Goodbye Kansas - Hello heart attack

I had been ignoring the pain, it had occasionally come on when I was walking, but slowing down or stopping for a while would make it fade away, or I would simply fight through the pain barrier and ignore it. It did not happen when exerting myself suddenly, like running up and down stairs, or moving heavy furniture and because sudden exertion did not bring it on, I put it down to being a little out of condition.

Whilst visiting the family in the USA, several of us had contracted some kind of flu like illness with headaches and a particularly painful sore throat with a persistent cough. By the end of the trip, my sore throat had finally gone, but the cough remained. This continued all the way home and for some days after arriving only getting better slowly.

I had arranged to give a presentation to the U3A in Fairford a few days after we were due home and I was a little more stressed than usual over this, since it was a complex talk and I was unsure if it would go down as well as the last talk I gave them. On the day I was late, because having almost got there I realised I had left behind some of my material and had to return to get it. Telling them that I would be a little late we turned around and raced back home, . As it happened, Joy who was driving got me back home and back to the meeting hall in record time and despite everything, the talk went over reasonably well.

My constant coughing had made my chest sore, so later that week I went to see the doctor and He examined me, listened to my heart and we discussed the cough and flu like thing I had contracted whilst away and came to the conclusion that I had been coughing so much my lungs were protesting about their overuse and I must be suffering from strained muscles due to the cough. Much relieved I went home, knowing I had been checked and it was not serious and I was OK and the pain would go away and sure enough it was not apparent, until the following morning.

It is our habit for Joy to shower first whilst I make the bed, shave and make the morning coffee. I was making the bed when the pain returned and I carried on with the usual, working through the pain barrier routine. I managed the coffee but afterwards had to sit down and wait for the intense pain to die away, which it did not. So I went upstairs and got into bed. Although the symptoms did not resemble any of the descriptions of a heart attack that I had ever heard, I had begun to wonder if it was a heart attack by this time. At one point I was also wondering if it was a heart attack, I would rather it would get it over and done with and kill me quickly. Anything to stop the pain. Apparently when Joy saw me in bed, I looked so bad that she immediately realised something was seriously wrong and after a discussion phoned 111. I spoke to the person on the other end and described my symptoms and they decided they should send the paramedics. They arrived quite soon and did all the tests, pulse, blood pressure and an ECG. Nothing conclusive but they decided I should go into A&E to be checked over more thoroughly, so off I went in an ambulance with another ECG attached, a soluble aspirin and a quick spray under the tongue. After the spray, the pain subsided and after a short rather bumpy ride, I was trolleyed into A&E and told to sit on a chair and a nurse would see me.
It was fairly early and the place was busy but not too bad and after a while Joy arrived, having found a car parking space, and came and sat with me until a nurse came and took my details. After a short wait, we followed the nurse into another room and from there on the hospital went into top gear. I was tested, ECG-ed, X-rayed, listened to and prodded and had blood taken and then more blood taken. A long time later, a doctor came up to me and said that the blood samples showed that I had just had a mild heart attack. There were high levels of the hormone that is released when the heart has been damaged. I was not expecting this, despite wondering if it was a heart attack during the peak of the pain, I had believed it was my lungs, because the pain I had experienced was a burning sensation like overworked lungs and it was on both sides of my chest.

 After another long wait I was put on a wheeled bed and taken up to the Acute Cardiac Ward and wheeled into a single room all to myself, where I was wired up to a big monitor on the wall which showed my state of play and which beeped loudly at intervals. More doctors, blood pressure tests, blood samples taken and being type II diabetic, blood sugar tests. My blood sugar was extremely low, but considering I had only eaten a small packet of peanuts all day and by then it was now early evening, that was not too surprising. More tests and so on until nightfall when Joy was ushered out and I was left all alone to sleep if I could. The sticky tabs holding the wires on kept pulling at the hairs whenever I moved and a machine that signaled a few characters of Morse code very loudly every now and then right by my ear made sleeping difficult. The monitor went BEEP BEEP BEEP, which is S, then, BEEP BEEEEP which is A. This was followed by a long pause, then a single BEEP, which is E on and on.
Outside my little room I could hear the same set of beeps from other similar machines throughout the main ward, All these other machines went through the same sequence one after the other until mine would respond and after a short pause, they all started again. This went on all night with the occasional visit from the nurse to check me over and take blood pressure readings. Blood pressure was taken using a small robot like machine on wheels which the nurse trundled around with her. This machine also beeped loudly, but with a different pattern of beeps in a kind of tune as each beep was a different pitch.

