA .