Doctor Feelgood (no I do honestly)


I mentioned in the last posting that I had a stonking tale to tell you about my recent medical condition.  It’s all about how close you might be to meeting your maker.  You probably won’t believe it but I swear it’s the truth.

Regular readers will know about my cancer diagnosis last year which has been life-changing unquestionably but in all reality it wasn’t actually life threatening (well not immediately). Ironically however I have had 3 close shaves with the grim reaper all as a result of treatment for dealing with the cancer. The first time was during the surgery to remove the carcinoma when, probably as a result of an excess of anaesthetic, my heart stopped for almost 5 minutes. Another half minute or so and they’d have been bagging me up. The second incident occurred when I had a bad reaction to the first chemo drug they prescribed for me. It resulted in the same effect as somebody strangling my aorta and needed an emergency visit to my local hospital to get the heart re-balanced. The final time was as a result of my Hickman line, which they’d installed in my chest to assist the delivery of chemo drugs and blood tests, becoming badly infected. The effect was that every time they were inserting drugs or taking blood tests or flushing my tubes (done 4 times a week), the medical staff were actually washing toxins straight into my circulatory system. Or poisoning me in everyday language (unwittingly of course, I’m sure). I ended up with near full-blown sepsis in an isolation room and another spell in hospital till they removed it.

Now I don’t want to sound all woe-is-me about this; I clearly survived and I’m strong as an ox again and can look back on it all with a smile now. The point is that whilst my precious little life wasn’t desperately challenged by the disease, it bloody well was by doctors (albeit trying to make me healthy again). It might sound like I’m being ungrateful but I’m not; I cannot praise the NHS  and its staff too highly for what they’ve done for me. But you do get to realise that doctors and nurses aren’t infallible; in fact they can get things horribly wrong sometimes. I started out on this journey utterly in awe of them and absolutely trusting in their judgements and I’ve ended up challenging them to justify every damn change in procedure, like the worst kind of cynic. But somehow I’ve still maintained great relations with all my consultants and key medical staff.

Anyway there’s more to the story than me becoming a bit wary of medical opinion. You see as a result of the first two incidents above,  I was referred to not one but two cardiologists to try and ascertain whether there was an underlying problem with my heart. The issue was that the incredibly strong chemo drugs could be fatal if my heart couldn’t handle the drugs’ potency. I can’t tell you how many bloody tests I’ve had in the last 9 months to analyse my heart’s condition. I’ve had tilt tests (which is like a medieval torture to actually induce a faint in the poor torturee), stress tests (which involved running on a treadmill for half an hour or until you dropped, whichever came sooner), CT scans, veinal dye tests, blood tests, cardiogram soundings, BP tests etc etc. Because this was all arranged through the NHS, the appointments and subsequent consultations were spread over many many months. In fact I’d kind of forgotten that there was a point to all this as I just seemed to be on a never-ending cycle of testing which is easier to put people through rather than come to some conclusion. There’s me being cynical again.

And then  a few weeks ago C and I were moving home from our lovely apartment to a new place just a few miles away. You all know how stressful moving home can be. Well our day was made a little more difficult because we had to bring the day forward from the Saturday to the Friday to suit the people moving into our apartment. This happened to co-incide with an appointment for my blood tests before my final chemo session on the Monday – a day I had been longing for for months. We had no choice in the matter really and it meant that I had to shoot into Charing Cross Hospital in c London first thing on the Friday morning leaving C and my daughter S (with new baby in tow) to oversee the moving at the apartment and the new place until I got back. Fortunately my oncologist saw me first of all the patients (I do like her) and I was back home before noon and still in time to oversee the removal  of the final load of boxes and things and to deal with the inventory agent etc etc.