The next morning I was given a set of pills and an injection in the tummy, a swab around my sweatiest places to see if I carried any nasty germs that they should know about before letting me loose in their hospital. This was followed by breakfast and a bit later the top doctor came along with his entourage of about six other people and told me again that I had had a mild heart attack. So - he continued, they would need to give me an angiogram to see what was going on and then decide what could be done to keep me going.
 After that I was connected to a portable non-beeping machine and trundled, on my bed, into another part of the Acute Cardiac Ward. This was a slightly larger room off the main ward where there were four bed spaces with a single narrow window squeezed into one corner. I now became known as Bed 14.

I then spent the next two weeks there. During that time various fellow inmates came, went and were replaced. Several were only there for a couple of days, having received their treatment and were only in the ward whilst they were being assessed and then released.

I noticed quite early on that only bed 12 and 14 had numbers whilst the two others did not. On pointing this out I found the nurses reluctant to discuss this oversite and in the end I decided that it was so that no one was quite sure which was bed 13, the unlucky bed.
Quite soon I was taken into the operating theatre for an angiogram, which showed an image that looked like a particularly distorted tree in winter. My three main arteries were very constricted and it was no wonder my heart had decided that enough was enough and had been screaming DO something.

The doctor in charge decided that it was going to need some consultation before they did anything. They had two choices, attempt to open the damaged arteries with one or more stents or give me a heart bypass. They could not decide on the spot and, besides being borderline stent/bypass, my X-ray had shown an anomaly that they had decided needed another specialist and further tests. So I was returned to bed 14.

 The portable ECG machine was carried in a kind of shoulder bag, which meant I could walk about and going to the loo was no longer a problem with trailing wires . I was now able to get out of bed and wander around if I wanted to. Not that there was a lot to see, but over the two weeks I learned all the notices off by heart as I read the notice boards all again and again whilst wandering around the larger part of the main ward.
The day to day routine of the ward was, wake you up at 5 to change your water jug. It was not intended to wake you, but I always woke up and usually switched on Radio 4 and listened to that using the headphones provided. About an hour later a nurse would take my blood pressure using the robot kind of beeping machine, test my blood sugar and then feed me my pills. About 8AM breakfast was served and then your time was your own until the next blood sample was taken and the robot blood pressure beeping machine was used once more.

 At ten o’clock visitors were allowed to come in and Joy would turn up with any stuff I needed and recycled my dirty washing. Visitors were turned out at 1PM, and she was not allowed back in until three o’clock, allowing us heart patients to have a siesta. At three she would return and stay until about five or six. After a few days of this we agreed that she should only visit in the morning not the afternoon unless I was having something done, like an angiogram, a scan or an X-ray, which would tell us what was going to be done to me.

This went on for over two weeks. Two weeks of blood testing and other tests outside the ward, which involved a couple of echo scans using ultrasound, where you could see a view of your heart beating away on the screen and I could not help make comparisons of the scans you see for unborn foetus and was prompted to remark, ‘is it a boy?’ The nurse laughed tiredly and I realised that everyone must make the same joke. I should have known.

