So grateful we are not in the UK for this

[soglad]

We moved from UK to Italy a year and a half ago. On Monday this week my husband felt unwell and his smart watch told him to go see the doctor immediately. He suspected he had atrial fibrillation (AF), as he had it 5 years ago.

He booked to see his GP at 5pm on Tuesday. She diagnosed him with AF and immediately referred him to a specialist hospital.

He was triaged into the hospital the same day at 8pm. At 9pm they started a procedure to correct the heartbeat chemically. It did not work.

At 9am this morning they performed a cardioversion, which restored his normal heart rhythm. They are discharging him today.

So total time from the very first appointment to successful treatment -- 16 hours. Free state healthcare.

This is in a country which a lot of people in the UK describe as poor, corrupt, slow and backwards.

All his doctors spoke good English and even nurses did their best to google translate everything for him.

By contrast, my last experience of helping mum get NHS treatment after a road traffic accident which required urgent operation left me in tears -- weeks and weeks of delays / cancellations meant she almost missed the window of opportunity for surgery as bones started to heal incorrectly. I'm so glad I didn't go through this again.

Clearly great state healthcare is possible, even in a country with a much lower GDP per capita than the UK. Why aren't we doing something?

My 11 year old daughter landed in A&E last Wednesday.

In the space of 6 hours, she'd had full bloodwork and results, a brain MRI and results, and an extensive neurology exam.

She's been diagnosed with a tumour.

YABU, glad your DH is ok.

@soglad

im pleased your DH had good treatment & is doing well.

however, there's no 'we' here, you're a British Citizen, but you're not living here. You're not able to have any impact here, there's no 'we'

AF is probably more complicated than MN suggests. If a patient is severely compromised by their AF (meaning low BP and low end-organ perfusion) then a quick DC (electrical) cardioversion may be the best first line option as the risks of sedation & the shock are lower than the risk of staying in a compromised state for a long time. There are risks though, including that it may precipitate different (worse) dysrhythmias, and the risks associated with sedation and a knackered heart. It's only simple in retrospect, when it hasn't killed the patient!

Chemical cardioversion (using drugs), may take longer and has some risk of side effects, but where a patient isn't compromised by the AF then it's often the safer option. It also allows a period of fasting so that if it fails then providing sedation for DCCV is slightly safer. Where chemical cardioversion fails then the balance of risk/benefit of using electricity may change.

There has to be a pretty clear start point to the AF as the risk of cardioversion (by either means) precipitating a stroke increases after about 48 hours, which is why it sounds like the OP's DH was cutting it pretty fine time-wise. If someone comes in later than that or doesn't give a clear history of the palpitations starting then there has to be some pretty hard thinking about whether its better to crack-on and accept the risk; rate control, anti-coagulate and do a cardioversion electively a few weeks later; or possibly echo to see if there are any big clots in the heart and crack-on if it looks ok.

There are also lots of things that can trigger AF that are not primary heart problems and it may be that fixing those things sorts the rhythm out for some patients (and if not fixing those things may reduce the chance of cardioversion working too).

HTH.

Yabu

Our NHS needs a massive overhaul. Everyone agrees it needs more money (and bloody review of their ways of working!) but individually people dont want to pay any more.

I would like to see a co payment system

I hope she starts treatment soon xx

Meantime there are 21 ambulances queuing outside our A&E today……

Sending hugs to everyone who has had, or is having, a scary experience. Wishing you well.

Thankfully I have not had to use the NHS in an emergency. No idea how it would be. But if it's anything like registering at our local surgery, I will die long before any treatment is proferred or suggested. It took us seven months to register DD (I kid you not). Recently tried to make an appointment for her to go on the pill for painful periods. Was (eventually) offered a telephone appointment. I said I was surprised because surely they needed to do a health check and take blood pressure? Was told no need. Telephone appointment made. Special permission from school for DD to have her mobile phone with her on the afternoon - we were given a time frame of between 1.30 and 4.30. The phone rang at 3.44, DD asked for permission to leave her lesson, hustled out the door, the call had already stopped. Rang straight back (call logs show her call at 3.46) - she was told the doctor had already left for the day. It took us nearly a month to make that appointment, so not holding out hope for a new one!

We had a bad time in Italy for a family member and travelled back to U.K. for healthcare

They have a plan ;

So much of it is down to sheer luck.

I’m not British and do not live in the UK, but on a holiday to England a few years ago I tripped and injured my ankle. I was concerned it was broken but it was a bad sprain with torn ligaments.

I didn’t need an ambulance as my husband drove me to hospital but I arrived to the Injury unit fully expecting to have to wait for hours. Was literally seen within five minutes, had an x-ray, consultation with a doctor, given a back-cast, crutches, and walked hobbled out within 90s, clutching some exceptionally good pain killers.

My first, and only, experience of the NHS was entirely impressive.

Hope your husband continues to make a strong recovery, OP.

@PoisonMaple wishing you and your daughter well.

I have a smug ex-pat gloater acquaintance like this, except he's in Switzerland. He picks isolated, incomparable situations and uses them to feed his narrative reassure himself about his move that Switzerland is great and the UK is crap. I am sure some things about Italy are better than the UK and others are worse. Depends on your priorities I suppose.

