At 6.30am June 6th 1944 Allied troops wade ashore on the Normandy beaches. Thus begins what Field Marshall Rommel claims will become “The Longest Day”. At the same hour, on the same day some 67 years later, Annie and I are on the road to Oxford. References on the News to what those men went through are a handy distraction from my own – I won’t say ‘fears’ as such – but certainly, apprehension.
My appointment is 7.45am so it’s an early start. I am staggered by the traffic – I had imagined the roads would be quiet at half past six, but the road from MK to Buckingham is nose-to-tail all the way. By the time we hit the M40 it’s a steady crawl. Annie’s eldest, Chris, had warned me to allow extra time for the journey – I’m clearly out of touch – it’s been along time since I’ve been on the road at this time on a working day.
The next shock comes when we reach the JR. The waiting room in the Cardiac Angiography Suite quickly fills and it’s standing room only. Apart from three men on their own, it’s all couples. Or rather pairs – I assume husband/wife, parent/child. I try to guess which of the two is in for treatment. It’s the style of the overnight bag that’s the inevitable give away.
By 8.00am I’m sitting on a bed waiting to be processed. It’s around 10.00am before I see the consultant electro-physiologist who will undertake the ablation. Although my last INR (five days ago) was 2.0, he’s not happy – two weeks ago the reading was 1.8 and he wants four continuous weeks of readings between 2 and 3. He’s concerned there might be a clot in my heart – a distinct possibility with a heart in flutter and a low INR. Suddenly the ablation looks as if it might be cancelled.
He takes my pulse; “slow and steady – good”. He outlines a plan: I’ll have another INR test and an ECG. If my heart is in normal rhythm (not in flutter mode) and my INR is between 2-3 he’ll go ahead. If my heart is in flutter, then there’s one more test to pass – a trans-oesophageal electrocardiograph (TOE). A probe will pass down my oesophagus and scan my heart from the inside to look for a clot. If it’s clear, the ablation will go ahead – if not, it will be cancelled.
Annie’s reluctant to leave, but I’m last on the list and it’s clear it’s going to be a long day. The consultant confirms that if they do go ahead I’ll stay in overnight. I lie on the bed and get my head into ‘patient’ mode. Be patient – chill out.
I have the ECG around midday – I can tell before it starts that my heart is no longer ‘slow and steady’. Perhaps this is not surprising; it’s not just the anticipation of the procedure, it’s also the stress of wondering whether it’ll go ahead or not. No heart fix – no voice fix. My INR result is 2.2, but my heart is all a flutter. So – it’s TOE.
I’m a little nervous about this – a doctor I saw in A&E back in April advised against this procedure given the damage to my oesophagus from radiotherapy and the paralysis of my left vocal cord. The consultant admits there is a risk of tearing the walls of the gullet, as he’ll be pushing the probe without any clear guide as to where he’s going. All this for the sake of 0.2 on the INR scale. It seems a big deal for a small number.
I’m asked to put on a gown in expectation of a 1.30pm start. I go to the loo, pack up my things, change and sit on the bed at the appointed time. In the event it’s almost 3.00pm by the time I walk into the catheter lab.
The place is well named – much more a laboratory than an operating theatre. In the centre, a long narrow table flanked by screens and consoles. Multi-coloured wiring looms snake across the floor to a control room at the end. And people – lots of people.
“Do you like bananas? I’m told this tastes like bananas.” The consultant sprays the back of my throat to numb the effects of the TOE probe. He’s wrong. Or my taste buds are shot to pieces. I turn over onto my left side and bite on a plastic mouth guard. There’s a hole in the centre for the probe and he feeds it through and asks me to swallow. I guess the sedation kicks in quickly because I feel nothing and remember very little. Except when he confirms that there are no clots in my heart. Then I’m on my back and the ablation begins.
I’m awake yet not awake. Voices seem distant and I have no idea of time. At some point there’s a pain in my right shoulder – not much to begin with but then it seems to penetrate through to my back. I let them know – “I say, would you mind being awfully careful – that really hurts.” Or something like that. I hear someone call out for an increase in pain control. Then “that’s it, we’re finished”. And my heart is back in normal rhythm.
I’m aware of damp around the top of my right leg. Someone is pressing down hard on my groin. The risk now is a haematoma. I lift my head and there’s blood covering my thigh to my knee. It’s not as serious as it looks, just messy from where the bloody wires have dripped as they were pulled out. And then I’m taken back to the ward.
I have to lie flat for two hours. A nurse brings me some toast and a cup of tea. She bends a straw so that I can drink without leaning forwards. Neat. My throat is sore from the TOE but little else bothers me and I doze off for a while. The consultant comes to see me – a brief announcement of success with details to follow; “you’re too dozy right now to take in what I say”. Around 6.00pm I’m allowed to sit up. I need to go to the loo – I’m taken by wheel chair but even that is clearly too much strain because the wound in my groin starts bleeding.
Annie arrives around 7.00pm with essential supplies and I decline the offer of a hospital sandwich in favour of goodies from M&S. A move to the cardiology ward for an overnight stay is scheduled for 8.00pm. The Oxford Heart Centre is really swish – think Hotel Cardiothoracic – with single occupancy, en-suite facilities (see June 2010).
By 10.00pm the room is dark and I’m alone. Annie’s on her way home, blood pressure and temperature have been measured and a remote heart monitor will send signals to the nurses’ station throughout the night. I’m left in peace to sleep and to reflect. It’s been a very long day – and a long time in coming. It’ll be a few weeks before I know if this is a permanent fix, but despite the delays and setbacks, I think it can be counted a success.