Friday 22nd July, 2022.
Three wise men have entered my life. Dr B, Dr P and Dr A. I owe them big time!
They have come bearing gifts – they are wise, well trained, professional, caring, empathetic and possess great diagnostic, communication, interventional and surgical skills. Their gifts? Giving me the opportunity to potentially live a lot longer.
So what went down on Friday?
I have written this blog a few times and tackled it in different ways – the outcome is the same. I am getting so many messages asking what happened, so here it is.
Friday was angiogram day – brought forward by a fortnight from the original appointment.
I was nervous – not so much the procedure as I have had a lot of medical ‘stuff’ happen over the years – but more the possible range of outcomes. Fear of the unknown.
There were five ahead of me on the list – and I got to hear the two way conversations between Dr P and each patient as he did his pre angio rounds. I got to hear his post angio findings too. Certainly there is no privacy in the pre theatre room. They all got good results – it all started off with “I’ve got good news…”
The nursing staff in preparing you do an ecg and insert a canula. Waiting, waiting, waiting. I found it hard to concentrate on my book. I tried word puzzles too but again my concentration was poor.
My turn was some 5.5 hours after being admitted, and by then I was extremely thirsty not having had any fluid for nearly 17 hours.
I walked into the theatre and popped myself up onto a very slender, long metal table. It was quite cold in there.
The senior nurse takes over with a series of instructions. Arms by your side – do not move them! Head looking up – do not move it! Do not talk! You can watch the screen but only by moving your eyes! Ok – noted – loud and clear!
Both arms are by your side as one staff members fiddles with the canula and nice, I could feel the midazolam hit my system. That takes the edge off the anxiety. They also injected fentanyl and a bit later contrast dye upon Dr P request.
The right arm is for the cardiologist – liberal use of iodine to cleanse the skin, then I could feel a wet, cold sponge like product. Dr P walks in, all clad in his lead suit (I gather they weigh over 7 kg). He feels my arm and injects local anaesthetic and the sheath and catheter are inserted into the artery on the wrist – and quick as lightening the catheter is checking out the heart.
There are four screens he is watching – two with data, two with images, and there is a very square and boxy xray head swivelling around at various angles taking the images. The xray head at time obscured my vision, and I dare not move my head to look.
The angiogram does not take that long – Dr P tells me he has finished it and that he will do a stress test on my heart – how that works I am not sure, but he is making my heart work out whilst I lay there – and I could feel my heart rate increase.
Dr P disappears for maybe 5 minutes and comes back telling me he wants to show me what he found (eek – this is not in line with the first five patients – I am sure they all want to know too….). He told me that I am one very lucky girl, sitting on a huge ticking time bomb.
He should probably have waited to do that stress test as I reckon my heart rate popped right up there and then. He told me that one day I would have just dropped dead without warning. Very sobering.
I think about the 3 000 km that we have recently cycled in Europe and think about what could have happened as I climbed up some of those 20 000 metres worth of hills and mountains. Thankfully we had a brilliant holiday.
He pointed out the issue on the screen – and it was pretty damn obvious to even my untrained eye.
I have an 80% blockage to the LAD – and it is in an awkward spot at the T junction. It is not possible to stent with a lesion in that particular position. Therefore I need open heart surgery and coronary artery bypass grafts.
The LAD is commonly referred to as the widow maker artery – it supplies blood to the larger, frontal part of the heart and is regarded as the most important artery. Survival from cardiac arrest cause by a LAD blockage outside of a hospital is around 6%.
In the few minutes that Dr P had disappeared from theatre, he had already rung Dr A and shared my imaging with him and jointly decided the surgery will be in the next week or so – when they can coordinate the hospital and other issues including current Covid impacts.
He leaves again- and I burst into tears. The senior nurse hits me around the head with a wet fish (metaphorically speaking!) and I needed it – she told me to invert my thinking (she read one of my earlier blogs?) and to remember what he said – that I am a lucky girl!! Others are not as fortunate and just drop dead. Salient!
Post the angiogram you need to stay in bed for a few hours and the catheter site has a pressurised wrist band that they regularly remove a little bit of air from – as it is an artery it is more prone to opening up and bleeding.
After two hours I was allowed to go to the loo (as they like you to drink 2 litres of water post procedure to flush out your kidneys) and what goes in….
It was whilst I was in the loo that I forgot about that hand and used it to assist me – and when I went to wash my hands saw the blood everywhere.
So the pressure bandage had more air go back into it and I needed to stay a bit longer.
Upon leaving I was met not only by Tony, but my eldest son Joshua, his wife Kimberley and my two darling grand kids. They had travelled up from Hobart for the day to be with Tony, hoping to see me when I left before driving back home again.
If ever I needed a salient reminder about all the good things in life, this was it – as my young granddaughter called out “Granny” and had a few flowers in her hand that she had picked from the hospital gardens.
This is worth living for.
Saturday 23rd July, 2022
Dr A rang me in the morning and had a chat – and arranged to do a Zoom meeting in the evening. Amazing on a Saturday that he is willing to put this time into me.
He tells me not to call him Dr – he is “Ash” – an extraordinarily unpretentious surgeon. I warm to him immediately.
To cut a long story short, I am to have surgery either late this week (Fri), or early the week after (Tue). The final date will be confirmed tomorrow by his assistant.
There are more tests to be done including a doppler on my carotid artery. Dr P and Dr A have said my risk factors are nearly all genetic based, and that there is a corresponding link to blockages in the carotid artery. If they find something, that will be an issue subsequent to the heart surgery for resolution.
He gives sobering data too – like there is a 6% chance of a heart attack during the surgery – but let’s wack that fish around a bit more and invert that – there is a 94% chance that it will be fine! Let’s stick to 94%.
In addition to this week, I will be off work for at least 8 weeks post surgery and not allowed on the bike for 2-3 months (that will be another conversation as I presume he is thinking bike riding on roads – and yes with the sternum repairing I totally understand why). I will be in hospital for maybe 8-9 days (bit longer than I was thinking) but he did counteract that with a “until you are sick of the hospital food”.
He has given me a number of websites to checkout – and one was on You Tube – so I digressed and watched an open heart coronary graft bypass procedure – ooh!!! Not for the squeamish and I certainly hope after they stop my heart that they can kick start it again ok!!!
I am very thankful for the three wise men. Huge thanks to Dr B, the radiologist who after seeing the results contacted Dr P immediately – and rang me that night to talk me through his findings.
Dr P who got me in a month earlier than planned to schedule the next step – and then upon diagnosis contacted Dr A who is getting me in earlier too.
I will be on the rehab road (hopefully) by the date of my first review appointment with Dr P ( originally Aug 5) such is the speed of this journey progress.
Now I need to do my bit and be that couch potato and chill and get ready for the next big hurdle.
I have faced hurdles before. In 1999 I had an undiagnosed (40 hours) ruptured appendix, gangrene and peritonitis – and I got through that after being told another 24 hours and I would have been dead.
This will be big – but I use my father in law as a wonderful example of exemplary recovery. At his first post surgery cardiac rehab session they were all asked to walk two laps of the oval. He very proudly lapped everyone!
I have the right attitude, and I will succeed. Watch me!