Patient Journey

Professor Mark E. O'Donnell

DipSEM(GB&I) MB BCH BAO(Dist) MFSEM(UK) MFSEM(RCSI&RCPI) MFSTEd MMedSc(Dist) MD ECFMG RPVI(ARDMS) FCPhleb FRCSEd(Gen&Vasc Surg) FEBVS(Hon)

Patient Journey

Professor O’Donnell believes that communication and its ability to reduce a patient’s stress is absolutely paramount in clinical practice. This part of the web-page describes the complete patient journey from initial referral through to definitive treatment and subsequent follow-up.

Each aspect of the journey is discussed separately and a video presentation has also been included for one of the procedures that Professor O’Donnell performs frequently – Endovenous Radiofrequency Ablation of Varicose Veins.

Professor O’Donnell receives NHS vascular referrals at both the Belfast Health and Social Care Trust and the Western Health and Social Care Trust from throughout Northern Ireland.
Private Healthcare Referrals are received at the Kingsbridge Private Hospital , North West Independent Hospital and The Newry Clinic from patients throughout Northern Ireland and also from the Republic of Ireland for all remits of primary and complex arterial, venous and lymphatic diseases.

Referral to Professor O’Donnell

There are a number of different ways to be referred for a specialist vascular consultation.

Patients may be referred to Professor O’Donnell’s Vascular Clinic after clinical assessment by their General Practitioner. Sometimes the patient attends a different medical specialist that may feel a referral to Professor O’Donnell’s Vascular Clinic is required.

Patients may also Self-Refer by contacting the Kingsbridge Private Hospital , North West Independent Hospital and The Newry Clinic directly using the contact numbers at the bottom of the webpage.

Alternatively, patients can contact Professor O’Donnell directly by either Clicking on Book Consultation or Emailing - info@markodonnellvascularsurgery.com

Initial Consultation

Professor O’Donnell will endeavour to make you feel at ease during your consultation. At this stage, you will be asked about your current symptoms and how they affect you.

It is important to inform Professor O’Donnell about any pre-existing medical conditions you may have or other medical factors you feel may be important during this consultation.

An up-to-date prescription list of all your current medications and allergies is appreciated.

Clinical Assessment

Depending on your clinical complaint, Professor O’Donnell will need to examine the affected area.

Patients with an aortic aneurysm will require an examination of their abdomen, groin pulses and feet.

Patients with varicose veins and peripheral arterial disease will require a full examination of their lower extremities and will need to remove trousers, socks and shoes. Underwear does not need to be removed. A gown will be provided.

The examination may then be completed with you lying on the examination couch, in the standing position or both.

Investigations during your Initial Consultation

Professor O’Donnell believes in a unique treatment plan for each individual patient which is guided by the completion of clinic based investigations during your first consultation.

All aspects of your clinical assessment and diagnosis will be discussed with you during this initial consultation. Professor O’Donnell will advise accordingly if further investigations are then required before a definitive treatment plan can be determined.

Varicose Veins

In patients presenting with varicose veins, a bedside venous duplex is performed. This requires the application of ultrasound gel, similar to a pregnancy scan, and passage of the ultrasound probe over the varicose veins to identify venous anatomy particularly the size of the vein and whether it is incompetent – leaky. This is a painless examination.
 

In certain circumstances, a formal venous duplex is required in the radiology department particularly if you have had previous varicose vein procedures or if you have had a history of a deep venous thrombosis (DVT).

Venous Duplex Examination

Peripheral Arterial Disease

In patients presenting with walking difficulty or other symptoms suggestive of peripheral arterial disease, an ankle-brachial pressure index will be performed.

This is another painless examination which evaluates the measurement of the pressure of blood supplying the lower limbs compared to the upper limbs and provides an indication of disease severity. This requires the application of a blood pressure cuff which is inflated while Professor O’Donnell listens to the audible blood flow signal using an Arterial Doppler.


Ankle-Brachial Pressure Index Evaluation
 






 

Additional Vascular and Radiological Investigations

Aortic Aneurysm

Patients presenting for investigation of an aortic aneurysm will require an abdominal ultrasound. A separate appointment in the radiology department will be required to perform the ultrasound test which Professor O’Donnell will request on your behalf.

If the ultrasound identifies that you have an aortic aneurysm greater than 5.5cm, you will be referred for a CT angiogram scan of your aortic aneurysm. You may require a blood test prior to this scan to evaluate your kidney function and to determine if the CT scan can proceed safely. You may also be asked by the radiology department about some of your medications at this stage particularly if you take metformin for diabetes.

