Well OT: Heart surgery - what would you do?

[Steve]

Had some tests done recently that ended in being told I need a triple bypass. Saw the surgeon in clinic on Wednesday 2nd July, during which he told me that ideally he would like me to lose some weight but we haven't got time for that - I need to be done urgently because, and I quote, *you've* *got* *critical* *heart* *disease,* and with that he scheduled the operation for the following week, on the 10th.

Unfortunately, pre-op blood tests threw up a problem and the op was postponed. Turns out I was starting with an infection - a dental abscess. The tooth has now been pulled out and I've had two courses of antibiotics that have sorted the infection. Repeat blood test has now come back as normal.

Thing is, the operation is now pencilled in for *24th* *SEPTEMBER* and my question to you is this - do I trust that the guy knows what he's doing? He's the one who's been to uni and med school and trained for years and years to do his job, and he also sees things like this day in and day out. If he says 24th September, he must reckon I can wait that long.

On the other hand, as the patient, hearing the words *"urgent"* and

*"critical"* being used when talking about me and my heart is putting the fear of God into me and I feel I should be done this very minute. There's already been a three-week delay because of my tooth - to find out this morning that I've now got to wait another SEVEN weeks has just blown my head!!

But how do you approach this? What sort of a can of worms do you open up if you start to complain? What would you do?

[fred]

In article , Steve writes

I'd say that the first thing you should do is to avoid all sources of excitement, that is chill out and don't start any arguments with anyone, including your surgeon.

That's not to say you shouldn't voice your concerns in a reasonable and unemotional manner, and ask, if it is a critical operation, could it perhaps be moved forward.

In the mean time, stay off the sauce, eat sensibly and don't get excited.

[Steve]

fred explained on 04/08/2014 :

Thanks Fred ;-)

[Nick Odell]

On the bright side: you've now got an extra seven weeks to lose some of the weight that you know will make the op easier to perform and more successful in outcome.

All the best,

Nick

[Andrew Gabriel]

It's given you time to start losing weight - I would book a GP appointment to ask what it is sensible to do over these weeks in terms of diet and exercise (e.g. it's probabl;y a bad idea to leap straight on to an exercise bike if you are waiting for a triple bypass, at least without close medical supervision).

I would also contact the consultant/surgeon just to confirm the date, givem how urgent you were told it is.

[Tony Bryer]

Why do you need a plumber: this is uk.d-i-y :)

Seriously though, have no useful experience but hope things work out OK

[Steve]

Thanks Andrew, Nick and Tony :-)

[Timothy Murphy]

Why don't you just say (politely) that you would like a second opinion?

[Nightjar]

As you will find, blood borne infections are the one thing that you really need to be careful of with heart surgery. My heart consultant insists that I have my teeth checked every six months, as teeth are by far the most likely source.

You don't really have a lot of choice, unless you have a few tens of thousands of pounds spare and insist upon going private. However, having said that, IME they do know what they are doing and, if they think you need to wait another few weeks, going private isn't going to change that opinion.

These days, it is a routine operation with an extremely high success rate.

Not very comforting, I know, but it will almost certainly be that there is an unacceptable risk, probably related to the after effects of the infection, in operating sooner. They are trying to save your life, not to put it at risk.

Easy for me to say (the consultant told me she had never seen anybody quite so calm after being told they needed open heart surgery) but you really need to try *not* to worry. Stress is the last thing you need right now.

There are procedures for complaints, but, in practice, it isn't likely to make any difference and may even delay things further.

You should ask to speak to the consultant, air your concerns and ask for an explanation of just why the delay is now so long.

You should also start losing weight, preferably under medical supervision, and studying the post operation exercises and recovery procedures they give you. It really does make a lot of difference to your recovery if you do exactly what they tell you to do. The same with the cardiac rehabilitation that will follow your release.

[Nightjar]

On 04/08/2014 14:02, Andrew Gabriel wrote: ...

The majority of people I met in cardiac rehabilitation had their heart attacks when exercising or jogging.

[Steve]

Interesting question Timothy. Trouble is, I'm 56 years old and from a time, and a family, where we basically put the medical profession on a pedestal. They were almost revered, never questioned, and what they said was taken as gospel, and it's a hard habit to break. Not only that, but I've never had to break the habit before - whatever a doctor has said or done, has always worked out for the best, which just goes to reinforce the belief.

But it's never been as serious as this before and now I'm finding that a) I wonder if I should question/ask, and b) even if the answer to that is yes, I don't know how to go about it - and would it open a can of worms and offend my current surgeon?

[Steve]

Now that one paragraph has put it all into perspective Colin. Thank you very much.

Some very good points there Colin and I do feel better for reading them. Thank you sir :-)

[Richard]

Yeah. That sort of behaviour would do the same for me :/

[Tim Watts]

Tell the surgeon you'd like a second opinion and ask your GP to refer you to another.

Any surgeon who's any good will be quite at ease with a patient asking for a 2nd opinion for something so critical.

It is not a complaint - it is simply recognising that sometimes people do not always make perfect judgements.

[Nightjar]

On 04/08/2014 14:32, Steve wrote: ...

Pleased to help. I've been there, although as mine was a heart valve replacement it was preventative rather than corrective surgery. As they were doing three open heart operations a day, I've also seen a number of people in the same boat, including one lad of 28 who went straight from his Army recruitment medical to the cardiac ward. The people with a positive attitude, who were not going to let themselves be beaten, recovered fastest.

Try to see this as the start of being fitter than you have been for a long time, particularly if you do all the rehabilitation exercises properly and go on after to the gym they will offer to refer you to.

[tony sayer]

In article , Nightjar

[philipuk]

Bets course of action is to speak to the consultant to put your mind at rest. They really do have your best interests at heart.

You can also get their opinion on self care in the period before the operation, such as maybe a little bit of weight without weakening your body too much before the OP. But I would only do that with their advice.

Seven weeks really isn't all that long and will arrive before you know it, so long as you don't spend those seven weeks fretting all the time. Relax and build up your strength. Don't overwork yourself but keep yourself occupied.

Philip

[Bill Wright]

My general experience with the NHS is that a polite and reasoned approach works best. The fact is, those who are not verbally fluent and who lack social skills get a raw deal. I suggest you take advantage of this unfair situation. I would write to the consultant making the point that since you were given to understand that the matter was very urgent you are concerned that you might be at risk by having to wait. Let him square the circle. They are very litigation conscious so will always bring an op forward to cover their own backs if they think there's any real risk. From what you say I'd guest you aren't at much risk, as long as you behave sensibly. After all, you had a tooth out, which must have stressed you, and survived.

I was closely involved with a situation in which the patient was told that she needed a pacemaker. Subsequently she was told that she didn't after all. The point was made by the patient's friend, in writing, very politely, that it was on the record that a pacemaker had been proposed, and in fact the patient even had all the pre-pacemaker documentation, so if she subsequently suffered an arrest of a type that a pacemaker could have corrected . . . The pacemaker decision was re-reversed on the day that the consultant received the letter, and the patient had one fitted. Pacemakers cost the NHS about £4000 including 'installation'. You can see the pressures.

Incidentally, don't assume that 'urgent' means that they think you are at risk of coronary arrest. It could just be that they fear further slow deterioration. My cousin waited four months because he was a tricky case and had to be done at Papworth, and he's as right as a bobbin now.

Bill

[Adrian]

Hmmm... I think if I was borderline for needing one, I'd rather go without and see if the situation changed than have one fitted that might not be needed.

[Dave Plowman (News)]

I've got a theory that you are only given so many heartbeats in a life, so why waste them by exercising? ;-)