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I am seeking some medical advice but I am not sure whether anyone can help me. I have a letter from my cardiotheracic surgeon regarding my heart condition. I do not understand how serious the condition is. This letter was written almost 12 months ago and should have gone to the DWP for my DLA application. My dr advised the dwp of this letter but did not send it.

1

there is significant damage to right coronary occlusion and aortic stenosis. by the same token this would suggest that she may well have mediastunal radiation adding to the the technical challenge of aortic valvee replacement and CABG. Inyerestingly her full pulmonary function test show relatively normal spirome and lung volumes, but moderate impairment of gas transfer reflection in depressed TLCO to 48% and KCO to 65% predicted this may also reflect some concomitant radiation injury to the adjacent lung.

 

Although we do not routinely offer surgery for moderate aortic stenosis, given the fact that she is very symtomatic with class 111 Angina and dyspnoea and concomitant right coronary occlusion, this may well be excepteptional indication logistic Euroscore predicts an operative risk of 2%.

 

Since this letter was written my condition has worsened to such an extent that my abdomen fills with fluid and immobolises me for days. I just need to know if anyone could give me any advise on what it all means.

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I could answer most of your questions but feel it

is inappropriate as your is serious and requires rapid

treatment, please make an urgent appointment to

see your GP who will be able to explain your conditions

the prognosis and treatment.

By urgent I mean at the latest Tuesday.

Any Letters I Draft are N0T approved by CAG and no personal liability is accepted.

Please Consider making a donation to keep this site running!

Nemo Mortalium Omnibus Horis Sapit: Animo et Fide:

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This sounds like congestive cardiac failure; Heart failure sounds frightening because it sounds like the heart just stops working. Do not be discouraged by the term heart failure-the heart has not stopped beating or pumping. Heart failure means the tissues of the body are temporarily not receiving enough blood and oxygen. With advancements in diagnosis and therapy for heart failure, patients are feeling better and living longer.

 

Although heart failure is a serious medical condition, the heart does not just stop abruptly.

 

Heart failure may develop gradually over several years, or move quickly after a heart attack or a disease of the heart muscle.

Heart failure is an illness in which the pumping action of the heart becomes less and less powerful. That is, the heart does not pump blood as well as it should. When this happens, blood does not move efficiently through the circulatory system and starts to back up, increasing the pressure in the blood vessels and forcing fluid from the blood vessels into body tissues.

When the left side of the heart starts to fail, fluid collects in the lungs (pulmonary edema). This extra fluid in the lungs (congestion) makes it more difficult for the airways to expand as you inhale. Breathing becomes more difficult, and you may feel short of breath, particularly with activity or lying down.

 

When the right side of the heart starts to fail, fluid collects in the feet and lower legs. As the heart failure becomes worse, the upper legs swell and eventually the abdomen collects fluid (ascites). Weight gain accompanies the fluid retention and is an excellent measure of how much fluid is being retained. Puffy swelling (edema) is a sign of right heart failure, especially if the edema is pitting edema. With pitting edema, a finger pressed on the swollen leg leaves a finger imprint.

As Brigadier says have a word with your GP and he can go through the report with you and answer any questions you may have

Gbarbm

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Hello there.

 

If you would like to read more about all this, I've always found the BBC health website very informative. I don't know if it's for you, only you can decide that.

 

My best, HB

Illegitimi non carborundum

 

 

 

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Due to several medical problems I have had my heart operation delayed and cancelled a number of times. I am awaiting a replacement aortic valve, they are to dio a valve repair? not sure which one and a bypass to the left ventricle.

BRIGADIER2JCS your advise is straight to the point and I really appreciate it. I could do with a Dr whoo could put it into terms I understand or give me another opinion that I could send to the DLA.

 

Gbardm - you seem to have great knowledge and that has helped thank you.

I have been going through the letters from the DWP and a registered Nurse commented on the class 111 angina and they stated - moderate limitations with ADL's. I feel this letter from my consultant will be swallowed up in the mass paper trail and not given the airing it deserves. If you as strangers can see that this letter shows how serious my heart is then why wasn't it sent by my GP I wonder if this would have made a difference to my DLA claim. Thank you.

