Bloodtests and other Matters

I hadn't had a blood test for at least a year. I'm keen to keep a check on my cholesterol levels because if it's too high there is always a risk of another clot which could lead to me having another heart attack. I'd had a letter from Ashfield Medical Centre to have my blood pressure done at their self-service unit within the waiting area of the surgery, which I did a week or two ago. It's not difficult to do and they've now put it behind a screen so that you don't have to endure other people waiting watching you, which rather put me off doing it myself. It is easy to use and the instructions are clear and the machine prints out the results and then you hand this over to the receptionist who then adds it to your notes. In some ways I suppose this is a good idea because it frees up the staff to do other things and you just do it yourself so you don't have to make an appointment.

As regards giving blood for a test has always been a bit of a problem for me. For a start, I don't like needles, particularly when they're stuck in my arm, or leg or any other part of my body. When I was in hospital, particularly when I was in the C.C.U. (Coronary Care Unit) at Bedford Hospital  I had some of the blood-thinning medications administered by hypodermic in my stomach. I think Carol had the same when she was in hospital. It's not to painful, but I think just thinking about it is unpleasant. As regards the blood test giving-of-blood, my problem is that it goes back to quite a few years ago when I lived in Bedford and probably at a time when I changed doctors surgeries and had to have an early-morning blood test and wasn't supposed to eat anything for around 12 hours beforehand. I went along to the blood-test unit at Bedford North Wing Hospital in Kimbolton Road. The actual taking of the blood wasn't too bad. It was when I left I went outside and then felt woosey and had to sit down on a low wall as I was feeling positively faint. I keeled over and fell on the ground, not pleasant, particularly as I wasn't capable of getting up. At that precise moment I think an ambulance arrived and I heard running feet as people were coming towards me. I could see them, but I heard them. I was taken into a building on the hospital campus and had a chance to recover and was then taken to Accident and Emergency to be checked over before being sent home, but the whole incident was somewhat embarrassing because I shouldn't have fainted as a result of the blood test. Most likely it was caused because I hadn't eaten for 12 hours. It's that horrible feeling when I have given blood that I'm going to feel faint and will pass out that is the worst part of the whole thing and I have to make sure I'm laying down when they start the procedure so there isn't a repetition of what happened all those years ago.

When I was in hospital after having my heart attack in 2006 I had to endure giving blood virtually every day of the week I was in the C.C.U. This was often a problem and on one occasion the nurse who did it couldn't find a suitable vain and wanted to take blood from the back of my hand, which I wouldn't allow. On an earlier occasion when I'd gone to my doctor when I lived in Bedford the nurse insisted  that a second nurse be present when I had to give blood, almost making it appear that I was the cause of the problem when they could find a vain and I was told it was because I had narrow veins or something or other, which didn't help either, but then on another occasion the nurse (or phlebotomist, to give the proper term for someone who takes blood) said she's use a special, narrow hypodermic needle which were supposed to be used on children or babies. Also, if I had such narrow pains, it might have contributed to my heart attack. Anyway, of someone of my age, I have exceptionally good skin tone and you can't see any raised blood vessels as a result. Drink plenty, I was told, before you go to have a blood test, because if you're dehydrated, your veins don't expand apparently which makes the finding of a suitable vain virtually impossible. I can see what they mean, because a hose without water in it isn't rigid, one filled with water expands, as it would a vain with blood in it.  When I came out of hospital after the week of being on the C.C.U. in 2006, one of my arms was black and blue with bruising where they'd taken blood. When Carol was in Milton Keynes Hospital recently she had a P.I.C.C. (Peripherally Inserted Central Catheter) line inserted for her chemotherapy and they used that to take blood from her arm.

I also recall when I was on the C.C.U. at Bedford Hospital in 2006 being given warfarin as part of my medication care plan. It's given to help prevent blood clotting. I don't think I can have been given it for long, just until the threat of another clot was reduced. Unfortunately, when one of the nurses came to remove a canal I had in my wrist, she forget about the blood-thinning properties of the warfarin (no doubt not looking at my care notes sufficiently) because as soon as it was removed there was a spout of blood from the place where the canal was in my wrist. Strangely enough I never had a problem with having a canula inserted in my arm when I was in hospital, unlike when giving blood at other times.