At one point I was sent for a CT scan, which was an experience all in itself. The porter trundled me down to the X-ray department in a wheel chair. I was not allowed to walk despite feeling fine, but nonetheless I was wheeled down and he dumped me in a queue of chairs, trolley beds and walking wounded. Amongst these were some really ill looking people, whom I instantly felt sorry for. I was feeling no different from how I felt before my heart attack but several of these people looked really bad and I felt that I was out of place. As the porter left he said, you should not have too long to wait, and all the others queueing laughed, from which I assumed I was actually in for a long wait and my fears were justified. Joy had been visiting when I was taken down and had remained in the ward and I wondered if she would find her way here after it became apparent I was taking a long time. One by one the halt the sick and the lame went into one of two doors with a sign over them saying something like ‘Do not enter without permission – X-rays.’ Eventually it was my turn and I was wheeled into a room with a huge CT scanner in it and a nice Australian sounding lady who told me to lie on the narrow bed of the machine. The scanner had a giant wheel which the bed slid into and it was much larger than the CAT scan I had once been thrust into thirty odd years ago. That was claustrophobic, but this was more like some kind of fairground ride. The Australian sounding lady told me it would feel warm and that I must not move, arranged my arms and my portable ECG machine so that they would not get in the way and proceeded to scan me. It was weird, the huge wheel started revolving and spun up faster and faster making a heck of a noise.

Eventually once it had reach operating speed of warp nine, the bed slid me into it and sure enough a weird warm sensation slid down my chest as I was moved through it. This was repeated and then the wheel started to wind down and I was able to get off the bed. I was then wheeled out to the same waiting room on my chair by another lady. I was not allowed to walk back to my ward, having had strict instructions to wait for a porter, so like a good patient hospital patient I sat in my chair and waited, wondering what Joy was doing. 
Various other people were still waiting for their porter, some of them I recognised as people who had been scanned or X-rayed before me and slowly one by one they disappeared as various porters came and wheeled them away. Other people were coming in constantly and it was getting quite crowded. 

One couple who arrived were strange, they seemed to be mother and daughter. The older woman was on a gurney and the younger woman was keeping her company. The older woman looked really hard and spoke with a really rough sounding voice, almost masculine in tone. She looked tough as old boots, as if she had had a really hard life and would stand no nonsense from anyone. The younger woman was obscenely obese. I mean huge! I was surprised she could still walk because she was way out of control with her weight. The older woman was taken into to be scanned and soon came out again. The daughter then suggested she took the gurney back to wherever they had come from, but a passing orderly heard what she said and told her she was not allowed to do that since she was not a member of the hospital staff and they would be breaching the health and safety regulations. This was not good enough for the younger lady, so as soon as the orderly had gone, she started to push the gurney but the older woman told her to stop because it was not allowed and an argument broke out between them. After a heated exchange the younger woman, now obviously in a petulant mood, gave in. Suddenly she left the gurney and shaking the ground with her footsteps went and thumped angrily on the office door, which was between the two X-ray theatres. After a while a woman came to see what the all the noise was about. By this time everyone in the room was watching in dismay as this awful woman shouted, ‘We need a porter, we have been waiting for much too long.’ The woman who had answered the door said, ‘The porters have a list of people to move and they will move you when you come up on their list. Please wait.’ and shut the door. The grossly large young lady then became really cross and grabbing her coat and bag off the gurney, urged the poor invalided lady off her gurney and forced her to walk out of the waiting room. I have no idea what was wrong with the lady on the gurney, but she could hardly walk and every one watched in horrified silence as she was herded out of the room. Everyone, like myself, too shocked to say anything.

A bit later when another patient on a bed was wheeled in, there was no place for it and the porter seeing an empty gurney asked the people in the office if he could move it. The same woman who had told them to wait came out and was astounded to find the gurney empty. She asked around if anyone knew where they were and someone told her they had walked out. She looked in the outside waiting room, but they were not there and so told the porter to take the empty gurney away so that they could fit the bed he was bringing in its place and exited muttering. I have no idea where they went, presumably back to the ward they had come from, but the mood the younger woman was in it is likely she got them on the next bus home. What the effect of being forced to walk had on the older woman I shudder to think. She did not look at all well.

