Another Fine Day

Thankfully the weather is cooler. As much as I like it sunny and warm, it's not advisable to be out in it when you have a heart condition as I have. After the incident at Camphill when I mistook a bout of reflux or heart burn as either an actual, full-on heart attack (correct terminology is myocardial infarction) or angina. I was relieved that it was cooler as I drove to Camphill yesterday (Tuesday.) No the full compliment of residents at the 'check-in,'where everyone has to give a brief description of how they were feeling at the beginning of the day (as I volunteer I don't get off the hook, but I've got used to it. From my first day when I was only there for a few hours, to get the feel of the drama workshop and had the residents firing questions at me to see where I would fit in.) which was somewhat nerve wracking, to several months later when I am feeling as if they are all my friends and chat to me freely and we have such a lovely relationship. They are truly a lovely lot and I am so pleased to have found something  so amazing to be part of. 

Teo, the leader of the drama workshop and coordinator/manager of the Chrysalis Theatre, was busy elsewhere in the building, busy with a young man who had come in to view the theatre from The Scouting organisation because he was involved in a Gang Show which was going to be staged in the Chrysalis Theatre. We hardly saw him all day because he was also involved with reorganising the rooms beneath the stage, a larger room called 'The Crypt', which is where we've worked on a couple of occasions, as well as the dressing rooms, and another room which used to be a prop room and which is being converted into a sort of tea and coffee bar for organisations who hire the under-stage rooms for various events and courses so they don't have to come upstairs to use the facilities in the theatre foyer when the theatre is being used by other organisations.

We sat in a circle and did a line-run, with some of the absent actors parts being read by either myself or some of the 'co-workers,' as the support staff are called at Camphill. The two girls who have beeb working with us, (one from Brazil and the other from Japan, both have remarkable English-speaking skills, incidentally, and get on well with the drama guys.) and then we were broken up into groups to work with the actors to get them to really push themselves to improve their performances. When we went back into the circle, the drama guys had to take a line from their roles in 'Stranger Danger,' and really give it their all, taking one of us support staff as a sort of audience and really giving a full-blown performance which was intended to get them to give their best. It really worked and it gave an idea of their potential as performers.

We sent some time brainstorming ideas for 'Treasure Island,' which will be the next production. This time we were trying to find out how the production will end and lots of ideas were thrown into the ring. It was really amazing what the guys came up with. I had plenty myself, but I don't really want to over-do it as it should be there ideas that get used. I have no real excuse in this area because I've done a lot of research on story theory, particularly from one academic, called Joseph Campbell, who created the Hero With A Thousand Faces and was used as the blueprint for such movies as the original 'Star Wars' created by George Lucas and has since been used by other film-makers and almost a standard text.

Towards the end of the day Teo put a slideshow on the computer and it was shown on the large screen in the Chrysalis, to show those of us who had more recently come to work or volunteer at Camphill. Over nine years it appears that they've produced quite a wide range of plays, from a production based loosely (and it would appear very loosely.) on Sherlock Holmes, a sort of pantomime version of Robin Hood and other assorted shows, many which not only starred the residents (many of them in the current drama workshop.) but also many volunteers and what they call 'Co-Workers.' One of them being Luke, who seems to be a sort of 'jack of all trades,' from gardener, mower of the lawns at Camphill, to supporter of the residents in various capacities as well as having quite a good go at acting and, so it would appear, being the leading light in many of the productions. The sets and the costumes looked quite remarkable, and quite a few would appear to have been stored in the wardrobe department under the stage, whilst the set for the Sherlock Holmes production appeared (from what I could see from the photographs on the slideshow.) included a revolving stage which would have been used to do many of the scene changes, with one set on one side and then, when it was turned round, would reveal a different set.

When we'd finished watching the slideshow we went downstairs to the area beneath the stage to see what work had been done. We were amazed by how much stuff had been shifted and a lot of it was in The Crypt and the former prop room was being converted into a kitchen area for those who hire these rooms, although there was obviously quite a lot of work to be done with the installation of a sink and kitchen cupboards as space for making tea and coffee.