Medications Side Effects

It's one thing having had a heart attack, but it's quite another that you have to contend with the side effects of the medications that you are prescribed. When I originally went into hospital, having had my heart attack, I was put on a range of medication, mostly to relieve pain. I had Warfarin to thin my blood and thus to prevent further blood clots. I recall that when a nurse was taking out the canula which was in my wrist, at around the time I was discharged, there was a quite a spectacular flow of blood as she had not noted that I was on Warfarin (which prevents not only blood clots, put prevents wounds from healing quickly.) I was put on statins, and the first type had the effect of giving me flu-like symptoms, which were rather unpleasant, to say the least. It wasn't until I discussed my state of health with one of the nurses on the C.C.U. ward that I learnt that this flu-like symptom was a side effect of taking this particular statin drug (which is used to control cholestrol levels in the blood.) I don't exactly remember what the name of this drug was, but I was soon put on another statin which didn't at first appear to have such violent side effects. I was also put on Bisoprolol (which I am still on, but at a much lower dosage, 5 mg.) I was also on Clopodogrel and soluble asprin (another drug to keep the blood thin and thus prevent clots.) 

Some of the side effects of the drugs, particularly statins, are that they give you muscle cramps. Without beating around the bush, another is rather unpleasant, bloating, flatulance and diarrhoea. Sometimes this can be very violent and you can spend quite a lot of time running to the toilet, and it can be quite uncomfortable. On the other hand, it can also have the opposite effect, constipation. Sorry if this is rather  too graphic for some people, but I'm writing this on this blog to try and help anyone else who is going through a similar experience. If my experiences can be shared with others then I hope it comes as some sort of comfort to know that there are others who have had a similar experience.

According to the leaflet which comes with a packet of Pravastatin it gives a list of possible side-effects. It reads as follows:
Dizziness
Headache
Sleeping problems
Sleeping disturbances
Vision disturbance such as blurred or double vision
Stomach upsets (such as feeling or being sick, constipation, diarrhoea, flatulance, indigestion and stomach pains.)
Hair loss
Rash
Itchiness
Tiredness
Feeling of weakness
Changes in the way your liver works
Heartburn
Bladder problems (painful or frequent urination

Very rare side effects:
Numbness or loss of sensation in the arms and legs
Tingling or pins and needles (paresthesia)
Inflammation of the liver or pancreas
Severe allergic reactions including localised swelling of the face/lips and/or throat
Yellowing of the skin and whites of the eyes (jaundice)
Muscle and joint pain

When I was first put on statins (although it might have been caused by other drugs I was on.) I used to get tingling in my feet and sometimes my fingers, and a sort of numb sensation in the soles of my feet, but that gradually went off after a couple of weeks. 

Immediately after I had the heart attack (which was back in May 2006.) I felt really depressed. I was told that this was a normal reaction to what had happened to me. I discussed this with a nurse on the C.C.U. Most men don't like to talk about their health, and particularly not depression. I have had a few periods of clinical depression, a couple of years before my heart attack, but I haven't experienced anything that severe since my heart attack. 

I was put on isosorbide mononitrate fairly recently, as an alternative to using glycerol trinitrate spray, which I used whenever I got an attack of angina. It was prescribed the last time I was in hospital back in October. It does seem to work, and I haven't had any severe angina attacks since then. But I get quite severe headaches and I'm sure it's that medication which causes insomnia. I go to bed as normal, but after a few hours I wake up, generally to go to the toilet, but then I cannot get back to sleep. I was told by my consultant at Milton Keynes Hospital that this drug would cause headaches for the first month or two, but that it would gradually ease off, which it did, but the headaches seem to have come back, but not quite as severely as when I first took this drug. The drug makes the blood vessels widen so as to increase blood flow, and this is very prominent in the brain, hence headaches (if you use the red spray,glyceryl trinitrate, you do find that you get headaches, as well as feeling light-headed, which is another effect of the iosborbide mononitrate, although I admit that it's not unpleasant, rather similar to the feeling you get when you've had one too many alcoholic drinks, but without the other unpleasant side-effects you get with alcohol.)

