Post-operative cardiac care?

A case study.

A couple of days ago I had an appointment with the doctor, the very pleasant Dr R., fresh back from her skiing trip. She has been at the practice she told me for twenty years but it was the first time we had met. It is also the first time she has seen me since my brush with death or serious incapacity over a year ago. To the NHS I am presumably only a number, and the sad reality is that no one would really care if I lived or died, even if they pretend otherwise!

The modern spacious waiting room in the new purpose-designed surgery, did not appear inordinately busy, despite catering for three GP practices with three receptionists sitting next to one another. This ensured no one had to wait long to be processed. However there was a twenty five minute delay from my alloted appointment time. It wasn't onerous. I assume Dr. R. was catching up on those twenty vacant years in my medical notes.

My main reason for requesting the consultation was to discuss the echocardiogram. This had been carried out four months previously but there had been no feedback. In January I enquired and asked for a copy of the report. After a request was submitted to the hospital Consultant, it eventually arrived but it then took another month to hand it over and a further month for the GP appointment as because of the impending holiday.

I took comfort by assuming that this lack of urgency indicated the results from the test were generally favourable - at least I hope that was the case. On one visit I jokingly suggested I might be dead by the time I found out what the test had revealed!

In the meantime this enquiry appeared to awaken the system and I got a letter in the post suggesting I have a blood test, "to make sure the various drugs prescribed for my condition were not having an adverse effect on my other systems - such as liver and kidneys." The receptionist was somewhat taken aback when I indicated I hadn't taken any prescribed medications. This was obviously news to her and caused something of a tither, such is the importance of medical routines and protocols. At my suggestion the blood test was then postponed until after the consultation with the doctor.

It went well. The doctor is perfectly charming but throughout only her eyes were visible as she spoke from behind a mask, whether to protect her or me I couldn't quite make out. At least I wasn't required to wear one as I had been a year previously. The covid scare had past but obviously not its psychological after-shocks for the medical profession. The fact that the mask interferred with communication, added to the problem of decyphering the technical language and abbreviations in the report.

It may be a personal view not shared by everyone but I have to say that talking to a doctor wearing a mask, when all the science suggests they are neither needed or effective, rather undermines confidence in the wearer and the medical profession in general. If doctors are not fully cognizant of the science, or more importantly of unobstructed communication with the patient, what hope for the rest of us?

The doctor was very kind. She explained some of the technical terms and medical abbreviations in the echocardiogram report. (I have to say I had cheated somewhat and had already 'brushed up my Shakespeare' on the internet, having had the benefit of some intensive symposia with leading cardiologists!) So I was not totally out of my depth or wholly subject to the mystical aura of the consulting room

The overall conclusion was that the old ticker worked reasonably well given the circumstances, had not noticeably deteriorated since the surgical intervention, and although permanently damaged had not deteriorated further. Temperature, oxygen levels, pulse and blood pressure were within acceptable parameters. (The nicest part of the examination was the stethoscope on the skin, so cold and smooth, I wish it could have continued!) In other words the mechanical aspects of my body appeared OK. So far, so good.

But I was to be chastised, very gently, for not taking the pills - the 'medications', no less than up to twelve per day that the hospital prescribed. Pills to thin the blood, to prevent coagulation, to reduce blood pressure, to cure pain, to counter the adverse effects of the former, to name but a few. (I have listed them and their known adverse effects, elsewhere on this blog)

Apart from the occasional Aspirin, I had obviously 'gone rogue' in considering but rejecting the advice and prescriptions recommended, despite the fact that the echocardiogram seemed to indicate my own regime of exercise, diet and rest seemed to have worked quite well. The medical advice appeared to be 100% drug-related beyond which there was nothing else on offer.

What was very much absent was any general health advice relating to diet, excercise or nuitrition or indeed any help or advice with the physical or psychological problems of living. No groups, physio or home help suggested, although I am fortunate enough not to need them but did the doctor know that? Any possible psychological implications of living with the condition were not even entertained. Did this shine a light on the inherent philosophical outlook of the medical profession, within the context of the NHS, one dependent on drugs to the exclusion of everything else?

The only time the surgery has appeared to have taken an active interest in my health or welfare was during the alleged covid 'pandemic'. As we all know this was more hysterical than epidemiological. However it elicited multiple telephone calls encouraging me to have the jab. I'm glad I didn't succomb to the pressure but it illustrates how the health system operates and how doctors are incentivised to act in certain directions but not others.

Fortunately I have been in a position to make my own informed decisions. They were not without risks but also avoided the multiple known adverse side effects of the prescribed medications. In the process I have also saved the NHS an unquantifiable sum of money and deprived drug companies of their profits. I also believe I am healthier as a result. Others might not be so lucky as me, and sucumbed to the well-intentioned, but arguably damaging regime.

Finally I should say that I was very grateful and impressed by the efficiency and technical expertise that unblocked my cardiac artery, installed stents and saved my life. I'm not so impressed with the after-care and follow-up afforded, which has been almost non-existent and reliant on a regime of drugs in the absence of physical or mental practical advice or support. For example not once have vitamin supplements been recommended. I have not missed it but others undoubtedly to their detriment will.

The NHS has come a long way since its inception over seventy years ago as a socialist enterprise. It has many strengths and attributes that should not be lightly dismissed. But by the same token, it is not without its faults. It should not be venerated like a religion. Does it provide good value for money? Is it overblown and wasteful of resources? Is it too dependent on drug-based solutions rather than-health promoting ones? My experience is just one of millions, however it might illustrate some of the ingrained weaknesses and suggest some of the ways in which it might be improved? If none of these, just an interesting read.