Help...I don't know what to do!

I have a private appointment next Wednesday with an EP at his private clinic. He also works at the Cardiology unit at the hospital where I have my first NHS appointment at the end of September. Can someone tell me (as I am becoming rather anxious about it), how do folks transfer from their first private appointment with an EP to continue treatment on the NHS? When I asked if I could have a Doctor's referral for the private appointment, he said he had already referred me....hence the NHS appointment in September. The surgery are, rather, printing my AF history for me to take to the private appointment. Do you think I should cancel the private appointment...since I will meet the guy at some point when I go to the Cardiology unit in the NHS hospital 5 weeks later?

23 Replies

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  • I saw an EP privately and after the consultation he asked me if I had private insurance or if I wished to be reviewed in the NHS, so it was easy to transfer. As you only have 5 weeks between private and NHS, it's really down to whether you want to spend the fee and have really fast treatment. Sounds good to me.

  • Thanks Finvola. Am I right in thinking I will get treated more quickly via the NHS if I see the EP privately? If so, it will definitely be worth paying to see him...

  • I can't answer that one clanmaggie - the waiting times here were horrendous but my 2 NHS reviews have been on time so perhaps once you are in the EP's system, there is more automaticity (pardon pun). Unless fees are an issue, I agree with Rellim's advice.

  • I may be wrong but i think that you still have to take your place on the N.H.S. waiting list. You save time by not having to wait for a consultation. For example, i saw an E.P. in 3 weeks wheras the N.H.S. waiting list for a consultation with a cardiologist was 8 months . Following my private appointment, i was trasferred to N.H.S. for an ablation and then had to wait 6months for that. I live ib Wales and it may be different somewhere else. X

  • Unless you want to save money, I would keep the private appointment and discuss the NHS one with the consultant. He may not need to see you again in a few weeks but if he does, the appointment is there.

    You'll have more time with the consultant at the private appointment and can ask as many questions as you want. You don't run the risk that, if he is busy, you will see someone else instead.

    I've saw my EP privately once and it was a good move. I wish now that I had done the same when I was first referred as it would have speeded everything up. There seems to be no problem with swapping between private treatment and the NHS.

  • That's exactly what I think Rellim! It could work in clanmaggies favour. If the EP wants tests done etc(he may do those on the NHS)then it could work out that The nhs appointment Falls at the right time for discussing the results and the next step of treatment.

    I would tell him about the NHS appointment during the private one. You're doing nothing wrong clanmaggie, so don't be worried.

    Pat

  • For some reason that seems to work for people here seeing EP's. From my experience it no longer seems not to work in other areas of the NHS.

  • I flit between NHS and Private. No one to date has had any issues. My view is that in regard to AF and its effects on you, and the suggested treatments, ALL advice and information can only be very positive. The NHS say they have cured me. No, they have stabilised me with large quantities of forever medication, and my heart rate is controlled. I am far from cured. So, at the end of the month, I am seeing one of the best EP's in the game. I gave it a year to see how I fared, after being pronounced cured by the NHS. The fact that I am now going privately, to an EP, may give you an insight as to how I am.

  • I have been under the same EP for 13 years. I started privately, consultations, drugs, then an ablation, all private. Then I changed to NHS but still with him. I had other private consultations which I paid for as no longer insured, followed by a monitor with the NHS ordered by him as a result of the private consultation, then back to him for interpretation and the an ablation under the NHS (by him).

    My GP told me that you cannot go between private and NHS more than once. The EP said this was wrong and he explained why, and I didn't understand I'm afraid but he seemed certain of his ground.

    So for me, private or NHS, it's the same guy, just quicker when private.

    Koll

  • Thank you so much for your very helpful replies. I will definitely keep my private appointment!

    Maggie

  • Definitely keep your private appointment because as Relim says you will get far more time with him for him to explain and you to ask questions.

    If you go straight to see him on the NHS there is no guarantee that you will actually see him. You may get seen by his registrar or one other of his senior team. However by going privately the first time there is probably a better chance that you will see the consultant himself in future on the NHS (maybe not the first time since you will have only seen him a few weeks earlier - just depends on his way of holding clinics).

  • Thanks for posting this question. I was referred by my GP to Cardiology at our local hospital and after three weeks got a letter saying the wait would be 26-28 weeks. I then asked her to refer me privately but to be honest can only afford a consultation and not all in Private, we don't have insurance. Glad to know I can mix and match, I just want to speak to someone who knows what they are talking about, my GP is lovely but admits she isn't a cardiologist.

  • keep your private appointment. There's no guarantee that you will see the same person at the NHS appointment especially if it's a large hospital/clinic

  • Very I teresting discussion. Having had a terrible appointment with NHS cardiologist at the district hospital, I asked the GP to refer me to a heart rhythm specialist, as recommended in AFA literature. Was told that you must go from GP to cardiology, and they refer to EP if ablation being considered. No suggestion that one could go straight to EP. Am about to have six day monitor fitted. I asked how the reading would be understood in the context of me being on 5mg biso, if I show few if any symptoms, and was advised this is good as it showed the treatment worked. I don't agree. Symptoms suppressed is all! I think the AF is linked to having had polymyalgia rheumatica, which could have implications for treatment. Also interested in fact I have only nocturnal symptoms. So I wonder about whether I need to consider anything else eg cellular electrolytes, diet, etc. Any thoughts anyone?

