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Kindle book - My Lanzarote. 10 walks and a personal view

Kindle Book And A Pub For Lunch

5 Walks In The Yorkshire Dales

 

My Cabbage and I

June 2014

As I will not be in a position to add new walks to my site for some time following heart surgery, I thought I would document my recuperation instead, mainly for my own amusement but for anyone interested.

Blogs normally have the latest entry first but to avoid having to scroll backwards for anyone arriving here for the first time, I am going to write the other way round.

Quick Link to Latest Entry here.

The Back Story

I have always kept myself reasonably fit. Not fanatically but I have:
  • Never smoked (not even one)
  • Eaten decent food, including Flora/Benecol, olive oil, omega 3 oil, wholemeal, fresh veg, lean meat etc etc.
  • Not become obese
  • Not drunk to excess most of the time (come on, allow me an odd “special” night!)
  • Exercised – regular hiking, energetic lunchtime walks when in the office. Played badminton weekly for 40 years – i.e. energetically, not just tapping the shuttlecock to and fro, as you sometimes see in sports centres.

What could possibly go wrong?

Outside my peripheral vision, the family genetics were conspiring against me. When I now think about this, I suppose I should not be surprised. My mother had angina – although she did make 93! My brother died of a heart attack at 57, Aunt on that side has a pacemaker and Uncle died fairly young of a heart attack. Thinking back, my grandfather on that side also died when I was only a tot. On the other hand, my father is a healthy 94.

In Feb/March 2014, I was playing badminton when about the third game of the night, I experienced a mild ache in my left chest. I stopped playing and it disappeared. The following week, I played with no problems. The week after that, the ache reappeared. Furthermore, the following day, I was walking up the slight hill out of Feizor in the Yorkshire Dales; a non event by my normal standards; when it happened again.

Time to investigate.

A visit to the GP, a consultant and a treadmill test resulted in a diagnosis of angina - chest pain that occurs when the blood supply to the muscles of the heart is restricted. It usually happens because the arteries supplying the heart become hardened and narrowed.

I suppose an option was to take the pills and take life easy but that would not have been my way and I asked if I could be “fixed”. I was referred to LGI on 16 May 2014, ostensibly for an angiogram, angioplasty, where they insert and inflate a balloon to expand the blocked artery and insert a stent to hold the artery open. It is a very common and successful procedure.

An entry point for the equipment is the groin or wrist and I was told to arrive with a shaved groin. A diagram showed which bits to shave but not wanting to get it wrong or end up with an area looking like a Hitler moustache, I just shaved the lot. So they used the wrist!

My wrist was numbed and after some fiddling about (the technical expression), a dye was inserted into my heart to show up the arteries. At this point the procedure stopped. The consultant said he would come to talk to me – oh dear!

As a matter of interest, the entry wound for this was no larger than a match head. Amazing.

The consultant duly came to se me, complete with photos of my heart. It turned out that the blockage was at a Y junction of arteries which meant the stent process could not be used. Furthermore, it was in the Left Main Coronary Artery, i.e. the main one. The recommended treatment was a Coronary Artery Bypass Graft. Gulp!

Not only that, my condition was described a “prognostically urgent” and that I needed to be admitted then and there as an acute patient! Having arrived in expectation of, at worst, an overnight stay, I was ill prepared.

I spent a frustrating few days because I could get no clear indication of when I might get an operation. I asked if I could go home to wait at which point, a consultant said he would not sleep at night if he let me go home. Double gulp! Yet, I felt fine; a fraud really.

I was subsequently told I was a “ticking time-bomb” (though there were differing opinions on the speed of the clock!), that I should not use the stairs, as they were not well used and if anything happened…..

You lose track of the different doctors but during one discussion, one looked me in the eye; and it was the way he looked as he said “if anything happens it will be very nasty”, that I realised if the said “anything” was to happen, it would in all probability be goodnight Vienna, or at best a severe heart attack. To that point, I had not had a heart attack and thankfully have not since. My heart, in itself, is evidently quite healthy. It just needed a decent blood supply.

