My fiancé had x3 bypass in late January 2020. He had AFib and a heart flutter after surgery and had to spend additional time in icu.
He has missed out on all aspects of aftercare - no cardiac rehab and 1 telephone consultation with his original cardiac consultant (not the team that completed his surgery) everything else was cancelled due to Covid.
Today he has received a letter telling him he’s been discharged back to the care of his GP and doesn’t need see the heart team at the hospital anymore.
He’s not had a X-ray, no ones checked he’s healing ok, he’s not even had a proper ecg since the surgery - it just seems incredible to me that after such a big operation that this is the accepted level of aftercare - is this normal? (I do get that the surgery has “fixed” him but thought someone would check him over at least!)
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Chickenlou
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I had a triple bypass after a HA and stent October 2019. Saw the surgeon seven weeks after surgery and really just a chat. No X-ray required after bypass. The healing of scars for me was fine so no need to seek help from anyone. The only thing he is missing is the rehab clinic as part of recovery. This takes place around six weeks post surgery. So unless there has been problems then after care is self controlled. My only follow up was a courtesy chat with my GP just to check how I was with the meds.
Has your fiancé had problems that makes you feel there has been a lack of care. Really after the bypass procedure unless there have been problems there is not much doctors or nurses can do. But if you are unsure call the rehab nurses and discuss any issues you have. Also the BHF site has a lot of guidance.
Thank you 😊 I think it’s just a case that we expected to see someone and have them say everything was going ok! But I’m guessing that’s not how it’s done.
(I had a much smaller surgery in September 2018 - not heart related or particularly serious but had several follow up appointments and am still under the consultant now. So guess we presumed after heart surgery similar would occur)
I guess the AFib is my main concern as he was put on meds and then taken off them but no one has checked on it since he was in the hospital.
I had Aortic valve replaced and bypass and saw my surgeon about 6 weeks after surgery, he listened to my heart and discharged me back to my cardiologist who I saw 6 months after surgery he told me my heart was now mended I have echocardiogram yearly and if the pressure is ok good for another year if it’s off I will need to go back to clinic.
Everything else I see my GP, drugs and blood tests, my op was nearly 4 years ago. I think the problem now is there is no cardio rehab, when I did it I saw the cardio nurse twice a week at rehab and she would keep an eye on how I was doing. Take my blood pressure and if I had any problems she was there.
It’s really tough that you haven’t had the opportunity to do rehab hopefully in the not too distant future he will be able get on a course.
Can I just add to this- the echocardiogram is for assessing the Valve Replacement. Ultrasound has limited use for CABG- which is probably why that is a little different to the experiences of other people.
I had a different operation- but actually the only aftercare that was different was I received an ECG at that cardiology appointment follow up. Everything else the same - I did not see the surgical team again after I was discharged from hospital, only cardiology about 15 weeks later. I had no follow up scans until over a year later (but that is because my condition is different and not fixed by the surgery and must see cardiology life long).
Referred back to GP is, I believe, normal for a CABG patients.
However, I did get a referral to Cardiac Rehab. With the virus many re-hab programmes are struggling to operate as normal. This said with the evidence of the surgery your GP will be able to refer directly to the rehabilitation team (if no one has already) so he can be seen by them. I would get on to your GP and ask for this- arguably at this point much more important. Often Hospitals will leave this to the GP to make sure you are referred to the programme closest to home.
My Rehab Programme Came in the following form:
1) Visit from Rehab nurse while in Hospital to explain the programme and ask if I wish to participate.
2) Weekly information sessions on healthy living, recovery and emotional challenges. (These are surprisingly informative). This happened at a local community hall.
3) Individual Progress Assessment at around 6-8 weeks with:
Advanced Cardiac Nurse Practitioner (checked scar and used stethoscope to have a listen - no scans),
(mini) Physical Exercise Test with Physiotherapist - it was like a bleep test but running was banned- so she could make the recommendation about what level rehab I should start with and
an individual consultation with a dietitian.
They also has the ability to request psychological support at this point if your diagnosis met the condition of being funded normally (most are with the exception of congenital heart disease).
