From open-heart surgery to the open road – a patient’s story

“I’ve been very fortunate to have been reasonably fit my whole life. My wife and I are keen regular walkers, and although our cycling holidays with our daughters are some ways in the past now, I still use my bike as a fair-weather cyclist when I can.”

However, when he was on holiday in France last year, Roy noticed his heartbeat was occasionally irregular.

“It was beating in twos and threes at times. Other than that, I was completely symptomless. But having scraped my leg in a minor fall I needed help from the GP surgery to bandage it and mentioned the irregular heartbeat to the Physician Assistant (PA).”

The PA arranged for an electrocardiogram (ECG), a simple test which records the electrical activity of the heart to assess the rate and rhythm. An abnormality was detected which required further exploration.

“I am very lucky to have private medical insurance and was able to be seen by a cardiologist soon after the ECG.”

“Even at that stage, I was without symptoms. Exactly four weeks before the operation I was walking up steep hills in Derbyshire with our grandchildren, with no adverse reactions at all.”

Diagnosis

Consultant Cardiac Surgeon Mr John Yap, advised Roy to undergo, an open-heart procedure to correct an ascending aortic aneurysm.

“The diagnosis process proceeded with increasing urgency which suggested a serious conclusion. Mr Yap told me after the surgery that the blood vessel had been in a poor state. At a consultation shortly before the surgery, in answer to our questions he had discussed with us in some detail what might be required.

“The urgent need for such a procedure was a shock to me and my family, but the fact that we were able to follow it up quickly, the opportunity to discuss it with those who could treat me, and their evident expertise and confidence were enormously reassuring.”

Although the news came as a shock, the team at Nuffield Health at St Bartholomew’s Hospital helped Roy feel fully prepared for his surgery.

Heart surgery

Roy underwent his surgery at Nuffield Health at St Bartholomew’s Hospital in November 2023. He was admitted to the intensive care unit following surgery so that his recovery and progress could be closely monitored.

Nuffield Health at St Bartholomew’s Hospital’s Critical Care Unit is staffed by specialists in cardiac intensive care medicine. This means they can support high risk patients as well as carry out complex heart surgery.

“Immediately after the operation, I was not aware of how long I had been under anaesthetic. I was probably sleeping for about 14 hours, with close attention from the nursing staff and others who were always immediately available.”

Mr Yap, his consultant, also visited Roy to reassure him that the surgery had gone well.

Making an active recovery from heart surgery

“I was amazed how quickly after the operation the emphasis moved to helping me to make an active recovery.”

The nursing staff showed Roy how to get mobile again starting with moving from his bed to sit in a chair, and then to stand on his own. Although this made him realise how weak he felt, it wasn’t long before he was encouraged to take brief walks in the corridor (initially accompanied by a physiotherapist) and, to prepare him for his return home, to start to practise using stairs.

“I was well aware that it was a major operation, but the full explanation of everything that was being done for me, and the readiness of everybody to answer my questions was immensely reassuring. So was their explanation of the progress they could expect me to make, and of course the contribution I would have to make to assist my recovery.”

“All those I met, from the nurses I saw every day and night to the most senior doctors, were supportive, encouraging people with a confident pride in their expertise. They were a cheerful bunch who gave every impression of enjoying the jobs they were doing. That applied equally to the non-medical staff, who were enthusiastic and helpful members of the team.”

Post-surgery

Roy had been provided with introductory material about what to expect before and after the operation. This meant he understood that post operative recovery would not be in a straight line: there would be good days and bad days. He understood that it would do him no good to push too hard. He felt it was equally clear that with the support of the staff, during and beyond his stay in the hospital, the best possible recovery in his case was down to him.

“The physiotherapists who saw me after the operation showed me simple exercises that I could begin immediately and continue at home. I continued them every day on going home and was able soon afterwards to start very short walks in the open air, with a small increase in distance every few days as increases in energy levels became apparent.”

Although continuing physiotherapy and exercise support is available at Barts, Roy lives too far from London to make regular trips and there are no equivalent facilities near his home.

However, Helen Alexander, Physiotherapy Manager, at the Physiotherapy Department at Barts directed him towards online YouTube exercises provided by the British Heart Foundation (BHF) for the benefit of those recovering from cardiac surgery.

Helen explains: “Roy lives some distance from our hospital so was unable to attend our cardiac rehabilitation programme. We did however feel he would benefit from a structured graduated approach to regaining his physical fitness.

“The BHF videos include warm-up and cool-down sections to enable participants to safely prepare for and recover from the main conditioning part of the exercise sessions. As there are different levels, participants can find the level that suits their current fitness and progress to higher levels as their fitness improves. It is great to hear Roy has regained fitness and confidence and is back to doing what is important to him.”

On Helen’s advice, Roy has been building up his exercises at home via the virtual physio classes provided by the British Heart Foundation.

“I started them about three weeks after I left the hospital, on alternate days with one walk every day.

“A week or two later I often added a second walk on the non-YouTube days. My wife and I quickly found that cardiac rehab is almost a full-time job. But for both of us, our daily walks and the video exercises with their choices gradually to increase their vigour provided encouraging monitors of improvement.”

Going for walks post surgery

Four weeks after the operation, Roy was back to see Mr Yap who was glad to see that Roy’s daily walks with his wife had extended to a distance of two miles.

“You can feel you're making progress and that's extremely important for morale. No doubt the rate of progress, and the recommended exercise regime, will differ from patient to patient.

“All the material available to me from Nuffield Health and the British Heart Foundation was clearly adaptable in that way. It was cleverly geared to encouraging each patient to find his or her own way back along the long and sometimes winding path from the inevitable after-effects of the operation to their attainable level of health.”

Following Roy’s successful recovery, he was discharged from the care of Mr Yap.

“I am so grateful for how it all went and count myself fortunate to have had such excellent treatment and skills applied to me. I have been signed off by John Yap, who told me to get on with normal life – and encouraged me to get back on my bike quite soon when the weather was warmer!”

Disclaimer

We are very grateful to Roy and Nuffield Health – one of the 600+ hospitals we collect data from – for allowing us to share this story to help other patients better understand what it can be like to be a private patient.

PHIN only provides information, we do not recommend individual hospitals, consultants or funding methods, and recommend you make sure you look into all your options before making your healthcare decisions.

Some patients will base their choice on the price (if they are self-pay) of the procedure, others will follow the recommendations of their private medical insurer. Other patients will focus on the consultant’s experience or something about the hospital, such as its regulator rating or location and facilities.