How much post ablation support would be reasonable to expect from Dr.Natale's post ablation team

I don't know if I am being unreasonable in my expectations but I had an ablation 7 weeks ago and have had very little follow up, like miniscule even though I have not had a smooth recovery. After two weeks I let them know a few times that I had some discomfort on breathing in which had been going on since I came out of the OR. I eventually was given two weeks worth of colchicine but again no follow up even though with each ECG I sent I told them I was having some discomfort. Yesterday I requested a prescription for propranolol because it works for me, having taken my daughter's out of desperation when I was away and in the mountains having some bad runs of tachycardia and arrhythmias. It worked like a dream. But my nurse told me to ask my family doctor. Am I supposed to go somewhere else post ablation even though I am still in the blanking period and have some side effects caused by the ablation, and I am still under their care? I don't know who to go to to ask for this medication because to see a cardiologist will take months, and i also don't know who to go to to talk about the discomfort I am feeling, I am having trigeminys and bigeminys some days (like today-13 trigeminus in a 30 second run)but the discomfort is in addition to these, more like a pain in the back and lungs that comes when I am stressed/tired or doing cardio. I am in Katy, Texas, so not too far from Austin, so fairly local to Natale, any suggestions? Just fyi I am not on beta blockers on a daily basis but Natale's team did prescribe me bisoprolol pre ablation to take if i needed to, which I did not. TBH my dogs get better after care after a vet visit....

From what I am hearing here the quality of followup care seems to depend on who your nurse navigator is. Mine was super good--I usually had an email answered the next day, and sometimes if I were having a problem, she would answer with a phone call. I could not have hoped for any better care than I received and you are under their care for a year from the date of your ablation. You do have to initiate questions/care though--usually when you send in your weekly Kardia strip. They always promptly send prescriptions like Eliquis, though I didn't need any other scripts from them.

If you want to compare notes on nurse navigators, send me a private message and we can discuss it in more detail.

That is when I send in a weekly update with my ECG reading, but no one seems to be taking any notice. Surely they should be the ones to send in a prescription for a beta blocker, not my family doctor...

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Fuzzyduck
That is when I send in a weekly update with my ECG reading, but no one seems to be taking any notice. Surely they should be the ones to send in a prescription for a beta blocker, not my family doctor...

It would seem that way to me, and your experience is understandable now that you have told me who your nurse navigator is. Maybe you can request reassignment?

Who would I ask? My husband and I are disappointed to be honest

Ok, I have to jump in, too. My post ablation care with Dr. Natale’s staff certainly had its ups and downs especially as I was getting to the end of the time I was assigned to a nurse navigator. I wish someone had told me who to ask for as a nurse navigator. I gave a name to someone who had her ablation there several months ago and she is experiencing wonderful follow-up care. I would guess it is the same person Daisy was assigned to. Hang in there and be persistent! Maybe you could contact Shannon Rose, Dr. Natale’s PA, and see if she would help.

You are paying for care. Care includes both consideration and feedback. Feedback might be as little as 'We got your ECG, will be in touch Tuesday latest.' I would counsel you to give a little jerk on 'someone's leash.

You might be doing many people a great favour by complaining that your post-op care has been less than the least you had expected.

What Daisy said.

I got wonderful follow-up care, but a year later we began to hear a lot of complaints about this. We heard so many, in fact, that we went to Natale about it. He had no idea there were issues, but told us that there had been some turnover in nursing staff and they had lost a couple of key people to retirement. Things started to improve after that, but it took a while. It sounds to me like now one or more less-then-optimal performers have found their way back into the system. I don't think Natale has a lot of hands-on control of that staffing. That's more likely a clinic or nursing manager's job.

I encourage anyone who's experience sub-optimal follow-up care to let Shannon Rose know, as Pixie suggested. They can't fix something they don't know is broken.

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Carey

I encourage anyone who's experience sub-optimal follow-up care to let Shannon Rose know, as Pixie suggested. They can't fix something they don't know is broken.

Thanks Carey, I just wasn’t sure what normal after care is and if it was correct that I shouldn’t ask them for a change in beta blockers, but it seems like I am not being unreasonable in my expectations so I will let Shannon know…

Yeah, it's perfectly reasonable that if they prescribed a med and you want it changed that they should handle it. An email or call to your nurse navigator should get a response within, say, 2 business days. If it's a more urgent issue, it should be 1 business day. If that's not happening, let Shannon know.

Since we are being honest here....I was assigned to Trent...nice guy etc, but I don't feel "the love", if you know what I mean. Kind of a dismissive attitude towards someone who is still experiencing issues after the ablation. It's like as if he does not want to believe it..."oh, maybe you are not hydrating enough..." and other vague one sentences email replies. Not to mention the robotic replies "you have to wait for your 1 yr consult in August". Seriously? What I am supposed to do til then? Finally I demanded to speak to Shannon and she told me to start taking Metoprolol again.

Yeah...not too happy to be honest. I just feel they have way too many patients and are seriously understaffed.

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Carey
Yeah, it's perfectly reasonable that if they prescribed a med and you want it changed that they should handle it. An email or call to your nurse navigator should get a response within, say, 2 business days. If it's a more urgent issue, it should be 1 business day. If that's not happening, let Shannon know.

Oh the response from my navigator was to ask my family doctor or local cardiologist about the prescription and dosing (and conveniently all of the other details about my condition were ignored yet again....)

