I can’t quite work out why, but I have been fighting very shy of writing this particular blog entry for several days, but given the event I am about to record – a significant one in its way by any standard – and given that this blog evolved from my writing a diary by hand more than 30 years ago, it might strike some as odd if I didn’t write. It would certainly strike me as odd if I didn’t.
Just over 12 years and six months ago, on May 2, 2006, I suffered a heart attack. Just over five days and five and a half hours ago, I suffered another. And I think the reason I was for some time reluctant to write about it here is that, oddly, having that second heart attack makes me feel rather foolish. I am, in fact, still in hospital, though all treatment has finished and I am sitting in the Friends of the Royal Cornwall Hospital café in Treliske, Truro, waiting to bugger off home again. The delay is that I am to be given a month supply of medications, and, I’m told, that can be a slow process.
The very odd thing about this heart attack is that unlike the first, it came out of the blue. OK, to a certain extent the other also came out of the blue in that I hadn’t been suffering chest pains or anything like that, but I had been feeling very exhausted - I mean really knackered. I would get up from a good night’s sleep and go downstairs for a cup of tea, but within minutes feel completely shattered. I remember once at work, a month or two before that first one happened, feeling so exhausted at lunchtime, that I simply went to a church next door (St Mary Abbots in Church Street, Kensington, the quietest place I could think of) and merely sat for 30 minutes. At the time I simply thought I was very tired and working to many long hours, and I didn’t further question the exhaustion.
That first attack began at about 10.45am while I was on the rowing machine desk in the works’ gym at the Daily Mail: I was pushing myself, but not overdoing it, when suddenly something seem to ‘give’ in my chest and I developed a small, persistent ache. I also began to feel quite a little off colour, grotty enough to decide to knock that gym session on the head for the day and return to my desk. Over the next 20 minutes the persistent ache got worse and I felt ever grottier, so I went upstairs to see the nurse (12 years on no longer there, the victim of ‘economy measures’), collapsed as soon as she saw me, came to 20 minutes later with an oxygen mask on and an ambulance on its way. By 1.10pm (13.10 for our European friends) a stent had been inserted after a procedure which seemed take just minutes at Hammersmith Hospital. I remember the time because I made a point of looking at my watch.
This second attack was almost nothing like that. Over the past 12 years, I have carried on going to the gym regularly, although less regularly since I retired in April, swimming and walking quite a bit taking our Jack Russell out to do his sniffing and leg-cocking. In fact, I was in the gym a week last Sunday and the following Wednesday, the day before that second attack happened. Again I didn’t stupidly go hell for leather, but I didn’t stint myself either.
I went to bed at 10pm (22.00, see above), and just before 4am I woke up, as I have occasionally been doing during the night, and there was an ache right in the centre of my chest, right in the centre of my breastplate. I beleived it might be acid and took an indigestion pill, but thought no more about it. About ten minutes later I began to feel a bit clammy. The clamminess then got worse and within minutes I began sweating, only a little at first, then increasingly more. There was no pain as such – and certainly no ‘elephant sitting on my chest’, pains down my arm, pain in my back or pain extending up to the jaw as we are told can be symptoms – and although the dull chest ache increased a little in intensity, it was certainly not unbearable.
I decided to have a pee, and the next thing I remember was wondering why the light was on in the bedroom. Next I began to wonder why I was lying on the floor with my head next to the lavatory bowl. I eventually and gingerly got up. However, the sweating increased and increased and increased, and it eventually it reached the point where the sweat was quite literally flowing off me and dripping to the floor. And that, dear reader, was the point when it first occurred to me that I was having a heart attack. It was also, I have to say, when I first began to feel rather foolish about having one because if truth be told this second attack was arguably eminently avoidable.
Eventually an ambulance arrived and I was taken the 40 miles from St Breward to The Royal Cornwall Hospital, Treliske Truro. An emergency cardio team had already been alerted and had already been sent the relevant medical details and by 4.45am last Thursday morning I was having a stent inserted to widen an almost closed artery. The surgeon also found, however, that another artery feeding the heart was also dangerously narrow and I second operation was scheduled for yesterday for a second stent to be inserted.
While working on me he came across a third narrowed artery, so I had two stents inserted yesterday. It couldn’t be done on the Friday because the ‘list’ as already full, so I was left metaphorically kicking my heels over the weekend, ironically feeling as right as rain.
. . .
I find I clarify my thoughts best in debate or when I write, and writing the above has made it very clear to me why I feel so foolish about having the second heart attack, and to be frank I suspect having it was wholly my fault. Not only did I become increasingly lax about taking my medications, but I carried on smoking.
In my case it was cigars and I believed that ‘because I didn’t inhale the smoke as one does with cigarettes, it isn’t half as dangerous’. Well, that is rubbish – nicotine, which thickens the blood enters your blood stream even if the smoke is in your mouth and nasal cavity, and talking to cardiac surgeon afterwards he told me that ‘smoking and blood never go together well’.
