23 – 06 David Bannister –Nearly the end of my life.

 

Airlife Device

A must have Device if recovering 

from Open Heart Surgery

Medical Diary

Date	Day	Status	Description
30/01/23	Monday	Unplanned	Heart Attack at 12.00 noon whilst cutting back trees alongside the house.
02/02/23	Thursday	Unplanned	Caught the Norovirus stomach bug whilst in the Alexandra Hospital.
06/02/23	Monday	Planned	Angiogram through wrist into heart at Worcester Royal Hospital.
07/02/23	Tuesday	Planned	Diagnosis. Stenosis (narrowing) of the Aorta Valve.
08/02/23	Wednesday	Unplanned	Caught Covid - 19 in the Alexandria Hospital.
09/02/23	Thursday	Planned	Prognosis. Risk of Death 25% per year. Possible 4 Year Life Expectancy.
09/02/23	Thursday	Planned	Fix. Open Heart Surgery to replace Aorta Valve. Mortality Risk 1.5 %.
10/02/23	Friday	Waiting	All clears required on Novovirus and Covid 19 before able to progress.
14/02/23	Tuesday	Waiting	All clear on infections.
15/02/23	Wednesday	Waiting	Bed required at Royal Wolverhampton, Heart and Lung Specialist Unit.
18/02/23	Saturday	Planned	Bed available at Royal Wolverhampton Hospital. Transfer to them.
20/02/23	Monday	Planned	Operation planned at mid- day. Entered Operating Theatre at 2.00 pm.
21/02/23	Tuesday	Planned	Post Operation Intensive Care Recovery.
21/02/23	Tuesday	Planned	Return to Ward.
25/02/23	Saturday	Planned	Discharged at 6 pm. Home 7.00 pm.
11/04/23	Tuesday	Planned	6 week Case Review at Royal Wolverhampton with Surgeon.

 

Introduction

Hopefully you have arrived here via a link from my FaceBook, Twitter, LinkedIN, or other ad hoc internet sources. I have never been comfortable posting personal information on these Social Media platforms. The type of acceptable personal information differs from platform to platform depending upon the particular culture that has developed. Adopt the wrong style and content and this leads to abuse. But at present there does not seem any better way to share a message. But for some reason I remain comfortable with adding it to a blogging platform (Blogspot) since so few people get to read it and it allows me to very easily maintain my diarised thought records without criticism. It also allows me to remain humorous whilst telling my many stories that often lead into the discussion of serious science and humanity subjects. I also have in mind these posts being potential source material for a future book. If this is not your cup of tea I suggest you don’t waste your time and exit now. Otherwise read on……..Welcome Friends and Family.

Narrative

The mechanical nature of my medical problem made me very keen to discuss it in detail and its rectification. Not so interested in the work necessary to gain access to the heart. Dr D. Ramnarase, Consultant Cardiologist, Alexandria Hospital was very willing to discuss the detail information I wanted and arranged to show me a “CT video” of my aorta valve struggling to open up due to calcification. But you still cannot beat a sausage sandwich with brown sauce !!! This gave me a very clear visual insight into the issue at hand. Access to the body and mind for newly oxygenated blood from the heart was severely restricted by its narrowness and clunky behaviour. The high risk of a further heart attack made an enforced hospital stay necessary with constant monitoring required. But at no point would he discuss the surgical solutions since this was not his area of expertise. Fortunately for me the other valves and most of the pipework was in line with their normal expectations of someone my age. (74 years). Had I smoked it would have likely ended it for me on the day and also they would be unlikely to proceed with the operation due to high risk of failure during and post operation. Not drinking and not being overweight also factors in favour of a successful operation. But at my age a decision to do open heart surgery is very much in the grey area of their decision making. It is certainly not a given. In fact more likely it is that an operation would not to be proceeded with whilst only using drugs to reduce risk. Stents solve pipework narrowing but not faulty valves. I was acknowledged as a DIY and walk around the park individual. This highlights the fact that if you don’t present yourself as “fit enough” they will not take the risks in respect of their careers operating on you. Whilst it is your life risk it is their career progression and reputational risk. They make the decision on an operation for you, you don’t get that opportunity. It maybe your body but it is their career statistics. They certainly don’t want a failure especially when there is time to carefully analyse the situation. Fast emergencies is another story.

