NHS Wales: Probably more of a rant than... - Atrial Fibrillati...

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NHS Wales

TikaTora profile image
31 Replies

Probably more of a rant than asking for help, this is my first post. Recently I replied to a question by someone to have an ablation first or a hip replacement, my choice was to have my hip replaced first that has been taken out of my hands. As in the title they have found a new way to reduce the waiting list! I had my first ablation last December while on the waiting list for my left hip operation. My cardiac specialist wrote to orthopaedic surgeon asking if they could carry out the operation first. This in my mind suggests there would be little complications due to my AF! I had my pre operation assessment 6 weeks ago for my hip op all was good so I thought then on Monday I get a phone call saying the anesthetist has cancelled the operation which also means I have been taken off the list!!! This means after my 2nd ablation I will have to start all the procedure for the hip op all over again. I was referred to the waiting list in 2019 so may have to wait another 4 years to have the chance for the operation.

I do not think the people involved in the decision making actually take into account the pain and lifestyle impairments impact on people's lives

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TikaTora profile image
TikaTora
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31 Replies
BobD profile image
BobDVolunteer

I always warn people that it is the anaesthetists who makes the decision whether to allow the operation or not. Luckily when needing life saving cancer surgery spme years ago, my third ablation had stopped my AF so I'm still here.

Sadly these things happen and for very good reasons. If the anaesthetist did not feel that they could adequately control your heart during the procedure it is quite right they decline or far more serious consequences could ensue.

TikaTora profile image
TikaTora in reply toBobD

I understand but when the cardiologist asks them to carry out the hip operation l would have thought he would know full well the implications the anaesthetic could have on me, even the anaesthetist who assed me for the Pre Operation Assessment was happy to continue. I see this as an easy way to reduce the waiting list

2learn profile image
2learn in reply toTikaTora

Hi, like you find it all bit confusing. I had open heart surgery, 5hrs, when in AF, and on blood thinners, so what's the issue, Hip replacements now can be done without you being unconscious, so is that less of a risk, don't know. Sounds like your anesthetist is saying people with AF can't have major surgery, bullshit!!

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply toBobD

Hi

I asked for uptodate blood tests and ECHO pre operation on my right shoulder.

I said to my Dr call it pre operation. So I had the ECHO 10days prior.

It showed my H/R (I was talking) @ 77.

The Anaesthetist said Diltiazem CCB controlled your H/R and I said that it was a 'wonder med'.

It went well. I did have GA and nerve block. Very little pain and last Tuesday surgeon said I don't need to have the sling on all the time. Yesterday and today no sling.

Freedom as I am right handed and it was so restrictive.

Hoping I can drive soon.

I'm at day 18 days post-op.

cheri JOY

wilsond profile image
wilsond

My nanna had AF and she had her hip replaced. She was not under GA but I think epidural. I know she was awake as she described getting fed up with the nurse by her side chatting and told her to get quiet and let the surgeon concentrate!

Yes,a feisty one!

I just won if this was an option to explore.

So sorry to read this.

TikaTora profile image
TikaTora in reply towilsond

Thanks for your reply and I agree they do talk a little too much my right hip was done with a spinal and that is what was planned for my left hip, they have known for a year about the ablation and have never said anything until this week

Qualipop profile image
Qualipop

My mum had heart failure but had her hip done by epidural with no problems. Complain via PALS and ask why that isn't an option.

TikaTora profile image
TikaTora in reply toQualipop

Thanks never thought about PALS will contact them spinal anaesthetic has always been talked about this is why I think it could be a way of the Welsh NHS bringing down the people on the waiting list as I am sure I will not be the only patient to be removed

Rainfern profile image
Rainfern

What a stressful situation. You shouldn’t have to go to back of the queue and Qualipop is right, explain the situation to Pals and get their advice. You could also try to get your GP on side as he’ll be able to clarify how painful and debilitating any further wait would be to the orthopaedic department. I’ve sometimes found it helps to talk directly to medical secretaries. Good luck with both procedures!

TikaTora profile image
TikaTora in reply toRainfern

thanks I will be calling PALS just had the letter stating my removal due to bd health!!! my blood pressure at its highest is 150 over 80 and pulse 60 this means AFIB makes you unwell for operations

Rainfern profile image
Rainfern in reply toTikaTora

Something has gone seriously wrong with the system here. It’s never easy putting your case right when you’re the one at receiving end, but Pals should be able to offer support. Do you have an email system for contacting GP so it’s down in writing? Meanwhile plenty deep breaths! And heaps of gentleness to yourself.

TikaTora profile image
TikaTora in reply toRainfern

Just tried contacting PALS nobody around to answer the phone. I have had AFIB since 2015 and know when it kicks in I didn't realise AFIB was classed as a serious health issue as to stop surgery

Rainfern profile image
Rainfern in reply toTikaTora

My sister has persistent Afib and had a hip joint replacement a year ago. They had to ensure she was stable and on the right meds - I’ll get in touch with her and ask for more precise details.

TikaTora profile image
TikaTora in reply toRainfern

Thanks for that but I am feeling anything I try will all be in vain and just hope my 2nd ablation comes quickly

BrotherThomas profile image
BrotherThomas

Typical NHS attitude these days and I wouldn't be at all surprised if it was about reducing waiting lists. After all, all they have to do is delay long enough and the waiting list will disappear. Definitely complain to PALS, I've found them easy to deal with and they get results.

