Wednesday, January 11, 2012

Sirens and red lights

Travelling by rail to and from Amsterdam, with a change of trains in Brussels, would seem to be the best method to choose for a winter’s visit. But there was, at Christmastime, a great deal of heavy luggage to lug about at stations.
And then, in Amsterdam, where space is at a premium, and where stairs are unproductive areas of a house with treads narrow and assents steep, heavy suitcases meant that extra muscle power was required.
Probably because of these additional manual matters, my heart acted strangely on our return to London.
When walking along a street I was suddenly short of breath and struggling. Something was not right.
So, for a few days before the New Year, I took my pulse rate at various times of the day and night. It seemed to be extremely low.
Margreet wanted me to see a doctor. An appointment was to be made at the counter of our local health centre, where we learned that no one could see me for several days. At Margreet’s cajoling, the receptionist then found that, due to a cancellation, I could be seen by my own doctor right away.
After the briefest of examinations, she ordered an ambulance and booked me into the cardiac clinic of Hammersmith Hospital.
So, with me in a wheelchair, ambulance paramedics and Margreet, we set off with sirens screaming and red traffic lights ignored.
Wheeled into the hospital for another brief but thorough examination (symptomatic complete heart block), I was put into a bed and connected up to a mass of cables that led to monitors of lights, flashing numbers and noisy alarms.
I was to have a heart pacemaker installed in my chest. These are inserted beneath the collarbone and connected to the heart by two wires. In place, it would result in my heartbeat being under control at a satisfactory level for life. Fine.
Speed was necessary, but I had to be fitted into the pre-arranged surgery programme. It was not until mid-day the following day that the operation took place. Antibiotic pills aplenty were administered.
The surgical procedure was to be conducted with local anaesthetic.
This obviously involved delicacy and, unexpectedly, some brutal force from a surgeon who was discussing his future in medicine with a colleague. The procedure appeared to be a success.
Margreet was much relieved when I appeared from the surgical quarters looking much the same as before.
With some aches and pains and soreness the following day, I dressed to go home. But a final and more comprehensive extra scan revealed that one wire from the pacemaker to the heart had become detached (atrial lead malpositioned).
So off came my street clothes and, once again, on went that surgical garment – one that surely needs some re-design and logical thought directed at it.
But, once again, with a surgical schedule full, could I be fitted in?
I was (possibly to make up for the previous failure).
Now, a glamorously dressed lady surgeon from another hospital appeared. She read my notes, and retired to change into her surgeon’s kit.
I was not really looking forward to another session of pain and brutality. So I asked for the more liberal use of anaesthetic.
She started the procedure after the accompanying sterilisation of about everyone and everything. I expected a repeat blood-letting and brute force – except that it was not that at all.
The surgeon operated so gently and skilfully that, compared with the previous day’s attempt, it was almost painless. She re-attached the atrial wire to the heart.
The female touch in surgery is to be recommended.
Poor Margreet was the one who suffered throughout this medical saga, imagining the worst – the very worst – when the risks were actually quite small.
So, with almost a new heart, I was returned to my hospital room and to Margreet with the prospect of, once again, returning home the following day.
Final (satisfactory) tests were taken, and doctors released me. I was ready to start life again – with the restricted movement of one arm for several weeks.
To remind me not to raise my left arm, I devised a simple cord (string) loop, tied around my belt and hanging down into which to thread my lower arm. With the arm dangling through this loop, there was a restraining reminder whenever I started to raise it. This was a simple idea and, apparently, one not thought of before. And it must be the cheapest medical appliance ever to be used.
Never throughout the saga having felt ill, at times I felt a bit of a fraud. But doctors and nurses knew otherwise, and had saved me with their expertise.
One must admire hugely the Hammersmith Hospital’s staff, the National Health Service – and Margreet, whose supportive hand needed holding much more than mine.