Questions to put to Cardiologist.

Hi. arrived back from Spain on Sunday, on Wednesday had a full blown AF attack first I have had since being diagnosed a year ago .Woke in the night sweating and heart turning summersaults I did not call an ambulance just lay there and tried to sleep woke up feeling fine yesterday morning walked into work at 8.30 but by noon had a raging migraine and blurred vision a colleague brought me home and I have been in bed since then until now. I feel absolutely drained.

The question I want to ask is, I have an appointment with Cardiologist next week with a view to asking for a referral to an EP.My GP disagrees with me that Aspirin in not a blood thinner although he has stated that if the Cardiologist refuses my request he himself will refer me to an EP...Although he doesn't see the necessity and even stated there was no risk of me having a stroke.

Could anyone please advise what questions I should be putting forward to the Cardiologist.

This latest attack came out of blue although remembering what Bob writes that AF begets AF so it didn't come as to great a shock.

I have two more trips out of the Uk soon and that was the main reason for not being admitted to Hospital as I would have had to notify my insurance company..

Thank you C.

[BobD Volunteer]

HI Caroma, your GP needs to understand that aspirin is an anti platelet not an anticoagulant and if a patient has AF and any stroke risk they need anticoagulation. PLEASE print off the relative fact sheet from the AF Association website and show it to him/her. If he thinks you have no stroke risk then why on earth has he told you to take aspirin? Also of interest is afinfographic,co,uk which shows the number of people in England with AF against the number at stroke risk and those actually on anticoagulation against the number of AF related strokes projected in the next year and the likely cost to NHS. I'm sorry but this makes me so angry as nearly 50% of at risk patients are not anticoagulated. A truly disgraceful figure for a supposedly civilised country.

BobD

[Hidden in reply to BobD]

Thanks Bob.Just preparing my Script.C

[Beancounter Volunteer]

Hi Caromia

If I remember rightly you have a CHADS score of 2, so just as Bob says, aspirin is about as useful as a chocolate fireguard in preventing stroke for you. Your GP needs to read up on Atrial Fibrilation, and you need to be on an anti-coagulant ASAP.

Number One question for the Cardio is why am I not on an anti-coagulant?

I then think you need to explore with the Cardio if he is feels you should be referred to an EP, or if not does he have specialist knowledge of AF. You need to discuss your symptoms, and then most importantly the treatment options, make sure you get timelines from him/her they love leaving things "open" and you want some closure here, so pin them down to a timeline for the various treatments you have jointly agreed to.

Couple of other things write down your questions, you will forget unless you do, and write down his/her answers, not only does this cement them with you, it gives you thinking time during the consultancy

Take someone with you, and make sure they have seen your list of questions, it will help and support you. You see a cardio a few times a year, he/she does this every hour of every day you need someone who will pipe up if they think your question has not been fullt answered.

Trust this helps, and wishing the very best

Ian

[Hidden in reply to Beancounter]

Hi Ian, liked the Chocolate Fireguard quote I shall use that one next week. I am just composing a dossier to 'put my case forward'. C

Sorry unable to make either you or Bobs 'Nosh and Natter'. Have friends at Hampton Court and others at Ringwood but still not near enough to get to either of you.C

[Geordielass]

Can't agree more with the 'aspirin versus anticoagulation' comments. Your stroke risk is very much higher without proper anticoagulation. As for your GP, my own GP told me when I asked her about an aspect of my own treatment for PAF: 'I'm not a cardiologist, so you need to speak to an expert'.

BUT, my main reason for commenting on your post is the throwaway reference you made to not wanting to go to hospital because of having to notify the insurance people for your trips abroad. Believe me, if you are ill abroad your insurance people will contact your GP and do everything in their power to wriggle out of covering any 'event' you may experience in connection with the PAF. I was admitted to hospital in Germany in 2005 with a genuine emergency, of a non-pre-existing condition, and I had a hell of a time getting re-imbursed for all the (very substantial) costs.

Very good luck with your cardio consultation.

[Hidden]

Hello Geordielass and fellow PAF suffer.

After 12months of being on Aspirin finally got the all clear for Warfarin.It seems incredulous to think that 12months ago the only medication that I have ever taken was the occasional paracetamol and a few antibiotics and now look where I am taking 'rat poison' but thats life for you.

Still coming to terms with having this condition just like many others on this Forum.

With regards to my my 'Throw away reference' to not taking myself off to AE I have taken on-board your comments.Re-imbursement was not the main issue.My business necessitates that I travel out of the UK at the very least once a month and my priority is that I have treatment if needed and then I shall worry about the cost after. This area of insurance is one that I shall have to address shortly.

Regards the cardio consultation I got the Warfarin but not an appointment with an EP but one step at a time.

Thank you for your good luck wishes.C