TikaTora profile image
TikaTora in reply toBrotherThomas

thanks I will call them this afternoon

Ppiman profile image
Ppiman

I am sure they don't, well, can't, I suppose, to be fairer to them. The NHS seems to be in a parlous state thanks to insufficient training places, years of dependence on foreign staff, Brexit and a lack of funding. Let's hope a different set of politicians come along some day soon and set it on a better trajectory. If most of Europe can do it, what the heck is going on here?

I'm currently up in arms over the state of NHS dentistry but it seems sufficient people are willing to pay privately than to shout "Enough!" leaving the voice of those who can't or won't not loud enough to be heard.

Sad times for many.

Steve

TikaTora profile image
TikaTora in reply toPpiman

I agree with you but do not hold your breath expecting a politician to change how things are as they seem to be bred from the same cloth and when they get into power they only think of ways to help themselves and close families

Ppiman profile image
Ppiman in reply toTikaTora

Well - I do see your point but we don't have any recent experiences of other politicians. I'm not wanting to make a political point here but the facts can be easily found to show that is that the last experience we did have left us with a vastly better NHS with vastly better waiting lists than we have now. I'm living in hope of something similar once again.

Steve

Desanthony profile image
Desanthony

I would contact your consultant surgeon's secretary. Do not leave a message on her ansaphone as I know from experience they rarely reply so keep phoning until you actually speak to the secretary in person. Explain the situation and ask in the light of all this why was it left so late to tell you that the operation could not go ahead when on the day of the assessment everything was to go ahead as planned. At the same time take this up with your hospital PALS your GP, cardiologist and/or EP.

Such an annoying situation!

TikaTora profile image
TikaTora in reply toDesanthony

the consultant has told me himself if the anaesthetist refuses to carry out the operation he will not do it, what they are saying is AFIB is too serious a condition to carry out any other operation

Desanthony profile image
Desanthony in reply toTikaTora

The thing is everything was fine until shortly before your Op was due. Has anything changed with you? Were they willing to do the Op until just now or had they voiced reservations before and just taken nearly 6 weeks to decide? I find it strange. My consultant and anaesthetist had no reservations about doing my total knee replacement using epidural and sedation when I was in AF - I was in persistent AF when I saw him but just before my Op I had a CV which put me in NSR for the Op. Neither he nor the anaesthetist thought it was anything to worry about whether I was in AF or not.

Gumbie_Cat profile image
Gumbie_Cat

It’s shocking that you lost your place on such a long waiting list. I am in permanent AFib, and there is a niggle in the back of my mind about what would happen if I needed an op.

JOY2THEWORLD49 profile image
JOY2THEWORLD49

Hi

Anaesthetist don't worry if you have AF .

What they worry is if your H/R at rest is over 100!

Its happened at last year's operation.

But I asked to have an updated ECHO which now shows that my H/R at rest Day is 60s. Due to the introduction of CCB Diltiazem.

Now because they can see a better picture of my Heart and Rate any Anaesthetist wont worry.

I had 2 Anaesthetists at my Thyroidectomy in 2020 (4 mths post stroke) and 2 last March just 3 months of starting Diltiazem CCB when AF was controlled but 88-96. A year from start and I lost 3kg it was showing 60s Day H/R.

And I feel heaps better with a slower H/R Day. Always at Night avge H/R is 47.

I reckon these specialists should have included you in their discussion of which procedure first.

I'm sure they haven't cancelled your Hip operation but delayed it. Check with the booking clerk.

I had 2 operations in front in November 2021. I talked about both to each of them.

So I ended up with one last March 2022 and just had my Right Shoulder done 30 October 2023 (waiting 3 years).

Hopefully no more operations.

cheri JOY. 74. (NZ)

TikaTora profile image
TikaTora in reply toJOY2THEWORLD49

hi thanks for your reply as of October this year on my Pre admission assessment all my BP 140/80 pulse 60 and bloods were all well inside there recomendations, before my last Ablation the consultant wrote to my orthopaedic surgen to suggest I have my hip operation done first. It is like hitting your head against a brick wall they all stick together

I was scheduled for a simple cataract surgery when the pre op nurse wouldn’t allow it because I had occasional AF and not on blood thinners. She said I needed a release from my cardiologist. The reason is they only did general anesthesia when I asked why not local as most of my friends all had local. The only answer was that is the way they do it. I cancelled and found a dr that did local and my AF was of no concern at all. It is so strange isn’t it?

MiniMeGreen profile image
MiniMeGreen

Sounds like they were afraid that you could develop a thrombosis. Liability issues you know.

TikaTora profile image
TikaTora in reply toMiniMeGreen

I do suffer with spontaneous DVT but during all this I have had right knee chondral graft, right hip replacement and the right knee replaced to to graft not being successful

MiniMeGreen profile image
MiniMeGreen in reply toTikaTora

However, I do think that you have not been treated fairly. The least one would expect would be talking to you before canceling your surgery.

The NHS is not well and the waiting queues are intolerable. It's unlikely to change unless there's a political system change.

TikaTora profile image
TikaTora in reply toMiniMeGreen

I agree apart from the political side as all the political parties are the same promise but don't deliver NHS is not there priority in the uk

MiniMeGreen profile image
MiniMeGreen

Sorry, I actually meant to answer to Peacefulneedshelp just above.

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