Heart Doctor No. 4 is as good as his word. Within a few days of my discharge from CCU, copies of letters to Oxford and my GP arrive summarising the current state of play. His diagnosis paroxysmal tachycardia, confirms that of my GP, with the proviso that this particular episode that had me in A&E was probably triggered by a lung infection.
He offers no firm opinion on the source of the chest pains. I come across a reference (from Googling ‘chest pain’) to ‘pseudo-angina’ which is a condition that appears to mimic heart-related pain. Its cause however, is to do with damage to the nerves around the ribs, neck and spine. Given the trauma of lung surgery this seems an avenue worth exploring.
I notice, for the first time, how lopsided or uneven my chest has become. My left hand, when placed flat on the right-hand side of my chest, moves in and out in sync with my breathing. But when I place my hand on the left-hand side of my chest, it stays perfectly still – there is no response to my breathing. I also notice a large depression just below my left collar bone; there’s no such depression on the right. I can see very clearly that something is missing. I mention it to Annie – she’s already noticed. I wonder why I’m only seeing these things now.
Heart Doctor No. 3 also promised copies of letters when I saw her about a month ago. As none had arrived I contacted Patient Advice and Liaison Service (PALs) at MK hospital and a large package arrived a day later. She saw me on a good day, HD No.4 saw me on a bad day so there is some, not unexpected, difference of opinion, notably whether to ablate or not. There is also a good deal of consensus; apart from ‘some thickening of the aortic valve leaflets’ and a tendency to go off the straight and narrow every so often, my heart is basically sound. There is one factual error in HD No.3’s letter; “Mr Spratley … was previously able to cycle 10 miles a day”. She’s out by a factor of 10 – although that was a long time ago.
In order to provide as much information as possible to whoever I see in future, I record my heart rate and oxygen saturation three times a day; on waking, at midday and on retiring to bed. I purchase a new note-book especially for the purpose. I feel like an 18th Century gentleman scientist meticulously recording things that an 18th Century gentleman scientist might meticulously record. And very interesting it is too.
Day 1; On the first day (which is two days after leaving hospital) my heart rate is fluctuating again. I take readings over a 2 minute period and it cycles between 67-92bpm. The next reading shows 87-102bpm. These are within what is considered normal – it is the variation that interests me; I am aware my heart rate is irregular and I am breathless. My oxygen saturation is 98% however; this is good. If it falls below 90% things can get a bit dodgy. By the 3rd reading I feel better and I predict a steady reading which turns out to be the case at 79bpm.
Day 2; Readings show a steady rhythm throughout the day, but I wake later that night with an irregular rhythm again.
Day 3; It’s back to the cyclic variation, oscillating between 69 and 102bpm for each of the three readings.
Day 4; Calm descends and things are back to normal. Until Day 8 when the wobbles return. It’s not until Day 10 that they depart. I guess this is the way it’s going to be from now on – days of steady heartbeats with the odd random fluctuation thrown in.
More letters (and numbers) arrive. As a result of the referral from HD No.3 I’m offered an appointment on June 10th to see a Thoracic consultant to assess the state of my lungs. And then a letter with an Oxford postmark. Can it be? As I tear open the envelope I notice the letter has a Headington address; the JR is in Headington. And there it is in black and white – a slot free on June 6th for the Catheter Ablation. Woohoo.
I have to attend an assessment clinic a week before to go through the procedure and I guess, check out my suitability. They provide some numbers for me to digest in the meantime; success rate (cure); 90%. Severe bleeding requiring surgery; 1%. Permanent damage to my heart resulting in the need for a pacemaker; 1%. Permanent damage to me – resulting in the need for a coffin; 0.05%. These look pretty good odds to me.