FAQ’S

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Am I entitled to free NHS prescriptions?

The prescription charge in England is currently £7.65 (April 2012). For residents of Scotland, Wales and Northern Ireland there is no charge for prescriptions.

Make sure you don’t pay for your prescriptions, if you don’t have to. You can obtain free prescriptions if you are under-16, pregnant, over 60, a student in full time education under 19, or receive certain benefits or tax credits.

You can also obtain medical exemption if you have any of the following:

a ‘continuing physical disability which means the person cannot go out without the help of another person’. This is non-specific and can cover a number of conditions not shown below. However temporary disabilities do not count even if they last for several months

a permanent fistula (for example caecostomy, colostomy, laryngostomy or ileostomy) requiring continuous surgical dressing or requiring an applicance

forms of hypoadrenalism (for example Addison’s disease) for which specific subsitution therapy is essential

diabetes insipidus or other forms of hypopituitarism

diabetes mellitus except where treatment is by diet alone

hypoparathyroidism (underactive thyroid)

myasthenia gravis

myxoedema

epilepsy requiring continuous anticonvulsive therapy

You will need to complete a medical exemption application form FP92A, available from your GP surgery which needs to be signed by the doctor.

If you do have to pay for prescriptions and have more than one prescription per month it’s probably worth buying a pre-payment certificate:

three months £29.10

year £104.00 (you can pay for the year’s certificate by 10 monthly Direct Debit instalments).

You can obtain a pre-payment certificate from the NHS Business Services Authority website or by calling 0845 850 0030.

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I am struggling to find an insurer who will offer me life or critical illness cover. Do you know of any insurers?

Our insurance broker, Redwood Business, may be able to assist you. Please email admin@thesf.org.uk or call 01473 252007 to ask for a Life Insurance referral form.

I have a pacemaker, is it safe to live near a pylon?

The Medicines and Healthcare Products Regulatory Authority (MHRA) deal with issues where medical devices, such as pacemakers, go wrong and decide if any action should be taken. They have provided the following information:

“There is a small, theoretical risk of interference between pacemakers and high voltage power lines. Manufacturers of pacemakers give general cautions about pacemaker patients spending extended times under overhead high voltage power transmission lines where the lines carry more than 100,000 volts. (These are the high voltage lines between pylons, which deliver energy to substations etc and are not to be confused with the lower voltage distribution system which delivers power to homes etc).

This caution is due to fact that pacemakers are designed to sense the electrical activity of the heart – whether it is beating properly, and adjust the heart rate in response to what is sensed. Since high voltage power transmission lines also produce electric and magnetic fields there is a theoretical risk that a pacemaker may sense these fields and mistake them for a heart signal which could effect on how the pacemaker responds. However, knowing that such interference signals exist pacemaker manufacturers have included filtering systems in their designs to negate as far as possible interference signals in the low frequency region (e.g. 50Hz).

Although the risk is theoretical, we are not aware of any confirmed reports where patients have been directly affected. It is difficult for manufacturers to give detailed guidance in this area, because although fields from high voltage transmission lines can be present a few feet from the ground, in practice the surrounding body tissue and depth of implant etc lessen the effect on the pacemaker. Some types of heart leads (bipolar) also reduce the effect of a potentially interfering signal.

It would seem appropriate to be guided by the advice from manufacturers and not spend long periods directly under the lines. Walking/driving underneath, or living nearby, is unlikely to cause a problem. For specific guidance pacemaker patients (particularly those who work with high voltage power lines) should seek advice from their pacemaker follow-up clinic since they would be fully aware of the patient’s heart condition and how the pacemaker has been programmed, and can liaise with the manufacturer concerned if there is any doubt.”

Medtronic & Vitatron UK (a pacemaker supplier) states:

“These will present very little risk to a pacemaker patient, at normal distances. I would advise against standing within 5 meters of the pylon, although in my experience, you would not be allowed to get that close anyway.”

You may also find the following information useful:

Pacemaker information: British Heart Foundation

Electric And Magnetic Fields And Your Health

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How long is it best to wait before going on holiday after surgery?