After another long uneventful wait I was trundled up to my ward, where I found Joy in the throes of trying to get a rescue mission from the nurses in my ward, but now she was able to tell then there was no need.
My way of life returned to the normal routine, with other people in the ward who came and went. One day I found I was the only one there, all the others had gone home and their beds taken to wherever unoccupied beds went. I was alone all morning until an older man, arrived on his bed. He introduced himself as Godfrey when I walked over to talk to him where he almost immediately launched into a story in intimate detail about the loss of his wife, some ten years previously, whilst on a cruise ship. Not something one usually tells a complete stranger on the first meeting.
He stayed in the ward for a long time and was still there when I finally left and he had become a real nuisance. I came to understand that he was once the dean, or head teacher of a private school, but I am not certain. What I was certain of was that he seemed to expect all the female nurses and orderlies to defer to him. I noticed that he never used a please or thank you to the female nurses, but was much more polite to all the male orderlies and nurses, using please and thank yous and would you minds. This told me something of what kind of person he was.
He was also a whiner. I have never before actually come across someone who really whined like he did. He found fault in everything the nurses did, he demanded attention and if no one came, he would continuously complain in a whining voice about how urgent his current problem was and how he was being mistreated and ignored. At night he became impossible.

By night time the first day there were two other people in the ward and one was having fluid retention problems and was on a special drip that needed constant care by the nurses. These drips have an alarm when they run out and they then beep regularly. I was on one of these a couple of times during my holiday there and I had managed to more or less tune the beep out, but G could not and he started to moan and complain. ‘Can’t someone stop that noise?’ A bit later, ‘Oh please stop that noise.’ ‘I just want to get to sleeeep! Please stop it.’ This went on for hours because each time the nurse came and stopped the alarm and fitted another drip, after a short while the alarm would go off and he would start again. This kind of thing went on for three nights. He needed the bed pan he was bursting, ‘Nurse I need to wee, nurse, please help me, oh do come soon.’ I had noticed he had a bottle on the side of his bed and so must have had a catheter. Knowing how that felt from a previous visit to a hospital I understand how he must be feeling, but although a nurse came in and told him he could let go, he did not believe her and continued to complain between bursts of complaints about the drip alarm, which was going off occasionally in the next bed to him. Although I had felt sorry for him at first, after three sleepless nights I became a lot less sympathetic. OK, the guy was suffering, but now no one in the ward could get any sleep for three long nights. Being in hospital is tedious enough during the day when things are going on around you but at night time does kind of drag when you are awake.

Eventually he got really angry with one of the nurses, when she came in to see what was troubling him. On this occasion he kept complaining that his bed was uncomfortable and he was lying in a pile or rubbish. ‘There is rubbish under me, I’m lying on a pile of rubbish. My bed is full of rubbish.’ He kept saying in various ways. One of the nurses was Indian and I guess had not long been working in England. It took me a couple of days to tune into her accent, but she was one of the nicest, most patient and skilled nurses I have had the privilege to meet. She could slide a blood test needle into a vein, with no pain and draw blood first time every time, not many nurses can do that. She was very helpful and did her best for her patients, having a charming bedside manner and was a genuinely pleasant lady. That night, she was on duty and she was obviously having difficulty with G and his complaint that he was lying on rubbish. Her idiom for rubbish meant trash, so he seemed to her to be delirious or confused, and at first she did not attempt to find out what the real problem was because she did not think there was a real problem. A bit later, to shut Godfrey up, she came in with another nurse and sat him in a chair whilst they remade his bed. What had happened was that a pencil he must have misplaced had somehow found its way into his bed and Godfrey had been lying on that.
 ‘There!. He said crossly, ‘I told you I was lying on rubbish and you would not believe me!’
 ‘That is not rubbish.’ She told him, ‘It is a pencil.’
The following day when she came on shift, I noticed that he was complaining about something again and at that point, she had had enough and really laid into him like a sergeant major disciplining the troops. She told him essentially that there are others in this ward, all very ill and they need their sleep. You are disturbing them, you must keep quiet. We are very busy and we will come as soon as we can, there are other people in this ward beside you who need our attention, you must wait your turn. She meant the main part of the Cardiac ward, because our little room was just one part of the larger ward. 
There was a lot more in her ticking off, but it did the trick, the next night, he was as quiet as a mouse and we all got a good night’s sleep for the first time in three days.

