I would like to high lite how the procedure of after care should be done in my view.
You have your procdures, then a check out meeting from the hospitol say 4 weeks
later or so.They then release you from there care and after that you are in the the hands
of your gps, and need a referal before you can be seen at out patients clinic.
In my view surely they should give some mandatory check after a year or so.Evan a car gets an mot each year so why not people.I had stents done, so surely they would want to see if theres any changes to arterys etc.This would seem logical.Then if theres any problems they could deal with them.But in my experience they dont want to know the outcomes of there work.They just wait till you have a problem then act then.Its just my view but surely this would be the best way to reassure patients and check on there work and improve the service.Hopefully some may agree.Please say if you think I am wrong.
"so surely they would want to see if theres any changes to arterys"
This question goes to the core of UK cardiac medicine. The fact is relatively little meaningful cardiac predictive work is performed in the UK, either for people who have had heart problems or for the general population. Unlike cancer care, which is based on early diagnosis, cardiac care is based on intervening after a cardiac event has happened or is imminent. And this could be ten, twenty, or thirty years after heart disease first manifested itself in your body.
You'll get a crude assessment of your future cardiac prospects based on standardised risk factors. But these risk factors are far from watertight, witness the large number of young, slim, marathon runners that arrive on this forum completely baffled why they had a heart attack! There are plenty of risk factors that are completely ignored in the NHS (and indeed in the BUPA Wellman and Wellwoman) tests, with more being discovered all the time.
Then there are a group of assessment techniques that basically measure the flow of blood through the heart, for example ECG stress tests or angiograms. The problem is that measuring the flow of blood provides only a poor early warning for plaque build up. The proof of this is that a significant percentage of heart attacks occur in people whose arteries are less than 50% occluded, and as far as I know it's extremely difficult to measure accurately any flow difference in an artery that's less than 50% blocked.
However, there are a cluster of tests that do actually go the the root causes of heart disease. For example you can be tested with an ultra sound scan for a build up of calcium in the carotid arteries of your neck, or you can be X-Rayed for calcium build up in the arteries of your heart. But neither of these procedures are fully endorsed by NICE, so you'll find the occasional health trust that tinkers with them, but if you want to preemptively or regularly track your cardiac health with these techniques, and give yourself the benefit of a reliable early warning signal, then you'll probably have to pay for private medicine.
You seem knowledgeable about matters, but it was just a view.I was suggesting that a mandatory check up after a year or so would high lite any changes in placue or calcium build up.it would reassure patients, and you could see any problem areas around the stents.As a layman it would seem a logical request, or is it better to wait as we do now
for patients to develop problems with the risks that follow.Thank you for comments.
I had the CT and MRI scans on my carotid arteries.
At our doctor's sugery, and I thought it was nationwide, we get an MOT every year after the age of 50. Mine is next week.
Jimmy there are two main ultra sound scans for the carotid arteries. One is a simple flow test, it uses the doppler principle to measure the flow of blood. The second is sometimes called the CIMT test, or Carotid Intima Media Thickness Test, which accurately measures the build up of calcium in the carotid arteries.
The first test I wouldn't get too excited about; but if you're having the second test, especially on an annual basis so you can monitor changes over time, then I'm very envious of your local health trust's policies!
Here in Hampshire the argument is that without explicit NICE approval they won't offer this test. A real shame as it would allow me to predict my risk factors much more accurately, and to quantifiably evaluate how my medication and lifestyle changes are working to manage my heart disease.
I've come to the conclusion that I either want a regular cardiac X-Ray to directly measure calcium build up in the heart, or the CIMT test to measure calcium build up in the carotid arteries. The first test has the advantage of direct heart measurement, but the second test has the advantage that it's ultra sound, so there's no radiation involved. However, getting either of these in my part of the world means paying to have it done privately.
I want tests to track my progress (or not) too but, like you, we can't get them round here. There is a private hospital that might do them but I can't afford that. You would think that they would want to monitor us hearties so that they could intervene if treatment was going awry.