Medical services on board

I posted in another thread that we may need to cancel our 15 day Hawaii cruise on the Grand this November due to my husband having a heart issue. Basically his heart was misfiring causing it going in SVT a high heart rate. He stayed at 230 beats per minute on June 14th for two hours. The meds at the hospital didn't work so they shocked him. The cardiologist said it was a misfire of the electrical system of the heart and he would need to have a heart study to see where it is misfiring and have a heart ablation to stop the arrhythmia. They set us for August. Well he had another episode on July 7th and had to be shocked again. Well they got us in for the heart study and ablation procedure yesterday. Sadly the cardiologist could not get it to go into the high heart rate, despite him being aggressive to get it to trigger. So the cardiologist said he will put him on meds that will keep his heart rate in the right rhythm. He sees the cardiologist for a follow up next week. So now we aren't sure if we should go on this cruise.

If by chance his heart goes into the high rhythm does the ship have the right tools to bring his heart rate down? The cardiologist does not feel it should happen with the meds, but I'm not so sure. If this happened at sea I think they would end up flying him off the ship. The cardiologist said not to cancel the cruise yet. He says to give the meds a chance to work. He feels my husband more than likely won't have another episode. But since it wasn't found in the study i am not so sure.

My husband does not want to stop living his life. All this is new to us. My husband is 52 and never had any heart problems.

Sorry for the long thread.

If his cardiologist says go then go. Make sure that you have insurance just in case.

A friend of mine had an episode such as you describe and they did treat on ship to control the condition, though he did have to leave at the next port. On ship treatment was expensive. Thus the need for insurance.

You have 3 months to check out if the meds work prior to the cruise. So you can always cancel later with a statement from the doctor, provided you have insurance.

OP, no offense intended, I know that you posted about this before, but, I would be talking to the doctors that are treating your husband rather than relying on CC for medical answers. Everyone's situation is different when it comes to specific medical issues. Please go with the doctor's recommendations. And talk to all of them who are involved with the situation.

Here's hoping your husband's condition is controlled and he has a long life.

If his cardiologist says go then go. Make sure that you have insurance just in case.

 

A friend of mine had an episode such as you describe and they did treat on ship to control the condition, though he did have to leave at the next port. On ship treatment was expensive. Thus the need for insurance.

 

You have 3 months to check out if the meds work prior to the cruise. So you can always cancel later with a statement from the doctor, provided you have insurance.

I have a heart condition too, controlled by meds. Go! I know if I lived by my fears I would neither fly nor leave my house. I have a 32 days cruise later this year. I'm going!

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The medical center is limited in what they can or will treat onboard.

For something serious like this (if there is an episode) they will stabilize and most likely medically disembark the passenger as soon as possible so as not to be caught at sea/between ports with a situation that could be dire/devastating.

I do say if the doctor says he is ok then go. Life is short.

They would certainly have the equipment and medications to do a cardioversion on an anticoagulated patient. The question would be their willingness and scope of practice. As scary as it seems, AEDs are surprisingly easy to use and no longer depend on clinician skill.

Two thoughts: one, I cruise with someone with SVT (not even 40 yet) who is controlled on medication and he doesn't think twice about it. So the meds do work and he has no issues getting on sailings where it's three sea days in a row.

Second, you might be able to set up a peer conversation between the fleet medical department and your husband's cardiologist. This might clarify their capabilities.

I hate to be a wet blanket/nay-sayer, but.....on the 15 day Hawaii cruise you will have 5 straight sea days going & the same on the return. Air evacuation may not be possible mid-way thru the sea days -- too far for the helicopter to fly.

I hope I'm wrong on this, but please check w/Princess AND your doctor.

Good luck!

If you have a travel insurance and medical evacuation coverage, I would trust and follow my cardiologist's advice to be optimistic and not cancel yet.,

As others have said, listen to the cardiologist. I had my AFib last July at 54 years old. My cardiologist originally cleared me for our cruise in August. But then when my meds did not seem to work well enough, we ended up having to cancel it so they could move up the ablation procedure. After the procedure, they cleared me to cruise again in December. We went in February as well and are going again in four weeks. Thankfully, I haven't had an episode since the procedure.

I have a friend who had to have the ablation repeated. He's doing great after the second procedure. Good luck to your husband.

If by chance his heart goes into the high rhythm does the ship have the right tools to bring his heart rate down?

One thing to consider -- even if the ship's doctor can provide perfect treatment, he might disembark you

after an incident, if he considers it too much risk to have you continue. Certainly an element of 'too much risk'

is a lot of sea days.

I was on emerald leaving from texas, and 2-3 hours into the cruise, we had to turn back and disembark

a sick passenger in Galveston.

The doctor was our table host at the MTP lunch, and he gave a few generalities about what had happened.

The issue was that the passenger was at risk for the upcoming sea days, and the the hospitals in the

next port might not be able to handle his condition.

So, not only does it matter how sick you are at the moment, but the ship's doctors assessment of

the upcoming risk is very important.

If I were in this situation, I would do a land vacation, rather than something with 5 sea days.

The physicians and medical staff onboard are required to have certifications in ACLS (Advanced Cardia Life Support) in order to be permitted to work in the medical center on Princess ships, according to the nurses I spoke with in the medical center. As a retired RN who worked with cardiac patients, I have made it a point to meet and chat with several nurses and EMTs that were employed on some of the Princess ships I have cruised on, because I wanted to know what working onboard is like and what qualifications they have to have to work there. I know from personal experience that attaining ACLS certification is not easy because a lot of specialized knowledge is necessary.

