Cardiothoracic surgery – first outpatient appointment

Cardiology

The Covid pandemic has had a significant impact on the ability of the NHS to provide some routine services. We recognise that patients are waiting longer than we would all like and it is not always possible to identify when treatment will take place.

This document provides you with information on how you can support yourself while waiting to attend the hospital.

You don’t need to ring your GP, or the hospital caring for you for an update on waiting times because all the information is available on the My Planned Care website.

This will help ensure you are in the best possible physical and mental health. Maintaining and improving your overall wellbeing will also lead to faster recovery if you require further investigations or treatment.

Guidance for patients

You will be contacted by your trust for your first appointment, while you wait do please read the remainder of this leaflet for more information on what can be done to support yourself.

How you can support yourself while you wait for your procedure?

There are things you can do whilst you wait for your appointment to make sure you are as healthy and strong as you can be. This will increase your chances of a better recovery if you go on to require a specific treatment following an outpatient appointment.

Take your medication

Whilst waiting for your hospital appointment continue to follow medical advice and continue to take any medications as prescribed.

Make a list of any medicines you are taking, including prescriptions, medicines you’ve bought yourself or any alternative treatments and take this along to any appointments you have.

If your specialist recommends you need a procedure following your first appointment, your clinician or pre-operative nurse will give clear instructions if you need to stop or change any of your medication. Please do not stop or change any medications yourself.

Improve your health

• Eat healthy foods
  Your body needs good nutrition to fight infection and recover following any procedure you may require.
• Avoid dehydration
• Avoid constipation
  Drink plenty of fluids and increase the amount of fibre in your diet. If this does not help you can attend your local pharmacy for over-the-counter remedies.

Smoking

We strongly advise you to stop smoking. This has numerous health benefits and lowers your risk of complications. If you are advised by your specialist that an operation is required, stopping smoking also reduces the risk of post-operative heart attacks, stroke, blood clots and respiratory complications.

You are much more likely to quit smoking than if you use willpower alone. Visit Make Smoking History to get free access to the latest quitting aids, one-to-one advice and support in your local area

Alcohol

Alcohol has many effects on your body, but importantly it can reduce your body’s ability to heal. Make sure you are drinking within the recommended limits to improve your ability to heal after any procedure you may require.

Prevention of Deep Vein Thrombosis (DVT) or Pulmonary Embolism (PE) before procedure

There are natural ways and lifestyle changes you can make to lower your risk of developing blood clots, these include:

• Staying active
  Make a point of moving every 30-60 minutes to ensure you keep your blood flowing

• Regular exercise
  Simply walking for 30 minutes a day is a great way to keep your circulation moving

• Maintain a healthy weight

• Keep hydrated

Your doctor will assess your risk of developing a blood clot when you come into hospital for a procedure and will order a treatment plan to minimise your risk. This may include prescribed medications before and after your procedure, including after your discharge from hospital this is to help reduce the risk of you developing blood clots.

Keep moving

Exercise regularly. Improved fitness levels reduce the risk of complications when having any procedure. This allows you to leave hospital and return to your normal quality of life more quickly.

Keeping an active lifestyle is good for your health. If you are normally an active person, it is important to keep this up before your procedure. People with low activity levels can improve their fitness levels within as little as 4 weeks. This gives you an opportunity to get fitter before any procedure you may require and improves your chances of a better and quicker recovery.

Use this tool to find out your BMI. If your BMI is high, you need to consider trying to lose some weight in order to optimise your surgery.

You can download a free NHS weight loss planning app to help you start healthier eating habits, be more active and start losing weight.

Good mental health

It is normal to be anxious about seeing a specialist or waiting for a procedure. Relaxation, mindfulness and breathing exercises can be beneficial and help you. It is important that you ask for help if you feel you need it. Your GP practice can advise you on support in your local area.

Please keep in touch with your GP or mental health professional if you are already under their care for depression or anxiety.

There are also Apps available to help support your health, mental health and wellbeing:

You can find tested and approved mental health apps here.

• Feeling anxious?
• Feeling stressed?
• Feeling low?
• Trouble sleeping?

If you do experience any of these issues, we recommend getting in touch with your hospital team. The number and email should be on your last hospital appointment letter.

Alternatively, you can contact your GP practice. Whilst your GP does not have access to the hospital waiting list to get you seen sooner, if your condition is getting worse, they can assess you, give advice and can contact the hospital on your behalf if necessary.

If your condition gets worse but you already have your date for surgery, we recommend getting in touch with your hospital team. The number and email for this should be on the hospital appointment letter.

General information

Please watch this useful video  ‘Preparing for surgery – Fitter Better Sooner’ from the Royal College of Anaesthetists which offers advice on preparing for a procedure.

There is also some useful information available on the North East and North Cumbria ICS website.

What should I do if my health is deteriorating?

This information is designed to help you manage your symptoms and stay in the best possible health whilst you are awaiting your appointment. It is however possible that your symptoms may get worse while you are waiting.

There are some things to look out for which would indicate you should seek medical help.

• If your pain gets worse to the point that it is unmanageable with the pain relief suggested by the pharmacist or doctor, and you are struggling to cope with it.

If you experience any of these issues, we recommend getting in touch with your GP in the first instance. Whilst your GP does not have access to the hospital waiting list to get you seen sooner, your GP can make a further assessment of you, give advice and can contact the hospital on your behalf if required.

Patient experience

South Tees Hospitals NHS Foundation Trust would like your feedback. If you wish to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Department who will advise you on how best to do this.

This service is based at The James Cook University Hospital but also covers the Friarage Hospital in Northallerton, our community hospitals and community health services.

To ensure we meet your communication needs please inform the Patient Experience Department of any special requirements, for example; braille or large print.

T: 01642 835964
E: [email protected]

The James Cook University Hospital, Marton Road, Middlesbrough, TS4 3BW.
Telephone: 01642 850850

My Planned Care – Cardiothoracic surgery – Version 1
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