Emergency Trip To The John Radcliffe In Oxford- Part 3

I can't remember exactly when I had several canulas put into one of my hands and my left hand. I think this may have been done when I was in the ambulance when travelling to Oxford. They are used to connect you to drips and in several cases to take blood. Also, I had several contacts stuck to my chest and other points on my body which were used to connect me to a monitor for heart beat and other body functions. A bit annoying that I had to contend with the cables when I lay in bed and had to disconnect them when I needed to go to the toilet and then the connection block got in the way and could be incredibly uncomfortable. Then the monitor, which all patients in the ward had these over their beds or at least nearby and they also gave off incredibly annoying bleeps which made it incredibly difficult to sleep. Not just these monitors, but many other electronic devices within the ward. There seemed no way you could either reduce their volume or turn them off completely.

It was odd not seeing the other patients in the unit. Being in a single room meant I was somewhat cut off from others on the ward. You could see people being moved around as they were shunted around in their beds. A bit like I was, all my belongings (such as they were. Not a lot, but still put in a large plastic bag) and then pushed by either a nurse or a porter to the vacant place on the ward.

Monday.

You get worken early in any hospital. I think I was awake already, but because there's always some noise on a ward, monitors buzzing along with outer machinery, staff moving about (they do try their hardest not to wake people) and the fact that I had a blood pressure cuff on which kept on automatically inflating to take my blood pressure during the night, I don't think I got a particularly good night's sleep. Then they begin to come round doing patients' 'obs' and at around 7.30-8.00 someone comes round with tea or coffee and breakfast. But for some reason you don't get toast, which i would have liked. A pity, but I bet the old Health and Safety rears it's ugly head, perhaps because of the possibility of fire, over-heating etc etc. Some wards I've been on had toasters in their kitchens, so it would have been out of the way to prevent accidents.

At around 10.00-10.15 I was visited by one of the doctors and given a brief explanation of what had happened to me and it was by then that I had actually had a heart attack myocardial infarction, to give it the correct name.) He explained what the stent was there for and the new medication I would be put on as a result of my recent episode. He had quite a lot of information which came from various E.C.Gs which had already been taken, as well as from my blood pressure and so on. You get regular observations ('obs'), taken by the nurses, covering temperature, blood pressure and heart rate, all taken with digital equipment. I was told by the doctor that I could possibly go home the next day (Tuesday) but I would be having a scan which would show the state of health of my heart and from this they could decide whether I could drive after a week or a month from having the heart attack on Sunday.

I was told that I would be in hospital until at least Wednesday. Not much to do. I had no books to read, no mobile phone, so I couldn't speak to Carol and there wasn't any television to watch, unless you had access to the in-hospital system which required you to pay, and similar to the dreadful Hospicom service at Milton Keynes Hospital. Also, I had no cash on me, nor either of our debit cards, so I couldn't even buy a newspaper.

I had breakfast on the ward. As I've mentioned, it's quite difficult to sleep with all the noises going on in the night, so I'm usually awake early. Partly because, having been bought up on a farm, life starts early so I'm used to it and it doesn't bother me. I'm a morning sort of person anyway. You get offered tea from a trolley and they come round regularly with the trolley and there's always water to drink with medication. No fear of dehydration. You have to fill in a menu for the next day's meals, lunch and dinner. Usually a fairly good selection of options.

Later in the day, probably 9.30-10.00 I was told I would be moving out of the single, en suite room and moving down to the Cardiac Rapid Response Unit, which is on the ground floor of the department. Everything was bundled up and I was pushed out of the room by a nurse and a porter, taking me down in a life and along a long corridor. Eventually entering the more open ward, with 6 beds in it, each bed facing another bed. It made a real change from being in a single room and it made a change to have other patients around. It was beginning to get slightly claustrophobic where I was. Much more space to inhabit that was the general amount of space patients were expected to inhabit in Milton Keynes Hospital.

Tuesday. Another night of attempting to sleep, due to the noises on the ward. But this wasn't really much of a problem, because I could sleep all day if necessary.  I was again told about the scan, an echocardiogram, or 'Jelly Scan' as Carol told me when I phoned later. Then I had the problem of how I was to get home. I asked one of the nurses whether I would have transport back to Milton Keynes but I was told that I couldn't have transport because I lived outside their official catchment area. A bit unfair, seeing how I had no choice of where I was taken by the paramedics after my heart attack. So I spoke to Carol via telephone and she said she would speak to Ross, Pastor at S.C.F. and he would come later to pick me up. Which is what happened.