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I think you have been given the right advice by those who've answered your query. Do you not have regular follow-up appointments with your consultant? I am sure your GP will be happy to explain the situation to you in layman's words, and I really think getting an appointment with her/him should be your first priority. You should, of course, mention that you feel worse than when this letter was written 12 months ago. When you've been checked and/or reassured then you can turn your attention to you DLA claim. But that's just my opinion.

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I am seeking some medical advice but I am not sure whether anyone can help me. I have a letter from my cardiotheracic surgeon regarding my heart condition. I do not understand how serious the condition is. This letter was written almost 12 months ago and should have gone to the DWP for my DLA application. My dr advised the dwp of this letter but did not send it.

1

there is significant damage to right coronary occlusion and aortic stenosis. by the same token this would suggest that she may well have mediastunal radiation adding to the the technical challenge of aortic valvee replacement and CABG. Inyerestingly her full pulmonary function test show relatively normal spirome and lung volumes, but moderate impairment of gas transfer reflection in depressed TLCO to 48% and KCO to 65% predicted this may also reflect some concomitant radiation injury to the adjacent lung.

 

Although we do not routinely offer surgery for moderate aortic stenosis, given the fact that she is very symtomatic with class 111 Angina and dyspnoea and concomitant right coronary occlusion, this may well be excepteptional indication logistic Euroscore predicts an operative risk of 2%.

 

Since this letter was written my condition has worsened to such an extent that my abdomen fills with fluid and immobolises me for days. I just need to know if anyone could give me any advise on what it all means.

 

As others have correctly said, if you are unwell and your condition has deteriorated, you should be seen again, initially by your GP, and if need be by the cardio thoracic surgeon again (did their letter say if they were planning on seeing you again?).

 

You've asked if someone could advise you what it all means ; I can translate some of the information, but would be "guessing" some of the gaps / where what you've typed may be mis-spelt ; the best people to explain it (and most importantly what it means TO YOU, as they'll know the rest of your situation, are your GP and the cardio thoracic surgeon).

 

Trying to translate what you've copied, my translation or comments[are in the square brackets]

there is significant damage to [are there some words missing here?]

right coronary occlusion [one of the 3 main blood vessels supplying the heart, the right one, has a narrowing in at least part of it]

and aortic stenosis [one of the four heart valves, the one from the main pumping chamber to the main blood vessel leading away from the heart, has a narrowing]

[again, are there some words missing?]

by the same token this would suggest that she may well have mediastunal [is this "mediastinal"? The "mediastinum" is the "bit between the lungs that isn't lung, including the heart and the space the heart lies in"]

radiation [again, are there some words missing here? Is the word "damage" missing?. Have you ever had radiotherapy?]

adding to the the technical challenge of aortic valvee replacement and CABG. [[Coronary Artery Bypass Graft(ing), 'plumbing a graft in to bypass a blocked / partially blocked segment of blood vessel supplying the heart muscle]

Inyerestingly her full pulmonary function test show relatively normal spirome [spirometry? Have you had a test where you had to blow into a tube, "fast and hard, as much as you can", where they get a 'trace' showing information on how you can move air out of your lungs]

and lung volumes, but moderate impairment of gas transfer reflection in depressed TLCO to 48% [TLCO, a.k.a. "transfer factor" is another lung function test, not looking at how much air you can move in or out, but how well the lungs can transfer a gas from the air sacs in the lung to the blood stream]

and KCO to 65% predicted [KCO is based on TLCO but "adjusted" for "lung volume". 2 people might both have a TLCO of 50%, but one may have TLCO of 50% with "normal working size lungs" due exclusively to thickening of the walls of the air sacs while another might have a TLCO of 50%, but due in part to thickening of the walls of the air sacs but also in part due to having "a smaller part of the lungs working" ; they'll have the same TLCO but different KCO's if that makes more sense?]

this may also reflect some concomitant radiation injury to the adjacent lung. [ again, suggests you have had radiotherapy in the past?]