I therefore had to settle down to an institutionalised life. I started on Ward L18 then moved to L16. I became part of the furniture and was able to observe in some detail the way the staff worked, their attitudes etc. I will sum all this up as absolutely fantastic. I could not fault them on anything at all and in fact have since written to the Chief Executive to thank the staff for their superb care.

In the toilets, I discovered a “Bristol Stool Chart”. This categorises poo from what might be considered construction quality through to minestrone soup. I assume at some point inspectors rigorously inspected the toilets of the good folk of Bristol. I think I scored about the "turd" one down! Such fun!

Occasional requests from me as to where I might be in the pecking order bore little fruit and one nurse told me she had known one patient have to wait 5 weeks. Gadzooks! The problem is that speed of operation depends on clinical urgency. This is reasonable enough but I started to feel that if the Gods were against me, I could be there for ever.

Passing the time became a case of walking the corridors (gently!) and making use of the wonderful roof garden provided by the Take Heart charity. This garden has a view of Leeds to die for – I really should put that another way! The tables and chairs are screwed down in a manner which would resist the Norman Conquest and I wondered who on earth could possibly nick them and sneak them out past security. Then I discovered why – the Air Ambulance helicopter lands on the roof above, when everyone has to vacate, because of the downdraft - or I suppose, in case it crashes! The helicopter was very busy on some days and you begin to appreciate how vital this service is.

Shift changes came and went and on the handovers, when other patients got an interesting summing up of the latest, I got “and this is John – bless”. On one such hand over, I was described as waiting for a “cabbage”. Peeping out from behind my shawl of ignorance I asked the obvious question to be told Coronary Artery Bypass Graft (CABG = cabbage) – of course! Silly me and hence the title.

Then, excitement. I was told a slot had been found for me on Tuesday 3 June, PM. However, the surgeon warned me that the morning operation was very complicated and might over-run. I had to sign a consent form. The risks were explained. I had a 5% chance of dieing or having a stroke. 5% well, that’s only 1 in 20. Hang on - ONE IN HOW MANY? Holy Bristol Stools! Still, stools or bust – I signed the form.

There was an area of concern. Veins are usually taken from the leg but I had had varicose vein surgery some years before. Were there enough spare veins left? Seemingly the body is a reclamation yard of parts and there was an option of a chunk from my arm. The arm was marked, just in case but the plan was to scan the leg in the operating theatre.

As I had been given no pre-meds by visiting time at 2.00pm, it was pretty obvious I had had it. I actually bumped into the anaesthetist taking a break at 3.00pm and the earlier operation was still going on. I learned later that the operation had continued to 7.00 pm, so overall, must have been 10 hours or so. At least I gather the patient survived.

This surgeon’s next available slot was the following Tuesday 10 June.

Suddenly, on 5 June, I was informed that a different surgeon had a slot the following day, Friday 6 June. This surgeon also went through the risks, confirmed I had signed the form etc. She rated my risk factor as probably more like 1%. I was warming to her already.

Two nurses armed with electric razors turned up to shave my body. They did a side each and I got the impression they were competing for speed and neatness of finish. I looked forward to their meeting in my nether regions but this area no longer seemed a priority.

Chest did not take long (bald there) then arms followed.

The operation was a non-event. Slept right through it!

On waking, in the Intensive Care Unit, it hurt. I could not achieve a comfortable position in bed. They tried rolling me on to my side at one point, which resulted in screams of agony (OK, I am a wimp). The best answer seemed an electric reclining chair and I lived and slept in this for a couple of days.

I had a very painful problem of trapped wind (they prefer “gas”). I was offered a laxative but Billy Bowel and I have always been good mates so I declined at first. Eventually out of desperation, I gave it a whirl but it seemed to make little difference, probably not least that I ate very little in ICU. The wind destroyed my appetite. However convinced I should try to eat something, when offered a yoghurt, I agreed. A lovely, fruity yoghurt might be enjoyable. So what turned up – toffee flavour! Its odour is enough to turn me off on a good day. I forced a little down but gave up. Rice pudding later proved a better bet.

The last action in ICU was to remove:

  • 3 drains which went into my chest

  • Forest of cannula from my arm

  • Line (or lines) from my neck. I gather these went deep into me somewhere and enabled various things to be measured remotely and/or given to me. I never did work out which did what, as I could not see them and it seemed folly to "fiddle".

