Hi , I was back in af again Friday after four weeks clear I have peroxomol af and awaiting dates for ablation , I'm 46 years old , I went to work Friday morning then about 9.30 am felt a flutter like bubbles coming up through my body so checked my pulse and it was very all over the place ,I carried on at work a very manual job till just after lunch and decided to knock off and go home were I stayed in af , it was about 8 pm when I decided to go a&e ,every time I stood up I'd black out for a few seconds also had a dull dizzy headache and the feeling of unwell ness , once in a&e the nurse did a ECG and confirmed I was in af but it wasn't over fast around 100/110 which I think the flecainide and bisoprolol was controlling , the doctor then came in and asked why I'd come to a&e I told him I was in af for 10 plus hours and felt unwell to which he spun around left the room chuntering to the nurse there's nothing we can do here for him ,I was go smacked at this point , the nurse then came back and took it on her own head to move me over to emergency assessment ward instead of sending me home like he had suggested ,i stayed in overnight then saw my cardiologist the next morning at which time after being in af for 20 plus hours I went back to nsr and was released , my cardiologist told me if this ever happens again to tell the doctor he said for me to go in and if any problems to ring him , is this really what it's come to .? Might I add the nurses and doctors on the ward were very good to me and totally different to that pillock in a&e cheers Paul
Very rude a&e doctor: Hi , I was back... - Atrial Fibrillati...
Very rude a&e doctor
Wasn't in Lincoln by any chance was it? Sounds like a Doc I met in the Lincoln county hospital. He diagnosed SVT only to be corrected by a staff nurse that I was in fast AF.
Hi Paul
Dreadful as it sounds, 100 bpm is looked at as under control. That's why the first doctor did what he did. Generally unless ts over 120 + they will send you home. Unless they have special instruction as in your case, you now have. I have been in this same situation. I assume you told the first doc you were blacking out. ? even so, par the course. However, that doesn't excuse him from being rude and arrogant as some of the registrars and consultants can be. Don't we all know it.
Hope you feel better.
Phil
You could let the Patient Advisory Service at the hospital how you felt about your experience, may mean the doctor stops and thinks about his attitude towards patients. Sorry you had that experience, I think medics can forget a patient but our own experience and memory can last a life time!
Wow, that's terrible. Compare that to my first diagnosis......12 years ago, I went in to A&E with what sounds like the same symptoms, I could hardly stand without passing out. First thing is that they rushed me to the front of the queue as soon as the word heart was mentioned, took an ECG within about 2 minutes and I was in the coronary ward in no time at all where I stayed for 8 days on a 24 hour monitor till they found a drug that worked.
4-5 years ago, I was sent to another hospital with a possibly heart attack (it wasn't as it happens). I was kept in the waiting room for 1.1/2 hours by myself before I saw anyone. I could not believe it and just spent all my time trying to keep calm because I can't stand bad "service" from anyone. They did keep me in for blood tests, but, yes, they didn't do an ECG!!!!!!! My GP put his head in his hands when he saw the report.
Such variation.
Koll
Put a complaint in Paul. That jerk shouldn't be practising. Period.
Keep well and keep us posted. This forums great. Off to hospital myself shortly almost certainly for my third DC Cardioversion.
All the best, bud
Nige
Hi nige, I'm a bit warey about complaining just in case I have to go up there again which is a certainty with this af , I've been up there several times since January and this was the worst , it just made me feel more anxious as to weather I would get treated , I was scared they would send me home still in af , but once I'd seen my cardiologist he said I must go so they can sort out a plan to revert me back which made me feel more relaxed and I reverted back almost immediately cheers Paul
Do I notice this was Friday night Paul?
Having been told he would be kept in "definitely", my husband was shunted out of A&E very rapidly after an influx of drunks and a very violent patient. No discharge note, no medications, - this was his first episode of AF and we had no idea what to do, what AF was or anything. It was quite frightening.
Anyone know when's the best time to go to A&E? Not that one can choose exactly!
Hi there , no it was Thursday night but the night before Good Friday so was still very busy , I don't think some of these doctors take af too seriously and don't realise how frightening and anxious it makes you , I've had about 15 episodes since starting with it since January and every one makes me feel frightened and anxious no matter how many times people tell me I won't come to any harm with it , hope your hubby gets it all under control soon and gets to see the rite medical experts be well Paul
Paul
That Dr wants reporting do it today.
