Peter Bargh

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Archive for the ‘Health’ Category

February 23rd, 2009 by Peter Bargh

Medication post Heart Attack

…continued

Nothing can really prepare you for the life changes following a heart attack. Apart from the uncertainty of the future, the restructure of life-style and diet, one of the main changes is medication.

For someone who refused to take tablets when I had a headache or pain, suddenly been told you have to take several, for life, is quite a shock, well not as big a shock as a  heart attack, but still.

Post heart attack there are several things that need to be controlled. In my case these can be split into four areas and involve taking five tablets-

  1. Blood Pressure (using ace inhibitor)
  2. Blood thickness/clotting ability (using aspirin and anti-platelet drug)
  3. Cholesterol (using statin)
  4. Heart rate (using beta-blocker)

Ace-inhibitor
Blood pressure is reduced using an ace inhibitor. Ace stands for Angiotensin Converting Enzyme. This drug reduces the activity of this enzyme, making arteries relax and widen, so the blood can travel under less pressure. The effect is your heart receives more oxygen. I take Ramipril.

Possible side effects
Drowsiness
Dizziness
Lightheadedness
Dry cough

Anti Platelet
Blood clotting is one of the main causes of a heart attack. Blood clots in a narrowed artery and blocks the path so the heart cannot function correctly.  The reason for this is that the platelets (small blood cells that clump together to form a clot) are sticky. Anti-platelet drugs reduce the stickiness. I now take Asprin and Clopidogrel.

Possible side effects
Indigestion
Nausea
Vomiting
Stomach bleeding

Statin
Cholesterol is seen to be a serious problem for our bodies. There are two types – one good one bad. The statin’s job is to reduce the cholesterol level but we can make big diet changes to reduce cholesterol naturally. Well, balance it actually, because the good cholesterol has important role – more about this when I touch on diet in a future blog
I take simvastatin,  the other common option is atorvastatin

Possible side effects
Sick feeling
vomiting
diarrhoea
headache

Beta blocker
Reduces the amount of work the heart has to do slowing it down this reducing the risk of failure. It’s like driving at 56mph in a car. You get better petrol consumption and there’s less chance of blowing a gasket  (or what ever the mechanical/electronic term is today).
This drug blocks the affect of naturally occurring substances called catecholamines. I take Bisoprolol

Possible side effects (minor)
Tiredness
Fatigue
Cold hands and/or feet
Disturbed sleep
Depression and or anxiety
Shortness of breath

I also have a Nitrate spray which I have to carry should I get an attack of angina. This spray (sprayed under the tongue) instantly reduces the muscles in the walls of arteries so the blood supply to the heart increases and it gets a quick dose of oxygen.

Other medication you may be prescribed
Calcium channel blockers
Anticoagulants
Anti-arrhythmic drugs
Diuretics
Potassium channel activators
So lots of drugs and many times more potential side-effects. Fortunately I have just three…cold feet and hands, shakiness (a feeling of lack of sugar type of shaky not nervous) and un-restful sleep pattern

next time I’ll look at diet changes

…to be continued

ps: this is just a light guide of my observations please seek correct medical advice should you need it.

February 12th, 2009 by Peter Bargh

The Treadmill test

….continued

A few weeks past before I received an invitation to take a Treadmill test. As the Angiogram had proved I had a heart problem this test is required to see how the heart copes under pressure. Another name for it is an exercise stress test.  And the medical name is Exercise ECG.

Don’t have a heavy meal before your appointment and where light comfirtable clothes with trainers or running shoes.

At the hospital you meet up with the nurses. Two are present to ensure you are in safe hands.  You remove your top and the patches are stuck to your chest so the ECG can be connected.

You are monitored before going on the Treadmill. For those who don’t know what one is it’s just a flat surface, large enough to cope with a huge stride, and is like a caterpillar track that revolves around. The speed the track moves can be increased and as it moves you walk or run to keep up with the movement. There are bars at chest height that you can hold on to for stability.

