Well, in short I've been feeling worse than I expect to for my age for a while now, most worryingly with shortness of breath and increased use of my GTN spray – the one I take when I have chest pain with exercise. Not a lot, maybe 4-6 times in a year, but that compares with none at all since my surgery in 2004 otherwise. And I know better than anyone that while I am pretty strict about saturated fat in my diet most of the time, a lot of the flavours I love are strongly associated with it. My view has been that it takes time for cholesterol to build up in my heart, and as I'm nearly 70 I should balance life-preserving abstinence with life-enhancing moderate use. So I have a little cheese or bacon from time to time, occasionally cook with butter and don't place any restrictions on my host or the chef if I am eating out. But knowing that I am breaking the rules, and have symptoms associated with heart problems, was in itself worrying and stressful. There are other symptoms too, not associated with my heart, and I went to the doctor with a list.
Frankly, he put the majority on the back burner in order to deal with the heart issue first, and the Consultant at Kettering who had seen me before and already had angiography results to look at from 3 years ago, cut out the middle man and sent me for an immediate second go on the table. I was expecting the result to be that I needed a stent to keep one of the cardiac arteries open, maybe more than one. So I wasn't hopeful of a good result.
On top of that one of my friends had a bad experience with the cardiac unit at Kettering, which alarmed me, as my previous time there had been problem free.
So I presented myself and after a waiting period a nurse came to collect me – and Bonnie who was at my side. Let's say straight away that everything was done to put me at my ease. The first nurse I saw, Suzie, was calm, attentive and ready to answer any questions I had, as well as supervising, again very calmly, a student nurse on her first placement. My hands were cold, and my blood vessels none too prominent, and Suzie had a problem getting the cannula into place. So she left me to warm up and get some circulation back into my hands. After a while Eva appeared. Brimming with personality and confidence she dealt with the cannula in one go, supervised the form the student was taking information with, and told me about the other benefits of sedation before the procedure – it opens the arteries a bit and makes the doctor's job easier. An impressive young lady. Now I had to wait my turn.
Eventually Lisa turned up to get me into the lab – someone else who oozed charm and confidence and, ushering me into the lab and onto the table, put me completely at my ease. Everyone was patient and laughed politely when I made my old joke about not minding what I was called so long as it wasn't late for meals. The Registrar, Nancy, checked that I knew what to expect and said she'd tell me what she found, and I asked her to let me know, if she had the opportunity, to clear up the disagreement between Bonnie and me about how many stents had been put in when I had my bypasses. No problem. By the time they got the sedation started I was as relaxed and cheerful as I've been in a long time, totally confident in the expertise of the people around me.
The procedure took about 75 minutes, longer than usual. Lisa said that was because my bypasses made it more difficult. She actually went into more detail than that, but I won't bore you with it. The technician driving the machine – the table and the scanner move like synchronised swimmers to get the angles the doctor wants for the pictures – was tilting the scanner at crazy angles and moving it over my head with only a few millimetres clearance. I thought he was very good. I could hear Nancy talking to him – “Down a bit, can you go back just a fraction, oh yes, that's very good” - then she'd pause for a closer look or move on for another view.
I was aware how incredibly lucky I was. If this technology had been available 30 years ago when my mother died from coronary heart disease she would probably have lived a good while longer. It's amazing that they can inspect the interior state of the arteries supplying oxygen to my heart muscles. My first experience of angiography in 2004 had led directly to the urgent bypass surgery that has so far given me an extra 8 years of life. The two angiographies at Kettering have showed, among other things, that the blockages bypassed then are now closed, which would have killed me had there not been diversions in place.
After the procedure Nancy told me there was something she wanted to discuss with the Consultant, but she could tell me that the bypasses were working fine. Lisa took me back to the ward, and Nancy came along to explain what they'd found. Item one was that the single stent put in by Prof Taggart at Oxford in 2004 was itself blocked. But there is a bypass in place around it which was working perfectly. There seemed to be no change since my angiography 3 years ago, all my bypasses were working as they should, and there is no sign of further damage. But they would be recommending a change in my medication.
Now super-confident, ultra-knowledgeable Dave turned up to deal with the wound in my femoral artery, the access point they'd used to get to my heart, and he had a lot to say about my medication. The new stuff I have been given is supposed to open my arteries and improve the flow of oxygenated blood to my heart. There are two common side-effects I should note – headaches (darn, I get those already) and if I drink alcohol (if? Did he say if?) I may become light-headed. Well, that'll be a change, normally I fall asleep. Okay, seriously, I will have to drink less and be rigid about not driving after drinking. And they're going to do an echo-cardiogram to check for leaky valves, just in case that's what's causing my symptoms. Anyway, it certainly isn't any worsening of my coronary heart disease.
Dave went home leaving me to the gentle and cheerful ministrations of Sadie, at the wrong end of a 12 hour shift, who removed my cannula, organised tea and a sandwich, monitored my blood pressure, kept me comfortable, and was both efficient and friendly before she finally sent me home.
I am very grateful first to the cardiologist at Northampton who, in 2004, passed me over with an urgent tag and to Prof Taggart at the John Radcliffe in Oxford who did an excellent job fixing me up, and second to the staff of the Cardiac Unit and KGH who were superb, both in getting me on the table so quickly after my GP handed me over, and then, on the day, looking after me so well so that what could have been a very unpleasant and stressful experience actually went far better than could have been expected. And, to top it all, good news at the end.
