Mary
Mary has had palpitations for many years caused by a hiatus hernia. A recent episode lasting 5 hours led to hospitalisation. Against her consultant’s wishes, she decided not to have cardioversion. She is currently taking warfarin and beta-blockers.
Mary has had palpitations since her forties and was told these were caused by a hiatus hernia. Palpitations would come on suddenly and her heart would give a jump; in places such as the supermarket and on her way to the airport. Advised not to have an operation to correct her hernia, she decided to just soldier on;, getting rid of occasional palpitations by standing on her head. In recent years, she was prescribed omeprazole tablets for reflux and the palpitations stopped.
Six months ago, however, after eating a few biscuits at 3am to help her sleep, Mary developed palpitations which went on and on and on;. At 7am she rang NHS Direct and was taken to hospital where AF was diagnosed. She remembers being given an injection to stop the palpitations and was advised to have a cardioversion. She declined and was prescribed warfarin and beta-blockers [bisoprolol].
Mary describes taking warfarin as her pet hate; and would prefer instead to take aspirin. Although she recognises that warfarin may help avoid a stroke, she wonders whether she is at increased risk because she has AF. She wishes she knew more. Mary has never attended a warfarin clinic as her local surgery organises regular blood tests to measure her INR levels (the time it takes for blood to clot) and to adjust the dosage of warfarin as necessary. She carries an alert card which she has to show to the chemist when buying products over the counter. She has had to stop taking vitamins such as zinc and ginkgo biloba, and found warfarin incompatible with antibiotics she took for an infection. The prospect of falling and cutting herself while taking warfarin concerns her because of the potential for bleeding.
As well as her dislike for warfarin, Mary has experienced side effects since taking beta-blockers including tiredness, dizzy spells, depression, and a patch of psoriasis on my scalp;. She is annoyed that she has had little say in her treatment and would really like to be in charge of my own body;. Care-wise, Mary is unimpressed: I can’t say I;ve seen that much care;. She describes how the consultant pressured her to have a cardioversion immediately and lost interest when I wasn’t cooperating; warning her that she would have to take more tablets. She felt she was given no explanation about the surgical procedure, knowing only that it involved stopping her heart;. Mary has had no follow-up since her admission to hospital and feels she’s in no man’s land; in terms of who she should turn to for advice. She plans to see her GP and ask for a referral to a cardiologist to have a good examination and find out more about AF;. She has the impression that she is overlooked because she is old.
Mary advises others diagnosed with AF to reduce stress but otherwise not change their lifestyle. She describes AF as just a nuisance; rather than a disease to worry about. A regular traveller to Italy, she is concerned about how her diagnosis will affect her travel insurance. Although she has had no further symptoms, Mary has been warned to call an ambulance in the event of another episode of AF.