The echocardiogram was done. I was expecting to go to another department to have this done, but a technician came with a portable machine and he did the scan with me laying on the hospital bed, with he curtains drawn around me. It's also referred to as a 'Jelly Scan' because they use a sort of jelly to put on your chest so that the probe device can slide across your skin more easily. I think it was KY Jelly, but I'm not sure.

The admin staff on the ward did the paperwork for myself, giving details of my care and my health condition which would also be sent to my GP at Ashfield Medical Centre as well as ordering additional medication and details of how it was to be administered. It was some while before the scan was analysed and I was told by one of the doctors that my heart looked healthy enough and that I would be able to drive after a week and not a month.

Around 3 o'clock Ross and Carol arrived on the ward. I wasn't too sure how long it would take them to drive over from Milton Keynes. So, having been given a bag full of the new medications, which had been sent from the hospital pharmacy, we walked out of the ward and out to the carpark and to Ross's car and we left Oxford to drive home to Milton Keynes.

I'm feeling fairly well, having undergone the trauma of the heart attack. I must have collapsed quite heavily, because I have bruises on both knees as well as the left side of my forehead and all these bruises are really painful and make walking quite uncomfortable and as I write this (4.00 p.m. on Thursday) they are beginning to come out quite blue and the pain is going off.

Feeling Sick This Morning

I'm not one to go over-board when I'm not feeling very well. Unlike some people who seem to make a great deal of fuss over being ill, for whatever reason, to get attention or even to get to the front of the queue at the doctor's reception desk. I had a chesty cough a few weeks ago and it seems to have left it's mark. I just can never seem to get rid of these nasty coughs and as a result I've had a very tight chest. As I've mentioned in one of my very earliest blog posts on here, where I describe what lead up to my heart attack, the weeks before that incident I had bronchitis which really drained me. So it is with this present bout of cold/flu.  It was very difficult to actually differentiate the pain and discomfort of the bronchitis with the pain of my heart attack. It can also be similar to having heart burn. I think that other people have described the pain of their heart attack as being similar to heart burn. Any sort of chest discomfort is bound to have some sort of concern for anyone with a heart condition and no more so when that condition has lead to a heart attack (M.I. or myocardial infarction to give it the correct medical name.) All the coughing I have been doing has probably caused a muscle to be pulled in my chest and it's really uncomfortable and very similar to an  extreme angina attack or even a heart attack. Any sort of strenuous activity such as walking, which we've been doing a fair amount of since the car has been off the road, can bring this pain on. I have been using my G.T.N. spray (Glyceryl Trinitrate spray.) which you use by spraying under your tongue (hence being described as 'sublingual.') which I have on repeat prescription and it doesn't seem to relieve this pain and so seems even more likely that this is brought on by continued coughing. Things are also not improved by constant running to the toilet (I'm not going into any more detail as you'd be pleased to hear.) But I think if this discomfort continues for any length of time I will have to make a doctor's appointment. But as I write this (at 7.57 a.m.) I have none of the discomfort. I write this sitting up in bed with both our dogs totally confused as I'm not downstairs in the lounge as usual at this time of day and their routine has been completely turned upside down. Alfie is sitting with me on the bed keeping me company. He is a very loyal little dog and follows me around wherever I am in the house.

I have run out of the isoborbide mononitrate tablets which are supposed to help relieve angina pain. It's not like me to run out of any of my medication as I'm usually very good at keeping a track of what  I'm taking as well as re-ordering. Which I will do later this morning when I ring up Sainsbury's pharmacy to do the repeat prescription order for the month.

The day has begun with fog, but it has cleared as the morning has progressed and the sun is attempting to break through. I did managed to see the Blood Moon last night as well as the partial eclipse, although I was somewhat disappointed that we didn't get the large moon we were supposed to get. The moon appeared a lot smaller than I was expecting. I tried in vain to get a photograph with our digital camera but it didn't work. Perhaps I needed to put the camera on the tripod and use a longer exposure or something.

A Royal Connection?