You are then asked to step onto the treadmill and the exercise begins. You walk steadily for 3mins and then you are told that the speed will increase. The machine can also be set to simulate a hill so the incline is adjusted too. This means that you are starting to do more strenious exerice and the ECG and any discomfort you feel will tell the Doctors how the heart is coping.

Prior to the heart attack I considered myself very fit. At 5mins I was feeling the pressure, discomfort in the chest and weary. The speed and include is increased at 6mins and then I was really feeling it. They stoppped the test at 9mins.

Throughout the test ecgs were printed off so the Doctors could eximne the changes. And A further three were recorded in the five minutes following the test to see how the heart relaxed down.

I had to wait a few days for the results which were positive. I thought that was a good sign but in this terminology positive means there’s still a problem.

So the latest news is I’ve been referred to a specialist at the Northern General in Sheffield and I await the outcome of their finding and what course of action will be taken.

It’s now just over two months since I had the attack and I feel fine. Apart from when I lift things and I get peculiar chest feeling or when I walk fast. I’m still only allowed to walk for 30mins per session. So I usually wander off around the locality trying to vary the route each day to make it interesting.

It’s funny how you start to take more notice of your surrounds when there’s nothing else to do. I’ve never taking such an interest in how the locals arrange their gardens.

…. to be continued

January 21st, 2009 by Peter Bargh

the angiogram

An angiogram is a way to determine the condition of the  arteries in  the heart. The doctor puts a catheter (fine hollow tube) into your artery from your groin region and feeds it up to the heart and then pumps dye into the heart so that any artery blockages or problems show up on xray.
You are told that there’s a 1 in 1000 chance of death or a stroke and sign a consent form. I had a certain amount of concern over this element, but not of the procedure itself.

I arrived at the hospital at 8:00 am on Christmas Eve. The ward was quiet, just three patients having the treatment. I was second in line. It’s a very smooth process. They can perform 12 per day in this hospital. You are told in advance to shave the left and right of your groin area. I looked up on the net to see if I could see where the insertion was made so I could determine where exactly to shave.

A photograph of the bruise from the Angiogram

A photograph of the bruise from the Angiogram

I couldn’t find anything so for anyone about to proceed with this treatment, you just need a clear area around the crease of your inner thigh – see pic (area highlighted by red frame is where you need to shave -on both sides)). Hopefully this will reassure you.

The photo also shows the bruise caused by the process taken one week later. Now as I write this, I just have a very faint outline of that bruise. (Edit it took one month to disappear completely)

Is it painful? If you can put up with needles no! The area around your groin is numbed with aesthetic so you just have a weird sensation of the insertion. You lay on a bed and a large 14-16in plate is manoeuvred over your chest area to get a good xray of the heart from all directions. You are asked to take a series of deep breaths and hold as the xrays are taken.

I’d read in the book that I may feel weird in the groin as though I was peeing myself, and also that there may be a hot sensation in the chest. As I lay watching the x-rays being made – I felt none of this. But then when I thought it was over the surgeon said that I may feel the peeing and heat. And I did, but it was just like butterflies you sometimes get and nothing too uncomfortable.   The whole process was about 30-40mins.

To reassure anyone with this a head of them don’t worry it’s no worse than a trip to the dentist for a filling – if anything less uncomfortable. And you wear paper pants so you’re not exposed.

After the treatment A nurse holds padding over your incision point for a few minutes and then you take over for 15mins. Make sure you’re comfortable!

Then you are wheeled back to your ward. You have to lie still for one hour. The you can sit up for an hour, then get out of bed and sit in a chair for an hour and then put your clothes on and return home. During this rehab session the consultant shares the results with you.

It turns out I have a totally blocked artery that cannot be opened using stents. Fortunately a nearby artery is providing necessary blood to that muscle, but I’m told I need to have treadmill test to test my heart stress levels and determine whether an operation is needed.