The hospital radiology team members performing the CT angiogram will need to insert an intravenous cannula in one of your arms to facilitate the injection of intravenous contrast which is required to highlight or emphasise the blood flow in the aneurysm during the scan to better evaluate it. The CT scan itself is painless and is performed very quickly.



CT angiogram demonstrating an aortic aneurysm.

Cerebrovascular Disease

Patients presenting for investigation of cerebrovascular disease where they may have had a mini-stroke (TIA) or full stroke will require an ultrasound scan of the neck artery to assess for significant narrowing (stenosis).

Procedural Planning

After your clinical evaluation and completion of subsequent investigations, Professor O’Donnell will discuss your clinical condition with you and will present the available treatment options. If an intervention is recommended, the benefits and risks of the suggested procedure will be discussed as part of the initial Informed Patient Consent process. This is a legal requirement prior to proceeding to the intervention or therapeutic procedure.

Procedural risks for the range of therapeutic interventions that Professor O’Donnell performs can be found on the Treatments section of this web-site .


 

You do not have to commit to any specific procedure at this stage. You can arrange a review appointment to discuss any issues you have prior to committing to any procedure.

At this stage if you are attending as a privately insured patient, you will need to contact your Medical Insurance Company for approval for the required procedure. Once you have approval, please contact the relevant hospital and advise them accordingly. Information regarding Private Medical Insurance can be found on the Consultations section of this website .

Due to the complexity of arterial surgery which is indicated for the prevention of strokes, aortic aneurysm rupture or to improve lower limb blood supply, such procedures or surgeries will be performed in the Royal Victoria Hospital. Clinical care for these procedures will be individualised for each specific patient. Further information for these conditions and procedures is available in the Patient Information section of this web site.

Professor O’Donnell performs all aspects of vein surgery at both the Kingsbridge Private Hospital and North West Independent Hospital . For the rest of this webpage section, Professor O’Donnell will describe the clinical pathway for patients requiring Endovenous Management of Varicose Veins. Clinical pathways may vary for each different condition that Professor O’Donnell treats.

All other aspects of vascular conditions that Professor O’Donnell treats are described in the Treatments section.

Day of Procedure

Once you have been scheduled for your procedure, the relevant hospital will inform you of all required details regarding your attendance.

Local anaesthetic vein procedures do not require a period of fasting. Although you should be able to take all of your normal medications, it is important that you have previously informed Professor O’Donnell and the hospital where you are having the procedure of your current medication prescription particularly blood thinning medications.

General anaesthetic procedures do require a period of fasting. Your surgical and anaesthetic teams will need to review your medications and determine which of your regular medications you should take on the day of your surgery.

Professor O’Donnell will examine you prior to your procedure to address any questions you may have and confirm the specific treatment you will undergo. At this stage, all aspects of the procedure will be discussed and you will be requested to confirm your agreement by signing the consent form.

Specific risks and complications of all procedures are available for review on the Treatments section of the web page. Further information may be obtained from the Patient Information section as well.

Finally your lower extremity varicose veins will be marked. You will be asked to look at the marked areas on your lower limbs to confirm inclusion of all the areas that you wish to have treated.

Endovenous Management of Varicose Veins

Video presentation by Professor O’Donnell describing individualised treatment of varicose veins using endovenous radiofrequency ablation combined with additional adjuncts of injection sclerotherapy and microphlebectomies as required.

Post-Procedural Instructions

Following your procedure, your treated limb will be lavaged. Small paper stitches (steri-strips) and adhesive dressings are applied to your treated lower limb. Compression hosiery (stockings) are then applied to your treated limb which are used to improve your clinical outcome following your intervention. These stockings can be slightly challenging to put on initially due to their snug fit – however this is exactly what we want.

You will then be taken to the recovery area for some light refreshment. At this stage, we will make sure you are fully mobile before your day case discharge.

As discussed during your pre-operative consultation, you will usually leave the hospital completely pain-free as your local anaesthetic is still effective. However, this will wear off approximately 4 to 6 hours following your procedure. Do not wait for the onset of discomfort after the local anaesthetic has worn off completely before you take pain relief medications. Professor O’Donnell advises you to ensure that you take your preferred oral analgesia tablets that work for you with every meal (breakfast, lunch and dinner) and before you go to bed to prevent you getting sore. Please start taking your pain relief with your next meal after your procedure. You should only require oral analgesia four-times a day for approximately 2 to 3 days.

