the angiogram

21. 01. 2009 at 15:36

An angiogram is a way to determine the condition of the  arteries in  the heart. The doctor puts a catheter (fine hollow tube) into your artery from your groin region and feeds it up to the heart and then pumps dye into the heart so that any artery blockages or problems show up on xray.
You are told that there’s a 1 in 1000 chance of death or a stroke and sign a consent form. I had a certain amount of concern over this element, but not of the procedure itself.

I arrived at the hospital at 8:00 am on Christmas Eve. The ward was quiet, just three patients having the treatment. I was second in line. It’s a very smooth process. They can perform 12 per day in this hospital. You are told in advance to shave the left and right of your groin area. I looked up on the net to see if I could see where the insertion was made so I could determine where exactly to shave.

A photograph of the bruise from the Angiogram

A photograph of the bruise from the Angiogram

I couldn’t find anything so for anyone about to proceed with this treatment, you just need a clear area around the crease of your inner thigh – see pic (area highlighted by red frame is where you need to shave -on both sides)). Hopefully this will reassure you.

The photo also shows the bruise caused by the process taken one week later. Now as I write this, I just have a very faint outline of that bruise. (Edit it took one month to disappear completely)

Is it painful? If you can put up with needles no! The area around your groin is numbed with aesthetic so you just have a weird sensation of the insertion. You lay on a bed and a large 14-16in plate is manoeuvred over your chest area to get a good xray of the heart from all directions. You are asked to take a series of deep breaths and hold as the xrays are taken.

I’d read in the book that I may feel weird in the groin as though I was peeing myself, and also that there may be a hot sensation in the chest. As I lay watching the x-rays being made – I felt none of this. But then when I thought it was over the surgeon said that I may feel the peeing and heat. And I did, but it was just like butterflies you sometimes get and nothing too uncomfortable.   The whole process was about 30-40mins.

To reassure anyone with this a head of them don’t worry it’s no worse than a trip to the dentist for a filling – if anything less uncomfortable. And you wear paper pants so you’re not exposed.

After the treatment A nurse holds padding over your incision point for a few minutes and then you take over for 15mins. Make sure you’re comfortable!

Then you are wheeled back to your ward. You have to lie still for one hour. The you can sit up for an hour, then get out of bed and sit in a chair for an hour and then put your clothes on and return home. During this rehab session the consultant shares the results with you.

It turns out I have a totally blocked artery that cannot be opened using stents. Fortunately a nearby artery is providing necessary blood to that muscle, but I’m told I need to have treadmill test to test my heart stress levels and determine whether an operation is needed.

My leg ached for a couple of days but nothing problematic.

to be continued…

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back home – after the heart attack

21. 01. 2009 at 15:11

continued…

After a five day period in hospital I return home with a selection of medicines, a weary body and a mind of mixed emotions. I have a collection of British Heart Foundation leaflets covering the various issues/solutions to my new problem. These include detailed guides to angiograms, surgery, reducing cholesterol, medication and diet. There are many books in the series and they are really informative. I also have a guide written by the local health authority explaining the various phases of rehab and am told I will be receiving a letter in due course to confirm a angiogram. I will also get a visit from a rehab nurse to see how I’m coping.

Despite the trauma. I actually felt generally okay. Slight pressure on the chest and tired, physically and emotionally, but not bedridden.  Guidelines for week one and two are quite strict and very rest based. 10mins walk per day, no lifting, no using arms above head when showering, no work, no sex. Basically chill, do bugger all. The weird thing is that you cannot see any damage. And the best way to describe how to react is consider the heart like a broken arm or leg. It’s put in plaster and you avoid bending it until it mends. In a way the heart is the same, but you cannot see that you’re “bending” it. I’m glad I had this analogy or I would probably be back in hospital by now.

My company had placed strict no-go restrictions on my access to work, as they knew I’d be back in straight away! So TV called. It was a chance to watch lots and lots of TV. About five minutes of Jeremy Kyle made me realise how well I’d been protected from such stuff by working.  So I relived some DVD moments. I watched the set of Planet of the Apes movies, Bang Bang Reeves and Mortimer, Monkey Trousers, first to third series of Peep Show and mixed this with some History channel, Dave repeats and a bit of reading.

Time actually flew by. Each day I spent 10mins walking around the house until I felt comfortable going outside. The first few days outdoors (freezing cold) brought back the pain I’d experienced prior to the heart attack.  I couldn’t determine if this was angina or the next stage of early warning signs  The a would determine the state of my heart so the consultants would have a clear idea of the next stage.  A letter came through to let me know that my angiogram would be done on 24th December.

to be continued…

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From A&E to the CCU

01. 01. 2009 at 15:07

…this continues from the heart attack post

Having spent around four hours in A&E, suffering a heart attack, is was told a bed was available. Lyn, the nurse, apologised for the delay and said that the journey up would be fast.  The porter arrived and he pushed the bed while Lyn controlled the drip – it all happened in a flash and in moments I was being told to shuffle (very carefully) across from the A&E bed onto a bed in the CCU (Coronary Care Unit).

Three other beds occupied the large space. Each one with a patient hooked up to drugs via an intravenous drip and to ECG machines to monitor their condition. I was still in pain so the nurse administered some more morphine.

I was connected to two drips – one was Heparin to prevent the formation of blood clots and I think the other was Isoprenaline to slow the body down, but I can’t remember. These were attached for two days, along with the ECG, so made sleep very uncomfortable. I didn’t get any the first night (Monday 8 December).

The only pain I had was a headache from the drugs and backache from sleeping uncomfortably. The feeling in my chest was tight but not painful. It was hard to describe, but the symptoms did result in the doctors considering moving me to Sheffield for further tests. On day two their concerns reduced so I could stay in Bassetlaw.

The experience reminded me of a long haul flight. You watch the hours, minutes and seconds pass, each minute becomes slightly more uncomfortable. As you try to sleep on a plane you are interrupted by passing trolleys hitting your seat, duty free requests, or an air hostess asking you if you want a drink, or the fasten seatbelt noise alerts, or the nearby cry of a baby, or someone talking annoyingly loud, or the dull sound of the engines, while you continually shuffle in the tight space to gain comfort.

In the hospital bed it’s similar but just a larger space and less rocky! I was constantly woken from my drowsy state by blood tests, other patients calling out, machines randomly beeping, visitors popping in, nurses checking up on you, shift changes,  tea breaks…and all along in a bed that I couldn’t move from or adjust easily.

Day two was easier – I was allowed to dangle feet and have a bed bath. The bath was a nightmare – a bowl on the trolley, doddery on the feet, wires and tubes everywhere and a flannel. I did the best I could. I have to say it was a huge relief when three days later I could walk to the shower and get a proper wash.

I spent five days in hospital – discharged on the late afternoon Friday 12 December.

Throughout the stay I found the nurses and teams were incredibly good. Working long shifts, limited breaks, always smiling, always their to help. You could pick up that they have issues with working conditions, but all gave 100% to patient care. And bizarrely we are in a unit that encourages patients to change lifestyles – relax more, eat better, exercise correctly, work more effectively etc, and here was a prime example of what not to do, nurses rushing from one situation to the next, missing breaks, eating on the go, working 13 hour shifts, working with terrible colds, etc.

…to be continued

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