Hello. May I ask what area you live in? I work within Cardiac Rehab. Unfortunately, a lot of cardiac rehabilitation teams have been redeployed during COVID-19 and surgical follow-up appointments face to face are being cancelled or changed to a telephone appointment. I completely understand how unsettling this can be for patients. Perhaps the cardiac rehab team local to you did not receive his referral, sounds very strange. Have you spoken to his GP?
Hi Chickenlou, having had my bypass a couple of weeks after your fiancee my aftercare has been the same, ie winging it. However, I was called in for my xray last Wednesday so I am expecting some follow up discussion or message with the cardiac team even if it's on the phone again.
I found that after my surgery Christmas 2019..I got more help and support from my GP..they kept an eye on my scar and arranged regular blood tests..you are better off going to your GP..
Three months after my elective triple bypass in 2018 at Papworth I had an appointment with the surgeon. Immediately before the consultation, I had an X ray and ECG. This enabled the surgeon to discharge me from the care of Papworth and the follow up was handed to Northampton General Hospital. At NGH I had several checks including an ultrasound ECG. I also met with the clinical pathologist to determine the cause of my original heart attack in 2017 (after which I had stents). About four months after my bypass I started rehab classes.
In my opinion this is how it should be and I could not fault the NHS in any way. I doubt that I would have had better care had I been a private patient. With the current situation, the service offered by the NHS has inevitably suffered. However, the level of care that your fiance has received does appear to be lacking in several respects, so I would suggest that he expresses his concerns to his GP as soon as he can in order to get the checks carried out.
The BHF website has a link to heart rehabilitation for you to look at. It is all about gentle exercise to start with, working gradually up to a much improved level of fitness. Quite a lot of people on this site are firm believers in regular exercise, either cycling or walking or running. When the gyms re- open you can have a chat with them regarding mixing it up a bit by using bike , treadmill and rowing machines, along with a bit of gentle weight lifting.
In many cases the local gym used to run the re-hab programs for the NHS.
The other path you can follow is to have a good look at your diet, particularly excess fat and sugar, so that your arteries don't start clogging up again. You could get the local chemist, or the chemist to give you a quick check over . The larger Tescos have chemists do a £10 check of your weight, height, and a blood test to work out your cholesterol and sugar levels, and calculate your BMI . The BHF are great believers in the mediterranean diet which doesn't contain lots of cup cakes, biscuits and chips, but does contain lots of fresh whole foods.
Another piece of the jigsaw is to get a fitness tracker i.e. a fitbit or an apple watch or a garmin, etc, so you can measure how active you are. It will tell you how many steps you have taken and how many calories you have burnt today. At the end of the day calories taken in have to match calories out by being burnt by you. If there is a mismatch, too much - your body will start clogging up your arteries again or too little and you will lose weight.
So you pays your money, you takes your choice. Eat, drink and be merry as in the old saying 'eat all drink all, pay nowt' , have a short life and a merry one , with a very sudden stop at the end., or get organised, seize the day, live long and prosper.
I had mitral valve op in papworth 2 years ago was brilliant care had a 8 week check up there and then 1 appt with cardiac nurse at northampton general and nothing else. Did have another echocardiogram as I was getting some AF again few months ago. Think it's just how it is now the NHS is stretched to capacity even so more now.
Hi Chickenlou, sorry I can’t speak for bypass (my op seems to require endless post-checks, so I’m at the other end, wishing I didn’t need them !)
But on the other aspect, his Afib incident & flutters. What meds was he on, when did he come off them, and has he had flutters since?
The Afib could have been a post-surgery thing (I had one in hospital as well, 36 hrs & needed cardio version shock to reset rhythm). I took amiodarone for 9 months (yuk). The flutters have slowly calmed down & are now negligible (they come when I get really emotional or stressed, due to cortisol etc). I’ve never had another full Afib event and I think it was just a post- op sensitivity.
But if you have any doubts, it wouldn’t be much to ask for an ECG. Either a one-off test, or if he gets flutters intermittently, maybe a Holter (a little machine with leads that one wears on chest) to get a multi-day ECG. The GP could probably arrange a one-off ECG there or at local (covid-clean) hospital, Holter’s usually requested after referral to cardio doctor & have longer wait-list.