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WhyMe
Since we are being honest here....I was assigned to Trent...nice guy etc, but I don't feel "the love", if you know what I mean. Kind of a dismissive attitude towards someone who is still experiencing issues after the ablation. It's like as if he does not want to believe it..."oh, maybe you are not hydrating enough..." and other vague one sentences email replies. Not to mention the robotic replies "you have to wait for your 1 yr consult in August". Seriously? What I am supposed to do til then? Finally I demanded to speak to Shannon and she told me to start taking Metoprolol again.

Yeah...not too happy to be honest. I just feel they have way too many patients and are seriously understaffed.

I will privately message you....

How much post ablation support would be reasonable to expec...t

Post ablation -- or anytime -- I think it's reasonable to expect to hear back from a ep nurse or PA within 2 days for routine questions and within a day for something more urgent. I also think it's reasonable to hear back from the ep performing the ablation within that same timeline, if you request or are unhappy with what the nurse tells you, or at a minimum to have the nurse or PA confirm that they spoke to the ep regarding your concern. This was my experience with two high-volume ep's (over 300 a year) at two different top-ten rated cardiac teaching hospitals and in fact, it's their hospital policy. If you're not getting anywhere with the nurse navigator, make a specific request to speak to Dr. Natale as he may be unaware of what is going on below him. And if/when you do speak to him, make him aware of your frustrations. Good luck and sorry you're being put through all this.

Jim

Thanks Jim, perhaps I shall email Dr.Natale, I am now frustrated that I didn't complain sooner because I have felt a bit isolated and in limbo regarding my symptoms, which limit my cardio

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mjamesone
How much post ablation support would be reasonable to expec...t

Post ablation -- or anytime -- I think it's reasonable to expect to hear back from a ep nurse or PA within 2 days for routine questions and within a day for something more urgent. I also think it's reasonable to hear back from the ep performing the ablation within that same timeline, if you request or are unhappy with what the nurse tells you, or at a minimum to have the nurse or PA confirm that they spoke to the ep regarding your concern. This was my experience with two high-volume ep's (over 300 a year) at two different top-ten rated cardiac teaching hospitals and in fact, it's their hospital policy. If you're not getting anywhere with the nurse navigator, make a specific request to speak to Dr. Natale as he may be unaware of what is going on below him. And if/when you do speak to him, make him aware of your frustrations. Good luck and sorry you're being put through all this.

Jim

I don't know how the messaging services work at Natale's office, but I've found that both messages and email's are often screened first by either nurses or others and many times are never routed to the Doctor. What I do is in cases like this is make it very clear in the email or message that I want to speak to the Doctor directly. Either that, or I do the same thing with a phone call and it may take more than one. Some offices unfortunately create a Maginot line between you and the doctor, but once you pierce it, I've found that the doctor(s) are more than forthcoming. If not, then find another ep to manage things from here on out. Lots of good ones.

Jim

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Fuzzyduck
Thanks Jim, perhaps I shall email Dr.Natale, I am now frustrated that I didn't complain sooner because I have felt a bit isolated and in limbo regarding my symptoms, which limit my cardio

Yes, you can feel very isolated if you think that what you have experienced is typical patient care in a practice--it just isn't and as far as I have heard the problem centers around one nurse navigator. I am very glad that you had the courage to bring it up here and discover this and hopefully find a way to make the right person aware of the problem. Dr. Natale really cares about the patient experience and would not find this acceptable.

Did you have your ablation at los Robles in Thousand Oaks? This office has only one NP compared to Austin that has rotated NPs. If you PM me, I can give you Austin’s head NP direct line.

Or why don’t you just email him directly? He is quick in replies. His email is on his business card or you can PM so computer bots don’t spam him since this is a public forum.

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mjamesone
I don't know how the messaging services work at Natale's office, but I've found that both messages and email's are often screened first by either nurses or others and many times are never routed to the Doctor. What I do is in cases like this is make it very clear in the email or message that I want to speak to the Doctor directly. Either that, or I do the same thing with a phone call and it may take more than one. Some offices unfortunately create a Maginot line between you and the doctor, but once you pierce it, I've found that the doctor(s) are more than forthcoming. If not, then find another ep to manage things from here on out. Lots of good ones.

Jim

Thanks Jim, your advice is always helpful. I was considering going to Dr.Wolf’s EP as he referred me to him, but I will try reaching out to Shannon etc first …

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Daisy

Thanks Jim, perhaps I shall email Dr.Natale, I am now frustrated that I didn't complain sooner because I have felt a bit isolated and in limbo regarding my symptoms, which limit my cardio


Yes, you can feel very isolated if you think that what you have experienced is typical patient care in a practice--it just isn't and as far as I have heard the problem centers around one nurse navigator. I am very glad that you had the courage to bring it up here and discover this and hopefully find a way to make the right person aware of the problem. Dr. Natale really cares about the patient experience and would not find this acceptable.

Thank you, I guess I brought it up because I was so shocked about the response I got to my request for Propranolol …



Edited 1 time(s). Last edit at 06/02/2024 01:41PM by Fuzzyduck.

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susan.d
Did you have your ablation at los Robles in Thousand Oaks? This office has only one NP compared to Austin that has rotated NPs. If you PM me, I can give you Austin’s head NP direct line.

Or why don’t you just email him directly? He is quick in replies. His email is on his business card or you can PM so computer bots don’t spam him since this is a public forum.

I had my ablation in Austin but was assigned a nurse navigator who seems to have lost his compass



Edited 1 time(s). Last edit at 06/01/2024 10:21PM by Fuzzyduck.

Check your PM

All this sounds encouraging as I'm having him do my PFA a week from Tuesday. Audrey has been assigned as my nurse navigator...other than being off every Friday she seems reasonably responsive to my emails and calls thus far. We'll see how it works out post-ablation.