The usual routine of waking at 5, eating sleeping and having blood and blood pressure tests, continued for a few more days and I was still waiting to see what could be done for me and Joy was visiting in the mornings and sometimes returning in the afternoon. I had suggested to her that she should only come once a day, but she wanted to be there when I found out what was to be done for me. Another part of my daily routine was to walk up to the end of the main ward and back. In doing this I passed the ward telemetry monitor that was recording all the patient’s ECG signals and after a while translating what I was seeing I realised I could pick which set of data was mine and could see that my heart was still beating and all the contacts on my chest were good.
Sleeping at night with a monitor in a shoulder bag was not easy, but early on I had managed to accomplish a method of moving the bag just before I turned over and this way, only the occasional lead became unplugged and the monitor would flash a warning. This action of moving the bag became such a habit, that when I eventually got home I was feeling for the bag for the first few nights in my own bed before I turned over.

 One morning Joy phoned me and said she may be a bit late because she had a bad headache and did not feel like driving. I told her no problem, but to come in when she felt up to it. Since she was not feeling well, I thought she may have gone back to bed, so I did not try to phone her all that morning but sent a couple of texts. By midday, I was beginning to wonder why she did not answer my texts, but after lunch, there were no visitors allowed until three, so I tried to phone her and her phone service told me that her phone was switched off. Unusual, but maybe in all the rush to keep coming to the hospital, she had forgotten to charge it. So I tried our home number, but just got through to the answerphone, so I left a message to phone me a.s.a.p. By two o’clock, I was getting worried and tried to phone our friend Penny, but got through to a wrong number, it turned out I had not updated her number when she changed her phone. I got no reply from her home number, so I was stuck and I really did not know what to do. I started to imagine images of Joy lying at the foot of the stairs unable to reach a telephone and other awful scenarios. I wandered around for a while wondering what to do, getting more and more worried. In the end I went to the nurse at the main desk and told her what was worrying me. She suggested all the things I had tried and then suggested I call the police on 101. I had not thought of that, so I tried using her desk phone but just as I had started to explain, the phone cut off suddenly for some reason. Meanwhile, the nearest patients had heard what was going on and started throwing in suggestions of what to do and for the three people who were near enough to see what was going on it became something of a soap opera which obviously relieved the monotony of their daily life in the ward and I suddenly became an interesting person.
What I really wanted to know, at that stage, was if both our cars were still on the drive. If there were, could maybe I find someone who could knock on our front door. I was not sure what I would do if her car was not there, or if it was and there was no reply to anyone knocking, but that seemed a good starting point. By this time it was approaching three PM and I was beginning to panic. As I wandered by the ECG monitor whilst pacing and wondering what to do, I saw that my heart rate was up to 128 bpm, so I went and sat on my bed for a while until it slowed down.

I decided to try the police again and this time the phone allowed me to get right through to explaining what was wrong. It took a long time to explain who I was, where I was and why I could not just go and look myself and so on. I had just completed all this when Penny suddenly walked into the ward. I was both relieved and alarmed. Why was she alone? But at least I could find out what had happened. Everything is OK she told me, Joy is in A&E and is being taken up to a ward. I don’t think my hair stood on end, but despite Penny’s reassurance, I immediately jumped to the conclusion she had had an accident.
It turned out that Joy had not been exactly truthful when she had phoned me and – ‘in order not to worry me’ - had not explained fully. She had woken up feeling really bad, her heart racing like a Formula one engine she felt dizzy with really disturbing vertigo. Everything was swimming around and she really was in no state to drive, so she had phoned Penny. Penny had quite rightly said she should go to the A&E and she would take her. From there on, Joy had been going through the same routine that I had gone through on the day I was brought into hospital and very nearly ended up in the same ward. However, an important difference was that she had shown no symptoms of having a heart attack.

It was obvious in hindsight that the stress of coming and going back and forth to hospital and trying to run the household chores in between had been too much for her. She was now in a ward upstairs from where I was and a bit later, after Penny had gone home, I asked if it was possible that I could go and see her. One of the nurses very kindly volunteered to wheel me up there, although I was walking around the ward, they would not let me walk out of the ward, so I had to be wheeled there. The sense of relief I experience when I saw Joy was so intense I was glad I was sitting in a chair already. We sat and talked and she told me what had really happened to her. By the time I had been able to get to see her, she had more or less fully recovered, with just the vertigo remaining, which took a several days to disappear. Eventually I returned to my ward and she, after an overnight stay was told she could go home. However, she was still not in a fit state to drive and she arranged for her friend Sheila to come and stay at our house and run her back and forth to the hospital.

