Complaining of severe epigastric abdominal pain and looking really unwell, with vomiting the out of hours doctor referred him to A & E. Until now he has been a healthy 73 year old overweight and has lost four stone in 60 months, just re=educating his palate and being married to me. Still working.
they did X-ray Normal
Blood tests = normal
Scan - everything normal. No dissecting aorta. no gall stones when it was established his aorta is normal and signs of abnormality,
ECG - within normal limits, they did another one - let's get this looked at
Monitor showing slow pulse 50- 60 beats a minute.
Another ECG done normal again, Papworth is contacted.
Fourth ECG done there it is again.
Aspiring given, IV paracetamol administered still no relief from the pain.
Pulse rate still slow.
Morphine administered after three hours to relieve pain.
Admitted to ward at 4am. husband slept soundly. 6am another lot of blood test, all come back normal. ECG done, - normal.
Consultant comes in and starts talking about strokes and cardiac ablation and anticoagulant drugs. Says husband has AF. I asked what is the CHADS2 score. to be told if this had happened two weeks ago he would have been prescribed aspirin as he would have been a medium risk of having a stroke but guidelines have been changed and now he is high risk, as there is only low risk and high risk, still didn't get the score, so I did my own scoring <2. To be told he will be referred to Papworth for a cardiac ablation...WHOA....we want a second opinion, all this for an intermittent blip and slow pulse rate? She also informed us, she has spoken to our GP and there would be no problem prescribing the Rivaroxaban. Omprezole was part of the cause of his massive weight gain, so he is not keen to go there again.
He does not have high blood pressure, he has low cholesterol and creatin levels are normal and no indication of raised blood sugar. BP was raised 142/70 when admitted but dropped to 136/68 after three hours.
Husband was Rugby player for years, he also was a swimmer and is active. I was an ultramarathon runner, my pulse rate is between 52 - 65 and have been told by the sports physiologist this is normal for sports people.
We travel overseas at least three times a year, all long haul and take 75mg aspirin to help prevent DVTS.
The Consultant was going on about DVTS because of his low pulse rate and the need for anticoagulants, went ahead an prescribed Rivaroxaban, Omperazole and Nitrolingual pump spray...funny he still has the abdominal pain. Home he comes after a six hours in hospital. Just told on the NOVA drug he wont need monitoring one tablet a day.
He made the decision not to take the medication and wanted to talk to our GP, but could not get an appointment.
He told the Consultant he does not want any intervention performed as he did not need intervention treatment in hospital and the abdominal pain had not been resolved.
Saturday the original symptoms returned. Diagnosed as gastroenteritis. treated for same.
Wednesday there is pphone call from the anticoagulation clinic he is supposed to have appointmet with them. Was not told this on discharge or at any other time. Clinic nurse informed as he is not taking the medication why does e need an appointment.
I read the discharge letter to our GP, we have a copy, diagnosis AF and low pulse rate with an out patient echocardiogram to done..
Another twist to this tale, husband went through RAF and Army over 25 years service with this cardiac blip known . he has seen active service from Borneo to Northern Ireland and postings to Germany. His only injury? Falling off the wing of an aircraft and hurting his knee.
He is now taking 75mg aspirin daily, it wont prevent a stroke, but at least it may help prevent a DVT.
Another thing we were told if he takes the Rivaroxaban, he could have an intracranial bleed. So between a rock and hard place as far as information.
He does not want to go down the path of no return by starting medication he is not sure he wants to take and really is only a band aid.
Of course if his was in AF all the time it would be a different matter he does not even notice flutters or anything else.
He is back at work and says he feels a lot better and no stomach pain.