 

Although we do not routinely offer surgery for moderate aortic stenosis, given the fact that she is very symtomatic with class 111 Angina [another "scoring system", where class III, or "3" rather than "111" means: getting angina at rest, rather than just on exertion, and having had angina within the previous 48 hours]

and dyspnoea [a "medical name" for shortness of breath or "having to work hard to breathe well enough"]

and concomitant right coronary occlusion, this may well be excepteptional indication [ "we don't usually operate on moderate aortic stenosis, but might on this lady given all the factors]

logistic Euroscore [European System for Cardiac Operative Risk Evaluation, a scoring system where they put in details about the patient (including age and sex), pre-existing conditions and the surgery being done and it derives a "risk score"]

predicts an operative risk of 2%. [if 10,000 people with those risk factors had that operation, 9,800 of them would be expected to survive the op. The problem with statistics like this is, it doesn't tell you which 98 in 100 will survive and which 2 wouldn't, so whilst it is a "general indicator of risk", it isn't much use for one individual to know what it means FOR THEM as an individual, rather than for a large group of people]

 

I hope ths provides at least some of the "translation" you wanted, but again ; if you are more unwell, please contact your GP. They are also the best people to explain things : I'm working off only what you have typed [+/- any "typo's" that have crept in from you or I : they can work from both the original letter, and from a position of knowing your background information, while also being able to examine you and talk to you face to face.

Edited by BazzaS
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firstly thank you everyone for all the help that you have given me. It has helped me get my head around the facts. I may have missed ords out, sorry my eyesight isn't great. The letter was sent to my GP in May 2011 - this letter was supposed to go to the DWP for my DLA application. My Dootor advised the DWP that it was attached - but it never was I only found out when I went to my tribunal on the 22nd March that it was missing. I needed to know if this letter would have made any difference to my claim to DLA.

 

I have a number of other medical problems that have delayed the surgery, but I have been in constnt contact with the Cardiotheracic Surgeons Secretary. Firstly I had a hysterectomy in December 2010 because I had a large cyst on my right ovary. The cyst was borderline cancerous cells. It took me a number of months to recover and my blood count kept coming back low so that was the first delay. Then I had a problem with my diabetes, I had become insulin resistant and my insulin was changed that took 3 months to sort out the diabetic nurse and consultant weren't as supportive as they should have been and it seemed to take forever for them to give me the ok. Then in September I had a haermmorhage on my right eye and I lost my sight - I was sent to Manchester eye hospital and had laser treatment, this didn't work so they decided to delat until after my heart op. On the 8th December the cardiotheracic surgeons secretary rang to tell me that there had been a cancellation and they wanted to do the heart op on the 19th December so could I come i9n for the usual checks before an op. SO I did and it was all going ok until I told him about the eye bleeding still. The operation was cancelled because when I would go onto a bypass machine my blood would have been thinned - this could have caused further damage to my eye so they said they could notrisk my sight for the heart op.

 

In January I finally got my eye repaired and all seemed ok - but my liver function test which had always been high all of a sudden went through the roof to 947.Following ta ct and a ultrasound scan they found that my liver was enlarged. I saw the cardiotheracic surgeon and he was still not happy to do the op with my liver being enlarged and my liver function being so high. He refferred me to a liver specialist.

 

I was admitted to hospital on the 25th Feb 2011 because I could not breaht and my abdomen was so bloated. Our local hospital is awful!!! and I did not receive the treatment I should. Whilst in there I was put on a ward where the winter vomitting virus was rife and I got it. By the time the medical tam came to see me my abdomen had reduced. I mentioned to the liver specialist who cameto see me about the refferral and he new nothing about it in fact he looked at me as if I was some kind of mad women. To cut a longstory short it turned out that my refferral letter from January was still in the assessment unit and had not been seen by the liver specialist. The secretary to the cardotheracic surgeon (she is based at another hospital) went mad when she found out that my refferal hadn't reached the Dr so i was finally seen by him last tuesday. Whilst he is concerned about my liver he does not want my heart op to be delayed and thinks that once this has been done then my liver may function properly.

My Gp retired a few weeks ago, my new dr starts this week and I have a consutation with her on the 13th April. I am going to email the cardiotheracic surgeons secretary today to let her now I am really struggling. I have formed a very good relationship with her.

I will takeall advise thatyou have given me and go from there thnak you again. Lainey

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