As for rehab, I couldn’t get referred for any 2 yrs ago. So I got my mental & social support from a patient forum like this, and did gradual increases in walking round the block till I was fitter for light gym stuff. I just had to learn to listen to my heart, which gives me “feedback” (feeling exhausted the day after, or 2 days) if I do too much !
It’s a real shame he’s not had support, however advocate via the Gp if he needs a new referral re flutters. Best wishes
Oh my Gosh!! I feel exactly the same to be honest. I am doing okay after having double bypass in February 2020 and yes I agree it has been minimal aftercare and only phone contact no rehab programme. Having said that I had problem with my wound and was seen at hospital straight away by cardiac team so I think if there was a problem and you ask for help it would be there for you. I have been monitoring my own blood pressure and heart rate which was a bit high, I spoke to my heart nurse and my meds were increased.
Do you have numbers to call ???
It is difficult time isn’t it but thankfully we got our operations done before lockdown came or we would still be waiting!! At least now we have been fixed and can get in with life xx
Very similar to Wendz60: Ozaki procedure AVR and double bypass on 26/02/2020. Had been told previously by a hospital volunteer and former patient that the booklet provided should be my "bible" and made sure from the physios that I knew what was expected of me before I left hospital. Feeling lucky that I just made it under the wire before coronavirus really hit, but the downside was that it was already clear that there would be no rehab available for this reason.
Concentrated on breathing exercises and steadily building up my fitbit steps. Now averaging 10k steps a day and managed 18k in one day last week.
Had a problem with a partially collapsed lung, which brought me under the care of my local GP surgery. I was dreading this as it is vastly oversubscribed and has a poor reputation. I was extremely lucky in that their Post-COVID procedures are really effective and the GP I saw used to work in the Bristol Heart Institute and knew my surgeon. After a couple of x-rays, bloods, and telephone drug reviews the problem has cleared and I'm feeling much more optimistic.
Would really have liked the opportunity for rehab and the feeling that someone from the hospital is keeping a regular eye on you. In the absence of that, I have found self-monitoring (blood pressure and pulse oximeter readings) have kept me going along with being prepared to ask for help when you feel you need it.
Had a lengthy telephone consultation with a surgeon at three months including a further drugs review and a technical discharge.
They do want me to go for a further echocardiogram about 6 months from now. I suspect this is more about monitoring the effectiveness of the relatively new AVR procedure than me as a patient, but I'm not complaining...
I guess they're doing the best they can in the current difficult times, but I've never actually felt abandoned..
I posted a similar comment a few days ago and nobody saw it as a problem given the current situation. I had an ICD fitted in March 18, I have seen or heard from nobody. However in November I had a TAVI procedure done in Stoke. Dr. Ratib had an ECG done on me in December and a follow up in January. I know things are different now but surely cardiac health professionals are still cardiac staff?
Hi Chickenlou. I just remember when my husband had a quad bypass in November 2018, he had a check up with the cardiologist at the hospital. This wasn't really a physical check up but an "alright mate,how are things". The chat lasted all of 3 minutes and we left!! I'd much rather have had a phone call as the 60 mile round trip seemed a bit excessive!!!
Hubby was transferred to the care of our GP. Fair play to our GP, he was in constant contact with the cardiologist when drugs needed stopping or changing.
We didn't really have any questions as the booklet supplied on leaving the hospital after his surgery covered everything you needed to know.
My fiancé has been exercising and walking since he came out of hospital (although he has struggled with motivation at times and it’s there I think the cardio rehab would have helped..)
It’s more the fact that no one has checked he’s ok and all is as it should be. He was taking amiodrone for the AFib until he was taken off them - but has had no checks since.
I will encourage him to speak to his gp and maybe ask if he can get a ecg or something arranged.
Just to add that I’m not “blaming” the nhs - I appreciate that they’ve been put in a terrible and unprecedented situation and it’s been a nightmare for them. I also appreciate all of the care he had whilst in hospital and during the surgery itself (and I’m glad he had it done before Covid.)
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