When I met Giuseppe Rescigno, the Italian Heart Surgeon, there was an immediate synergy between us. When he was prepared to draw and explain diagrams in my Note Book my confidence in him rocketed. Precise and academic with an innovative way about him. A willingness to explain the pros and cons of metal verse animal tissue valve structures and how he actually stitched it in place. He recommended pig tissue rather than cow. This surprised me since when I owned my Cake shop come Deli pork was always the first meat to go off. The metal option required you to take anti-rejection drugs for the rest of your life. In truth I had no choice and rightly he decided.

Then I saw the anaesthetist but to be honest the whole process there was too frightening to contemplate with the switching off of my heart and then running my body on a Heart and Lung Machine. Did not even note his name nor ask any questions. I was too frightened. This Royal Wolverhampton, Heart and Lung unit had been sponsored by Lord Nuffield, the famous motor car manufacturer in the 1950’s, to develop Heart and Lung Machines with Lucas closely involved with their manufacture. At the time nobody in the medical profession thought it possible and I must admit I still remain sceptical. You know loose jubilee clips and faulty switches. Visions of a car mechanic having to step into keep the damn machine running and the patient alive whilst all the medics retreated to the tea room. Then the shout, “Damn I cannot find my 8 mm socket or do I need a 9 mm?”. Anyone seen it on the floor? With me fading away slowly in the background with the bells and alarms ringing away in a classic boffin control room chaos film sequence.

From then on life becomes surreal. One huge benefit was being surrounded with new characters to get to know. Both patients and staff. Trying to understand the staff roles was a nightmare. Asking the Food Staff to remove anything clinical on your bedside table got a rule based response. Food Staff were welfare defined and Cleaning Staff was a different category. Ward Cleaning at night took on Dr Who dimensions with automated ward cleaning devices. Sister was still the sister. Firm command and control with empathy. Consultants and Doctors still did their bed by bed rounds followed by a gaggle of Junior Doctors. Many staff hunched over Computer Laptops both day and night was the normal with many laptops on sophisticated wheeled human height trolleys as tall as the user. The Patient Multi-Media offerings were more often than not faulty. Touch screens were strike full on screens as if you were physically moving a button behind the screen. Yet they seemed to work better when the patient was using “paid services”. My conspiracy theory.

Patient interactions like always remained the main source of entertainment. Whilst sadly in many cases the patient was off in a very painful fairyland. People are and looked so ill. Then post operation you join them. Feeling very ill amongst others is a huge levelling experience. Whilst amongst this anguish humour can still survive. Always impressed by the articulate logical patient with Stage 4 Cancer being able to discuss their Pain Management Plan with the Oncologist as if planning a holiday. Some people are so stoic. Discussing this with one such patient his point was you just become a fatalist. Yes, my end date is sooner than yours but we all have one. But it is a time to be very kind to each other. Human supporting human. Full stop.

Never cease to be amazed how post operation recovery can be so painful and physically demanding. It is as if your whole body has been trampled on top to bottom. Well it may have been you are not to know?

After such an “out of the blue” event its time for a lot of reflection. It was very nearly the end of my life and there would have been no written record like this one for you to read. Most patients said that after their experiences they would review their lives. But how many do and what latitude is there really to do so in our complex western way of life. My plan was to be a financially successful author in retirement but that has not happened. But being honest writing and publishing has given me a real purpose to my life and lots of enjoyment. Strangely English History has become a major interest of mine. Sorry I know it is a boring subject !!!

Medical Note - Relates to Airlife Device Pictured Above

When the Nurse dropped this device on my bed as I was about to be discharged I must admit I lacked focus on what she had to say. She rightly gathered my attention. She explained that when I wanted to clear mucus from my lungs and it was too painful to cough due to the surgery then progressively blow into this device making the blow force stronger each time. It will loosen the mucus and when you cough you will be able to bring it up and spit it out. In terms of post op recovery this has proved the best possible advice. If you are unfortunate enough to have to face open heart surgery please do not forget this piece of advice and ensure you leave with a Airlife Device. We call it the puffer at home. It’s brilliant.