I hadn’t been back there 10 minutes when out of the blue I got a call from my cardiologist to say that he’d had the results of the latest scans and he was seriously worried about my condition. Eh? He explained that the scans had shown that I had what appeared to be seriously diseased arteries and that he wanted me to check into my local hospital immediately whilst they monitored my condition over the week-end prior to moving me to a more senior hospital on Monday for an angiogram/possible surgery.  WTF. I’d come close to pegging it because of wrong treatment decisions, now I was in danger from an actual medical condition.  That said, out of all the problems I did have with the chemo etc, the one thing I was unconvinced about was the supposed condition of my heart; I’d never had pains (other than with the initial drug), breathlessness nor any bad feelings throughout my life even when I was playing serious 5 a-side into my 50’s.  So I pushed the doctor to tell me again what had triggered his concerns and it was all down to the latest scans which he said clearly indicated a serious problem. I told him I was literally in the middle of moving house and he nearly had apoplexy himself saying I had not to lift any boxes nor anything heavy which might trigger an attack. You can imagine how I was feeling to get this news. It couldn’t have happened at a worse time and I was literally coming to the end of a long and difficult period of chemo treatment for my cancer  which I so wanted to now put behind me. ‘What’ I asked ‘was I supposed to do about Monday’s final chemo session?’ ‘Postpone it’ he replied matter-of-factly. I told him that I couldn’t just leave my wife and daughter to finish off the move without me, knowing that vital things like the beds and big items of furniture needed re-assembling and dozens of boxes unpacking.  He basically said it was my life in my hands then  – as critical as that. I then said that I’d been in hospital over the week-end before and because no doctors are on duty you’re just left in the hands of the nursing staff taking readings etc. He kind of sympathised with this point but pointed out that I had to be admitted to my local hospital before I could be transferred to a major London hospital for surgery on Monday. We agreed that I should  wait until Sunday afternoon then check into the local hosp; meanwhile he forbade me from doing anything strenuous over the move. We both knew that wasn’t going to be likely.

I went back into the room where my daughter was; she was concerned because she could hear the tone of the conversation and she became seriously worried when I gave her the gist of the doctor’s advice. I resolved to finish off the stuff at the apartment and then we headed off to the new place to catch up with C who was up her neck in boxes and stuff. I told her the news and she was visibly upset too. We both knew that I (well all of us) had been through so much and now it looked like a whole new area of surgery and recovery  and ongoing treatment was on the horizon. Plus my final chemo might be delayed indefinitely. It didn’t seem fair. We had a discussion about going to hospital straight away but C knew I wasn’t going to do that and we got on with the rest of the move as best we could.

The girls and the fellas came over the next day to help us with the big stuff thank goodness and the rest of the week-end was very peculiar. I didn’t fancy another operation given what had happened with the heart arrest the last time and it was hard to forget this. But we had plenty to do and by late afternoon on the Sunday we were 90% sorted and I felt like I could leave C with the place at least looking decent.  We headed off to the hospital where I checked in and said goodbye to C. The nurses monitored me up and I spent the evening being checked on every hour or so. I was in a ward beside a very old guy who had the squits (why does it always happen to  me?) so it was like resting in a latrine. I don’t remember sleeping very well that night.

Next morning I was visited by the doctor team who came en masse to see me. The lead doctor was just a registrar not a consultant so I knew she was just passing on information. She couldn’t show me the evidence of the scans however her advice was highly specific. She maintained that the films showed that I had chronically-diseased arteries and because it looked like 3 of the main ones to the heart were compromised the likely outcome was that it was too unreliable simply to install stents. Her opinion was that I would need  surgery  to the heart. Those were virtually her last words as the ambulance guys arrived to take me off to hospital. I asked where I’d be headed so that I could let my wife know. I was expecting a London hospital. ‘Harefield’ she said ‘it’s the best place to perform the initial angiogram and the subsequent operation’. I had no idea where it was but texted C to say I was en-route and would text her again once I knew for sure what procedures were necessary.  I was concerned by C’s distress over the whole situation. She undertook to let the girls and my family know what was happening. What a bloody continuing nightmare I thought.

I have to tell you that Harefield is a fantastic facility and the staff (5 nurses dedicated to my needs!) were marvellous. I was taken through the angiogram procedure. It was basically the insertion of a camera into a main artery either via the wrist or the groin (grim) under local anaesthetic which would then proceed up to the heart where the main arteries (the fat veiny things in the image above) would be studied to ascertain the extent of the disease and to gauge the necessary remedial procedures – either the insertion of stents or open-heart surgery. The angiogram itself would take around 40 minutes.  Oh lawd.

I went down fairly quickly and spoke to two consultants before I was wheeled in. They both asked a load of questions and neither could believe I wasn’t experiencing pain episodes – they’d never come across arterial disease/blockages without significant discomfort issues. Umm. Anyway I went in and met the specialist who would do the op. I was rooting for a wrist insertion but he immediately asked one of the junior staff to shave me down below as he was going in via my groin. I asked him why and he said that he wanted a good look round as the circumstances were unusual and the groin was preferable in this case. The procedure was uncomfortable but bearable to be honest, except when they pulled the thing out. Then it hurt like hell. The hardest bit was still to come though – would it be stents or surgery? Would my heart hold out? Would they be bagging me for good this time?

