Passing the buck!

[Callista]

At short notice I have to go for an eye operation for ectropion on Tuesday. .The surgeon asked me to check if I could come off Rivaroxaban prior to the op.

I contacted my heart team who told me to check with my GP or the surgeon doing the eye op. I checked with my GP and the receptionist came back and said I should check with the heart team or surgeon involved. Back to square one. I pointed this out to the GP receptionist (who is obviously medically qualified) and she said it is usually 48 hours.

Do I go with the receptionist? Not much time left as NHS do not work weekends in my experience…

[meadfoot]

For some procedures i have been told to stop 48 hours in advance. For my gall bladder op five days in advance. One thing is for sure the surgeon is unlikely to risk the op unless you have stopped it for a period of time. Thats my experience anyway.

Somehow you need to get to the answer from a medic who knows about these things and some seem not to know, clearly. Did your heart people prescribe your anticoagulant if so try them if you havent already. Sorry you are having this hassle.

[MDR1]

Personally I would want an answer from my GP or cardiologist/cardiac nurse. Receptionists are NOT medically qualified.

[Retirement65 in reply to MDR1]

Hello MDRI your absolutely right of course receptionists are not medically qualified but having done the job for many years there is a lot of responsibility put on our shoulders unfortunately - the GP should have found the time to ring the patient him/herself - I don’t know of any receptionist/care navigator that would tell a patient anything without the consent of the GP believe me it wouldn’t be worth it this does not help Callista of course in the present situation but for what it’s worth I would say the best the GP/reception team could do is speak to the consultant who is doing the op via his secretary and get the proper advice he’s the main man in all this as ultimately he’s doing this operation that’s what would happen in my practice hope you are well 😊

[MDR1 in reply to Retirement65]

I completely agree with you and did not means to criticize the receptionist 😊

[Retirement65 in reply to MDR1]

I Know you didn’t at all - it’s understandable though as slowly but surely the responsibilities have been landed on receptionists more and more so I understand totally patients despair 😞 sadly I don’t see things changing anytime time soon my advice to patients if in doubt at your surgery insist on a tel consultation with your GP take care stay well 😊

[Callista in reply to Retirement65]

Thank you to all who replied to my post. The good news is that I managed to contact my heart consultant’s secretary this morning who then came back to me with the advice to stop the rivaroxaban 48 hours before and 48 hours after the op. on my eyes. It was a great relief to have it sorted.I too feel that too much is expected of GP’s receptionists. At our practice they vet patients to see who needs to see a doctor and who gets a nurse and who doesn’t get an appointment for weeks. This is not the role of a receptionist as they do not have sufficient medical training as some of you pointed out.

Any rate onwards and upwards, now just have to get through the eye op. I will stop the blood thinner tomorrow and resume it on Thursday.

[Retirement65 in reply to Callista]

So glad you got sorted callista and hopefully you will have your operation and you can get back to normal take care and very best wishes xx

[Heather1957]

I'd ask a pharmacist at somewhere like Boots, they know more about medication than the GP.

[Hoocher]

Surely it's up to the surgeon to contact the cardiologist and find out

[spinningjenny]

I’m due to have a biopsy in ten days time and have been told to stop anticoagulants 48 hours beforehand. This seems to be fairly standard. Good luck with your eye op.

[Surreychica_1]

When I had a tooth out. I had to come of for 48 hours, not that the dentist said it was necessary he said he had taken dozens out with people coming off of a blood thinner. I know yours is different but it was 48 hours for me to give time for it to clear out of the blood

[DaveSpice]

Someone once described a GP's knowledge of medicine as a mile wide and an inch deep. Your cardiologist is the person to give advice on this. I don't know what this "heart team" is, but the cardio is the only person.

[richard_jw]

NHS guidelines suggest stopping rivaroxaban at least 24 hours before surgery. There is also the issue of when to start taking it again which must depend on when bleeding stops naturally.

[lisburb]

Sorry that you are being given the runaround, its so annoying. I would get back on the phone first thing tomorrow morning to your surgeon/consultants secretary explain whats happenning and see if they can get you the answer you need from the correct medical professional. I have always found secretarys very helpful in situations such as these.Good luck with your op.

[Glasgowgirl1947]

Hi Callista do you mind saying what operation you're going to be having?

[Callista in reply to Glasgowgirl1947]

Sure, it is for ectropion or drooping of the eyelids which has led to constant eye infections over several years. My eyes have always been a problem and I have had 5 operations over the years including cataracts and a vitrectomy and peel at Moorfields. None particularly heart related except the xanthelasma ones which are orange deposits round the eyes. These are caused by high cholesterol and should perhaps have raised suspicions of heart problems. Unfortunately the NHS lost half my notes when I moved to a different area which has not helped! I think it is genetic as 2 of my 4 daughters have the same problem. I was lucky in that the NHS did operate to remove them but now you have to pay to get them removed. Hope this answers your question. Do you have similar problems with your eyes?

[Glasgowgirl1947 in reply to Callista]

I have a condition called Feuks Dystrophy which my sister also hasIt doesn't do any harm unless you have cataracts. The operation causes the cornea to degrade

It started 2 days after my operation. I used Sodium Chloride drops for almost 5 years before I finally got a corneal transplant in October 2020

I'm still using daily Prednisolone Eye Drops don't know if they will be for ever but I should see Mr Usmami in a few months. He said he might sack me off then but since I have a small cataract on my right eye and trust him implicitly I will ask him to give me an appointment for a year, I don't want to lose contact with him.

I wish you well for your operation and I hope you will make a good recovery xx

[MDR1]

That's interesting. Did your previous op help the drooping?I've had eye problems for a couple of years now. Drooping is one problem, the other is that the eye that is drooping is also constantly fatigued and I can't read for more than 5 minutes without having to close it. Opthalmologist recommended surgery for drooping but said it wouldn't solve the fatigue problem so I turned down surgery.

Hope they manage to solve your problem.

[Callista in reply to MDR1]

My eyelid doesn’t so much droop as turn outwards. I think the 3 ops. for xanthelasma caused this. Re fatigue of eye consider trying Hylo-forte eye drops and Hylo night ointment both available over the counter or on prescription. They helped alleviate my pain considerably. I too could not read for more than 5 minutes or watch tv and all other medications, drops etc. failed to help. Good luck - sore eyes can be really enervating. Off for op. this morning. I will let you know if it works…

[MDR1]

Thank you Callista. I am already using Hylo forte but it doesn't seem to help much.Good luck with your op.

[Callista in reply to MDR1]

Two weeks tomorrow since I had my eye operation. It has been much more uncomfortable than I expected and still has not healed on outer edge. I waited to reply to you to see if the fatigue in eyes had improved but still too painful to tell.I think the problem may be that the consultant instructed the junior doctor to stitch up the outside incision and did not supervise. I know we all have to learn but experience does improve performance and first attempts are not always the best! No check up until 8 weeks so I just have to grin and bear it.

Try the Hylo night as well as the Hylo forte. People do not realise how much bad eyes affect one. At present I cannot recommend surgery but things may improve

[MDR1 in reply to Callista]

Thank you for your reply and sorry to hear you're in pain. I hope once the wound heals that your fatigue has improved. I'm very reluctant to have surgery but I have a long wait anyway. My GP has requested a visual fields test before he even refers me to hospital and I have an appointment for that in 2 weeks.All the best for your recovery.