We have been hearing (or reading, or listening, depending on how you read the news.) about the Duke Of Edinburgh  (ie: husband, and Consort of The Queen, Elizabeth II,  monarch of  Great Britain.) being taken to Papworth Hospital due to the fact that he had complained of a pain in his chest over the Christmas holiday while staying at Sandringham, the royal Norfolk estate. I only mention this because I went to Papworth for tests after I had my heart attack. He had an operation to insert a stent into a blood vessel to unblock a blood clot. For anyone who doesn't know what a stent is, it's a quite amazing invention, inserted into the vein in the patient's groin and then gradually worked up through the vein, and the surgeon can see this using X-ray. The end of the stent is a tiny umbrella-like construction, which, when in the correct position, is  opened up, thus enlarging the vein and helping the blood to flow properly and preventing a further clot developing. The stent is then removed and the patient allowed to recover.  I have not had this procedure, as I had an angiogram which was done weeks after my heart attack. A dye is injected into the blood-supply, and as a result can be seen by X ray and can then show up exactly were the blood clot that caused a heart attack is. I had a test at Papworth Hospital to show up any further clot and it was decided that I didn't need invasive surgery, but, apparently now, a good 5 and a half years after my original heart attack (or to give it the correct medical name: myocardial infarction.) if you have a heart attack you are automatically given the stent procedure. My  heart condition is controlled by medication.

The Duke of Edinburgh has since been discharged from Papworth Hospital and has returned to Sandringham.

Cardiology Department Diagnosis

This morning I had a copy of the letter the Milton Keynes  Hospital cardiology department sent my G.P. following my recent appointment. The following is a report in that letter. If it is in any way helpful to anyone who has had a similar medical problem, had a heart attack, suffers from angina, or in any way identifies with my medical history, then I am recording it here.

Diagnosis list

'1. Myocardial infarction 2006 (angiogram at Bedford, conservative management.)

2. DSE 2008: no inducible ischaemia.

3. Hospital admission with troponin negative chest pain and equivocal exercise test- September 2010.

4. DSE October 2010: negative for inductible ischemia.

Medication List

Asprin 75 mg od

Pravastatin 20mg od

Isosorbide mononitrate 20 mg

Plan

1. GP to please discontinue isosorbide mononitrate and commence Amplodipine 5 mg od- uptitrating to 10 mg od

2. GP to please commence proton pump inhibitor

3. GP to please commence ACE inhibitor if no contra-indications.

On his admission his troponin was negative and he went on to have an exercise tolerance test which showed no gignificant changes, although there were some equivocal lateral ECG changes. He had no limiting chest pain but managed 6 minutes, 7.3 METS.

Cardiovascular system examination was unremarkable and his blood pressure today was 129/72.

He had a dobutamine stress echocardiogram on 16th October which was negative for inducible ischaemia.'

 I have Googled 'ischemia' as I had no idea what it meant, and this is what I found:

'Myocardial ischemia is an intermediate condition in coronary artery disease during which the heart tissue is slowly or suddenly starved of oxygen and other nutrients. Eventually, the affected heart tissue will die. When blood flow is completely blocked to the heart, ischemia can lead to a heart attack. Ischemia can be silent or symptomatic. According to the American Heart Association, up to four million Americans may have silent ischemia and be at high risk of having a heart attack with no warning.

Symptomatic ischemia is characterized by chest pain called angina pectoris. The American Heart Association estimates that nearly seven million Americans have angina pectoris, usually called angina. Angina occurs more frequently in women than in men, and in blacks and Hispanics more than in whites. It also occurs more frequently as people age—25% of women over the age of 85 and 27% of men who are 80-84 years old have angina.

People with angina are at risk of having a heart attack. Stable angina occurs during exertion, can be quickly relieved by resting or taking nitroglycerine, and lasts from three to twenty minutes. Unstable angina, which increases the risk of a heart attack, occurs more frequently, lasts longer, is more severe, and may cause discomfort during rest or light exertion.

Ischemia can also occur in the arteries of the brain, where blockages can lead to a stroke. About 80-85% of all strokes are ischemic. Most blockages in the cerebral arteries are due to a blood clot, often in an artery narrowed by plaque. Sometimes, a blood clot in the heart or aorta travels to a cerebral artery. A transient ischemic attack (TIA) is a "mini-stroke" caused by a temporary deficiency of blood supply to the brain. It occurs suddenly, lasts a few minutes to a few hours, and is a strong warning sign of an impending stroke. Ischemia can also effect intestines, legs, feet and kidneys. Pain, malfunctions, and damage in those areas may result.'