Saturday, 20 February 2010

24 Hours - Give or take

Dateline: Brisbane, Thursday 18 February, 10:30am An appointment with my Cardiologist is about to start. He commences with an ECG and then we have a discussion. My reason for being there is I have recently started getting Angina. I have been symptom free for 5 years, so sudden changes need investigation.
I think that you need an Angiogram he says. He picks up the phone has a quick conversation and then turns to me. "How about this afternoon?" I think for a few seconds, then indicate that will be fine.
Arrangements are soon made and I leave his office to get to the hospital. I detour via a Supermarket to lay in some easily prepared food in case I am not mobile for a few days. I drop this at home and pack an overnight bag and toiletries. A few hurried phone calls to work and parents. By midday I am being admitted to Hospital.
I spend the afternoon in a hospital room reading and watching the TV. I am nervous but have been through this before so know what to expect. About 4pm I am ordered into bed and given a Valium. Only a Valium! I wanted something a bit stronger than that as a pre-med. Still my anxiety level dropped off and soon they wheel me away to theatre.
I lost track of time about here was it 4:30 or 4:00 when I went in? Was it 5:30 or 6:30 when I was back in my room? Not sure.
The procedure (you are not cut open so it is not classified as an operation) involves local anaesthetic in your right groin and then a long tube inserted up your femoral artery into your heart. They feed instruments and various tools through this tube. During this time you are awake, aware and being directed to take breaths, stop breathing, breathe again. I can feel warm fluid running down my leg to my buttocks. I comment that I can feel the blood pouring out. I am told it is mucus and fluids not blood. I have to take their word, but I don't know where mucus can come from. Possibly they mean lubricants and the excess dye that they use. Dye that is visible to an X-ray machine is injected into your heart and the surgeon can see on a video screen in real time if blockages are present and where they are. To a certain extent you can see what is going on as you can see the monitors at an angle.
My blood pressure drops drastically and my heart rate is down to 40 bpm. This is a crisis. They suspend the procedure while they restore my blood pressure. I am bathed in sweat and only vaguely conscious. I hear them dial up the drip to squirt fluids into me and repeated calls of "pressure, pressure". I am stabilised and they continue.
I am told that I have an artery that is 80% blocked and that they will need to perform balloon angioplasty and insert a stent.
I am prepared for this and let them know to continue. To be honest I don't have a choice they would do it anyway. But my chances of a post procedural issue have just increased to 1 in 500. I hear them call to inflate the balloon. I let them know that I can feel it. While the balloon is inflated there is no blood flow in the artery. Basically I have a temporary angina, induced by the balloon, which is why I came in in the first place, so it should feel the same and it does.
They close me up and place some stitches in place. They leave a sheath behind. Not exactly sure what this is. I think that it drains blood from the puncture site. Unfortunately when it is removed later it will reopen the femoral artery and I will be at risk of bleeding to death. They will use a clamp on my artery called a "FemStop". This clamps the artery shut and over a period of time it is loosened as the artery heals itself and closes the wound. This is the worst part of the procedure as you are strictly forbidden to move and you lie flat on your back. The FemStop hurts. By the time it is removed your back and buttocks and legs are in agony as the blood has pooled in those regions and not been able to reach the pressure spots. It is now common to use a plug to seal the artery but my drop in blood pressure has forced them to use anti clotting drugs that make that impossible.
By 6:30 (or was it 5:30?) they are cleaning me up and slide me off the operating table and onto my bed. I was able to climb onto the operating table prior to the operation but I am now at risk of bleeding so need to be carried off. I feel like a dolphin that is being rescued as I am in a sheet with people lifting all around. The person closest to me is an extremely attractive nurse and her chest rubs against mine as I am moved. In other circumstances I would have been sexually aroused, but not today.
Shortly thereafter I am back in my room. I am brought food and water. I am both hungry and thirsty so I manage to eat a couple of sandwiches and drink some water. A little awkward while I am flat on my back but the relief is wonderful.
I am monitored continually by machines and every 15 minutes checked by a nurse. My cardiologist visits, tells me all is well and that I will be going home in the morning. The regular checks continue until midnight when blood coagulation tests indicate that I am now safe to have the sheath removed. I am dreading this. As I described above it is not pleasant. However I am informed that the FemStop is only on for about 90 minutes. This is a huge relief as during my first angioplasty it was on for 8 hours and the after effects of lying flat for such a period lasted for days.
Despite the discomfort I am able to sleep a bit and then the FemStop is removed. No bleeding until the Nurse starts to clean up the wound site. She now must compress my artery with her thumb or fingers to prevent the bleeding and let a clot form. She calls for assistance and plunges her hands into my groin. She delicately moves my penis out of the way to have better access.
She needs to be there for 15 minutes. I know that pushing your thumb down for 15 minutes at that pressure will be agony for her (try it!). It is also agony for me. We talk to keep our minds off the personal pain we are both in. She was born in Nepal, educated in India and America and is now working in Brisbane. She moved here 8 months ago. She is well travelled and the time passes quickly. I admire her pluck, courage and mental toughness, it is not easy for someone to move to a foreign country with no social support on her own. I wished that I had met someone with that character and courage many years ago when I was travelling.
The bleeding stops and I am left alone again apart from the regular visits to check progress.
By daylight I have spent a very sleepless night but am pronounced as recovering well. By not moving I have allowed my artery to seal without further bleeding. It is worth the short term pain to prevent complications over the next few days. I an now allowed to sit upright and am even moved off the bed into a chair. Breakfast arrives and I can eat it in relative comfort. Over the next couple of hours I am visited by my cardiologist who declares me well enough to go home, also the surgeon who also declares me fit to go home. I am finally unplugged from drips and the electronic monitors and allowed a shower. The water running off my body turns red. I check for bleeding but it is merely the coagulated blood that had spilt during the procedure washing off me.
I can finally dress and all that needs to happen now is the Pharmacist to deliver a new set of medications and instruct me in their use. Take one a day in the morning is obviously a difficult concept for some. While I wait alarms go off and there is a lot of running in the corridor. Controlled panic. I learn later that someone has had a heart attack in one of the other rooms, he or she is treated immediately and survives. It brings home that this is serious stuff happening around here.
The pharmacist finally arrives talks me through the medications and with that it is all over I am discharged. It is exactly midday, 24 hours since checking in.
I go home and sleep the afternoon away.
The staff in the Cardiac Ward (Ward 2E) in the Wesley Hospital at Brisbane were wonderful. From the moment I entered I was treated with professionalism, friendliness, courtesy and respect. I always felt that I was in good competent hands. The regular care and attention was calming and the nursing staff were cheerful and always willing to help. You can't do a lot to disguise the fact that you are in hospital and I was fortunate enough to have a private room with my own facilities. Even the food was decent.
The bludger is recovering well and taking it easy for a few days.

No comments:

Post a comment