Implantable cardioverter defibrillator (ICDs);not keen

[Julia121]

I have been recommended for a ICD to be fitted on Monday and too be honest it's all going too fast for me. I feel steam rolled into it and there is no one to talk to about it apart from the people who want me to have it who are giving the 'have it or die but we can't force you' line. I want a second opinion but they want it all done and get the wards empty for the Christmas holidays. Ideally what I would like is to stay in a controlled environment as I am now so when we get past Christmas I can get a second opinion and get them to go through it clearly so I can make an informed decision. The chaps here are telling me how lucky I am as the thing is so expensive which is not a good enough argument for me to have one fitted.

There is no private wards or patients in this hospital and my options are restricted to either having the procedure Monday or, well, I don't know what the alternative is (I guess I just get discharged). Any suggestions how I can get some control back into this so I can find out what my options are without feeling getting the ward empty for Christmas is more important?

[Bill]

Are you an inpatient at the moment? And where in the country are you?

Lots of places are stopping non-essential work due to Covid. Presumably you may need an ICU bed post op and they're getting full.

[Julia121]

Bill said:

Are you an inpatient at the moment? And where in the country are you?

Lots of places are stopping non-essential work due to Covid. Presumably you may need an ICU bed post op and they're getting full.

Hi Bill and yes bought in last week and down in South East. I've overheard the nurses at the desk openly moaning about being laid off over Christmas because they are bank workers. Some of the wards here are almost empty.

I'm happy to pay for this and the procedure is only under a local anesthetic and could leave same day if all goes well.

[Bill]

Julia121 said:

Hi Bill and yes bought in last week and down in South East. I've overheard the nurses at the desk openly moaning about being laid off over Christmas because they are bank workers. Some of the wards here are almost empty.

I'm happy to pay for this and the procedure is only under a local anesthetic and could leave same day if all goes well.

I have friends who are medics in Kent and the st has really hit the fan there, and Bournemouth has apparently stopped non-urgent surgery so I guess it's a question of how likely you are to have an issue before Easter.

Collar one of the medics tomorrow for a chat. If there isn't a ward round ask one of the nurses to bleep the on call registrar and explain your concerns. Without knowing a lot more about the history I can't see anyone online giving you answers.

[55palfers]

I have had an ICD for the last few years.

Feel free to PM me any questions

[Justin S]

Mate has an ICD for 5 or 6 yrs and just had a replacement this year. He has struggled with a hole in his heart ( just repaired after 6 yrs of NHS chaos) and also has sarcodosis. He isnt a well chap but it has gone off a couple of times and 'straightened' his heart rate after it went on diesel runaway.
Without it, I am sure he wouldnt be here today. He seems to not worry about it. Used to air travel a lot and had a special pass for metal detection.

[numtumfutunch]

Julia121 said:

I have been recommended for a ICD to be fitted on Monday and too be honest it's all going too fast for me. I feel steam rolled into it and there is no one to talk to about it apart from the people who want me to have it who are giving the 'have it or die but we can't force you' line. I want a second opinion but they want it all done and get the wards empty for the Christmas holidays. Ideally what I would like is to stay in a controlled environment as I am now so when we get past Christmas I can get a second opinion and get them to go through it clearly so I can make an informed decision. The chaps here are telling me how lucky I am as the thing is so expensive which is not a good enough argument for me to have one fitted.

There is no private wards or patients in this hospital and my options are restricted to either having the procedure Monday or, well, I don't know what the alternative is (I guess I just get discharged). Any suggestions how I can get some control back into this so I can find out what my options are without feeling getting the ward empty for Christmas is more important?

Oh FFS how much notice have you paid to NHS posts since you joined PH?

Ignore all advice you've been given so far and ask for internet help

It's a public sector embarrassed and I'm amazed you're still alive

Get out ASAP and go private

It's your only chance

Probably

[QuickQuack]

I assume you've had it implanted by now so this may be a little late, but here it goes anyway.

It's a straightforward, minor procedure just like a pacemaker. That's all it is. Nothing more. It's NOT a heart operation, it's not surgery. It's not done by a heart surgeon (cardiac or cardiothoracic surgeon) but by a cardiologist in the angio suite. It's not much more complicated than a routine angiogram.

You will have been admitted because you've had a potentially fatal irregularity of the rhythm of your heart - an arrhythmia. Next time it happens, you may not be so lucky and simply drop dead, and there's often no way to predict or prevent these. An ICD administers a tiny electrical shock to your heart and resets it, thereby terminating the abnormal rhythm. As the leads are in the heart muscle, there's no other both tissue (bone, muscle, fat, lung) or air; therefore, there's no need for a massive electrical current that makes your body jump like you see in TV dramas or films. You do have the option to self discharge, but that would be taking a hell of a risk for no real benefit as you could literally drop dead at any point.

Remember, this is t the USA, we don't get paid per procedure we do, we have no personal benefit from performing a particular procedure over another, and, if anything, recommending a procedure rather than discharging you adds to the workload rather than reducing it. I appreciate that you're feeling a bit cornered about this and as if you're getting a hard sell from a double glazing salesman, but all they're doing is telling you the cold, hard truth.

Private medicine really falls down in this sort of urgent procedure in the UK, I wouldn't recommend going private. An NHS unit also has far superior aftercare and out of hours emergency cover.

I am a doctor, but I'm not your doctor. Although I can no longer operate due to a spinal injury and work in the pharmaceutical industry, I am a trained cardiothoracic surgeon so I know my way around the heart.