Local anaesthetic will also be used in those patients undergoing operative intervention under general anaesthesia to minimise any discomfort in the immediate time period following your surgery.

The compression hosiery should not be removed for the first 48-hours. After this period, you may remove them for a shower. The steri-strips and dressings often fall off in the shower and this is normal. You then need to immediately re-apply the compression hosiery which is to be worn day and night for one week.

Very occasionally, there may be some ooze from some of the local anaesthetic injection sites in the lower limb. If this occurs, you are advised to sit or lie down, elevate leg and apply pressure to the site of ooze with a wad of tissues for at least 5 minutes. The ooze normally settles.

Patients are advised not to fly;

  • For two weeks after the procedure for short flights up to two hours.
  • For four weeks after the procedure for middle distance flights.
  • For six weeks after the procedure for long haul flights.

Post-Procedural Contact Phone Numbers

If you have an urgent concern or problem relating to your recent procedure, please contact the relevant hospital where you had your procedure completed.

Kingsbridge Private Hospital
Ward 02890 688867 or Main Switchboard 02890 667878

North West Independent Hospital
Main Switchboard 02877 763090

Post-Procedural Follow-Up

A follow-up appointment will then be scheduled for you depending on the specifics of your procedure.

This is particularly important if you have had foam sclerotherapy performed where occasionally aspiration (drainage) of haematoma (old blood) is required from the treated segment using a needle and syringe. This leads to reduced discomfort and an improved clinical outcome. These review appointments are provided earlier approximately two weeks following your procedure.

Other appointments are normally provided between 6 weeks and 12 weeks after your procedure.

Patient Feedback

“I have just completed seven months hospital treatment for a vein bypass in my leg under the direction of Professor Mark O’Donnell. I am now able to walk again as the operation has been a complete success. I cannot express too strongly his professionalism and attention and would like to commend him as a valuable asset to the hospital”
WW October 2017

“With gratitude for your kindness, gentleness, encouragement and medical skills in extending my life. We are forever grateful to you”.
PR October 2017

“I would just like to thank-you for your kindness and professionalism. The operation has greatly transformed my quality of life and now allows me to do many tasks that people take for granted – many thanks”.
JH September 2017

“Thank you for everything you have done for me”.
PM September 2017

“Once again a big thank you. You deserve it after your great work on my leg – it is clearing up fast”.
TS June 2017

“I would like to say a sincere thank you to you and your wonderful team for the excellent work you carried out on my leg – I feel fully recovered and can walk freely with no pain at all thanks to you. I must admit that having read about the angioplasty procedure I was just a little nervous prior to the operation. You had a calming effect on me as it did with the rest of your team”.
JAD February 2017

“All the staff and team, at the vascular clinic, and to the team of Mr O’Donnell, could not have thanked you all from the bottom of our hearts. And especially to Mr O’Donnell, for doing everything and pushing me to get to the end of a long journey. I would of not kept my legs, if it were not for the brilliant surgeons, we have in our N.H.S hospital today. But especially a very big thank you to Mr O’Donnell who has been there at the beginning with me and my wife”.
JW March 2016

“Thank you for all the care and support you have given me. Good cop bad cop obviously works. You are an asset to the East Lancashire Hospitals Trust”.
JM September 2016

“Just a quick email as I want to say a huge thank you for the care and treatment you gave my grandma. You literally are a life saver and I cannot thank you enough for what you have done for her”.
CM April 2016

“I would like to pass on sincere thanks and compliments to the staff on the Surgical Day Unit, Critical Care Unit B and my surgeon Mr O’Donnell, following my recent surgery. I feel I need to write this letter as there are many negative comments and complaints made to and about the NHS and I guess it’s not very often when a written compliment is made”.
KW October 2015

Clinical Practice

Royal Victoria Hospital
Grosvenor Road
Belfast BT12 6BA
Phone: 02890 635936

Kingsbridge Private Hospital
811-815 Lisburn Road,
Belfast BT9 7GX
Phone: 028 9066 7878

NorthWest Independent Hospital
Church Hill House, Main Street
Ballykelly BT49 9HS
Phone: 028 7776 3090

The Newry Clinic
Windsor Avenue
Newry BT34 1EG
Phone: 028 3025 7708

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