What should you expect from your GP after major heart surgery, shirt term and long term?

[Pefki]

Apart from my initial call to request repeat warfarin prescription in which case I was told to go online, my GP has not acknowledged the last 2½ months of my urgent surgery. I am a congenital heart patient who had been trying to get cardio check ups in London every year to no avail. I had to take another route to actually get a cardiologist appointment, through a private doctor, and as soon as the NHS cardio saw me, I was treated as an urgent case and operated on in 3 weeks. Is it time to change GP's? How easy is that procedure?

[Hidden]

Dear You,

I think that you have already answered a part of your post, once you lose faith in your GP then its time to move on which you are fully in your rights to do so.

Pick another surgery within your area { find that out on line by putting in your postcode } and register , they will have all your details/notes etc sent electronically to them.

Be prepaid to have a mini check up with your new surgery .

Good luck, I hope your new practice looks after you better than your last.

[Yumz199725]

Aw hi pefkiSorry to hear about how your gp surgery are treating you. Just read your bio you have been through alot and little similar to me I also have congenital heart disease and will be having surgery under the same hospital ☺️. Cant believe you had to go private but so glad you got your appointment in the end from NHS a well needed one by the sounds of it they had definitely left you too long but they soon sorted you out for surgery with in 3 weeks that impressive 😯. It's not easy to change doctors surgerys from my experience the one I'm with now I joined and never got a checkup! Hope your able to find a gp that actually cares about what you have been through! Noticed aswell we nearly same age I will be 26 in October 😅.

[Hidden]

Hi Pefki,

Can I ask what your expectations are and why?

Also, have you been discharged from the Surgical Team at Hospital yet?

Please bear in mind that with Valve Surgery the whole point is that your heart is fixed to all intents and purposes. Its unlike people recovering from HA's and other debilitating heart issues who will have ongoing contact with the GP.

Unless you have other underlying issues I'm not sure what the GP can do, so moving to another GP may not be much better if at all.

You should have an Annual Check-up at Hospital but other than, bloods taken perhaps, even that would be subject to if your on meds, which I suspect your not.

All in all don't be surprised if there's minimal contact going forward.

The good thing is that within a few weeks, you will be well advanced in recovery and can move on.

[Pefki in reply to Hidden]

I had my 6 week post surgery check last week. I am on warfarin forever. I am still having weekly blood tests for INE levels but on the whole, things have stabilised in that respect and I have started cardiac rehab. I had no expectations, wanted to know from other patients, what kind of extra care, if any, I should expect from my GP. Obviously he was not involved in my cardiac issues and surgery, before or after although I had provided him with all my records and yearly private check ups as he was not referring me through NHS. Maybe I just thought that he may ask to see me to discuss any other testing I may need going forward, what to expect from long term warfarin use, or maybe just my mental state after urgent surgery, I don't know which is why I asked

[Hidden in reply to Pefki]

Thanks for clarifying, I wasn't sure if you thought you'd have some form of extra care package from your GP.

Once your INR is stable and the Anti-Coagulation/Warfarin Clinic are happy you can expect to have testing periods extended. Unless the testing is being done at the GP Practice, the GP wouldnt be involved and have no reason to discuss with you. Warfarin Clinic is best in any case as the Pharmacists role is purely testing, and they are experts at their role.

As I wrote earlier, we are essentially considered fixed, so are different to other heart patients. The likes of Heart Attack patients would be under care of GPs after discharge, whereas we are still cared for/reviewed by a NHS Cardiologist at hospital. You should have an Annual check-up which the GP may need to facilitate if it's a different hospital to where you had surgery.

In fairness to your GP, it's unlikely you would be on their radar, especially if you hadn't been discharged from hospital care. That said, now you've had your 6 week post surgery check, it would be worth contacting them to make an appointment and put your mind at rest. The less contact with the medical fraternity the better, as it means things are going well.

To be honest, I do understand where you're coming from, I'm also Congenital, and I probably had the same questions as you when I had my first surgery 29 years ago, its slightly disconcerting and takes time to adapt, but, once you get to grips with it, you start looking forward and getting on with your life. I sincerley hope you get to that point, because it makes everything you've gone through worthwhile.

Heed

[Anon2023]

hi. A locum gp at my practice referred me to cardiology and despite having open heart surgery, many complications and resulting heart failure, I’ve not seen my GP for years. I’ve had the occasional phone call but only in response to e consults when I’ve been very poorly. I’ve not had a face to face appointment with my GP for as long as I can remember. My care is provided by hospital staff with the exception of having an annual check up with the nurse at my GP practice due to suffering from a long term condition. I get the impression that my GP is there for emergencies only.

[Kristin1812 Heart Star]

i get the idea from the forum that surgeries act a bit differently. But when I have the occasional heart blip I contact my surgery, and I’m given a phone slot usually pretty quickly.

I cant remember a time I have been invited for any routine annual or follow-up check for my heart. I’m assuming they depend on me to call if something changes.

[Pefki in reply to Kristin1812]

I may have a different concept of GP's or maybe things have really changed alot in the last few years because my parents grew up in Sydney where I also spent a few years and the family doctor/GP, was more personable, more approachable, and involved in the complete welfare of his patients-not just a 5 minute phone conversation for a referral. He would call a few days later to ask how you were getting on after you had seen him. Yes, the surgery waiting room time was ridiculous but I suppose we were all willing to wait hours to see a doctor who we believed cared. How can a doctor really consult over the phone? Maybe outside central London, the situation is different.

