General Rant

Some of you know I have had some knee problems over the last few months very painful and on the 18th July I am going in for some surgery to hopefully correct the problem. And I have to say I despair at the general standard of knowledge about AF and anti-coagulants within the medical profession.

So last week I went in for my "pre-op" check up, yes usual height and weight and then she tries to take my blood pressure, using a machine, I explain gently that as I am in persistent AF the machine will give a false reading and suggest she uses the old fashioned sphygmomanometer (that's the correct name for that rubber cuff) and she told me "she does not know how to use one" Despair number 1 unsurprisingly the machine has no idea what pulse to use, measures me at 120/115, and she has to call a "sister" to do it manually 120/72 which I would expect

Then we talk about the drugs I am on, I tell her Rivaroxaban she has to look it up, and then says "Oh a blood thinner" No I say it's an anti-coagulant none of them thin the blood. Oh she says I will have to refer you to the anaesthesia team. I ask if it is really that rare to come across someone on a NOAC (mistake that sends her into the books to try and find out what I am talking about)

Now we get to me AF, she asks me loads of questions like "how frequent is it" Persistent I reply, "How do you feel during an episode" I am having one now how do you think I feel?. What drugs do I take to control episodes" She it literally working down a checklist and not listening to a single word I say, so frustrating....

OK finish with her, she now wants blood tests and an ECG (yes to check I know what I am saying) Blood tests fine, and then off for an ECG.

Now this hospital which shall remain nameless is a PRIVATE hospital, although I am an NHS patient, like many of you ECGs have been very common maybe 30 or more in the last few years. I promise you their ECG machine was 15 - 20 years old, the very pleasant operator apologised for the state of the machine, we chat generally about AF she is very knowledgable, and takes my ECG, not a hint of a P wave very irregular, but at the top says "Patient is in NSR" She shows it to me and say "it's wrong we both know that shall I do it again? Same result. She says she will have to manually write notes on the ECG to the surgical team to explain.

It seems to be that our biggest battle with AF is not merely the education of those of us who suffer it, but the education of the medical profession in general, their knowledge is shockingly poor, and worse, they are confident in their ignorance, and refuse to listen to other points of view.

Rant over but feel better for saying it....Grrr


23 Replies

  • Hi Ian,

    Thanks for the input, and l agree with you entirely. On a separate note l take it that you are having a total knee replacement? I am having problems with my knees being an ex-runner.



  • Lucky that you knew what you were talking about Ian, shudder to think what could have happened otherwise. The 'confident in their ignorance' bit has to be the saddest and scariest comment.

    Look forward to seeing you on Saturday we will reserve three chairs - one for you and two for that poorly leg!

    Take care


  • Absolutely agree Ian - sometimes it's an uphill struggle with disbelief and patronisation.

    Best wishes for the op.

  • I regularly read that AF is the most common form of heart rhythm disorder with nearly 1 million people affected in the UK, so surely the medical profession would know more about it. Shocking

  • Rather worrying.....doesn't exactly inspire confidence !


  • Unfortunately I don't have time to add quite a few other things. Some of which would make your hair curl in an instance (except those ladies with curly hair😀😀

  • It's scary how little knowledge some in the medical profession has. I paid private health insurance for years but give me NHS every time. The lack of knowledge of af in GP, hospital settings is appalling.

    Good luck with your procedure.

  • Glad you feel better for getting that off your raises so many questions about the lack of knowledge and understanding that exists in some areas of the medical profession, but it also emphasises how important this forum is in making AF sufferers aware of the many issues that can affect their condition.

    On a lighter note, I'm also pleased you've had your rant coz it might mean the 2nd July will be a little less traumatic.....😜 On a more serious note, everyone here, I'm sure, will want the operation to be a were clearly in a lot of pain when we last met!

    Best wishes Ian, see you next week.


  • Good luck Ian.

    Things aren't a lot different here in Australia. I am constantly having to explain this condition to people including my GP who despite getting a report from my Cardiologist insist I have an ECG Everytime before renewing my prescriptions for Anti coags and Metaprolol. Everytime he seems surprised that I'm "STILL" in Afib.

  • Hi Ian, It's all so disheartening isn't it! All we want is to feel understood and looked after. We certainly shouldn't have to lead the way to hospital staff who should really be better informed than us!

    I'm really impressed that you used the word sphygmomanometer and indeed knew how to spell it! I hope all goes well with your op and wish you a speedy recovery.


  • I did Greek (Ancient) at school Jean, so I can even break down the derivations (boasting of course :) )

  • Lol. x

  • Always the way. Surgical specialties know about surgery. Orthopaedics know about bones and joints..... plastics know about wounds and skin.... medics know about pills and pneumonia etc....

    Sadly, it's a sign of the times that you can't expect a person specialising in one thing to know extensively about another.

    Having said that, AF is pretty common, and the majority of grumbles you have could easily be addressed properly without needing too much "specialist" knowledge.....

    Having been in the profession 12 years and been on Warfarin myself, I get more qualified surgical colleagues still asking me about vitamin K, warfarin and INRs...

  • I understand that Colin, and would not expect a different specialist to possibly even know as much as me about AF.

    But this was the general pre-op department for the whole hospital covering all types of surgery. OK potentially not a medic person, but you'd have expected a little better than I got to be honest.

    Be well


  • Sorry for the late reply Ian been up country. All sounds normal to me but more importantly good luck with your procedure. See you soon I hope.


  • Always good to have a rant, best wishes for July, Kath

  • Sympathise Ian. f you think that it is bad for AF - try explaining Mg!

    I now carry a 'Health Passport' issued by the Mg charity - Myaware - in which we can enter all our treatments, name of our consultant etc and where it gives advice for anaesthesia, Emergency treatments etc and lists all the do's & do nots & referral to a website for further information - I now just hand that to the medics and go let them figure as most of the time they don't believe sufferers.

    Best of luck for the op and do hope your pain is relieved.

  • Hi Ian,

    As it happens I have also been going through pre-op stuff for a new hip,although I have to say every one concerned seemed to be well up on the AF knowledge.

    The ecg says in AF, the ultrasound tech says I am in AF and the anaesthesia ( I hope you spelt that right cos I copied yours!) team says I am in persistent af.

    The only people who have been ignoring my AF seems to be the cardiac department who I have not seen for a review since 2013, although you may remember I paid for a consultation at the Harefield about 18 months ago but was in Paf at the time. I have to stop the Warfarin some five days before surgery,but will have some daily injection as a bridging procedure during that period. I must admit I did'nt know about the BP machine, something I will be looking out for in future.

    This was at my local normal old NHS hospital so apart from the waiting list of some six months it appears most of them are switched on, ( or maybe there is a lot of it about in the area).

    Anyway all the best when you get your knee done, perhaps with my new hip we could enter the marathon as a bionic pair.....


  • Well ranted, Beancounter and very worrying. We have taken it upon ourselves to find out all that we can about AF and so can respond to situations like this knowledgeably. But what about all the people who aren't as 'clued up' as we are. Oh dear.

  • What a to do - so frustrating! On a different note, if it is not too late I would love to join you all on Saturday for lunch.

  • Looking at the other side of the story my brother-in-law recently went for a pre-op assessment for a hip replacement & they picked up that he had a very irregular HR & has since had to have a pacemaker fitted. He said he hadn't had any symptoms either. So that was good that it was picked up. The down side his hip replacement has been put hold & he is really struggling.

    Best wishes for your procedure - you have made them aware!


  • good luck Ian with your op. Thank goodness for this forum and people such as yourself on hand to learn from and share experiences.

  • I've said it before....knowledge is power..........Thank goodness you have that knowledge!

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