As for the medication, 12 years ago I was put on a blood thinner, a statin and one to lower blood so that if I ever suffered from high blood pressure, it would be kept lower. Well, the blood thinner was a complete pain in the arse because, clumsy oaf that I am (‘oaf’ somehow implying that I am over 6ft and with a big build when in fact I am the opposite, but I’m sure you know what I mean) I am prone to cutting myself shaving, cutting myself preparing food, cutting myself by banging against a doorframe, scratching myself on any available protruding nail and otherwise giving my body every conceivable excuse to bleed. The thing is when you are on a blood thinner, you don’t just bleed a little for a few minutes until the clotting process starts, it bloody goes on for bloody hours. Well, I can’t remember what case I presented to my family doctor to stop taking that drug, but he agreed to allow me to come off it.
Statins were the next problem. They did not seem to have any immediate effect on me, but after a few years I realised that bit by bloody bit my joints and limbs were seizing up. As it was happening only imperceptibly, I was adapting to it. I knew something was up when a colleague (I won’t say ‘friend’ because he is what we hacks and former hacks technically call ‘a evil cunt’ who seems to delight in causing discord and upset – Pete, you know who) remarked that I, then still only 57/58, was walking like a 70-year-old. I was also concerned that getting out of the car was had become something of a struggle and that it took me several minutes to walk without pain in my feet and legs when I got up in the morning.
So I eventually knocked the statins on the head, too. I did so after seeing my GP (family doctor) who referred me to a consultant who judged (at the time) that my cholesterol count wasn’t excessively high, so it wasn’t as reckless and irresponsible as it might sound. The only drug I nominally carried on taking was blood pressure one and, as I have admitted, if I remembered to take it more than four times a month, that would be a lot. Yes, I know it sounds incredible that you can forget to take a medication prescribed for daily use but, well, I did. I lulled myself into a false sense of security: I had had my heart attack, survived, so that was that. Well, the other morning told me differently.
The following day, (my 69th birthday as it happens) and back at home
So I feel foolish in bringing on this second heart attack, and I have resolved to be less reckless and more responsible. The cigars – sadly – will have to go from however many I was smoking a week - and my use pretty much doubled when I retired and the spring, summer and early autumn good weather allowed my to sit outside of an evening with a drink and a cigar - to none at all. Sadly because I did enjoy them and, unlike with cigarettes, there was no craving for them at all (a craving cigarette smokers will all know and dislike intensely, as well as that fretting verging on panic to make sure when you are going out that you have enough fags with you. I least I’ve been shot of that for many years). As for the medication, I must put a lot more effort into remembering to take the as prescribed.
What does puzzle me, though, is my cholesterol level: compared to most reading this blog entry I venture to claim my diet is healthier. I eat loads of fruit (’cos I like it), I eat very little meat, I eat a salad of some kind – tomatoes/onions/red pepper etc in olive oil – with most meals, I don’t eat to much and I’m not overweight (according to the discharge nurse two days ago my body mass index is what it should be), I don’t eat bread, and I eat cake and biscuits so rarely that I could even claim that I ‘don’t eat cake or biscuits’, and I have been physically active. So why did it happen?
It has to be the smoking. I really can’t think of anything else. But what worries me now – which didn’t worry me after my first heart attack – was that this time there was absolutely no warning. Damn! Does that mean that now – because there are no obvious warning signs – I must expect to suffer a third attack pretty much at any time? Bloody hope not.
I am really not one of those inclined to bouts of sentimental gushing about Britain’s welfare state and especially our National Health Service, but I really can’t leave this blog without recording just how remarkably lucky we (and other countries with a comparable health service) are. That is not to say that the care I was given could not and would not be matched in a country in which citizens are expected to pay for the health care, but there is one very crucial difference: my surgery and overall treatment, my ambulance ride to Treliske, my after-op care and the medications I shall have to take until the day I die were all absolutely free.
The mean-spirited might point out that technically I am ‘paying’ for ‘the service’ through my taxes and National Insurance contributions, but as far as I am concerned such views are wilfully ignorant. The level of care I would have got in, say the United States, would have depended on my level of insurance, and had I been on welfare, I suspect that would have been the bare minimum and that I would have been out on my arse as soon as possible. Well, a millionaire on the best medical his money could buy would not have been given any better care than I.
Yes, there would have been perhaps flowers in his private room whereas I shared a recovery ward with five other old farts, and yes he might have been shown the degree of obsequious deference it was assumed his millions warranted whereas I had to share and put up with the ever cheerful, ever attentive, ever pleasant, ever irreverent banter of the NHS nurses and auxiliaries and the other patients, but I do know which system prefer.
I can’t help but add that taking (as I just have done) five tablets every morning and two every night, and knowing that I shall have to take some for the rest of my life does piss me off a little. Yes, I know they were prescribed to help me avoid a third heart attack, but - especially today on my 69th birthday and as a guy - they are something of a blow to my ego. It makes me feel a little ‘older’ and none of us likes that.
I can honestly say that in myself I feel as fit as a fiddle - seeing the physical state of the other five in my ward, all my age or just a bit older, was a revelation - but obviously I wasn’t and am not, and it would be conceitedly dangerous to try to kid myself I am in better shape. And the discharging nurse did warn me that such feelings of fitness and self-confidence can misleading.
