Hi guys, has anybody recently had any form of surgery. I had the misfortune of developing an anal fissure about 3 weeks ago. My GP was unable to do an investigation due to the severe pain so referred me urgently to the hospital.
After waiting a week I called only to be told it was a 2 month waiting time to be seen. I was in such constant pain I made a private appointment and was told I needed a minor op but the private practise would not do it due to my AF and mild atrial stenosis. I was at my wits end but he called in a favour at the local hospital and after a long wait I got to see a specialist who said he would do the op on the NHS the next day as it couldn't be left untreated.
Unfortunately after spending the entire day in the waiting room I was sent home and told to come back tomorrow. The next day I spent 7 hours again in the waiting room and finally taken down to theatre. The anaesthestist and surgeon spent 45 minutes examining me and discussing the various options once they could see what was happening inside. While discussing my history she revealed I had a mildly dilated left atrium which I was unaware of and had apparently only developed in the 2 years that I've been experiencing PAF. Up until my cryo ablation in December I'd only had minor symptoms and infrequent episodes but since the procedure I've had more episodes but shorter lasting and a little more noticeable with short runs of ectopics in beween.
I'm curious as to firstly, does having AF lead to enlargement of the left atrium which I understand can be progressive and secondly, now that I'm still experiencing AF is it more likely or necessary to have another ablation to slow or halt that progression. I'm surprised my EP has never mentioned the LA dilation as its a newish change to my heart and the reason I mention the surgery is that the private hospital would not contemplate doing the operation due to my mild heart disease.
On a final note, everything went well and I was discharged the same evening with no ill effects. The only thing I noticed the following day was that my heart rate was slightly elevated from mid 50's at rest to mid 70's, my BP was normal but I was having 3 strong beats followed by a weak beat for hours and I'm not sure if that was a mild episode of AF or some form of ectopic. I will say its a very strange time to be needing hospital treatment because if not for the help of the private consultant I would still be in constant pain and possibly waiting months for any form of treatment. He told me all the private hospitals are fully booked with NHS patients and they are loathe to take on anything risky.
Thanks in advance for taking the time to read this. 😊
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Hammerboy
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I can't answer your questions but can say that having AF and needing any kind of procedure seems to throw the medics into panic mode, particularly private docs and hospitals who won't usually touch anyone who isn't 100% fit and normal ! lm due an op in 2 weeks, should have been today but the surgeon was worried that no Cardiology staff would be available if there was a problem, it was cancelled 2 days ago !! I'm not convinced it will go ahead seeing as how twitchy they all are about my dicky ticker 🙄
I was told by the physio consultant I saw that I could only have a hip operation on the NHS and in the local big hospital as there needed to be a bed in ITU reserved for me just in case I needed it 😱 I had no idea my heart was in such bad shape! So I have resigned myself to probably never having it done.....
I have AF and a pacemaker which is what they are getting in a twiddle over, I asked at my pacing check 2 weeks ago if it was a problem and they said no but the surgeon is wanting cardio back up just in case, I guess I should be grateful he is being cautious, it has to be done so hopefully there's no detectable AF on the day !!
Doesn't mean your heart is in such bad shape . NHS is just being prepared for any possible complications. Can you have it done privately or by other means? Seems a shame to suffer chronic hip pain or disability because the system won't accomadate you. Is going to another country an option? Wishing you all the best.
No, No and No 😬 He was specific that I can’t go to a private hospital but even if possible to have it privately in NHS hospital I can’t really afford it/would rather spend the money on private cataract op. But thanks for the kind thoughts!
Ouch! You are lucky the procedure didn’t provoke full blown AF - I was told an anaesthetic often does. There is a word for the ectopics you experienced I think but no harm done. Uncontrolled AF can cause LA enlargement which can be reversed if AF is effectively treated. I have recently had a bit of an argument with someone on the forum on this subject so it’s fresh in my mind! As you have had a cryoablation an RF ablation to touch up missed spots may be the next step.
Also it may be helpful for you to know in case of further problems that topical Diltiazem is effective in treating anal fissure although unlicensed for that purpose. I have found the small dose I take does wonders for IBS/diverticular disease.
Sounds hopeful I take it its only on prescription? I've been 2 days pain free but had a bowel movement this morning and been in agony since. As with AF there is no recovery information given by the hospital on discharge. They only thing I was told was that they had found a fissure and the botox would last about 6 months. Are there any side effects with Diltiazem ?
Orally a high dose causes constipation but a topical treatment I presume not. Your GP should have given you a stool softener I think and maybe not aware of the Diltiazem use. I think you might get more joy out of a pharmacist by the sound of it 🙄
From what I've read the cream is helpful but has a high incidence of side effect headaches. Possibly more palatable than rectal pain 🤨. I'll try the GP next week for some pain relief. I've heard lignocaine works
I was having an AF episode when I went to an NHS hospital for my pre-op assessment for a bladder operation. First the anaesthetist and then the consultant were called. Both decided not to do it!!😱
I was firstly referred to an outsourced facility at a hospital without a cardiac unit despite reminding my GP that I sometimes have PAF.