Heart surgery scars

Clearly removing these things was going to hurt! A nurse explained the technique. Breathe in, breathe out and hold. The drain would be pulled out and sutures already in place tied. I was given a practice run. Once we were both sure I had got it, off we went.

I breathed in. I fully exhaled and held my breath. “Breathe away” said the nurse. So I lay there, breath held exhaled, wondering what “breathe away” meant. This had not been part of the project plan. She said “breathe”. By now, this seemed a good idea. The penny dropped of course. “Breath normally”, I would have grasped but “breathe away,” in the tension awaiting the pain, passed me by.

As regards the pain, all drains, lines and of course the catheter were removed and I felt nothing at all. Amazing.

Back to life on Ward L16. Same routine, just a different bed and more discomfort than before.

There were the inevitable questions about whether I had opened my bowels. On my first day back, I went twice in the day. I vaguely wondered if I could clock one up as a credit for the deficient days.

Wind was an ever present problem and of course, when excess bubbled to the surface, my old mate Billy had to shout about it!

On 9 June, one of the doctors came to see me and there was talk about me possibly going home on Tuesday 10 June. I definitely did not feel up to this and said so. This seemed to lapse. However 24 hours later, I changed and expectation of discharge on 11 June became an obsession.

On the 11th, the doctor said I could go subject to an X-ray (slight concern about fluid on one lung), a blood test and making sure I could go up stairs.

The vampire turned up for blood. At exactly the same time, to the second, so did a porter to take me to X-ray. I asked the porter if he could wait a couple of minutes until the vampire had finished. Time and porters wait for no man. He became very twitchy and I really thought he was going to flatly refuse. I gather porter runs are timed to a milli-second. He did wait but on the journey had to explain over his radio where he was. I offered to take the rap but seemingly there was no need.

On return to the ward, I passed the stairs test and all that remained was to remove two wires still in my chest. These are evidently left in place, against the heart, literally as jump leads, just in case. A nurse said these would soon be “whipped out”, not an expression I favoured in the circumstances. Application of the now familiar breathing technique resulted in totally painless extraction.

Finally, I was seen by a Cardiac Rehabilitation Nurse. He handed me a booklet “Rehabilitation After Heart Surgery” detailing the rehabilitation programme and went to great lengths to emphasis how I must not do too much too soon. I had had a serious operation (I know, it hurts!). As it happens, a friend of mine had exactly the same procedure two or three years ago and he had told me how important it had proved for him to stick to the rules so I paid respectful attention to the nurse. More about this later.

I collected my stuff together, said a few goodbyes, got my meds and away home.

12 June 2014

First day of freedom. Knackered. Consulted the booklet, henceforth known as The Bible (it’s as close as I’ll get!).

Week 1 – essentially potter about the house/garden, read, do puzzles, sew, watch TV. No lifting, pushing, pulling of anything heavy. No housework (phew). Writing this blog is my substitute for sewing etc!

I had been warned about taking it easy up stairs and I found out the hard way that if you get this wrong it is a bit scary. I went upstairs to the toilet and at the top had to stop and breathe deeply for some minutes. I won’t make that mistake again.

13 to 15 June 2014

Been pottering like crazy. Nice weather has meant walks round the family estate have been nice (it takes about 30 seconds). Still suffering from wind periodically. Used a plastic litre jug to water pots on the patio to avoid lifting a watering can. Takes ages with trips to the tap but increases pottering. Must rig up my watering system.

Watched the tennis at Queens – good final.

Daughters and grandson been over at the weekend but I cannot play with him very much or pick him up (he is two).

I still have to be careful on the stairs and not get up from a chair too quickly or I feel dizzy.

Local cardiac nurse to visit me on Tuesday 17 June.

16 June 2014

Managed a walk to the end of my street and back. All of a flat 200 yards in total! Still, one small step for man and all that. No problems. Know it's early but want to push myself a bit. Nothing wrong with my legs apart from under-use in hospital. Will check out with cardiac nurse tomorrow, first. Friends came PM so cracked open a beer/wine or two!