Christo.
Christo's right, it needs to be reported. I don't think doctors like that have any idea of the effect they have on people...
Lis
I had a similar experience Paul it's disgusting, if casualty drs dont have enough experience to treat patients they shouldn't be there! I went to A&E the week before dx with stage 3 heart failure, I wad struggling to walk, nauseous, very short of breath. Id had chest xray day before so asked dr to look at it, he said 'your hearts a bit enlarged but ill leave that for you gp to deal with' next day gp looked at xray...lungs full of fluid!
I did complain but never had a reply!
OK I guess I am going to upset a few people here but then you know me. Many people are in persistent AF , they have it all the time yet manage to carry on with their lives without constantly rushing to A and E . Many people with paroxysmal AF accept this and carry on with their lives once properly diagnosed. At HRC last year an EP told us that he suffered from AF and was once in the middle of doing an ablation on a patient when he went into AF. Did he stop and go to A and E, hell he did. lol I found that once I had a diagnosis going there was pointless as all it did was clutter up another bed until I converted and they sent me home. OK whilst trying to get a correct diagnosis A and E is often the only choice.
My point I suppose is that whilst this doctor's attitude should be corrected there is an old Chinese proverb. "Before you condemn a man walk a mile in his shoes." I know some A and E doctors and many work 18 hours straight and often more. With a waiting room full of drunks and sportsmen with avoidable injuries you can see his point although he does need to re-think his bedside manner. I should also point out that most A and E doctors are prevented by policy from changing or adjusting prescribed medication so unless you have a direct line to your cardiologist there isn't much they can do except observe. One young friend of mine on his third straight night of A and E once had a formal reprimand for prescribing a new drug to a heart patient.
Just trying for some balance here you understand.
Bob
I agree BobD, A&E drs do work long & difficult hrs but, the issue here is they dismissed a patients concerns, if they can't or dont know how to treat a patient then they should pass on to the appropriate department.
The Dr I saw sent me home in a distressed state which, after being examined by my gp & a cardiologist 2 days later could have cost me my life.
Hi bob , I've had af since Christmas and stayed at home more times than I'd been to a&e ,I did not rush upto a&e I stayed at work till about 2,30 mite I add on a very big construction site were I was laying a 1200 mtr floor with very heavy tiles and a very tight schedule to get the job done , I carried on regardless with a very fuzzy head and blacking out every time I got to my feet ,when I arrived home after a two hour drive up the motorway I remained there till about 8.30 still feeling unwell and made the decision to then after almost 10 plus hours to go up to a&e as my cardiologist had told me to because I wasn't on any anticoagulants and if I leave it too long they wouldn't even attempt to cardio vert me , I understand the saff are busy but his attitude was very wrong , I work and always have and paid into this system all my life and this is the first time I've ever wanted anything back from it , just saying .
I am not doubting that the doctor was rude nor that you were feeling bad. We have all been there. I just wanted to put some balance into the arguments. Since you mentioned anticoagulation you might now like to think about discussing that with your EP. You will need to be on some before your ablation anyway. Cardioversion can be a mixed blessing but seldom a long term solution although it does suggest that an ablation could be successful. Must be done within 24 hours of onset of AF unless you are anti-coagulant.
Bob
Sorry Bob but I have to disagree with you strongly here.
I would suggest that all these brave people with persistent or paroxysmal AF are not experiencing heart rates of 160 - 240 but probably just slightly above normal ( 100/110 - 120 ? ) Whether persistent or paroxysmal , it is not brave , clever or whatever to ignore this.
I was left in a lowish rate of 120/130 AF for 3 weeks some years ago & suffered severe heart failure . A very frightening experience but fortunately a ' one off '. I was told that this was attributable to AF.
The fact that an EP went into AF whilst performing a procedure is really neither 'here nor there '. What matters is the rate & how it affected him.
As you probably recall ( & no doubt fed up with hearing ) I was diagnosed with AF 22 years ago & have undergone probably all drug treatments, 3 ablations ( no 4 in offing ? ) & had 14 DCCV's.
I am not ignorant of the condition & in fact consider myself quite well informed. For you to state so categorically that to go to A&E is a waste of time is irresponsible & misleading to many . I do however accept that there are those who would be better served visiting their GP. Do not forget though how very frightening AF can be in the early days.
