Any anaesthetists or nurses here?

[CrimsonCloverHoney]

I had a pre-op for a breast augmentation and my pulse rate was abnormally low (44). I've since had an ECG and the results showed a first degree heart block and arrythmia. The cosmetic surgery company are waiting for my GP to send over the responses to a medical questionnaire they sent over but in the meantime I'm feeling anxious wondering whether or not the surgery is going to go ahead on Monday.

Are they likely to proceed with the surgery given the findings of my ECG? I've been referred to the cardiology department but my appointment isn't until Feb. I just feel anxious not knowing what's happening.

I'd wait till I'd seen the cardiologist. I'm a nurse.

I think it’s unlikely they’ll proceed until after your cardiology appointment. If it was me I think I’d feel safer waiting until then anyway.

I very much doubt you'll have surgery, anything untoward happens imagine the lawsuit!
Hope the problem they've found gets sorted

Ex nurse (and future ODP) here. I highly doubt they will operate considering the stress that a general anaesthetic (not to mention the surgery itself) will put on your body - and so they shouldn't.

You need assessing by the cardiology team.

First deg HB isn’t a problem. HR of 44 isn’t necessarily a problem - if you’re young and fit and asymptomatic it’s probably normal for you. The dealbreaker is what you mean by ‘arhythmia’. If this is just what the printout at the top of the ECG has said, they are almost universally wong. If there is really a rhythm problem then it will depend on what that is/whether it can be optimised/how much risk you are prepared to accept with regards to proceeding with elective, (presumably) cosmetic surgery. The anaesthetist will be able to decide how safe it is to proceed. If it’s not safe then the cardiologist will be able to advise re management/optimisation. (From an anaesthetist).

Nurse hear. I'd hope the hospital would wait until you've seen the cardiologist.

After the ECG my GP said my heart rate was unusually slow with an irregular beat. I sometimes feel breathless and struggle to take in a deep breath - I have to yawn to get a decent breath. Can't be a good sign.

I feel like calling them and postponing.

There's absolutely zero way you will be having surgery on Monday.

I doubt they will do the surgery.

As it is cosmetic surgery it is not a case of the benefits outweighing the risks, is it? Why take the risk for a cosmetic issue.

You need further review. Most people with a first degree block won't need any treatment or intervention especially if they have no symptoms.

However your GP/cardiologist will want to rule out any related or underlying issues.

Do you take any medication that could affect your heart rate ?

To be honest if the breast augmentation company DON’T postpone I’d cancel the whole thing!

Up until a few months ago I was taking 100mg of Sertraline. I'm not sure whether that could be the cause?

I'm just worried that there's only a few days to go and they still haven't decided either way whether the op is going ahead or not. It's all paid for so I'm wondering whether or not they're going to risk it or just think about the money they're getting.

The sertraline will be out of your system if you stopped taking it months ago.

What is ringing bells for me is a private breast Augmentation on someone who has recently come off Sertraline though. Have you had psychological assessment as part of the preparation for this?

Sadly, people can have unrealistic expectations about how cosmetic surgery can change their lives and those who are low in mood are especially vulnerable.

I would halt the procedure whilst you have your physical health checked and use the opportunity to talk to a therapist about why you feel you need this. If it's right for you, it will still be right if you wait.

I haven't had a psychological assessment but their policy states that I have to have been off the medication for 3 months prior to surgery.

I'm not worried about the results of the surgery - it's to correct tuberous, asymmetrical breasts so I'm 100% certain that I want to have it done. My main concern is the heart issue and the risk of dying under GA.

I'm wondering whether I should just take the decision out of their hands and postpone.

They won't go ahead if there are any doubts anyway - but I'd give them a call and discuss. You need to get that heart sorted out first and foremost.

Postpone. It's just not worth the risk, is it?

Ok good to know you haven't got unrealistic expectations.

But yes, it might be better to take the decision yourself. As I said for most people the outcome of further assessment will be no further action at least you would know for certain.

It's a delay at the end of the day, not a cancellation.

Have the people who would be looking after you for the surgery actually seen the ECG or examined you? There is no way they can make the decision otherwise. It’s a bit of a dump on their part to have not done the ECG themselves & expected your GO to sort it out. If your GP was that worried that you had a dangerous bradycardia you’d probably be in hospital by now so I’d be reassured that you’re not. The ECG findings you’ve described may still be completely innocent.

They haven't seen the ECG or done any sort of tests on me apart from basic blood pressure/heart rate. They sent my GP a medical questionnaire thing to complete which the GP sent back to them today. I'm not left feeling very confident about the whole thing

Not a medic.
OP, hand hold here. Whilst you must be feeling very uneasy at present, I would take the pressure off yourself, and postpone your surgery.
I hope your results are favourable, be kind to yourself.🌺

Thanks, Sugar - I'm just worried that they're going to be arsey if I postpone it but then I can't see it happening anyway. It's stressful enough without the added worry of this heart thing.

It’s highly likely they will postpone (doctor here)

I hope so olympics - I've mentally checked out of having it done now, but I'd prefer it if it was on their terms rather than mine. I don't know much about first degree heart block but surely it's not worth the risk until after I've seen a cardiologist?

Nurse here and I would postpone until after a cardiology opinion especially as you say you have symptoms.

I will call and speak to them tomorrow. I feel like I've been short of breath today but I don't know if that's my mind playing tricks on me due to the circumstances. I'll be surprised if they declare me fit enough to operate on and i think it will put me off.