NO FEAR ANGIAGRAMS, Heart checks made simple
Only those who have sat in front of a Medical Consultant and heard the pronouncement from such lips that you have, for example, Cancer, can fully understand the impact that hits the patient. In my opinion, anyone placed in that position who maintains a stance that they were not feared by the news, is simply being disengenious.
That is based on my own recollection of my diagnosis in 2010 of Non Hodgkin"s Lymphoma. First and foremost a blast of chilling fear was reaction number one from which all else had to follow. In my own case, the fear was rapidly overtaken by a pragmatic view that as now 1 in every 3 people get some form of cancer, I had not received a simple death sentence and had therefore got to get a grip and find how how the problem was to be dealt with and what I personally, could do to help the process.
As a result, there are now over 200 of my Hubs published, simply plotting events and progress to the point where the same Consultant, in the same room, pronounced me to be in full remission in 2011, a state that continues happily, to this very day.
Those, like myself gifted with more than one brain cell and thus able to read prose and narrative without the need for cartoons or pictures, may find the story of interest and visit, as many still do, the various Hubs tracing the treatment path.
All this is by way of introducing this Hub, for in similar circumstances recently, I was told by another Consultant that, following a small stroke in mid 2013, an ECG suggested that I had atrial fibrilation and that further investigation was recommended. in the form of an angiagram. Cue initial fear again !
TAKING IN THE NEWS.
The heart, as we all know is the pump from which flows life.Thus, we view any problem with it with justifiable seriousness. After all, Cancer rarely kills at a stroke but heart attacks strike one down in an instant as we have all witnessed may times on the screens of the movies and our own televisions.
Even so, the fear factor differs hardly and, in my case, a similar process to the discovery of my cancer had to be followed. Firstly, I was to an extent able to convince myself that, as in medicine diagnosis is everything, this was positive not negative news. Secondly, the progress required me to understand fully what was involved.
The Consultant must get tired of explaining, what to him is an everyday procedure, but he did so patiently and with great clarity which was most reassuring.
Briefly, for those without detail of the procedure what happens is as follows:
1. The patient is admitted to "Day Stay" ward and told to expect a 6 hour stay.
2. Having been given a bed area and divested of clothing replaced by one of those terrible back fastening Hospital Gowns, one is fitted by injection with a device in one wrist to allow fluid to be passed into the body if required.
3. As the procedure requires a further invasive process into either wrist or groin, the latter area, unless already done at home, is shaved to cut down risk of infection.
4. The Consultant undertaking the procedure then visits to check out the patient personally and to obtain the signature of consent I found this the most unnerving aspect of the whole thing as it is stressed that, as with all invasive procedures, an element of risk must be accepted.
The patient then waits patiently until the time comes to be wheeled through miles of Hospital corridors and up in a lift to the appointed Theatre ,where, like a ship arriving at port, one is "stacked", moving up the line until the turn to be dealt with arrives and the bed is pushed into the Theatre area. for the main action to begin.
In my case this took 3 and a half hours from arrival to mounting the special table over which was positioned an x-ray machine that was able to be moved as requred by the Consultant to convey pictures to a bank of screens place to the left of the table as he performed his work from the right assisted by two nurses.
By this stage the patient is as ready as he or she ever will be, to face up to the fact that this is actually about to begin and that shortly a tube will be providing pictures to the screens from inside their own heart
. Reality sets in and patients fall into various categories ranging from the mildly apprehensive to the openly petrified. On my day there were 9 people receiving the procedure all with differing aspcts to be covered and exhibiting the whole range of human feelings about what they were to endure.
One man in particular, openly advised to all and sundry that he was "Terrified with a capital T"
.THIS DID LITTLE TO CALM THE NERVES OF SEVERAL OTHERS WHO OPENLY DISCUSSED THEIR CONCERN THAT BEFORE THEY SIGNED A CONSENT FORM, THE CONSULTANT HAD ADVISED THEM THAT THERE WAS SOME ELEMENT OF RISK INVOLVED IN WHAT THEY WERE TO SHORTLY ENDURE AND THAT THEY WOULD NOT DO THAT UNLESS IT WAS SERIOUS!.
Some did not understand this to be standard practice before any operation or invasive procedure but most took it in their stride. The majority, like myself , held the view that the sooner things started, the sooner they would be over.
RIDING THE DODGEM CAR.