  • You'll get far longer in the private appointment and it is guaranteed to be with the consultant him/herself, rather than some junior who is supervised by the consultant. Stick with the private consultation - it's rarely a waste of money

  • I went for a private consultation and it was worth every penny. It was a 12 week wait to see the EP and it was reassuring to have the private chat. But in terms of speeding up the process it was a trip to A&E which worked best. My heart was racing so went to A&E where they stabilised it and referred me to the rapid access cardiology clinic run by arrhythmia nurses within a few days. The clinic arranged 24 HR Holter monitor and echocardiogram so whe I finally got to see the EP he had all the results and put me on hhis cardioversion list and ablation list straightaway. Also arranged a test to see if I could take Flecainide. It saved about 3 months I think because otherwise I would have seen him, had tests then waited to see him again... another 12 weeks or more.

  • Hi could you yell me what the test was to see if you can take flecanide my doctor wants to put me on it it is very scary to me as i thought the first dose should be in hospital but my doctor said that it didnt?thankyou

  • Hi there. I didn't have Flecainide in hospital. I think that might be more if you are high risk for some reason. As for the test, well here goes...it was January 2016 and I had to have a perfusion study to show I did not have heart disease. You can't take Flecainide if you have it.

    I can't say it was pleasant, but don't get too scared because it's really quick. It works like this: they have to raise your heart rate and inject some radioactive dye. After that you are scanned to see if any part of the heart is not getting a good blood supply. Then you go back 2 days later and get scanned again so the two scans can be compared.

    The scans took about 15 minutes with the scanner really close to my chest and travelling slowly round, but it wasn't enclosed thank goodness. The drug to raise the heart rate and the radioactive tracer were given to me by a team of people who were monitoring me closely. I think I had it for 3 minutes intravenously. It felt a bit unpleasant - dizzy, out of control, and hot - (interestingly it's hard to remember exactly) . If you've ever had a CT scan it's a bit like that. but it was over so quickly and I felt well supported. They were kind and I trusted them. It can be done using a treadmill but I was in persistent AF and had been for 3 months. They thought the treadmill would have been unwise so I got the drug as well as the tracer.

    I sympathise because they tell you so much about the down sides you get worked up thinking about it. Afterwards you wonder what the fuss was about. So I really hope that helps. It's not nice but it's short. The nuisance was that Flecainide disagreed with me at first, taken regularly it aggravated my gastritis and made me nauseous. But I tried again after some omeprazole using lower doses and grew to tolerate it. It has worked as a pill in the pocket on several occasions so worth persisting. Some people swear by it. Now just recovering from my 2nd ablation and glad to know my heart is structurally sound and Flecainide is there if I need it!

    Courage and good luck. Sending you good vibes.

  • Thankyou for your kind reply i am finding that i need a lot of courage nowa days. ive had an echo and my ep said from that my heart was ok but i wasnt sure that was enough to go on , thankyou and wishing you a complete recovery xxx

  • Yes I recognise that feeling! AF eats away at your confidence and even just leaving the house can be a challenge. But you are not alone and bit by bit you can learn to live with it - or live with the treatments. There's lots of help on this forum and the AFA website.

    Just to say I also had the Echo test but the EP wanted the other one too as my ECG was a bit ambiguous.

    Very best wishes, Janet xx

  • Thank you xxx

  • Thank you again for all your replies. I'll let you know how I get on on Wednesday when I see the EP privately. If it wasn't for this site, I wouldn't have had a clue about the best (and quickest) way to move forward towards the treatment I need. Finding out that I was in persistent AF when I had never been diagnosed with paroxysmal AF was a huge shock. I thought I would be sent to my local hospital for a cardio version almost immediately but it is now 4 months since diagnosis.

    Maggie

  • When I was first diagnosed i was in persistent AF. Saw an EP less than two weeks later and the first step was an echo and he put me on flecainide and apixaban (GP put me on Bisoprolol straight away). He said about cardioversion but not until echo to determine heart condition and not until I had been on apixaban and flecainide for over a month. Then zapped!!!! However he had told me that as I was in persistent AF it was unlikely to keep me in sinus rthythm for very long. The two key things he wanted from the cardioversion was could I be returned to sinus rthythm (almost all do) and importantly did I feel better being in sinus rthythm (yes I most definitely did!!!).

    As for any ordinary doctor (GP or in hospital) arranging a cardioversion they don't normally do it unless they are sure someone has only recently gone into AF or they are on Anticoagulation and the patient has seen an EP or cardiologist. Obviously when someone has had a cardiac arrest the stroke risk is immaterial.

    Apologies if you have read this before.

    Good luck on Wednesday.

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