Wednesday 24th June. My Birthday!

My Birthday!  The noisy couple by the door are not there.  Nurse tells me that he was shipped out, along with his chatty wife, around midnight, by which time I was asleep.

 

A quiet morning is slipping by.  A nurse says she will pop back in to make my bed but she never does.  Three hours later another nurse tells me I am not staying overnight so they won't make it.  I straighten it out myself. 

At 1300 hrs I am getting peckish and ask when lunch will be served.  A nurse going on her break says "we don't do not meals on this wed as it is for day cases only". I point out I am not a day case and she nips to the fridge to get me a chicken sandwich, banana, yoghurt and apple juice.  Yummy!

The doctors are doing ward rounds but not on the day-ward.  They may not even know I am here.  After asking the nurses to contact the consultant I wait and eventually, mid-afternoon, the Cardiac (medical) registrar comes in and tells me what they found.  He draws a picture.  Both left and right side coronary arteries are narrowed and one bifurcation on the left is blocked altogether.  Amazingly, a new vessel has grown from a different direction to cover the area previously fed by the blocked one.  Stents will not provide as effective a solution as they would most likely clog within the next 5 -10 years, while  a coronary artery bypass will last 10 a 15 and possibly much more.  He then explains how a vein will be taken from my leg and an artery will be redirected from my chest to provide alternative pathways for blood running to the heart muscles.  At last someone gives me a clear explanation.  He tells me that someone from the cardiac surgery team will be up to se me later.  He was pleasant, polite and very clear.  I am going to give him good marks in the feedback survey.

He also clarified that angiograms and stent insertion are actually performed by the medical team, not by the surgeons.  They also use the labs for angiograms, angioplasty, TAVIs (valve replacements) and other exercises using the same approach (basically pushing stuff up an artery towards the heart). 

Tony arrives with the new pyjamas I requested, a happy birthday and a wisecrack birthday card.  He also gives me a gizmo that is a "3" network 4G data-only sim and wireless router, so that I can now connect to the Internet.   Brilliant.   At this point the cardiac surgical registrar arrives and Tony discretely disappears.  

The surgeon takes a short history (the same one I have provided to every other doctor) goes over pretty much the same ground as the medical man but makes it clear that I need surgery pretty soon as my arteries are in a terrible state.  We discuss options and I confirm I am happy to go ahead with the bypass surgery, but when I explain that I would like certainty about when it will take place and will invoke my BUPA cover, he says he must consult with his colleagues about who will be able to do it. I guess that means he will talk to the consultant.  

Tony returns and we chat for a while.  I think I upset him by telling him not to come back from his holiday in Macedonia, but I hope he forgives me.  I only wanted to avoid being selfish.  Another visit from the medical registrar, who says that A Mr Shipolini will be along to see when he comes out of the operating theatre.  When the registrar leaves, Tony googles Shipolini and I google chipolata, or at least that is what my phone thins I want to look up.  We discover that Alex Shipolini has a specialist interest in adult cardiac surgery, with the vast number of his operations on CABGs (coronary artery bypass graft) and that he has a significantly lower mortality rate than the UK average, despite tackling some high risk groups.  Looks like will be in good hands.

Tony produces a box of iced fancies spelling out Happy Birthday.   Just the thing for someone with furred up arteries, but we each eat one anyway.  Later dinner arrives; cream of mushroom soup (a regular here it seems), vegetable lasagne (quite tasty) and a fruit pot.  

Helen and Tor join us and, seconds later, Chris (Helen's nephew).  A few more cakes are eaten but that still leaves HAPPY IRDY for me to dispose of.  There is quite a crowd, so Tor and Tony head for the pub for a drink while Chris, Helen and I chat, before returning an hour later for farewells. Tor is kindly driving everyone back to Tufnell Park. 

At last the surgeon, Alex Shipolini, arrives between two operations.  He sits patiently with me, reviews the history and convince me that the bypass operation has a lot better outcome, long term, than stents.  He also notes I don't smoke, I do lots of exercise and I have normal or slightly elevated cholesterol.  Since smoking and high cholesterol are frequent causes of blocked arteries I ask him why he supposes that mine are in such bad shape.  He acknowledges this is a puzzle but points out that it is not important; only dealing with the outcome is important.  A practical and action-orientated mind;  probably typical of a surgeon.

We discuss a private transfer.  I have two concerns; the first is timing and he acknowledges that the NHS could do the operation but there is always the chance that it is delayed by an emergency that intervenes.  I know one chap who has been waiting in the Whittington for over two weeks.  The other concern is accommodation,if I am going to be stuck there for 10 days there needs to be wifi, TV and a telephone signal, which unbelievably are not available at the moment in the super-new Barts Heart unit.   We agree on a private transfer, though I did not ask specifically if he was BUPA approved.  He also says he would prefer to operate in Stepney as it is closer to where he lives so he can keep an eye on me.  This is a pity as it is further from Tufnell Park that the Wellington, but if H is travelling by taxi then it doesn't much matter

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The operation should take place next Monday, 29th June, which will be earlier than it would have been on the NHS, where there is also the risk of being bumped by emergencies.  But best of all, I will have some lung function tests tomorrow but then I can spend the weekend at home.  OK to potter in the garden, if I have one he said, but no running.  Definitely no running.