Inside the theatre, on the slab, wired up and ready to go, the patient can see their blood pressure and pulse rate clearly on the screens. Almost surrealy, the Consultant appears at the right side and administers the local anaesthetic. In my case this was in my right wrist, though often it is in the groin, hence the need for pubic shaving.
Swiftly following the "local" , the procedure proper commences once the arm are is numbed. A larger needle paves the way for the tubes to be inserted and thence threaded upwards and then across the chest via the arteries into the right and left ventricular areas to allow the dye that is used to give the screen pictures the information required by the Consultant.
Once the tubes are in place, a dye is sent up the tube giving a feeling of a warm flush up the arm. No other feeling prevails and there was no feeling of anything being in the chest area, though it was clearly possible to see what was progressing by looking to the left and taking in the pictures on the screen.
From time to time, the body was shifted into a different position and the x-ray slab above moved to focus on another area of the heart.
These movements could not be considered as "smooth", in fact I told the Consultant it felt like being at a fairground and in a dodgem car. He fully agreed with me and also with my observation that if this was the worst to happen ,then the procedure was certainly not one to worry about.
In my case the "RIDE" lasted from start to finish 21 minutes according to the Consultant. The average, according to data required is 30 minutes, though some can last up to 1 hour. I never felt the tubes being removed and was taken by surprise to be told all was over.
I was then given the first of several lectures on what NOT to do with my right hand,wrist ,and arm for the next 24/48 hours. In essence the message was to do nothing with it lest it encouraged blood that had yet to congeal to spurt out of the hole where the tubes had been inserted. A wrist band which was segmented and took in some blood was attached to my wrist and I was given a type of syringe to take back to the ward where the Nurse would explain all.
THIS EQUIPMENT ATTACHED , I WAS ALLOWED TO LEAVE THE TABLE AND REPLACE MYSELF ON THE BED TO BE TRANSPORTED BACK FROM WHENCE I HAD COME BUT NOT BEFORE I HAD BEEN TAKEN TO TELL THE PETRIFIED PATIENT WAITING TO COME IN THAT HE HAD NOTHING TO WORRY ABOUT. I DID SO BUT THE PATIENT LOOKED AT ME IN A MANNER WHICH CLEARLY SAID HE DID NOT BELIEVE ME !
That done, I was again taken on a magical mystery tour of Hospital corridors eventually arriving back at the ward I had first entered at 12.30 pm. It was now 4.45pm.
RECOVERY, OVER AND OUT !
Back in ward, the young nurse who had prepared me earler returned to give me my orders as to what to do if I had aspirations to return home that day. Much of this centred on my right arm and to ensure I did nothing to affect it and the blood it contained.
The mysterious syringe was explained as an instrument here not to add things to me but to take out in 3ml amounts every 20 minutes, air which was there initially to assist coagulation.She would perform this task for me and all I had to do was nothing, save rest, read my book and keep an eye that no blood spouted beyond the wrist bangle in place.
20 MINUTES LATER SHE RETURNED TO TAKE OUT SOME AIR AND ALL WAS IN ORDER. ANOTHER 20 MINUTES AND A REPEAT TOOK PLACE.
SHORTLY AFTER THAT MY WRIST WAS SURROUNDED BY A WARM LIQUID AND I LOOKED OVER TO SEE BLOOD EVERYWHERE !
Thankfully, the nurse swiftly returned, put BACK some air and order was restored sufficient to allow me to eat, in comfort, a reasonable meal of Cajun Salmon ,ordered earlier by myself.
Thankfully further removals of air went calmly, the Doctors came and advised they would be in touch with my GP and gave me a prescription for change of drugs in the meantime offering also words of encouragement on what they had viewed. Eventually at 7.30pm I was allowed to ring for my family transportation to home. I arrived at 8.00pm, exactly 7 hours and 45 minutes from leaving it. My "ORDEAL" was over, though 48 hours had to elapse before I could drive and also, dress with both hands again.
A daily event for Doctors but not patients and even though it is now behind me, I still retain apprehension to some extent, though as hopefully as this Hup will have shown I am keen to ensure others who may yet have to face one, that an angiagram, whilst no day at the beach, is not something to cause with justification anyway, sleepless nights.
So, if, dear reader , you face one soon, or may do so one day in the future , take please, this HUB, as living proof that there is life after it is behind you and that the procedure itself is nothing to cause either pain or alarm..