Telegram, kissogram, gorillagram, just over a gram…not sure the nurse quite appreciated my jovial attitude as she told me I was going for an angiogram in the morning. Being a professional, however, she did try to smile and then elaborated on how they had managed to squeeze me into an already packed elective list, such was the urgency of my case.
By this time I had already been in hospital for two days. I’d been poked & prodded, sampled & scanned, investigated & injected. I’d been pumped so full of nitrates that my serous blood must have resembled chamomile tea! I was thankful, however, because whilst I felt like the stuffing had been knocked out of me, I could still waddle off to the chocolate machine or go to the toilet unaided. I really was very lucky!
What is an Angiogram?
Having worked as an information analyst in several large hospitals, I had a vague idea of what an angiogram was. The devil of course is in the detail. The doctors were scarce and the nursing staff were super busy, but I was given a leaflet of what to expect and I seem to remember signing a consent form at some point. East Surrey Hospital has free WiFi and I had my iPhone & laptop so I was able to do a bit of research. To be honest, however, I decided to offer myself up to fate and put my trust in the staff. Much of the knowledge I now have comes from the experience of the angiogram itself and subsequently trying to make sense of the discharge summary online.
A coronary angiogram, also known as cardiac catheterisation, is a test whereby a catheter is inserted into an artery either at the wrist or the groin. This is then passed through the artery to the heart with the aid of x-ray. In order to make any narrowed areas or blockages more visible a contrast dye is injected into the blood. for a much better description you can check out the British Heart Foundation Coronary Angiogram page.
By way of preparation I was told not to eat after my evening meal. I was also given an NHS issue disposable razor and asked to shave my groin; my man garden was most definitely in need of some pruning so managed to kill two birds with one razor. I did ponder if these two birds were the same as those in the bush, proverbially one of which would be better in my hand? I’ll stop there, but you’ll be pleased to note that I managed to spare inflicting my laddish humour on the nursing staff.
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In the morning I changed into a gown and packed away all of my stuff. About 08:30 I was wheeled down to the Cath Lab in my bed. I was positioned in front of some screens and a large horseshoe shaped x-ray machine was manoeuvred around me. The room was really cold with air conditioning. Lots of people buzzing around. I felt quite lonely and vulnerable at this point.
No Pain No Gain
A nurse asked me if I wanted some morphine. This may sound silly but I felt that I didn’t deserve it as I had no-one but myself to blame for being in this position. I wasn’t trying to be a hero, but looking back I think I was being a bit of a martyr to the cause. I definitely regretted my decision to decline the pain killer; ah for want of hindsight!
At first they tried to get the catheter in through my right wrist. A painful knick and some prodding and poking, but they couldn’t get it in so they decided to go in through my right femoral artery near the groin. Another painful knick but other than that the tube was in without event. They had placed a sort of plastic screen across my belly, perpendicular to my body, so I couldn’t really see the insertion site.
For quite a while I just lay there daydreaming and getting cold. After a bit I started to shiver and asked for some blankets because I was freezing. I even started to geek out at the screens on my left and was amazed to see the pictures of my own heart.
Call the Plumber
Then things started to get lively. Suddenly everyone near the insertion site jumped back and I saw a load of goo hit the interventional cardiologist in the face. Luckily he was wearing a large plastic visor on his head. On the discharge summary this was detailed as ‘Export catheter – successful clot aspiration’. It’s a bit like when the plumber has to clear your drain because you’ve been pouring chip fat down the sink; just imaging the doctor doing a sharp intake of breath, scratching his chin and saying “that’s gonna cost ya!”
Angiogram Becomes Angioplasty
As with many others, and as was predicted, my angiogram became an intervention. More precisely, I had a coronary angioplasty with stents. This is also known in the trade as a percutaneous coronary intervention (PCI), or if you really want to show off down the pub then you could slip in percutaneous transluminal coronary angioplasty (PTCA). Basically this involves using a balloon to stretch open a narrowed or blocked artery and inserting a short wire mesh tube to keep the blood flowing. For more details check out this NHS Choices page.
Sounds simple right? It was the balloon that had me regretting my decision to decline the morphine. It was the balloon that had me in tears. It was the balloon that had me shouting “****, ****, morphine, ******* ****, sorry, morphine, ****, sorry, ****”. I don’t know why it took an age for them to find some morphine, and millennia for it to kick in, but like I say no pain no gain I guess! It was like having another heart attack, which I guess in effect I was because the balloon had blocked my artery again.
What’s the ExStent of the Damage Doc?
To cut a long story short, the worst of it was a long segment of atheroma (heart disease to you and I) in my Left Anterior Descending (LAD) artery. I’d like to express my sincere gratitude to Dr R Iqbal and team for the two stents that you left in place; they appear to be working fine. Hopefully I won’t have to see you or another of your colleagues in a professional capacity again.
More to come soon…