Friday 7 February 2014

Looking Into My Heart...

I was up bright and early on the Monday morning, actually feeling relatively well. The nursing care in Whipps Cross had been excellent, both attentive and professional. The place had something of a reputation a few years back and I remember many a joke from those days to the effect that, if you were going into Whipps as a patient, you only needed to buy a one way ticket to the place as it was somewhat unlikely that you would be making the return journey… Happily, those days are long gone and, speaking personally, I could not testify highly enough to the standards of nursing and medical care that I experienced.
During the morning I was visited by an array of doctors. principally though, the chat with Dr. Hogan, the head of cardiology was quite enlightening. I had some expectation that he may be conducting the angiogram itself but it transpired that Dr. Rajiv Amersey was chosen for the part. The hours ticked slowly by until around three in the afternoon when I was told to change into the surgical gown and ready myself to be wheeled through to the ante room.
One of my problems in life is that I stand at something slightly in excess of two metres tall. The surgical gowns provided in hospital seem to be designed with Mr. Average, or indeed Ms. Average, in mind. Whichever it is they are singularly unsuitable for the likes of myself. I may as well ware a T-shirt and be done with it for all the coverage it provides. It seems bad enough that one has to go through the indignity of being prodded and poked, pricked and swabbed, but to add the frankly ridiculous (at least on me) surgical gown felt like adding insult to injury.
I was nervous, I have to admit, bordering on a little frightened even. I had experienced a previous angiogram a couple of years previously at the London Chest Hospital, so I had some idea what to expect. The main problem from the patients point of view is that one is entirely conscious throughout the procedure. I have had several operations in the past, mostly related to a back injury sustained whilst rock climbing many years ago. For each and every one of them I had received a general anaesthetist. usually involving fluid induced through a cannula inserted into a vein in the arm, but sometimes inhaled. The blissful thing about this is that you can happily wave goodbye to consciousness whilst all the worrying stuff takes place. Unfortunately, this is not so with an angiogram. You are wide awake and fully aware throughout the whole process.

Before the procedure was to take place, Dr. Amersey sat down beside the bed I was on and explained what it was that he was intending to do. I could not help but immediately like him. He has an intensity and an obvious commitment to what he is doing, he gives off an aura of both competence and focus. These qualities are very reassuring when one is about to allow somebody access to such vital organs as one’s heart. He explained the risk factors to me. For an angiogram, approximately 1 in 1000 are victims of a heart attack, stroke or ‘sudden death.’ A nice catch all phrase that last one.
Now, 1 in 1000 might sound quite reasonable as you read this from the comfort of your home unexposed to the potential dangers of the procedure. To me, somehow it didn’t sound quite so good! He went on to explain that if, during the angiogram, they found narrowing of the cardiac arteries, he intended to perform an angioplasty. If this were to be the case, the risk ratios go up considerably. In the UK, something like 2% of patients die immediately or within a short period after an angioplasty. Although that sounds quite high, in many other countries it is even worse. I read of one hospital in New York where they managed to record a rate of 12.5 % in one year, 1 in 8. These figures were not, as you can imagine, overly reassuring.

Within but a few brief minutes I was being wheeled into the theatre….

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