Hopefully, you will feel happy and safe with the team that are looking after you, but that sometimes isn’t the case. What do you do if you’d like a second opinion?
How to get a second opinion
Getting a second opinion is a bit like telling your hairdresser you don’t like what she’s done, though it’s obviously more important.
The problem is many of us feel embarrassed or are afraid of causing offence by asking for a second opinion – I certainly did – but it’s something that could affect the rest of your life, so it has be done, no matter how awkward it makes you feel.
So when is a second opinion called for? There are three possible scenarios
- You have a serious or life-threatening disease
- The treatment is risky or toxic or experimental
- The diagnosis is not clear.
- You are having problems communicating with your doctor
During the first few months after my heart attacks, I saw so many doctors who gave such conflicting advice that I felt lost. This was probably partly due to the fact that my condition was so rare – but equally due to doctors having differing opinions.
What I needed was someone who stood apart from my daily care, and who understood me, to give me their advice.
My cardiology nurse saved me – she told me to listen to my instincts and choose one consultant I felt I could talk to and who would take the time to listen to me. If the communication was good and I felt cared for and comfortable, I should stick with this one person and listen only to his advice.
I started by asking my GP and heart nurses who they thought ‘matched’ me. In the end, three people recommended one particular cardiologist, so I contacted his secretary and made a private appointment. This cost £150, but was worth it because I got to spend an hour with him.
During this hour I was able to share my full story, and show him my medical reports and records (I’d asked for a copy of these from the hospital and had paid around £30 to get them all printed, but at least I had them in my possession, so again it was worth the money).
When I realised he was indeed the cardio-man for me, I asked if he’d be prepared to take me on as an NHS patient – he agreed and I informed my GP and phoned my previous cardiologists’ secretary to have my records transferred.
I didn’t have to see my previous cardiologist or explain why I’d moved – it’s like moving house, you don’t have to justify it, or feel any guilt.
The first step is to be sure a second opinion is the best route for you. If you want it because you don’t understand what you’ve been told, or you’ve been told you have a life-threatening condition and you want to ensure this is the right diagnosis, first get your GP to do the legwork on your behalf. He can ask for further information from your consultant.
It’s also always a good idea to speak to patients who’ve been through your proposed treatment, so ask your doctor if he knows anyone who will speak to you.
Find out if there is a specialist nurse you can chat to. In my experience they give the most realistic view on treatments as they deal with day-to-day issues. You may also find a nurse more approachable than a doctor and feel more confident asking difficult questions.
I spoke to my heart nurse at the hospital and she put me in touch with a cardiac support group, which really helped. Ask about support groups, charities and online forums, all of which will be able to tell you everything the doctor can’t!
A second opinion doesn’t mean swapping permanently to a new doctor – it can be just that, a second opinion. Health and social care professionals in the UK are required under NHS guidelines to ensure all patients are aware that they are able to ask for a second opinion.
If you wish to change your consultant, ask your GP to refer you to someone else – also ask who’d they’d recommend if it was for their own family. You can still go back to the old consultant if you want.
If you have arranged for a second opinion yourself privately, always tell your GP because you will need medical records and any pathology results for your second doctor.
Ideally, if there are two different opinions, you want the experts to be able to discuss your case openly. If you don’t tell your doctor because you’re afraid you’ll insult him, it’s hard to get the records together and communication will suffer.
Getting a second appointment may mean a delay in treatment so weigh up the pros and cons with your GP. And certainly don’t cancel any appointments with your old consultant before you get your second opinion, in case you like them even less than the first doctor.
When you go for your second opinion, write down what you want to know and take someone with you as a second pair of ears.
Many years down the line, I’m still with the same cardiologist I ‘chose’ and I feel content and reassured that I made the right decision.
If you are not satisfied with the service your doctor is giving you, contact the Patients Association Helpline: 0845 608 4455 Email: helpline@patients-association.
A note on driving
When you can start driving again depends on your heart condition and the sort of treatment you have had. You will need to contact the Driver and Vehicle Licensing Agency (DVLA) to make sure it is safe for you to start driving again.
(Write to them at DVLA, Swansea SA99 1TU, or call them on 0300 790 6806.)
