Monday, March 4th 2013
I am writing this on my Blackberry in hospital. To be precise, I am lying on an examination couch in the Accident and Emergence (A&E) department of University College Hospital (UCH), connected to a monitoring machine. I expect to be released to go home in an hour or two.
Why am I here? If you mean for what reason did I come here, I can tell you that, but if you mean what health problem brought me here, then that is a little more difficult to answer.
On Thursday afternoon, I became aware of my heartbeats. Normally, you are not aware of your heart beating so this struck me as odd. Every few beats, at a regular interval, the beat would be stronger than the others, enough to be noticed when just sitting normally.
I thought this would be a momentary thing, the heart “skipping a beat”, but when it continued, I began to feel a little worried. Should I seek medical advice or was this something unimportant? I did not feel unwell or have any pain.
The “beats” were still there on Friday morning and I considered asking for an emergency appointment at my GP’s surgery but in the end decided against this. We were busy over the weekend and this distracted me sometimes from the problem and its consequent worry. I determined, however, to seek an emergency appointment at my GP’s surgery on Monday morning (today).
I secured an appointment for 9:20am this morning and went along in a state of trepidation. I no longer worried that I might be wasting the doctor’s time and instead was anxious about what the diagnosis would be. The doctor took my pulse, agreed that it was irregular and had no doubts about what I should do next: take myself to A&E. She seemed to think that I might have suffered a heart attack even though I could recall nothing that I could recognize as such. If anything, this increased my concern and so I went off to UCH forthwith.
At A&E I presented the chit issued by the doctor and took a seat in the waiting room. All around me other people were waiting, some with obvious injuries, like the young builder’s labourer with a bandaged hand who had cut himself at work, and others with no overt signs of distress. A&E departments in the NHS are notorious for the long waiting times. The joke is that you either get better or die before you are attended to. Looking around at all those people and calculating reasonable consulting times for each, it seemed I might have to wait a long while… unless heart problems are prioritised. Perhaps they are because I just had time for a quick visit to the loo before I was called.
A nurse took me to a cubicle with two beds in it. There she instructed me to take off the clothes on my upper part, and put on a hospital gown. After a while, someone came and wired me up for an ECG. They also took my blood pressure, fitted a cannula too my arm and took some blood samples.
I felt relatively comfortable and cheerful at this point and joked with the various people looking after me. After all, if there was something wrong with me, I was in the right place for it to be diagnosed and sorted out – or so I thought.
A doctor came and questioned me in detail about the circumstances of my “beats” and about my medical history. As the questioning proceeded, I began to get the idea that my story was not producing a consistent picture in the doctor’s mind. As I said above, the reason for my coming here is obvious but the nature of the problem that has driven me here is less easy to specify. The scans, tests, examinations, and questionings have not so far provided a diagnosis. There will be more scans and tests to see whether these turn up something not found so far.
The good news is that there is no sign of a heart attack. All the doctor can say is that my heart rate is unusually slow (he asked whether I had regularly engaged in athletics, to which the answer was a definite no!) and that the “beats” occur periodically as the heart catches up on itself.
It is all very mysterious. On the one hand it is reassuring to know that my condition is not immediately life-threatening but annoying, and still a little worrying, to feel these continuous “beats”. There will be more tests later with a cardiologist and there is always a possibility, either that the condition will clear up by itself or that it will turn out to be the start of something.
In the meantime, I am alone, resting on my cot, with my Blackberry for company. As well as writing this account, I am sending blow-by-blow accounts to Tigger by email.
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I have now been disconnected from the machines, instructed to get dressed and been sent to a seating area to await the results of the blood test. I still have the cannula in my arm, apparently in case they need to take further samples.
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I am now on a number 73 bus heading along Euston Road towards the Angel. The blood test turned out satisfactory and a cardiologist, when shown the ECG scans apparently pronounced himself “happy” with them. A nurse removed the cannula and the doctor brought me a copy of his report. One will be sent to my GP but mine serves as a backup in case the other goes astray – a not unheard-of occurrence.
I feel both relieved and anxious at the same time. I have been told my condition is not immediately life-threatening but, on the other hand, they don’t know the cause. And the “beats” are still there. It looks as though I will have to get used to them unless and until they disappear of themselves or the cause declares itself.
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Later.
Suspecting that I might have to spend time in hospital, where valuables are at risk, I reluctantly left my camera at home. As it happens there were not many opportunities for taking photos, anyway. Unwilling to let my day out be completely “dry”, I took a few photos with the Blackberry’s camera. Here is a small selection. None are very exciting, I’m sorry to say.
UCH
Showing the understated entrance to A&E
UCH is a huge glass and metal building in which the colour light green predominates. If this is not my favourite architectural style, I also have to admit the it is better than some modern buildings. The entrance to A&E is quite small though there is a bigger entrance around the back where the ambulances deposit their passengers. This is the street entrance for the walking wounded.