After my first appointment at the hospital and then 2 weeks later after seeing the anaesthetist, they told me that I could not have the operation at that hospital because of my heart and was then referred to the main hospital in the city.
The Consultant then ‘forget’ to refer me and another month passed by.
The whole fiasco took over 6 months and I was in pain with the whole time.
Crazy, why do we put up with it, I've lost count of the times I've had to remind my GP to read my notes 🙄
My AF was diagnosed in Jan 2010. Among the comments were dilated left atrium. In Nov 2015 I had a partial knee replacement ... I think I was on the slab for 2 to 3 hours. I obviously told my Consultant and Anesthetist of my AF and my last known event at the time and it just didn't phase them at all ....... in addition I had to stop Warfarin for a week before hand. No problems, no issues and no after effects.
John
I went into AF having one of my many pacemakers inserted . The consultant got the procedure done as quick as possible . I was in AF for sometime eventually heart settled back into sinus rhythm .
I have had two ops since being diagnosed with AF. Both in private hospitals and without problem. The first was a partial nephrectomy which is no small op. I was in surgery for 4 hours. At the time I wasn’t on anti coagulants as my CHaDVASC didn’t show that I needed to be. Prior to the op I had persuaded my surgeon to let me go on a previously booked cruise first.
We went on the cruise and had a fab time, however, I spent one night in the ships hospital with AF. I was new to it then and it was very fast.
Because of this the surgeon wanted me to see my cardiologist before the op, which I did. He told be to take an additional dose of Bisoprolol on the day of the op and let the anaesthetist know.
As a precaution I was in HDU for 24 hours post op but no problems.
The second op was no problem at all.
I think the main thing is that you are kept well hydrated. For both of my ops I was started on intravenous fluids before the op, once I had to stop drinking water.
It seems that they won't touch patients with af in private hospitals, or in Treatments centres, (unless they are specifically geared up to do ablations that is). I had a knee arthroscopy and a total knee replacement in Emersons Green Treatment Centre before I was diagnosed with af. Once I was diagnosed, they wouldn't touch me for my second knee replacement, because they don't have any back up services.
When I went into my local NHS hospital to have my second knee replacement the anaesthetist said they would only do it if I wasn't in af when they started the op, but said they would obviously deal with it if things changed once it began. I went into af during the evening after the op and that sent the nurses into a tizzy as it isn't what they're used to in orthopaedics, I remained calm of course and just told them to let me take my pip, which they wouldn't let me do until I saw a doctor, despite the fact they were locked in the cupboard next to me!
I’ve had a couple of intermediate ops in two separate hospitals one private & the anaesthetist both times was unconcerned and I was fine I am on meds & fairly well controlled.
Thankfully, I dodged some major surgery behind the knee on my circulation compromised leg, when the cancer surgeon refused to operate until he saw the pathology himself. He was not happy about operating considering my A Fib and my compromised circulation, with calcified blood clots behind the knee. He said it would have to be done in the hospital instead of his in office surgical suite. When he saw the pathology slides, he called it off, gave me steroid cream, and firmly told me that I had been misdiagnosed. I did not have a huge squamous cell lesion. I had a lichen planus lesion that was a side effect of the Lisionopril.
My father in law developed an anal fissure due to constipation from the morphine he was given following his quadruple bypass. He was in terrible pain when released from the hospital from the heart surgery, but the nurses and cardiac surgeon said it was not heart related, so they sent him home anyway. My mother in law took him straight to their Internist when it was obvious he was unable to sit on the long car ride home. He had developed an abcesss the size of the orange in the fissure. The GP called a colo-rectal surgeon who saw him immediately and that night, he was back in the hospital under general anesthesia having the abcess drained. They kept him in the hospital for several nights to give him IV Antibiotics.
They did general anesthesia because he was unable to tolerate laying on his stomach due to the recent heart surgery. It turned out to be a great thing because when they intubated him, all kinds of gunk that was in his lungs came up. He was unable to cough it up due to the pain from having his chest cracked open. After that, his recovery progressed.
The heart surgeon chastised the colo-rectal surgeon for operating on him so soon after the quadruple bypass, but that doctor said that he could have died if the infection had spread.
I required surgery for breast cancer. The anaesthetist was concerned about my PAF so I had an echocardiogram. He paid particular attention to the left ventricle When looking at it, but all was fine with me. My cardiologist was asked for an opinion and he doubled my heart rate meds to keep things as steady as possible for surgery, as I would have to stop my apixaban for two days prior to the surgery. All went well and I am back on normal meds.
I have had AF for years so I was glad that the echo showed no change since the last one six years ago.
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