I can feel extremely tired. This particularly was a side effect of not only taking some of the drugs, but the effect of actually having a heart attack. A heart attack is a very traumatic experience in itself, and tiredness is the body's way of repairing itself. If I over-exert myself, like going on long walks, I find that my leg muscles can get quite painful, but if I rest for a short while, stop and sit down, this soon eases off. 

My Heart Attack

I'm new at this. Well, there's a first time for everything, I suppose. At one time the very thought of a computer would bring me out in goose-bumps. But here I am, using the internet, writing letters on my Mac, sending emails and now writing a blog! Whatever next?

Why am I at home, in the middle of the day, you may be asking, which allows me time to write this? A fairly simple answer (if anything is simple!). I had a heart-attack on the night of 17th/18th of May 2006 . Not something I was expecting, but it happened. If I hadn't rung the '999' emergency number for an ambulance, I might not be here now.

I worked as a carer for a young man who had cerebal Palsy. I 'lived-in' with him, and did two-weeks at a time. The pain started on the Saturday at the middle of my two-week period. I felt quite awful, but really thought that it was no more than a chest infection as I had had a bout of bronchitis the previous week and imagined that this pain was associated with that. I had to walk to the local shop to get milk and also got mint tea as I thought that the pain might be a sort of heart-burn or indigestion and this would help to relieve it. I knew that it would be really difficult to leave to go home as I have to remain with David as he can't look after himself (the whole point of being a live-in carer, of course.) If I'd rung the agency whom I work for, I very much doubt that they would have been able to send a replacement at short notice. So, unless things improved, I would just have to remain with him and wait until I went home to deal with things. I went to a chemist and got some linctus, thinking that this would relieve things. Of course, it didn't. On the day I was due to leave and to hand over to the next carer I rang my doctor and made an appointment for later that afternoon. I went to the doctor and I was given antibiotics, as the doctor wasn't sure what the pain was. When, by the end of a week, the pain hadn't gone away, and I taken all the tablets, I returned to the doctor's surgery. I saw a different doctor this time, and when she said the word 'angina' then things started to make sense and I got slightly scared (to say the least.) She told me to ring '999' if the pain kept on, and gave me a prescription for a red spray which I had to spray under my tongue if the pain didn't stop.I really thought, when the 'thing' first happened, that it was a chest infection. I'm not the sort of person who makes a fuss about things. I usually just 'get on' with things, which is basically because I'm a carer. I'm used to looking after OTHER people, and I suppose I haven't looked after myself, hence the surprise when I was in need of care and attention.

The following two days I got some chest pain, so I used the spray. It happened several more times. By the Wednesday evening it didn't go away. At around 7.30 I decided to settle down to watch some television, and the pain started, but this time it didn't go away. I used the spray, but it didn't seem to help. I thought to myself, 'I may need to ring 999 for an ambulance.' But I decided that I wouldn't need one, and continued using the spray. I thought to myself 'I don't want to bother anyone at this time of night! If I need an ambulance, I can ring after 9 in the morning!' I even prepared a holdall with clothes that I would need for a hospital stay. That's the sort of person I am, as a carer, I have to be organised to look after someone else. As the night progressed, the pain didn't go away, in fact it got worse. By 6 in the morning I had to ring 999 as the pain was really bad. Within 20 minutes the paramedics arrived at my flat. I was getting stressed and was hyperventilating, so they had to calm me down and used oxygen which was given to me through a mask over my face. They eventually walked me down to the ambulance which was drawn up to the front entrance of the block of flats. Well, I thought, if I can walk, I can't be too bad. As we left the flat, one of the paramedics told me to bring some cash with me as I'd need to pay for a taxi to bring me home, so I imagined that I'd be at the hospital for an hour or so and then come home by taxi. How wrong could I be! My hospital stay lasted a week.