So near and so far
The bus stop is on the other side of the underpass
When I emerge from UCH, the bus stop seems the symbol of freedom. The road here is divided by an underpass so, although the bus stop is visible, it is not immediately accessible. You have to detour around the underpass.
Freedom regained
The bus stop for buses home
Here we are at the bus stop at last, with a sense of freedom regained. If you are wondering what the red machine is, I will explain that it is a dispenser for bus tickets. In order to speed things along, you are not allowed to buy tickets on the bus in certain parts of London. You have to obtain your ticket beforehand and show it to the driver as you board the bus. You can either invest in a rechargeable Oyster card or buy single tickets from the machines.
The Blackberry camera performs reasonably in bright light, though I find the preview screen hard to see in sunny conditions like today. It is not so good in low light, when grain and false colour become a problem. Also, strangely, if you zoom the image, the camera for some reason reduces the size of the picture making the resolution so low that the photo is virtually useless. A very strange “feature” (or is it a bug?).
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Hope you feel “in sorts” ASAP. I’ve been through a similar thing (rush to hospital at 4am, weird beating of the heart, tests show nothing life-threatening, you can go home now) so I can empathise. I have a relative who has an ectopic heart (as opposed to heart beat), which means they have that waiting-for-Godot moment every few beats (only in this case, Godot does in fact turn up) because their heart is slightly rotated from the normal position.
Heart beats are triggered by a specialised group of cells that can, on occasion, fail to get their act together. Some of their number can go off on their own to march to a different beat, which confuses the hell out of the heart. As I recall, the treatment is usually ablation, where the extremists get theirs with a laser or whatever. Worst case the sufferer gets a pacemaker that takes over.
I don’t think that applies to your case, but the body has a habit of presenting one set of symptoms that are confusing and later settles into a more recognisable state that does submit to being diagnosed, so you may get a better answer down the road. Disconcerting, but at least nice to know a heart attack has been ruled out.
The small amount of information that came out of the examination makes it hard to draw any solid conclusions. The report requests my GP to arrange follow-up investigations and perhaps something more positive will emerge then. We shall see.
Hope you are home and ‘chilled’ Wise move getting things checked out. In my experience no health care professional will ever think you are ‘wasting their time’ with concerns about chest pains/ heartbeat irregularities. Mr uphilldowndales heart rate all ways sets off the alarms, being a fellrunner he ‘ticks over’ at a very slow rate.
One of my favourite charities is the British Heart Foundation (Their head office is very photogenic) http://www.bhf.org.uk/
Thanks. I am keeping busy to distract myself and not think to much about my “condition”.
It is true that both at my present GP surgery and UCH I have always been received with sympathy and kindness.
Good to see it was nothing but as Uphilldowndales says, the fear of wasting health professionals’ time is unfounded in most, if not in all, cases – a stitch in time saves nine. Have a relaxing day tomorrow!
There is also the “bloke syndrome” to contend with: for some of us, it takes a while for us to convince ourselves that there is actually something wrong that needs professional treatment. We prefer to think that whatever it is will get better of its own accord in a couple of days.
The slow heart rate and irregular rhythm suggests a rhythm disturbance, as BFG points out. It can be a side effect of medication, or too much caffeine, or perhaps not enough caffeine, or the sinus node (the heart’s own pacemaker) can go wonky for one reason or another. Rhythm disturbances are much easier to treat than blockages of the coronary arteries. Some respond to medication, and, as BFG notes, in the more recalcitrant cases, pacemakers are called for. However, so long as the coronary arteries are free of disease, rhythm disturbances have a very good treatment outcome. You may be asked to wear an event monitor for a certain period of time — rather like a portable ECG machine. Your vegetarian lifestyle and your and Tigger’s frequent walkabouts are both points in your favor with regard to risks factors for coronary artery disease. Hopefully, they’ll sort things out soon.
As I daid in another reply, the hospital has requested the doctor to arrange follow-up investigations. As it happens I already have a doctor’s appointment but it’s not for 10 days or so. There is a waiting time for a regular, as opposed to emergency, appointment, so I will just have to wait it out.
So glad you had some device to amuse/distract you. What an unsettling situation. As you say, men tend to ignore things sometimes – better to check it out than not – if nothing else you’ve got a “baseline” established that may be useful in the future. Irregular heart beats have many causes – WOL’s comments are good – (you should be fitted with a monitor and wear it about a week.)
You are probably fine and it’s all precautionary – but nothing wrong with that.
I liked that last picture – (we have ticket machines like that here for the little rail line around downtown to the medical center hospitals.) – an interesting shot with the roads, buildings- lots of depth and perpective
The follow-up, possibly involving a monitor, will only happen after I have seen my GP on March 15th. Then we are due to go away for a few days so I don’t quite know hoe it will be fitted in.
Glad you liked the picture. Visitors to London often don’t understand that they can’t buy tickets on the bus and when they’re told, they may not have change for the machine…