I Need a CABG!?!: One Patient’s Experience

1. I Need a CABG!?!:One Patient’s Experience Camille Haddad MD Dawn Haddad RN BN MN

2. What if your patient is a Healthcare provider? • Should that change anything?

3. History • Had a MI age 38 - angioplasty - started aspirin and statins • Family History – 2 uncles – sudden cardiac death - several cousins – angioplasty /CABG in their 40’s and 50’s - It is not “ if ” but “ when”

4. What happened after my MI? • Medications • Lifestyle • Stress – work

5. How I ended up back in Saint John • July 2009 – Chest heaviness while walking exercising (post flu) • Continued for 2-3 days • Positive Stress Test • Wait listed for Elective Cardiac Catheterization

6. Waiting for Call Asked to be put on a cancellation list

7. Day of Catheterization • Informed of what to expect and timelines • Consecutive appointments that flowed from one area to the next • Everything went like clock work

8. Nearing the end of the Cardiac Catheterization • Interventionist : “ I’m almost done” • My response: “You didn’t put a stent in” • His response: Too difficult to stent” • My response: “You’re talking surgery aren’t you!? • “ YES, it is your BEST option

9. COLD SWEAT SURREAL FEELING

10. Waiting for Surgery • Went home to wait for call from Heart Centre and the surgeon

11. Patient Teaching • Pre-operative session - you are a patient not a physician • Patient Education session - very helpful - don’t assume Health Care Professionals know everything

12. Important point to remember: • Treat each patient the same regardless of who they are and how much you think they know • When we skip steps that is when we open ourselves to possible errors

13. The morning of the surgery • A 45 minute shaving session

14. Include the family • Meanwhile we can’t forget the family as they are getting ready too • How do we prepare them? • Waiting Time • Keeping them informed • Remember you are their advocate

15. Visiting Hours • Family want to be close • Advocate for family – remind them they need their rest as they will be the caregivers at home • Do they have questions? • Let them know they can call and check • Family need to feel confident their loved ones are being cared for when they leave

16. Care was amazing • Teamwork/collaboration was evident • Some nurses didn’t know I was a physician • Don’t be afraid to stand your ground • Embarrassing moments • Dignity and Respect

17. When can I go Home? • 100 yards and walk up 3 steps - Easier said than done

18. Going Home takes planning • Don’t want to assume HCP know everything • Telehealth Home Unit • Getting out of bed, opening the fridge, milk containers, • It did help to have a nurse at home

19. Has our experienced impacted our interactions with our patients?

20. Key Take Home Points • Remember not to deviate from your process- treat everyone the same • Never assume health care professionals know everything • Try to anticipate questions where possible • Have written materials available • Teamwork and collaboration is key

21. Key Take Home Points Most importantly: • Maintain a patient and family centered approach to health care delivery

22. Questions