17 to 18 June

Cardiac nurse came on Tuesday. I seem to be healing OK. Consulted on activity levels with a view to walking more than less. My legs are used to walking and it is my chest which needs TLC.  Although she counselled taking things easy, the bottom line seemed to be that if I overdid walking, the worst outcome would be that I might be very tired the following day. From my house is an easy circuit of 0.7 miles, including a walk through some allotments, along by a stream with a slight uphill section at the start and end. I cannot avoid these hills, wherever I walk from my house. There are also a couple of strategic benches. Set off Tuesday afternoon, taking it steady and resting on the benches. No problems. Did it again in reverse on Wednesday and did not need the benches. Rested when I got home but no problems. I feel optimistic!

A stabbing pain has cropped up in my lower right chest. Cardiac nurse thinks it is muscular. Offered to get tablets changed for paracetamol plus codene but we agreed that I would keep the normal paracetamol with separate codene tablets if needed. Codene always causes me constipation so I would only use them in extremis.

19 June 2014

Walked round to a friend's house today, about a half a mile return then later did the circuit above. So I walked over a mile today altogether! Also after two weeks, ditched the compression stockings. Evil things! My wife almost needed an operation for a hernia after putting them on for me!!

20 to 22 June

Extended my circuit via another footpath to 0.8 mile. There is a 100 yard section from the end of my street which is quite steep. If I walk at my normal pace, I end up out of breath. Fortunately there is a bench at the end of it where I can rest if I need to. Feel a bit pathetic when I do though. Grandson, daughter and son-in-law been overnight as went to a wedding do. Managed to play briefly with my grandson with a football but then had to sit down!. Wounds still look to be healing nicely. Slight numbness alongside leg wound which I hope will improve. Managing to reduce the paracetamol during the day.

22 to 24 June

Advanced my walking to a circuit of a mile. This means I can now walk to the paper shop which is 0.6 mile each way and do something useful. Did it today for the first time (24 June) with no problems. According to my bible (Rehabilitation After Heart Surgery), walking a mile is not expected until the end of week 4 at home. I am the end of week 2 so I reckon I am ahead of the curve.  I do get a bit breathless if I try much of an incline at my normal pace. Attending LGI again on 25 June for an X-ray to see how fluid on my lung is progressing. Judging from my breathing and deep breathing, I think it must have resolved. Wish I could sleep better - 3 hours some nights. Poor sleep is listed as an after effect (temporary).

25 to 29 June

In week 3 now following return home. By the end of week 3 (1/7/14), my "bible" says I may be able to walk half a mile. According to my mapping software, I walked 1.4 miles this morning, so building up nicely. Shame the shop had no papers left (at least ones I was prepared to buy) and the cash machine had no money! I can now begin "light social activities" such as visiting friends and going out for a meal. Seemed like a good excuse to go out with friends to the pub for lunch on Friday. Having said that, with the morning walk, then the lunch, I felt exhausted yesterday (Saturday). I can increase household tasks such as ironing (I don't think so. Hankies are about my limit), light hand washing (we have a washing machine thanks, with umpteen clever programs to wash almost anything), making light meals and make beds. Lots more Wimbledon to watch then, especially now we have a bottle of Pimms! Still cannot do any of the useful things I need to do such as cutting all the hedges so a man who "does" comes tomorrow.

Attended LGI on 25th June. had the X-ray and saw the registrar. The fluid on my lung is diminished and I can stop taking the water tablets which reduce it more quickly, by 1 July. The registrar examined my wounds etc and described my condition as "splendid". A long time since anyone so described me!

30 June to 7 July

A busy period this. The cardiac nurse came to see me on 1 July. Everything is as it should be so that is good. This period covers week 4 of my rehabilitation when I can start to "access public transport" and "social activities". Combined the two by going on the train to a friend's house for an "open day" on the day of Le Tour. This passed both our towns/villages and the idea was to go see the event then go to the open day. Unfortunately, because of my condition, did not feel up to standing about for hours, nor did I want to be in a crowd and risk getting knocked so I settled for watching the event on TV. The views were spectacular, especially from the helecopters and Yorkshire was certainly shown off to fantastic advantage. The coverage was only spoiled by poor comentators who mispronounced village names and at one point commented that some dry-stone walls were over 100 years old (really, so old!) and of course the incessant adverts which seemed to occur every 20 minutes regardless of what was happening on the race. No wonder I hardly ever watch ITV.