Sandra
Sandra I do not think I ever said that it was a waste of time. What I said was that "FOR ME" it was pointless. I understand that this whole question of should you shouldn't you is very emotive and would never try to tell anybody that what they do is wrong. I was ,as I have said several times already, trying to put both side of the story and whilst not excusing rudeness in any form showing that an over stretched A and E department is not always able to deal with AF. I do also understand that for many/some people just being there helps. I recall one member stating that she always went but seldom went in as arrival in car park at hospital was usually enough to convert her. lol
Going to A and E in the hope of being cardioverted is not always realistic either due to the unknown time scale unless one is anti-coagulated and has a good record of range available in the old yellow book. I would be interested to hear how emergency doctors would deal with a patient on NOACs in such circumstances.
As you so rightly point out we are all different and in this mad world of AF there is no one size fits all.
Lovely evening down here. Spring at last.
Bob
OK then Bob -- perhaps the impression I was given from your post is that A&E is for wimps ! You are undoubtedly very knowledgeable re AF & consequently looked to for the definitive answer by many. I would not like those who really should be seen at AE to be put off doing so.
For the record I have never been made to feel a nuisance & all my DCCV's have been ' emergencies '. I always try to ' sit it out' but my GP's are very much against me doing so. Mind you, when i am in the 200's I don't do much 'sitting out '.... Hell no!!
Lovely weather here on the SE coast as well Bob. Looking forward to another visit to The Saunton Sands later in the year.
Sandra
Watch out for Hercule Poirot.
i agree with Bob i had permanent AF for 3 years before getting to where i am now i never went to A and E once during that time despite nausea and faint feelings and breathless on many occasions day and night. But everyones different i suppose i used to wait till it passed the other symptoms that is. If that meant sitting on the floor in tesco so be it. My turned out to be a multitude of things including cardiac tumour meds keeping me on even keel now
I agree 100% with Bob.
I was in persistent AF for a long time. Then last Monday had my ablation. Late afternoon last Thursday I felt myself go back into AF. I just monitored my heartbeat and BOP every hour or so with my AliveCor and BP Monitor. I accept that ,fortunately, my HB was not excessive (98 to 110bpm) over 8 hours but thought that there was no point going to A&E. After a few hours I did actually phone the heart ward where I had the CA (they don't have an A&E at that site) just to double check that they did not want me to go to A&E and I was told that if I was uncomfortable or excessive HB then to dial 999 to get taken to local A&E and then get them to transfer me back to London by ambulance. If that was not the case at any stage then to phone back Tuesday for an appointment. I recognise that many may get significant pain, that everyone's pain thresholds are different and that many people's AF is different.
I can agree with Bob in some areas...what I can't excuse or justify, is a rude and frightening attitude from any doctor. I don't care how hard that doctor feels he has to work, or how many drunks and crackheads come staggering into A&E - it is his and the hospital's job to treat or put people's minds at rest. All he had to do was to explain, in simple terms, what the situation was. I used to work under a lot of stress at times and had to deal with people who tried my patience off the dial at times. If I had treated them in a rude and dismissive manner, I'd have been out of the job.
At the very least, I would put in a complaint about this guy. Not all doctors are like this and the NHS needs to know this goes on.
I think we need to consider the situation carefully. This was Friday night, the worst night of the week for A&E. No doubt the doctor was having to handle lots of rowdy drunks, car crashes etc. and had been working long hours with little sleep. AF is not an emergency, it is a long term condition. When I had AF I would grey out briefly on standing until my body caught up.
If everyone with AF went to A&E every time they had an episode, it would be so full, the drunks would never be able to get through the door (perhaps no bad thing!).
So the doctor was rude, which is not good, but we need to put that in context. I would hate to work in A&E and have to treat all these abusive drunks who are in their only because of their own actions. There's a shortage of A&E doctors and doctors are not going to want to take it up if everytime someone gets slighted they put in a complaint.
I agree with MarkS here. If you caught the doctor's name then perhaps send him a private letter, but I suspect he'd been on duty for 12 hours, wanted to go home but couldn't because the Friday night influx was starting up. We're all human after all and we're short of doctors as it is, especially in A&E.