So the medical staff should be capable of handling even pretty serious medical events in the medical center, at least enough to stabilize most patients until the ship gets close enough to land that they can be evacuated to landside hospitals.

That being said, IMO, OP should do what makes her and her husband the most comfortable when it comes to them deciding whether or not to cancel. If you choose to keep the booking and end up going, will you spend most of the cruise worrying about whether he is going to have another episode? If so, how enjoyable would that cruise be for either of you?

You might want to talk to your cardiologist about a pacemaker

Thank you all. We are waiting on the follow up, but after the procedure, the cardiologist seems confident the meds will work. We have until September to decide so we are in a wait and see plan right now.

OP, no offense intended, I know that you posted about this before, but, I would be talking to the doctors that are treating your husband rather than relying on CC for medical answers. Everyone's situation is different when it comes to specific medical issues. Please go with the doctor's recommendations. And talk to all of them who are involved with the situation.

 

Here's hoping your husband's condition is controlled and he has a long life.

We are talking with the cardiologist. He says don't cancel right now. He wants see the meds do its job.

I think I'm just concerned because we thought the ablation would be the fix, but since his heart did not go into SVT we are where we were when he had his first episode.

First, I think it is up to your husband to determine if he is confident and comfortable being on a cruise with so many sea days in a row. There is no air evacuation in an emergency, in the midst of the sea days, due to the distances involved, only what can be done on board, which is quite a lot, but not "everything". Second, make sure the cardiologist completely understands the length of sea days involved, and the fact that air evac cannot really happen. If they both say it is a go knowing these facts, enjoy your cruise. It is one of our favs, due in part to the long, relaxing stretch of sea days, couple that with beautiful islands, and we just love it. All the best.

Keep in mind also, if the ship does have to return to port for you, or divert to another port and change their schedule, it will not only be a problem for you, for an inconvenience for all the other passengers on the ship.

I can tell you as a nurse on cruise ships ( not princess) that yes,you can be treated onboard, as above you will not be airlifted if it is too far for the coastguard to fly and the cost of onboard treatment is very expensive. More than likely you will be disembarked at the next appropriate port. You would also have to consider if your insurance will cover you for pre-existing conditions

Terry

My mom had an Afib episode two months before a cruise and was hospitalized for three days, and we thought we'd have to cancel. The cardiologist was adamant that we should not cancel right away and wait to see if the meds would control it. Ultimately, she was given the okay to go.

She actually didn't want to go until the doctors encouraged her to go, then she felt much better about it.

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First, I think it is up to your husband to determine if he is confident and comfortable being on a cruise with so many sea days in a row. There is no air evacuation in an emergency, in the midst of the sea days, due to the distances involved, only what can be done on board, which is quite a lot, but not "everything". Second, make sure the cardiologist completely understands the length of sea days involved, and the fact that air evac cannot really happen. If they both say it is a go knowing these facts, enjoy your cruise. It is one of our favs, due in part to the long, relaxing stretch of sea days, couple that with beautiful islands, and we just love it. All the best.

+1

I know with all those days at sea, there and back, I would not be going. There are way too many variations in lifestyle and behaviors that people who are on a cruise have to consider. I just know if it were me or my DH, I would reschedule until definitive treatment has been provided. I believe a Pacific Coastal would be a safer choice. I am not trying to be a wet blanket and do hope that if you decide to go, you enjoy your cruise but only after discussing the absence of emergency rescue at sea with your physician.

Make sure you get a written statement from your doctor that your husband is fit to travel. We had one when my elderly husband required medical care on the ship and in Tahiti. My medical insurance covered all of the medical costs. That was 15 years ago, so things could have changed, but does not hurt to have the statement.

As someone who has been there done that I will relate my experience and re iterate to listen to his doctor (cardiologist).

When you fill out your personalizer there is a medical section with information for the doctor to fill out.

The medical team actually had a phone conversation with my doctor and after this conversation everyone was comfortable with me traveling safely. After this conversation and knowing what is available we also got the clearance from both the Princess medical team and my doctor to plan a Transatlantic for next year.

I know you both have a lot looming ahead of you and the unknown can be fearful but when you are on the other side it will be easier.

52 is way to young to let fear ruin you lives.

Sending healing and calming thoughts your way.

Just adding......

Our friend had an unexpected problem while cruising on Princess.

She was given great care in the ship's med area until she could be airlifted at our next port. Happily, full recovery for her.

You might want to talk to your cardiologist about a pacemaker

If I had to come to cruise critic and get treatment advice to pass along to my cardiologist...

...I'd be looking for a new cardiologist!

If your doctor says ok to go, I don't see why its an issue other than personal level of comfort. At a minimum get a document from the cardiologist outlining the situation and what the treatment is that you can give to the doctor onboard if needed. To feel really comfortable, contact Princess medical in advance and verify they can perform the necessary steps onboard.

As previously mentioned be sure to have trip insurance with emergency evacuation coverage. If your MD clears him knowing you will be at sea for 4-5 days away from a port that has up to date medical facilities then just decide where your comfort level is. I don't want to be away knowing I'd be worried.

As for invasive Rx. like a pacemaker or really an AICD or internal defibrillator as also suggested that's really up to you and your MD. Any competent cardiologist would know when it's time to try that.

Good luck.