Hope Gary Verity of Welcome to Yorkshire gets a gong/knighthood or something because he has done an amazing job with Le Tour, which I think has surpassed everyone's expectations.

Daughters, partners and grandson also came to stay to see Le Tour and they had a really good day. Us, Le Tour and Welcome to Yorkshire were so lucky with the weather. With the walking to build myself up, socialising and visitors, I was shattered by Sunday night but no matter. I actually seem to be sleeping a bit (emphasis on bit) better now.

My "bible" says I should be up to walking up to a mile now but I am managing up to two. That sounds good but inclines are still giving me a problem. I get breathless. I could not climb out of a Yorkshire Dale if my life depended on it.

Since I returned home we have been blessed with glorious weather and this must be classed as a good summer. Trouble is, I just keep thinking of all the walk opportunities I am missing! Having said that, I could not wear walking boots at the moment. The area where they stole a vein from my leg to fix my heart is very tender at the lower end. I cannot even stand the elasticated top of socks. The offending sock has to be turned well down or I use pop socks. The good weather has allowed me to wear sandals and shorts most of the time which is perfect and leaves the scar totally uncovered, if unsightly!

Unusually (because usually, at this time of year, I am on holiday and walking somewhere), I have managed to watch most of the important Wimbledon matches, culminating in the Djokovic/Federer final which was really exciting.

7 to 13 July

Not much to report really. I have not tried to push the distance beyond 2 miles. Inclines still making me breathless.

Trimmed some plants in the garden yesterday and ended up puffing like an old boiler and had to stop. Had another gardening session today (Sunday) putting in some plants and snipping here and there. Better than yeaterday.My wife cut the grass as I cannot manage the mower yet.

Leg wound still a bit of a mess as it is aggravated by flexing when I walk. Scab is getting bigger but everyone who has looked at it seems to think it is ok - dry, not infected.

14 to 22 July

Walking two miles with no problem as long as it is level-ish. On Sunday 20th, did a couple of miles in the morning then about 3 in the afternoon over fields/tracks without too much difficulty. Been to see a consultant cardiologist today. After X-rays, there is still a little fluid on one lung so back to taking some stuff called Furosemide which is supposed to help shift it. He thinks my breathlessness on inclines might be at least partly due to post operative anaemia. A blood test has been carried out but pending results, he has said I should take some iron tablets. Got some from the chemist. Side effects can be constipation or diarrhoea - I'll let you know (or perhaps not!). Side effects are less if taken after food but then they are less effective. Terrific choice! Copious pints of Guiness seem a more fun option to me!

I have another consultant to see next week at LGI on the surgical side of things. Also start cardiac rehabilitation (i.e. exercise) classes next week.

23 to 28 July

Maybe the cardiologist knew his stuff. Been taking the iron tablets thrice daily and now seem to be able to tackle the inclines without a problem. Billy has behaved! My wife says I am walking at much more my normal speed. Did around 1.5/2 miles by taking an indirect route to the paper shop on Saturday then in the afternoon did 3 miles across fields etc. No real problems. Now I can drive again, went to see my Dad on Sunday morning. He is 94 and has been a bit worried about me. Seems more appropriate that I should be worrying about him but he battles on regardless. Sunday afternoon, my wife and I had a BBQ. First time this year I have felt up to it despite the weather. Cooked steak and asparagus on the BBQ. Great.

Monday 28 July, went to LGI. Had to be there for 8:30am. Brought back memories of commuting. Had an X-ray and ECG, the results of both were available to the surgical consultant I saw afterwards. The consultant said there was nothing to report. I am healing very well. He seemed to think there was little, if any, evidence of fluid on the lung and advised reducing the Furosemide to one per day for a week then just taking it every other day until I see the cardiologist again in September. He said he could tell just by looking at me that I did not have an iron deficiency (not sure how) so I am going to reduce the dosage from 3 iron pills per day to one for now - these are over the counter pills that anyone can buy - and hope to hear something from the cardiologist on the blood test done on 22nd. I do not want to take an excess of iron pills - unless I will become Iron Man!. Might continue with some Guiness though; purely for medicinal reasons you understand! The surgical consultant said breathlessness at this stage was quite normal and actually good because it meant I was pushing myself. The guy was very good and explained a lot of things about what was going on with my body. The way forward seems to be to exercise and be patient. I must admit I am an impatient patient! Cardiac rehabilitation classes (i.e. supervised exercise classes) start tomorrow.