I haven't complained , I'm not a drunk never have been , kept fit all my life , worked all my life , paid into the system all my life , and to add to that my cardiologist told me to go there if I was at all concerned , just saying
There are two separate issues here, to my mind - the need/necessity of going to A & E and the response of the doctor concerned.
Each of us has to decide when and if we need to seek help for a condition which can frighten the most stalwart, whether that help is from A & E or not.
A bad mannered response from a professional is totally unacceptable, whatever his/her pressures and from the opening post, that attitude seems to come with the doctor concerned.
Don't let it put you off, Paul in deciding what is best for you.
I totally agree with you and can see both sides of the coin. My AF has been very scary every time it happened (and it happened 5 times in as many months). I live on my own, did leave it 12/24 hours for two of the episodes but just felt more and more unwell and worried as they persisted.
And a couple of them I had associated chest pain and breathlessness too!
I work in Trauma, I know how it works, I know what resources are like in the hospital - but I also know my own body. Each time, be it by outreach or the doctor on duty or the A&E crew on a couple of occasions, I have been told "no, you're not wasting our time you're doing the right thing".
They would rather have 10 people symptomatic and worried about getting worse coming in to get checked out and reassured than 10 people that have punched glass windows because they're drunk.
I would not hesitate in going back if the situation became as it was before (touch wood, I'm worlds away from where I was) and one publicly bad attitude from a Doctor wouldn't put me off, regardless of what he says about me in private through frustration at the job/workload. We've all sounded off, but to do it openly like that is out of order.
Thanks jed , at least there's someone else out there hat thinks like me ,pleased to hear your doing well my friend and hope I can eventually get there too ,just seems a long road to travel at the moment tho ,keep well Paul
Thank you finvola , this was what I was thinking , everyone else and whenever I've been upto a&e have been fantastic in dealing with me and calming me down not making me more anxious ,which goes a long way this doctor could have been a locum probably charging the nhs thousands of pounds a shift , but anyway I'm home now and feeling a bit better thanks again Paul
I also think that the situation is different with seasoned" AF sufferers because we are probably very much more in tune with our bodies than most people and also know more than some doctors and nurses because they have limited experience of dealing with AF (GPs and A&E staff cannot be experts in all areas of medicine).
Also I think that many people (possibly including some medical people) do not appreciate (and some will not listen) as to how bad we are feeling and how the AF is affecting us. If we had sprained an ankle there is something much more visible!!! Therefore we probably get treated like some of those who just go to A&E because it is the easy cop out or those who have inflicted things on themselves (eg the drunk).
Thanks Peter , this is what I was thinking , I'd done nothing wrong apart from start with this unpredictable damn af which I'd sooner be without ,
I'm sure it was the doctor who was in the wrong and not me ,but a few people on here are basically insinuating that it was me in the wrong ,I don't meen you Peter thanks again
I too am very surprised at some of the responses on here ,generally I find this forum a good source of nowledge and advice , but maybe some long term sufferers of af have forgotten just how scarey and bad this new illness can make people feel , I thought it was about supporting one another on this long rocky road cheers Paul
Hahaha thanks David , at least I've kept a few people busy with there replying today
Suppose it keeps them out of mischief lol cheers Paul
If I had an episode of tachycardic AF and had any sign of blacking out (which I've never had by the way) I would be straight on the phone to my GP and I know what he would do - send an ambulance! You were right to go to A+E and the doctors manner was extremely uncaring.
Jean
I am sticking this at the bottom since there are a number of places that this could go in the string above!!!!
In MHO there are a few key points that may have been lost in all the responses.
Regardless as to what was going on or not in A&E, in just the same way that members of the public must not be physically violent or verbally excessive or rude or frightening, the same must also apply to staff, whether a doctor or not. It can be difficult under pressure and sometimes people may be sharper than on most occasions without going to excess.
From what was said by Runcrans about his perception of the nurse's actions this may not have been the first time that this has happened with the doctor in question. Other staff may be too scared to report the doctor.
In fact if the doctor is a locum or agency one and there are numerous complaints it is much easier for the hospital not to use that person again (if the trust so chooses). It is much more difficult if he is permanent staff but if there are complaints their formal procedures have to be followed.
It could well be that the doctor does not know / understand the multitude of complex issues regarding this mongrel affliction called AF or that his experience was dealing with AFers who were not as afflicted as Paul was and therefore he thought that there was nothing he could do there and then.