If you have angina and it is well controlled, you can drive.
If you have had a planned coronary angioplasty, you should not drive for one week after having the angioplasty.
Many people who have had a heart attack are not allowed to drive for the first month after their heart attack. Check with your doctors if you are unsure.
Some people who have had a heart attack and have had successful treatment with an angioplasty will be able to start driving again after one week. Again, check with your doctor or the DVLA.
If you have had coronary bypass surgery, you will have to wait at least four weeks before you can start driving again. However, many doctors prefer you to wait for at least six weeks, to make sure your breastbone is healing properly. You know the score; don’t drive before checking with your doctor.
If you ever have an attack of angina while you are driving, you should stop driving. Once your symptoms are controlled, you can start driving again.
Whatever sort of cardiac event or treatment or procedure you have had, you will need to let your car insurance company know about your heart problem
Health and life insurance
After a heart attack, it’s important to check any insurance policies you have. You should check if you have any cover for a heart attack of any surgery you have had. Even if you are not covered, you should check any health insurance you have and let them know of your change in medical circumstance. If you don’t let them know and have to make a claim in the future for anything at all, your policy will be void and they will not pay out.
You need to be careful where you buy holiday insurance from after suffering a heart attack or heart surgery, as some policies now won’t cover you. Be very careful with ‘cover-all’ type policies. These are sometimes sold by the bank or by a travel agent or sometimes through your credit card company.
Beware – these policies are generally sold as a standard policy but don’t cover anything out of the ordinary. Therefore, if you don’t inform them of your heart condition, the policy will be void and you won’t actually be covered even though you will be paying the premiums!
I suggest you go to a specialist medical insurance company,
These companies will insure your heart separately to the rest of your body after you go through telephone medical screening. Make sure you tell them EVERYTHING! There is no point in making light of things to get a cheaper deal, as you will not be covered in the event of an accident or emergency.
By buying your travel insurance in this way, you will insure your heart separately, by paying an extra premium for this, but the rest of your body gets insured in the same way as anyone else. It keeps the cost down and ensures that you will get the right medical help if needed.
It’s also worth mentioning that the premiums will be higher to begin with but these will go down in time as you move further away from your heart event. Initially after my heart attacks I could only get European cover for 1 trip at a time, now, 9 years later I can get worldwide travel for a year at a time. This is because I have been well since my attacks, take all my medications and so am classed as ‘stable’. (Mr Bee might disagree with that!)
Getting back to work
If you have a job, I’m sure that getting back to work will be playing on your mind. Again your case is relevant only to you. There are many things for you to consider.
How physical is your job? If you have a desk job that’s isn’t too physical, you may be able to return after a few weeks. You may still feel tired and concentration may be an issue, so making sure that you plan in plenty of rest around work hours will be crucial.
Obviously if your work is very physical, you will have to make a plan with your doctor and your employers and look at a phased return to work. I think honesty is always the best policy. If you are keen to get back to work, don’t keep your employers in the dark about your physical condition. It’s much better to have them work with you and be supportive whilst you build your strength back up. As no-one will really know for sure how it will take you to regain your strength, I would suggest that you agree to discuss your progress every couple of weeks to decide on the best course of action for you. Always check with your doctor for his or her opinion.
How do you travel to work? I know that some people can feel quite vulnerable on public transport particularly after heart surgery. The fear of getting knocked is very real. Maybe you could change your working hours to avoid the rush hour or do some work from home. Hopefully your employers will be kind, decent and understanding of your situation.
I decided pretty early on that my life was too short to spend it doing things that really worried me, so I simply found other ways of doing things. Therefore not everyone always understands my reasons for travelling ahead somewhere the night before, or only agreeing to be at meetings after the rush hour has passed and many, many other little ways I have of doing things. Look, I can’t begin to guess which situation will make you feel vulnerable, but try to work around them. Sometimes the world has to fit with your schedule and not the other way around!
It may be that you have already retired, or decide not to go back to work. If this is the case, look at your future with bright eyes as this can be a new and exciting phase for you.
One of the most useful bits of advice I can give you is to keep track of your heart with regular ECG readings. I use a KardiaMobile – you can find out more HERE