It seems like September was dominated by me getting to terms with having had an angioplasty and learning to live with a stent.
It started strangely of course because I didn’t really think I was ill. There was no deteriorating physical condition, no blue light dash to the hospital and no touch and go emergency operation in theatre. It was all very calm and measured and a tribute to the GPs and consultants who firmly put me on the right track. But that’s another story and will be told elsewhere.
What that meant of course is that after the first few days of post-op elation I felt worse than I did before the op. In fact I’d say that it’s only been in the last few days that I’ve felt consistently good. It’s been a mix of the physical and mental and I guess that I’m no different from anyone else who’s been through the same process.
On the physical side I realised that although there was no outward signs my right coronary artery and the pathway to it had been subject to some stress and would be bruised. That would give rise to some aching. It did but nothing untoward. What troubled me though was a feeling of ‘heart burn’ which I thought would be gastric on origin. After all that’s what it felt like and why else would I be prescribed Lansoprazole? But I couldn’t be sure and a telephone chat with a GP didn’t help.
Fortunately one of the excellent cardiac nurses at my rehab course also reckoned it was gastric and when I met the GP who’d started this off she agreed and recommended that I double the dose of Lansoprazole. I did and that seemed to do the trick.
It didn’t help that the cardiac rehab advice although excellent is a bit one size fits all. A part of this advice relates to the glyceryl trinitrate (GTN) spray which is given to everyone to use when they experience a cardiac event. You’re told to use it once, then a second time if there’s no improvement after 5 minutes, and then to dial 999 if it still doesn’t get better. My problem was that I had no yardstick. What constituted a cardiac event? I’d never really had one and certainly my ‘heart burn’ didn’t seem to be one to me. And of course if I used the GTN and the cause of my problem was not cardiac and the spray had no effect what then?
I don’t want to overstate the mental challenges but they have been there.
As I mentioned above the first few days were dominated by elation and gratitude but then I began to realise more and more that I wasn’t indestructible. Before the op I reckoned that I ate well, exercised frequently and had plenty of social engagement, all key contributors to a healthy and lasting life. Then suddenly I was diagnosed with a blocked artery and after it was unblocked the guy who did it told me that if it had not been done I’d have had a heart attack in the not too distant future. Makes you think.
So with this as a realisation and the messages about use of the GTN spray I’ve been through a period of some anxiety fuelled to some extent by blood pressure that remained high, came down and then spiked again. Plus you never know what sort of side effects the drugs you’re taking might have.
This all came together about three weeks in when my blood pressure inexplicably rose just when I was starting to feel much better and that night I seemed to lie awake for some time with an empty feeling of anxiety in my stomach. I couldn’t pinpoint any particular reason for worry, beyond my heart problem of course, it was just a big fat empty feeling.
My GP was again excellent firstly by being available to talk and secondly by responding with an increased beta blocker prescription. Not only do beta blockers get blood pressure down but they also reduce anxiety. My GP told me that sometimes they are prescribed to people getting anxious about giving speeches and making presentations. If only I’d know that earlier in my career.
The NHS cardio rehab program is excellent notwithstanding my comments about the GTN spray. There’s a series of information sessions on medicines, diet, etc and a circuit training session with 20 minutes of exercises, bookended by comprehensive warm-up and cool-down routines, specifically chosen for each participant. And whilst you’re engaged in these cardiac nurses are on hand with clipboards monitoring progress They really are very good.
With the support and guidance of the NHS team I’ve progressed to walking at normal pace for just about as far as I need to and after starting on my bike ‘at walking pace’ I’ve now moved on to more of a jog. I’m allowed to go to the gym but must warm-up and cool-down.
I’ve also done my best to be objective. Yes I did have a blocked artery but now it’s been unblocked and the other three arteries, although they show signs of aging, are not presently cause for concern. Plus all the positive features of my life earlier are still there. So although I need to be sensible there are no grounds to be negative and worry unnecessarily.
But what does it mean to be sensible? I can start by slowing down and generating less stress in my life. That’s welcome anyway. I can modify my diet. It’s always been good but I’ve not been careful about excluding the bad stuff so I’m sorry but now it’s no dairy products, no fatty meats and no processed foods. That still leaves an awful lot of good food to eat. And finally, and I’ve got to be honest, it means less alcohol. I’m embracing two alcohol free days a week, I’m eliminating the occasional glass of wine at lunch times and I’m reducing my idea of two glasses of wine by about 10%. I don’t expect to get down to the 14 strictly defined units now set by the NHS but I can meet the previous level of 18 with a somewhat looser definition which is the recommended level in many other countries.
That’s it. I regard it all as setting a new base line which allows occasional treats but no more. So far it seems to be working well. I’ve lost weight, about 4kg, I am more relaxed and I feel that my mental acuity is sharper. But I realise that I must show patience and be deliberate as I follow my rehab program. I guess I’ll need to report again in a month’s time.