I have heard / read that many EPs do not like A&E doctors / consultants just to do a cardioversion there and then unless it is essential to do so and in reverse A&E consultants similarly sometimes don't like to do so. The latter case is probably very true if the A&E hospital is one where there is no cardio unit at the hospital or where there are no EPs in their cardio department.
Apologies for the length but these are my thoughts / observations.
I forgot to add that if having an "AF" attack or having excessive heartbeat or having blackouts people should not be driving themselves and if a passenger should be in the back seat in consideration of their own safety and the safety of other drivers / passengers / pedestrians.
Hi Runcrans, I went into A+E with a very painful ankle about 15 years ago and after x-ray was asked if I was sciving off work and not to waste people's time when there are more urgent cases waiting in the wings. A year later I was involved in a bad car crash and had a plaster put on my leg for a broken ankle. A week later the specialist told me that it was an old injury which should have been dealt with at the time and would now probably become arthritic at a later stage. A+E is not perfect but you deserved to be treated with courtesy and consideration and it is b*llocks to blame ignorance on long shifts!
Hi runcrans,
I am sorry you were treated so badly at your hospital.
I think by going for medical help and advice when you did was wise
even when you arrived at A/E maybe you rate was not excessively high,
I suspect while you were doing hard physical work earlier your heart rate could have been at a more dangerous value.
I am in permanent AF, have been for over 3 years now , as Bob says you learn to live with it. My heart rate varies between say 56 to 120 bpm depending what I am doing and I am quite happy with that
However on 4 occasions by heart rate was up around 180 bpm and remained at that value and I just could not function.
The first time this happened I waited for over 4hours before seeking medical advice I phoning my G.P., who sent an ambulance and I was taken into resus at Edinburgh Royal Infirmary where I was converted back to NSR.
I have been advised by my G.P. and cardiology dept if my heart rate ever reaches those levels again and continues for over 30 mins.to 1hour to call an ambulance no matter where I am and get myself into A /E.
I have been told it can be dangerous to allow such a high heart rate to continue.
The max. heart value I have been advised is 220 minus age, to allow you rate to persist for any length of time can eventually damage your heart.
Hi rosailer , thanks for that , my gp told me to go straight to a&e if I went above 110 , and my cardiologist just said if it becomes troublesome to come up and they would have to get a plan together to get me back into rhythm ,when I'm in af I find it very difficult to carry on has normal I get a thick head and have no strength or energy , I've had to give up my running which I loved because when I asked my ep about continuing he pulled a face and said maybe a jog but he didn't instill me with confidence to carry on and suggested that running was the cause of it to start with so who nows cheers Paul
Thanks for your reply Paul, it's always good to share our experiences.
I find when I am physically tired, maybe the day after doing too much at the gym or any other excessive physical activity then my heart rate starts climbing and can stay high.
There are a few things I do when this happens or to prevent this happening.
I "listen to my body" and when I begin feeling " distressed" with a fast thumping heart rate.
I stop what ever I'm doing, sit down where ever I am ( even on the street) take slow deep breaths letting the air the fill the top of my chest, then take one a very long deep breath and hold it in for as long as possible, then let it out slowly and relax.
By doing this it has an influence on the vagus nerve which an effect on the heart rate.
It usually works for me.
My philosophy to AF is not allow it to control my life
I try to keep as fit as I can and push myself physically to reach the point in physical exercising /working just below the point where my heart rate rises too high and becomes uncomfortable and not go above that point
As I wrote above I listen to my body. There are good days and bad days on the bad days I generally laze around being good to myself but then I can do that now that I am retired.I know that sounds selfish.
I hope my experiences dealing with AF is of use to you Paul. I wish you all the best, please tell me how you are getting on from time to time
Ian
Hi rosailer, lat week before going upto hospital I did try holding my breath breathing deep ,I also went into the shower put it on hot for 5 mins then hit the lever to cold it took my breath I stayed under for a few minutes ,I did this twice but nothing helped me , it's usually just a matter of time with mine , I've got a friend with af and he can control his by holding his breath and cramming or just stripping off and Laying flat , I wonder if its something to do with where the af is triggered from my friends in for an ablation of the av node ? And mines of the pulmonary veins woner if this makes a difference to how some can control it and others can't keep well Paul
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