Meanwhile, I still had not been informed what treatment I should have and the choices were driving us both mad. If I needed a heart bypass, then I would have to go to either Oxford or Bristol, both a long enough drive for Joy to consider looking for overnight accommodation. This had all added to the stress she was suffering and a lot to do with why she ended up in the A&E.
One day I had two visitors, my two sons came to visit and we sat in the small guest room lost for something to talk about which did not have anything to do with heart attacks.  I recalled visiting my father when he was ill and discovering how ill he really was and so wondering what to say to him.  I was nothing like as bad as my dad, because there was nothing that could be done for him, but I knew how they felt and tried to sound cheerful and hopeful.

After a couple more days,a specialist doctor came to talk to me about the spot they had found on my lung. This being one of the main reasons they had held off doing any procedures. He decided it was too small to worry about but should be checked again later, but it was no reason not to do the procedure for my heart. Armed with this news, the heart surgeon now had do decide if he could fix me with a stent or two or send me to Oxford or Bristol. After a few more long days, doing jigsaw after jigsaw on my iPad, they finally came to a decision and decided they would attempt to insert stents. The surgeon had said that it would take a very long stent to open one of the arteries, but he believed it would be possible. So after the usual warnings that I may die from all manner of complications, he thrust a form under my nose with a request sign permission to subject me to all these risks.  Once signed, they gave me a date for my procedure.  On the day, Joy and I waited and waited the time came and went and we waited some more, then... “Sorry an emergency took precedence over you and we will take you down tomorrow.”

The same next day. I appreciated that someone dying needed to jump the queue but it is difficult waiting and waiting for something like that and Joy was getting very frustrated. Finally they could fit me in, so off I went to the operating area. After a long wait getting colder and colder, I was prepared by a nurse who told me I must remove my pajama trousers and now wearing nothing but a surgical gown wandered across to the toilets for a pre-op pee, with the nurse walking alongside me holding my inadequate garment together at the back to preserve what remained of my dignity.
 After this little display, I waited for another thirty minutes and finally I was wheeled into the operating theater. They then opened up my wrist again and inserted the piping for the angiogram which makes the veins visible to X-rays so that the surgeon could guide the stents into the right places.

This took an exceptionally long time and after about an hour and a half, I badly needed to pee again. Since I was lying flat to a table with strict instructions not to move at all and a man working metal things around inside my heart, I was getting more and more desperate. In the end I had to tell them I was bursting for a pee. “Would you like a bottle?” “I’m sorry, but yes I must have one soon.” A nurse produced a bottle and thrusting it under my surgical gown helped me get it into the correct position. I needed further help because I only had one hand free, had to remain perfectly still and could not see where everything was. So the poor woman had to grope me under the gown and insert my member in the bottle’s orifice and soon there could be heard a trickling sound that everyone pretended to ignore whilst the operating crew carried on as normal. Eventually the nurse was able to remove the bottle and the procedure continued without sound effects from the patient.

 After a very long time, I was wheeled back to the ward and was able to tell Joy I had been operated on successfully. I was told the effect was immediate, but the first thing I noticed was that I could breathe more easily. Later the surgeon who had performed the procedure came along looking really pleased with himself and informed me that mine was the longest stent he had ever inserted and was really happy with his success. He told me that he had inserted the overlong stent and a second normal length one, plus he had opened up another artery that was too small to take a stent. This was why it took so long apparently and it was in fact a rather tricky procedure. Anyway I was still alive and after a night of further interrupted rest with tests and blood pressure etc, I was able to eat breakfast and  by the time Joy arrived I was being chucked out.  We hastily packed up all my now fairly numerous belongings and I was wheeled into a waiting area where we were told we would get my prescription. As soon as that arrived, I could go and after a short wait, the medicine arrived and another nurse wheeled me out to Joy’s car where Sheila was waiting for us and at last I was free!