We got the the hospital and I went into the Accident and Emergency department. I was told to lay on a trolley in a curtained-off area. A tablet was put in my mouth and I was told not to swallow it but to hold it under my tongue. An X Ray was taken of my chest. Doctors and nurses came and went and a canula was put in the back of my hand. I was left alone for what seemed like ages. Nurses came and went, but they wouldn't tell me anything. I really wanted to know what was causing the pain. No answer was forthcoming. After what seemed quite some time I was informed by one of the nurses that I was going to be moved to the Acute ward. I wasn't sure what that meant. Why couldn't I just go home? Why couldn't someone just tell me what was causing the pain?? I was kept on the trolley and pushed rather unceremoniously out of the Accident and Emergency department and through the corridors of the hospital until we arrived at the Acute ward. I seem to remember that a doctor did come and speak to me, and the words 'heart attack' were actually mentioned. I didn't stay on the Acute ward for long as I was evenutally moved to the Coronary Care Unit which is several floors up from the Acute ward, and by this time I realised that if I was in the Coronary Care Unit things certainly weren't too good for me! All during this the pain in my chest was continuing.

I had to give one of the nurses my daughter Chloe's phone number, as none of my family knew what had happened to me and where I was. She turned up later in the evening to visit me, which was a real surprise, as she was in Worcester, where she is at university. Also, someone I know through my church, Steve LePage, was also telephoned, and he and his wife visited me during my stay in hospital.

I haven't spent a great deal of time in hospital. I had my appendix out when I was 12, but I haven't spent any length of time in hospital more recently. I had never realised what a noisy place a ward could be. At night there is always the sound of something or other. I was connected to a monitor, for heart-rate, pulse etc. Other people on the ward were also on these things, as well as drips etc. I had several of these, connected to me via a canular in the arm. When the drug or whatever that they administer runs out the machine automatically sounds an alarm, and these keep going off all night, and the duty nurse will come and replace the drug. Also, as part of the on-going observation ('obs') you have an E.C.G. attached to your chest by way of electrodes and this measures your heartrate etc. I am also somewhat impressed by all this modern technology, as well as the blood-pressure monitoring system which in some cases can automatically take your blood pressure, for example, at night. The thing automatically inflates and takes your blood pressure. One poor man had one which took his blood pressure every hour on the hour all night. I doubt very much whether he actually got a good night's sleep.

It took three days for the doctors and nurses to get the pain under control and at one time I was on morphene and warfarin, which is also used as a rat-poison! It is used becuse it helps to prevent blood clots, but as a result of this I was advised not to shave for several days, because if I cut myself it would be difficult to stop the bleeding. I don't like going without shaving, so as soon as I was able, and after I was taken off the Warfarin, I shaved again. There was a time when one of the canulas was taken out of my arm, but the nurse who did it forgot I was on Warfarin and there was quite a flow of blood when the canula was taken out. Not nice.

As I write this I've been for an angiogram at Bedford Hospital and have also had a Stress Test and two M.I.B.I. scans at Papworth Hospital. I expect that I will get an appointment within the next week or so with one of the heart specialists at Bedford Hospital and from that I will learn what they have discovered from the scans. I'm not too worried about all this as I know that they know what they're doing.

Well, the reports eventually came back from all the tests and I was told that I wouldn't need any sort of surgery, and that the medication I was put on is sufficient to manage my heart problems. I don't need any sort of surgery.

The medication I was originally put on was Clopodogrel, (which I have since been taken off by my doctor.), Bisoprolol, Pravastatin and Dispersible Asprin. I have been on several types of Statin tablets, but they have had severe side-effects. When I was in hospital the Statin drugs I was on gave me flu-like symptoms, and it wasn't until I talked to one of the nurses that I discovered that this was that particular statin drug which had that side effect, so it was changed to another type. I have since been on several other types of Statin drugs, all of which have side effects, usually upsetting my stomach, causing me to run to the toilet a great deal, stomach and muscle cramps, sleeplessness and tiredness. This seems to be fairly general with these drugs, but I have found that Pravastatin has the least side effects. The statins are for lowering the level of cholesterol in my blood, which is what causes blood clots and leads to heart attacks and strokes. Asprin prevents blood clots.

I have had two emergency visits to hospital, one when I had a really bad angina attack and another similar one in May 2007. On both occasions I had to stay in over-night as they wanted to keep an eye on me. After the May 2007 attack I had to undergo two sessions of tests, one done on a treadmill, to test my heart's strength, and another where they put a drug into my blood stream which made my heart beat faster, as if I had been doing strenuous evercise, and they used an ultra sound scan to see my heart working. On both cases it appeared relatively healthy. I have not had any really severe angina attacks since then, but if I do get an attack I use the red spray, which helps to relieve the pain.