My leg ached for a couple of days but nothing problematic.

to be continued…

January 21st, 2009 by Peter Bargh

back home – after the heart attack

continued…

After a five day period in hospital I return home with a selection of medicines, a weary body and a mind of mixed emotions. I have a collection of British Heart Foundation leaflets covering the various issues/solutions to my new problem. These include detailed guides to angiograms, surgery, reducing cholesterol, medication and diet. There are many books in the series and they are really informative. I also have a guide written by the local health authority explaining the various phases of rehab and am told I will be receiving a letter in due course to confirm a angiogram. I will also get a visit from a rehab nurse to see how I’m coping.

Despite the trauma. I actually felt generally okay. Slight pressure on the chest and tired, physically and emotionally, but not bedridden.  Guidelines for week one and two are quite strict and very rest based. 10mins walk per day, no lifting, no using arms above head when showering, no work, no sex. Basically chill, do bugger all. The weird thing is that you cannot see any damage. And the best way to describe how to react is consider the heart like a broken arm or leg. It’s put in plaster and you avoid bending it until it mends. In a way the heart is the same, but you cannot see that you’re “bending” it. I’m glad I had this analogy or I would probably be back in hospital by now.

My company had placed strict no-go restrictions on my access to work, as they knew I’d be back in straight away! So TV called. It was a chance to watch lots and lots of TV. About five minutes of Jeremy Kyle made me realise how well I’d been protected from such stuff by working.  So I relived some DVD moments. I watched the set of Planet of the Apes movies, Bang Bang Reeves and Mortimer, Monkey Trousers, first to third series of Peep Show and mixed this with some History channel, Dave repeats and a bit of reading.

Time actually flew by. Each day I spent 10mins walking around the house until I felt comfortable going outside. The first few days outdoors (freezing cold) brought back the pain I’d experienced prior to the heart attack.  I couldn’t determine if this was angina or the next stage of early warning signs  The a would determine the state of my heart so the consultants would have a clear idea of the next stage.  A letter came through to let me know that my angiogram would be done on 24th December.

to be continued…

January 1st, 2009 by Peter Bargh

From A&E to the CCU

…this continues from the heart attack post

Having spent around four hours in A&E, suffering a heart attack, is was told a bed was available. Lyn, the nurse, apologised for the delay and said that the journey up would be fast.  The porter arrived and he pushed the bed while Lyn controlled the drip – it all happened in a flash and in moments I was being told to shuffle (very carefully) across from the A&E bed onto a bed in the CCU (Coronary Care Unit).

Three other beds occupied the large space. Each one with a patient hooked up to drugs via an intravenous drip and to ECG machines to monitor their condition. I was still in pain so the nurse administered some more morphine.

I was connected to two drips – one was Heparin to prevent the formation of blood clots and I think the other was Isoprenaline to slow the body down, but I can’t remember. These were attached for two days, along with the ECG, so made sleep very uncomfortable. I didn’t get any the first night (Monday 8 December).

The only pain I had was a headache from the drugs and backache from sleeping uncomfortably. The feeling in my chest was tight but not painful. It was hard to describe, but the symptoms did result in the doctors considering moving me to Sheffield for further tests. On day two their concerns reduced so I could stay in Bassetlaw.

The experience reminded me of a long haul flight. You watch the hours, minutes and seconds pass, each minute becomes slightly more uncomfortable. As you try to sleep on a plane you are interrupted by passing trolleys hitting your seat, duty free requests, or an air hostess asking you if you want a drink, or the fasten seatbelt noise alerts, or the nearby cry of a baby, or someone talking annoyingly loud, or the dull sound of the engines, while you continually shuffle in the tight space to gain comfort.

In the hospital bed it’s similar but just a larger space and less rocky! I was constantly woken from my drowsy state by blood tests, other patients calling out, machines randomly beeping, visitors popping in, nurses checking up on you, shift changes,  tea breaks…and all along in a bed that I couldn’t move from or adjust easily.

Day two was easier – I was allowed to dangle feet and have a bed bath. The bath was a nightmare – a bowl on the trolley, doddery on the feet, wires and tubes everywhere and a flannel. I did the best I could. I have to say it was a huge relief when three days later I could walk to the shower and get a proper wash.

I spent five days in hospital – discharged on the late afternoon Friday 12 December.

