I am writing as I am a little concerned that there is no annual review post catheter procedure to implant stents in my coronary arteries. I thought I was going to get a review to check on my cholesterol at least if not a stress test and/or other measurements, BP etc, instead I have been passed from one of the most prestigious facilities in the country, if not the world for cardiac surgery, to my local hospital from whom I had the referral, to my GP in the space of 1 month after the last procedure. Is this normal? Is this something that is offered in any medical practice either private or public post operations of this type? Is it not a bit too soon to say "job done". I was hoping that after the procedure and the rehab and gym referral was complete that there is a semblence of continued interest which helps you defer a return to a cardiology facility after a subsequent cardiac event with a progress report, and then a referral for further methods of prevention like a nutritionist/dietitian, medicine review, etc.
Looking for advice and guidance here.
Written by
StressedEric
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Hello and welcome to the forum! I had my quadruple bypass done in one of the leading hospitals. Eight weeks later I had an appointment with my surgeon's assistant and was discharged back to the care of my local hospital's cardiology department. They reviewed me at seven months. If I had not had Type I diabetes and severe PAD I would have been discharged to the care of my GP. This is the norm as cardiology departments to monitor all patients routinely. However your GP should be checking your BP, cholesterol and LFT (if on a statin) at least yearly. Cholesterol and LFT should be checked at around six weeks if your statin dose is changed or the type of statin changed.
With CovID rehab is virtually non-existent and access to dieticians limited. However, the BHF website is a great resource and, of course, you can always speak to the BHF nurses.
I agree they should do but as another respondent has stated, sometimes you have to request it from GP rather than it be readily volunteered and I think that in normal circumstances this will be a reasonable baseline. I would like to have more, regular information to hand to understand a situation than the system seems willing to provide. We are have a self interest in our health and it would be far more beneficial for all to understand the consequences of a course of action, good or bad, so that the information can be used to better advise others.
Hi we don't have re hab as it was before covid,the gym is still closed, nine weeks after surgery I had a video consultation with the re hab nurse and physio, I was then told to watch the re hab video on the Bhf website, I was also told the dietitian will be in touch, char
Honestly if you can it is so important to watch a post op exercise video. Before I managed to get there before lockdown I had all sorts of “symptoms” and wasn’t sure how far I could go regarding exercise. I was constantly having breathless episodes, stiff shoulders, and the rest. Now I realise a lot of it was stress and really enjoy doing the workout
As Michael said, unless there are special circumstances, once you're discharged then for most patients future care is fairly light touch.
Most patient's GP will arrange a brief annual review, either in person or with the practise nurse, but it's normally just a blood check for things like cholesterol and HbA1c for glycated haemoglobin to see if there's any drift towards type 2 diabetes, a check on blood pressure, and a check on your weight. You might get an ECG, but based on comments I've read on this forum that only seems to be done in a minority of cases.
However, my own view is this level of care is actually appropriate, and I don't feel short changed.
For most patients with heart disease there's not a huge amount the doctors can do to arrest the development of the disease. There's a fairly standard cocktail of medication, and even though it certainly helps, it's still a long way from being a silver bullet solution. The reality is that long term care is primarily in the hands of the patient, in that the life style changes that we all individually choose to implement (or not implement!) are the main initiatives that will gain us extra years of life and extra years of healthy life. That's probably why the NHS invests so much into Cardio Rehab, because that's the thing that can make the most difference.
Cardio Rehab is being maintained on-line, I'm sure a call to one of the excellent BHF nurses would get you more details.
I take your point, and understand that the disease cannot be reversed or arrested completely but surely an annual review to include ECG stress test with or without ultrasound to determine heart function, with a medicine review in relation to a full blood test does not seem to much of a stretch to me in order to understand your situation at that time to gauge when you need to push for more help or be happy that you are in a good place.
Am I being unrealistic? I don't think I am. I think a regular status report helps you understand more than worrying and stressing yourself because you don't know your status and you are having weird twinges and pains you can't explain.
In Poland, and maybe other countries too, there are private clinics that will perform a full blood test from which you can provide the results of to your GP as an when you feel the need to, or perform an ECG stress test, or dietitians/Nutritionists to help with your diet needs to reduce your cholesterol intake, and you dont have to be referred by a GP or a large health insurance company. That does not seem to be an alternative we have here and you are guided to the larger private clinics who feed of NHS or large private health care company, referrals primarily. i am happy to be wrong and someone can tell me I can go and do that here. please let me know where, if I can.
I come from a background in IT where, in order, to understand the consequence of changing a thing you test and then measure the results against the desired result. That is a scientific approach that is applied in most medicine. Why not also in the after care?
As the others have confirmed there’s not much rehab due to COVID But if you feel you need to follow up on worries you must, you know by now you cannot wait for things to happen!!!!
I asked for a blood test a month ago to check cholesterol etc and had it with a nurse very quickly. They checked everything in the test. I think you have to request it as they don’t seem to do follow ups
This is my experience. I had to go to a clinic in Poland while on holiday due to feeling completely washed out of energy. I paid £30 for a full blood work which i provided to my GP who seemed entirely disinterested in the results as they were not in mmol/L?! the conversion is easy and readily available. I guess some GP you have to drive harder than others
When I left rehab the Cardiac Nurses told me that I would probably have to prompt the GP for the yearly check ups or any other needs. They were correct, I have had to book my yearly check up every time for the last 4 years. All the GP recommended is that the check up is in my birth month as it makes it easier for people to remember to book one.
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