[Kristin1812 Heart Star in reply to Pefki]

I’m sure things have changed here too, as the service has come under increasing and severe pressure. But I’m one if those people who’s pretty happy with my GPs service, and phone consultations (though hate the process of phone queuing) because, if they cant do it all by phone, I am then told to come in.

But unfortunately, its a v v long time since I remember GPs here being anything like your Sydney GP, when my GP who knew our whole family invited me to bring my toddler daughter for a quick check, in his garden, on a Sunday.

[Thanksnhs]

Hi when I was discharged from hospital after my transplant the GP surgery I had been with for 54 years point blank refused to prescribe my immunosuppressants they said they didn't want the responsibility of looking after me! I was so stressed as it was only two weeks since my surgery and I had to find a doctor that would take me on. When I did it was easy to arrange I done it by telephone as we were in lock down, my GP doesn't deal with anything heart related including meds the hospital does that, they only do bloods for kidneys cholesterol etc.I hope you get things sorted out take care char

[Qualipop in reply to Thanksnhs]

OMG that's shocking. Can they actually do that? You are I'm sure much better off away from that GP.

[Thanksnhs in reply to Qualipop]

Hi, apparently it's very rare but unfortunately they can just dump a patient if they want to, my cardiologist and transplant nurse were livid. It was so awful at the time. My new surgery have been great so maybe it was a good thing in the end. Char

[Qualipop in reply to Thanksnhs]

Well they may be able to do it legally but morally it's horrific. I'm glad you are happy with your new one.

[Thanksnhs in reply to Qualipop]

Thank you, they never even had the guts to phone and tell me it was the poor receptionist that had to do it when I phoned to say that I hadn't received the meds with the rest of my prescription, abs awful. Char

[Qualipop in reply to Thanksnhs]

They shoudl at least have given your first prescription to give you time to find someone else. I think I'd write to the health authority and point out how it was done. They may have the right to do it but there are much better ways.

[Thanksnhs in reply to Qualipop]

I was so stressed at the time (it was nearly three years ago) I had just had my transplant, I live alone and I just didn't have the strength to do anything about it. I was just glad to find another practice that would take me on char

[Qualipop in reply to Thanksnhs]

Well it sounds as if it was a good move, however traumatic at the time

[Heather1957]

My experience after having bypass surgery in 2017 was that the GP only became involved when I called them.

I was only in hospital 4 days and given details of a wound clinic where I was to go to have my drainage stitches out.

I had a few issues with a trapped nerve and pain after I started to drive again, but they never called for me.

The cardiac nurse phoned and set up on going appointments but they cancelled twice so I didn't bother again and got on with my life.

I have diabetes so had annual check ups anyway.

I had 2 stents fitted in October 2021, I did get a phone call from my GP, understandable dur to the pandemic, she talked through the letter she received from the hospital and we talked about medication but I never had contact again with the GP or cardiologist. The cardiac nurse did contact me and this time I did take them up on the fitness programme and was discharged by the cardiac nurse.

Personally while I find ongoing aftercare missing from the process I do feel I can seek help if needed.

[Wellington19]

I found it quite easy , called in at new gp surgery, got forms, filled them in and took them back next day, had appointment with gp there within a week

[Qualipop]

Changing GP is simple. Get recommendations from people you know; ring the new GP to be sure they are taking new patients and have a list of questions to ask before making your decision l ike how long does it take to get an appointment; whether they have a doctor who specialises in hearts, what percentage of appointments are face to face; how their telephone system works ( Mine puts you in a long queue) then just fill in their form. It took just over a week for my records to be transferred but that was before they were all online. The new GP will probably want to see you and do a check up. One tip, stock up on your medication before you move.

[StevepH2012]

Hi I can add my personal experience to the mix as I approach 3 years post AVR surgery. The GP renews my meds every 8 weeks along with an annual blood test and on-line submission of BP. NHS Cardio unit performs an annual ECG and out of 3 scans I've received 3 letters between 3 & 6 months later and one follow-up phone call from the cardio consultant. On each of the 3 occasions I've phoned the cardio unit to "innocently" ask if they have a scan date on the records for me to find a letter arriving within a day or three with an appointment.

my feeling is that the level of monitoring/attention one gets depends very much on where in the country you live and what type of surgery you've had. (I would say for sure that the nature of service delivered by your GP has changed dramatically over the last 54 years and bears very little little resemblance to that of my child-hood. basically people are living longer and therefore there are more people with more health 'conditions' to serve, whilst measures to increase capacity in the system haven't happened. )

wishing you continued recovery

steve

[Football-Mum]

Hi, I'm in a similar situation (4 months post mechanical AVR surgery). I too have never seen my GP. I moved house and GP 6 years ago and was already under a Cardiologist. My practice has an INR clinic so I go there for warfarin check and any changes to my prescription the nurse deals with the GP directly. I had a really good relationship with my old GP prior to moving house (who actually picked up my heart issue which was congenital but only diagnosed in adulthood) but as others have commented things have changed so much with GP provision and that GP/patient relationship just doesn't seem to exist any more. Saying that I don't believe I am any worse off for the lack of GP care. Any queries I have I go to the Specialist Nursing team based at the hospital I had my surgery. Also the nurse at the INR clinic is very knowledgeable. And even though I'm very late to the party, I've only just discovered this online forum which is also a wealth of advice and information. I wouldn't worry about the GP. If its anything like mine you can't get an appointment anyhow!