The surgical consultant said my wounds were healing well and that my breastbone is now solid. There is no further input on the surgical side so he signed me off. He also said I could cease Lanzoprazole, as long as I did not get gastritis from the asprin, which I now have to take for ever, to reduce the "stickiness" of my blood and keep my arteries clear(er). The Lanzoprazole reduces the acid in your stomach. The problem is that you are supposed to take it half to an hour before food (breakfast in my case) and the asprins. This is a bit inconvenient as you have to wait around (although I try to take before going for my paper). However, the asprin dose is low and I take after my breakfast, which provides some protection, so we will see how this goes.

The "system" has two halves. The cardiologists, who diagnose the problem then refer you to the surgical side to effect the repairs. As the repairs are complete, it is now down to the cardiologist to keep an eye on my progress until he too sees fit to sign me off.

I wonder if anyone is actually reading this rubbish!

29 July 2014

First cardiac rehabilitation class today. As instructed, I arrived early so paperwork could be done. Two nurses were checking oxygen cylinders and what I took to be a defribillator. My imediate thought was that maybe these classes were a bit more intense than I thought!

In essence, the class is what I take to be circuit training (never having done it before) with about 10 exercises to perform in sequence. No problem doing them in terms of strength/exertion but was hopeless at the ones involving co-ordination - right leg, left arm, that sort of thing. I'll never make a dancer! I was upgraded to level two for next time when each exercise is done for longer. Having done no exercise except walking since my op, my body must have thought it had had a hard time as I fell asleep after lunch, something I never do.

So each Tuesday and Thursday I will be off to the classes. I hope they put the air con. on a bit more promptly in future. The place was roasting and I came out like a wet rag.

I hope it all leads to an early resumption of proper hiking and badminton.

30 July to 6 August 2014

Having done 2 exercise classes, I reckoned it was time to start hiking again. Obviously, I am not going to wake up one day capable of going up Helvellyn so it will be a gradual building up process. Monday 4 August was a perfect day for walking. I wanted something not too challenging, about 4 to 5 miles and something I had not done before so opted for a walk round a reservoir. How hard could it be? The answer was quite hard because unfortunately, I picked Thruscross, never having been round it before. There is quite a lot of up and down in the trees and it is much harder than (say) Swinsty, which you can push a pram round - and some do. Still. I have to start somewhere. I cannot wear my boots yet because of a large scab still on my leg where spare parts came from so did the walk in trainers. Fortunately they are waterproof, as it was very muddy in places. Still here to tell the tale.

12 August 2014

Nothing much to report since the last entry and to be honest, ecxept to say I was upgragded to level 3 at my exercise class today and now knackered! I think it is maybe time to draw this page to a close, unless there is a dramatic development. Indeed, I might delete it altogether eventually. It is going to be a matter of (hopefully) a gradual return to normal, including a progressive return to normal hiking and their associated walk descriptions. I hope this has been of interest to some. Thanks for reading and a special thanks to those who have taken the trouble to send their good wishes.

30 March 2016

Just a full stop to this tale, I had a recent final consultation with the cardiologist. I feel fine and am back to normal activities. However my speed up steep hills is noticably down on previously. This seems to be because there are "diastolic abnormalities of the left ventricular function". In people speak, this means the left bit which receives the pumped blood has gone a bit stiff. Evidently this is normal in people with my condition. The good news is that a couple of echo-cardiograms confirm it is not worsening. The bad news is it will not improve. So, I can still climb the hills, it will just take a bit longer!

I attend exercise classes once a week, specially for cardiac folk. I seem to be the only one working up a sweat but no pain no gain. Should really go twice a week but I substiture playing badminton for the other visit. I am playing as well as before the operation. That does not mean much! So, all good.

QED

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