The doctor leaned over me and gave me the news; two of the arteries were…. as clean as whistles with no disease whatsoever. The third was slightly furred but no more than he’d expect from someone my age, in fact he said I had the heart of a man half my age. Wey hey. I asked if I’d need stent surgery on the mildly furred artery and he said no, it could be managed easily with a daily aspirin and statin pill. He could see I was delighted with the news but he had some critical comments on the reasons why I had been referred for the treatment. I couldn’t agree more. They kept me in recovery for a good 20 minutes explaining that the camera had been inserted into the femeral artery which was the ‘big bleeder’. There was a small stitch and plug in the groin area which would be in place for around 90 days but I had to be careful not to overly exert as a popped stitch would result in me bleeding out within minutes. Blimey. I went back to the ward where the nurses were surprised that I’d had no further surgery too. They watched me for another hour or so before saying I could go back to my local hospital. The ambulance guys arrived and took me off.

I’d called C to give her the news and of course she was just so relieved and delighted. I said I was similarly over the moon with the outcome but not a little annoyed that I had to go through all this unnecessarily. C and the girls met me at the hosp and there was some joy as you can imagine. I was received by a very young doctor who couldn’t quite believe the saga. They were going to monitor me all up again when I asked her ‘Look, I’ve been given a massive clean bill of health by the country’s best heart doctors, couldn’t I just go home now?’ She readily agreed and got me discharged without delay.

There’s a bit of a post-script to this story. I received a copy of the letter the consultant who’d referred me sent to my oncologist to explain the episode. He referred to the diagnosis as a slight ‘over-calling’ and to some small ‘inconvenience’ I may have endured as a result. Inconvenience? I’d just had the shit scared out of me and had to have a camera stuck up through my groin and up into my heart. I saw him just a week or so later. We had a full and frank conversation as they say, in fact the air was blue. He knew I was seriously upset, not at the outcome – after all I’d just had a thorough  MOT and come away with a brilliant all-clear certificate – but at the major misdiagnosis and the unnecessary stress it had put me and my family through. He did apologise but said that it was a valid call as the scan showed something on the artery walls that 99 times out of 100 caused serious disease/furring on the inside. I was just a very lucky 1%er. I think he was tempted to use another word for 1%. Somehow with my bruised groin I didn’t feel so lucky but secretly I was of course.

We actually parted on good terms as he offered me some excellent advice on how to manage the statin intake going forward through regular blood tests at my GPs and what signs to watch for. He also said that he would ensure that advice given to cardiac patients is less absolute going forward (bearing in mind the advice I was given that I could almost certainly look forward to heart surgery). So I’ve had a part to play in hospital procedures being tightened up. You see, it does pay to be cynical and challenging at times. I’ve also had another letter from him to my GP which goes in to some detail about the whole procedure (3 pages of it) and is more mindful of my reaction to the diagnosis and the invasive surgery. He even called one week-end to discuss certain aspects and to say that he’s likely to use the case in teaching courses. Blimey. At this rate we’ll be having drinks next.

So there it is folks. My heart looks to be alright after all though I could have done without all the heartache finding out.

This could well be the last medical bulletin on my condition – new postings will be all light and achingly amusing… to match my personality, ha!

pp

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About Paul

Having decided on a change of life by moving home from the UK to Italy, this is the story and thoughts of a man on a personal journey from the Blackpool Tower to the Leaning Tower of Pisa, in search of la dolce vita. After several olive harvests he's now back in London but en route he shares his very personal perspectives on life.

2 thoughts on “Doctor Feelgood (no I do honestly)

  1. Hey P, I wished my heart piccys looked as good as yours. Welcome to the angiogram club. I have had two now, one in the groin and one in the wrist, the groin was a bleeder when the tourniquet was removed and the wrist hurt like hell so either way it’s a pain. Stents went in through the groin. After what you have been through we are so pleased that you didn’t need treatment.
    A great post, thanks.
    J and C.

  2. Hi John
    Gosh once was enough for me mate. I never realised you’d been through all this – and come through the other side looking as cool as Daniel Craig. It’s a bugger this getting old lark isn’t it? Stay well J and love to C
    pp

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