Long term care, consultation

Being an Afib newbie, this site has been invaluable. First, it revealed Dr. Natalie as the pre-eminent ablationist (with whom I now have an
appointment !). However it has also made abundantly clear how complex the Afib prognosis is, even after any "successful" ablation. Therefore almost as much as choosing the best ablationist, it seems appropriate to select a Dr. with easy accessibility for consultations or follow ups. So, I am concerned that Dr. Natalie, given how busy he apparently is, may not be very approachable for ongoing advice, discussion, guidance. unfortunately I have quite a lot of experience with cardiologists/EPs being being entirely unresponsive (really unreachable; insulated by a "team" of handlers). I would like to know that the Dr. in charge of my heart is available better than having to make a formal 1/2hr office appointment 3-5 months in advance!. I'd appreciate any good commentary on what follow on care to expect at TCA.

I'm not going to kid you. You're not going to have ready access to Natale for advice, discussion, etc. I think you'll find that's an extremely rare thing these days. In fact, if your EP is readily available to consult with you, that probably means they're not very busy, which isn't a good sign when it comes to ablations. My first EP was like that. I could call or email or set up an appointment within days to speak with him. He also botched three ablations. I'm sure you can guess what I would have traded for less access.

What you will have, however, is a dedicated nurse practitioner assigned to you. You'll have his/her email and direct phone number and can consult with them at any time. They'll be able to answer 90% of your questions directly, and the remaining 10% will require them to consult with him and get back to you. My experience was excellent. If I ever have any sort of arrhythmia problems in the future, I wouldn't consider anyone else regardless of how much time they might have to spend with me.

Having just returned from a one-trip ablation with Dr.Natale on Sunday, I would say that you won’t get lots of face time with Dr. Natale, and you will likely have an unspecified wait time to see him for consultation and any procedure you elect, if my experience was typical.

Thanks to posts I had read on this site, I was very much prepared for any time with him to adhere only very loosely to the scheduled times. No one would describe me as super-laid-back, but I was fine with the wait, truly believing that he wasn’t ordering dessert after lunch or perfecting his golf swing, but working on someone’s heart (and probably someone whose heart needed it badly).

Same for the procedure itself (waiting)... but I was comfortable, spending the time playing cards with my family, reading a good book. I was feeling calm and secure and cared for by the hospital staff, and had expected for there to be delays, so other than being hungrier than I would have liked due to fasting, it was all fine. (Again, I’m not the most laid-back person in the world, so I’m not sure if this was a function of being geographically far away from the stresses of my daily life, or of the friendly positivity and competence of the hospital staff? Maybe both, maybe serendipity.)

Also, Natale is insulated by a team, for sure. Here’s the thing, though: the nurse practitioner spent a long, long time talking to me, looking over my records and results, listening to my “story”, answering questions I had been storing up for months. I never got the sense that she had somewhere else to be, and she KNEW her STUFF. When Dr. Natale came in, after finishing a case, so much of the preliminary stuff was resolved to my satisfaction that it did not feel necessary to go back over much of anything, though I certainly had the opportunity to ask any questions I had.

I did feel that during the consult, and again when I saw the doctor after the procedure, and again when I saw him just prior to discharge, that he was 100% present with my case.

Maybe not what you want to hear? but I did feel the system they have in Austin works well and probably keeps everyone doing what they do best.

Good luck!

Karen



Edited 1 time(s). Last edit at 02/26/2019 10:46PM by kbog.

I agree with both Carey and Kbog. I had a consult/procedure done July of last year. The time I had to spend with Dr Natale was short, however so much was already covered before hand with his staff that the time I did have with him was productive. My afib nurse has been great the entire time since. I have not felt neglected in the least.

I have also maintained contact with my local EP for followup appointments and such.

Agree with the above. This has been said before in other posts over the years, but I have always taken it as a very good indicator of Dr. Natale's excellence is that he seems to attract, select, hire, and retain wonderful staff. The NPs in his office that I've worked with over the years (San Francisco, then San Diego) have been fantastic: smart, highly competent, caring, concerned about you as a person.

Hope this helps.

--Lance