Cabbage and I
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
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.
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
possibly go wrong?
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.
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.
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.
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
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!
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.
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
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.
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
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
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
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
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
13 to 15 June
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.
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
nurse to visit me on Tuesday 17 June.
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.
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).
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
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.
Not much to report really. I
have not tried to push the distance beyond 2 miles. Inclines still making me
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.
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
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!
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
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.
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.
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
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.
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