Taking time to relax and rejuvenate after surgery is important, however if you are planning a holiday or wish to travel abroad soon after, it is critical that you check with your cardiac nurse or cardiologist before you contact your travel agent in case there are limitations. Recovery times differ among patients depending on the type of surgery you have had.

For tips on travelling abroad as a GUCH patient, please read advice sheet

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I have regular liver function blood tests done, but am concerned about getting Liver damage due to medication. Is there anything I can do to ensure I keep my liver in as tip top condition as possible?

Some cardiac medications can cause problems with the liver. The commonest drug that is used in GUCH patients that can cause liver problems is Amiodarone, a powerful drug used to treat heart rhythm problems. If you take amiodarone you should have blood tests to check liver (and thyroid function) at six monthly intervals. Some GUCH patients may take Bosentan or Sitaxsentan for high blood pressure in the lungs. Again these drugs are known to cause liver problems and all patients who are on these drugs should be having regular blood tests to check on this. Most of the other drugs that are used commonly aren’t particularly problematic. From the patients point of view, the best things to do to keep the liver in good condition are to avoid excessive amounts of alcohol, and to eat a healthy diet.

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Is there anyone out there that is taking diuretics/water tablets has weak nails?I have incredibly weak nails.

Diuretics/water tablets are not commonly associated with weak or brittle nails, although that’s not to say it could never happen. A healthy diet may help.

General Information: Eating a balanced diet and possibly taking a multi-vitamin may help as nail weakness can be caused by zinc, iron or calcium. Never use a metal nail file, if you use nail polish use a light shade as it will make your nails look longer. Massaging almond oil into the cuticle may help strengthen your nails. Avoid prolonged contact with water – use rubber gloves for washing up, use a nourishing hand cream. Try not to file your nails before they reach ¼ inch long as filing can cause damage and only file in one direction.

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What should I know about pregnancy and birth control?

Young women with congenital heart defects often have special concerns when they think about having a baby. Two of the most commonly asked questions are: “Is my heart strong enough for a pregnancy?” and “Will my baby have a heart problem?”

Most women who have had successful heart surgery can have a normal pregnancy and delivery. If you are a woman with a very severe heart problem, pregnancy may be dangerous to both you and your child. It is very important that you consult with your cardiologist before attempting to become pregnant.

A pregnant woman should follow a nutritious diet and have regular, medically supervised prenatal care. Smoking, using street drugs, and drinking alcohol must be avoided. She should also have her doctor approve any medicine she uses.

It is also important for women and couples to consider carefully what they choose to use for birth control. Some women should avoid the ‘pill’ and use other forms of birth control instead. Your cardiologist can give you advice about selecting the correct contraceptive method.

You can find out more information about GUCH and Pregnancy here.

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How does a “normal” heart work?

Dark blood, low in oxygen, flows through veins to the heart and enters the right atrium. It passes through the tricuspid valve into the right ventricle. The right ventricle pumps the blood under low pressure through the pulmonary valve into the pulmonary artery. The pulmonary artery branches into the left and right pulmonary arteries which lead to the lungs. The lungs provide fresh oxygen to the circulating blood.

Blood returns to the heart from the lungs by the left and right pulmonary veins. It is now bright red as it enters the left atrium. From there it flows through the mitral valve and enters the left ventricle. This strong chamber pumps the red oxygen-rich blood out through the aortic valve into the aorta. The aorta takes blood to the body’s general circulation. The blood pressure in the left ventricle is the same as the blood pressure measured in your arm.

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Should I limit my physical activity?

Most people with a congenital heart defect can be fully active. They do not need restrictions. You are encouraged to participate in physical activities that help keep your heart fit and that you can enjoy for a lifetime. Such healthful activities include swimming, bicycling, tennis, and low-impact aerobics. In a few specific heart conditions, your cardiologist may advise you against some intense physical activities such as competitive or contact sports.

Visit our Physical Health section for more information.

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