Throughout the stay I found the nurses and teams were incredibly good. Working long shifts, limited breaks, always smiling, always their to help. You could pick up that they have issues with working conditions, but all gave 100% to patient care. And bizarrely we are in a unit that encourages patients to change lifestyles – relax more, eat better, exercise correctly, work more effectively etc, and here was a prime example of what not to do, nurses rushing from one situation to the next, missing breaks, eating on the go, working 13 hour shifts, working with terrible colds, etc.

…to be continued

December 28th, 2008 by Peter Bargh

Heart Attack – the experience

Those who know me know that I recently had a heart attack.
I thought I’d explain what it was like, so hopefully it will put any one’s mind at rest who experiences chest pain and for any one who fears an attack.

What follows is a brief account of the experience… which I wasn’t expecting!

I’d woken about 8:30am on Monday 8 December. It was a day off and I’d pre-planned a day of fun. I was intending to install Photoshop CS4 on a new PC and then I was going to create some music using Logic and a midi-interfaced JVC30 keyboard.

I dressed and as I walked down stairs felt a pressure in my chest. I boiled a kettle for a cuppa. As I opened the eye-level cupboard door the chest pressure was increasing. This feeling wasn’t new.

I’d experienced it for the first time on Friday 05 December in the evening as I walked to meet a friend in Meadowhall. The distance from the car park to the Oasis is only about 800yards but it was enough to give me a slight worry. I even thought quite flippantly  “I hope I don’t collapse with a heart attack” As I reached the meeting point it went, so I thought nothing of it.

The next day, Saturday 06 December, I raced the family up that steep hill in Lincoln without even thinking about my chest. I was always proud that I had good energy. My 16 year old and I went up Snowdon via the Miners Track three months ago. He was knackered at the end of the climb. I bragged about being 47 and not out of breath.  Thinking back, there was a point when I did feel unusually faint and in need of an energy boost. I ate a chocolate bar and banana and it resolved.

Sunday 07 December went by without any problem, until I walked to the local shop to pick up some milk in the evening. On the way back I had the tightness again, but this time it was sharper and it did make me realise something wasn’t right. I mentioned it to my partner, but it disappeared again so I didn’t think any more of it that evening.

Now on the morning of the 8th, as I walked into the computer room to check the emails and web sites for messages, while the tea bag brewed, the pain was increasing.  I was starting to panic. This did not feel normal. I can only describe it as the feeling you got as a kid when doing school cross country in winter. The cold air biting as you try to breathe. Imagine that and multiply the pain by 10.

My usual action with pain is to grin and bear it. I attempted this by putting on a CD and trying to relax, but the pain grew. I decided to call 999. It was a hard thing to do. I felt silly, but some voice was urging me to do it.

The ambulance arrived 5-10mins later I felt embarrassed, but they were great. I explained the felling of pain/tightness right across the chest so they connected an ECG machine and took a reading. Everything seemed stable so I apologised for “wasting their time”.
They said it was up to me if I went to the hospital to check it out. I wasn’t sure what to do. A second ECG reading caused a slightly different reaction. They decided to take me to be on the safe side.

10mins later I was in Accident and Emergency. I explained all the symptoms to Lyn (the Nurse) but there were still no signs of any major problem, and then things changed! Lyn said I was having an attack – she administered Morphine then,  what seemed like seconds later, she asked if I would consent to being given a thrombolyser. Consent because the drug has risks of a stroke. I was uncertain what to do but the morphine was feeling great and a Doctor heard I was undecided and suggested I did take the Thrombolyser. Seconds later I was being injected with the drug and in process of a full  heart attack…all with minimal pain. thanks to the quick-thinking team and morphine.

The team were really pleased with the outcome, especially as four other patients were admitted at the same time, all suffering heart attacks and all were looked after by the very talented (and stretched) Lyn and her team. The CCU ward was full and I had to wait about four hours in A&E until a bed came free. I wasn’t uncomfortable – morphine made sure of that.

…to be continued.

I will over the course of the coming months explain about the recover process, the diet, the medicine, the stress test, having an angiogram, and the future.