I would like to defend the NHS and work within it. However, in the last day I have had the experience of my step dad at an emergency clinic where he was left with nothing to eat or drink (80 year old diabetic) for 8 hours until I could help him, and the sister of a friend who broke her ankle and waited for 17 hours for the ambulance. The tories have broken the NHS.

Its the government who aren't doing something about it. They could make the NHS great if they wanted to.

This is in a country which a lot of people in the UK describe as poor, corrupt, slow and backwards.

Who's saying that except you, OP?

The point of my post is that if a poorer country can make it work, why can't we.

Because the conservative government want the NHS to become so crippled that people buy into their privatisation agenda, and they and their mates rake in the money yet again. They did it to trains, water and energy, all of which now offer an appalling service while paying massive dividends out. And yet we are too stupid to recognise it’s happening again, and the Daily Fail runs regular articles about how awful the NHS is and how much money it wastes thanks to its woke agenda and ineptitude. It is quite literally criminal, and heartbreaking given that the Conservatives will follow a healthcare model where those who cannot afford private healthcare basically get left to rot.

Those of us that have lived through labour and conservative governments know that they’re all full of promises when in opposition, nothing ever changes.

This is a bit of smug post OP. For every negative story you hear about the NHS there are thousands of positive ones. I was referred on the two week path way in late November and very quickly received biopsy, MRI, x-Ray, diagnosis and then had surgery two weeks ago. I can't comment on non urgent situations but in an emergency they are excellent.

I worked in the NHS in the previous Tory government and then in the Labour government. I saw significant positive changes in the NHS during the Labour years. We had massive investment in services and equipment. Personally I was involved in the roll out of the national bowel canal screening program, we couldn’t have done it without that massive investment.
Sadly since the austerity measures the NHS has gone rapidly downhill - hardly a surprise.

Thank you kindly for your help.

I've done more cardioversions than you have probably had hot dinners. A biphasic shock is better than a monophasic and it is synched to the qRS complex so no it shouldn't lead to other arrhythmias.

The OP's husband has had two episodes of AF, that is why he should have an EPS to map any substrate that is initiating the AF, with an ablation or if it is sinus node dysfunction then a pacemaker may be appropriate.

Or a planned ablate and pacemaker implantation as a single procedure.

OP

You need to push for an EPS, using just cardioversion will put your DH in to a normal rhythm but does nothing to stop it happening again.

@StandardLFinegan

Cath labs (used for EPS, stents, angioplasty and sometimes for pacemaker implant) work every day and there are staff on call 24 hours a day. Most cases are day cases so there is usually a bed available because other people have gone home.

I found the same in Turkey back in 2009, better than healthcare in any Western Country I've ever been to) also we were foreign tourists that had an unfortunate accident. Also everything was free (or just a nominal cost). It was absolutely amazing.

Sounds like your husband got good care.
Not all care in the NHS is terrible.
DH had an infected sebaceous cyst about 3 weeks ago.
He went to A&E on Saturday afternoon. They referred him to the surgical team to get rid of it. He was told they'd get it removed. They said on second thoughts, come back tomorrow morning, 7am. There was a wait because they had more urgent cases coming in. He left hospital at 4pm, having had hospital procedure and biopsy taken.
Less than 24 hours.

He has had appointments every two days to deal with the wound since.

He has a new painful lump just by the area, scheduled in to be checked on Thursday- after he raised it yesterday.

DD attended A&E on Tuesday night- 10:45pm with symptoms of concussion. She was home having been seen, given advice and a course of painkillers by 2 am.

Last time my husband needed an operation, he fell, broke his arm in 2 places. Went to A&E. This was 5pm ish on a Friday. They sent him home by 10pm. They scheduled an operation for the next morning for him to have hardware put in to help heal the break.

I really don't think all of the NHS is failing miserably.

Doesn’t sound like very good treatment if this is his second (known) episode and he’s been rushed out with a cardioversion and nothing else. No pacemaker? No blood thinners?

I see upthread that there is a poster with greater knowledge than mine, but from my personal experience as a long-term cardiac patient if he has recurring AF then blood thinners should be a consideration as he is at greater risk of stroke. In fact at my last ICD check the technician asked if I take blood thinners because there are AF episodes showing on my ICD download.

I have hypertrophic cardiomyopathy, atrial fibrillation and mitral regurgitation so possibly more complex. But having had a mitraclip (aerial synthetic valve repair) fitted and an ICD fitted post cardiac arrest, the biggest issue by far is my AF which needs to be controlled by some seriously powerful meds, and yet my episodes have started increasing over the past couple o months.

Due to the construction of my heart I am not eligible to be able to have cardioversion, ablation or even a VAD if it comes to that, so my next port of call is going to be the transplant list, and I am in fact seen regularly by the transplant team at papworth although not on the list yet.

But the AF is the greatest risk to my life ATm, which is why I’m on anti Arhythmic drugs to keep the AF under control, but also warferin because AF presents a real and genuine risk of TIA and stroke.

So no, I wouldn’t consider a quick in and out with a cheery goodbye to be a great result.

@IsThePopeCatholic hope you won’t get too disappointed.