This should be the story of my Atrial Tachycardia ablation last Thursday but knowing me it might fly off at a tangent from time to time.
Took the train to London Wednesday evening and cab across to Fulham where I had booked Travel Lodge. Had a few hours kip and taxi booked for 6.45 to take me to RBHT where I arrived at 7 am. Down into basement to day care unit? No phone signal so had to walk up stairs to ring Sam and assure her I was OK. Previously I had on rising showered with Hibiscrub as instructed . After booking in I was taken into another area where my groins were shaved and I was given a gown to put on. NB they never shave enough. Lower body and feet not undressed and eventually had to walk to lift and up to fifth floor to cath lab department. Sitting on chair in corridor I had long chat with anaesthetist and others and suddenly a choir of angels began and I hear my voice called "Bob, good to see you again" and Dr Jonathan Clague (JC) walks across to shake my hand. "Going to sort you out once and for all today " he assures me and is gone.
I am shown into the lab and various canulas are installed along with some very cold pads stuck on my back,. It is during this period that I gleaned the knowledge I imparted before. My right hand canula is connected to bag stand and I lay down. The anaesthetist is chatting to me and asks me where I want to dream about while they are working on me and then I am in recovery. Lying B--s---d never sent me to Monza.
I thought he might have actually as most of the chaps in recovery were Italian. lol 😁 Jonathan pops in and with great glee tells me he found and ablated four tachyardias.
Usual grogginess and euphoria of waking up ensued and after about an hour they rang the ward to come and collect me. Fransisco--"Sorry Bob. Nobody want you. Beds not ready" Ok I'm fine here and the company is good. Bang oops I've gone into tachycardia and occasional AF. Discussion ensues and I suggest if all else fails amiodarone drip. They try valsala with me blowing into a syringe . They try carrotic artery massage and even pressing on my eye balls (didn't know about either of those) but eventually hook me up to the dreaded A while they go to talk to JC who is working on another patient. They came back and changed the A to Flecainide and after about half an hour I reverted to NSR . Now some of you may know but I am not without some knowledge so none of the above phased me in any way but i have to say that the staff were brilliant and I doubt I would have been too worried even if I hadn't known what to expect. One of the nurses who was free at the time even ofered to phone Sam which took one of my worries away. Three hours later and I'm still in recovery wating for a bed so I borrow Fransco's phone to call Sam. (By this time we are old mates and I have established my position as capo di capi.)
Eventually a little after 5 15 a nurse arrives from the ward to collect me and off I go . I forgot to mention the cups of water and straw (my drinks bottle is in my bag) and the cup of tea Fransisco brought me and of course as soon as I get to the ward I am brought a chicken sandwich and a carton of blackcurrant juice. Big mistake! Suddenly I feel bloated and nauseous even before eating the chicken. Panic. Look around. Plastic bag with shoes. Shoes go across the ward and I just manage to get my head in the bag in time. I am not the quietest of people at these times and soon a nurse appears with paper mache bowl. Not needed thanks All better. Where is that chicken sandwich? Almost inmediatedly the auras started and continue although now much reduced.
Bad night with noise in ward and then it is breakfast, porridge and toast and jam .
Get up and shower as expect to go home. Usual routine, Echocaradiogram. ecg, bloods BP and temp and I lay reading until doctors arrives. Apparently they see some conduction anomalies and do not wan't me to go home. In fact they want me to stay in over the weekend and have a pacemaker next week. Mood descends to darkness and I phone Sam who is just approaching Reading on M4. Go home I'm not coming out. (it took her 10 hours from home to home due to it being grockle season) My kidneys have woken up by this time and I am getting plenty of exercise walking to the loo. Late afternoon and I have finished the one book I took. I am becoming very low. Estimated height of building but decide not enough sheets. Then as I am on one return journey JC calls me and he had popped in to remind me he had found four tachycardias. Obviously very pleased. I explain what they had said and he scoffed and rushed off to look at the data . "No I'm happy with that. You had a shed load of flecainide and that will do it. Best stay here tonight and you can go home in the morning."
Next morning Sam itching to get on the road but I insist she wait till duty doctor has released me. Just as well. Eventually we have the same conversation but I inist that JC had approved my release so they agree to e mail him and be guided by his reply to which I also agree. Around 4pm I am told JC has overuled and I can go.
Now 4 pm on a Saturday is not a good time to even look at M5 motorway. It is a carpark for at least forty miles with all the home going grockles crashing their caravans. So I negotiate staying in my bed one last night so long as my release papers are signed and ready for me. I was up at 6, showered and dressed as Sam hit the road but managed to wait for my breakfast (scrambled eggs on toast with porridge and tea) before legging it down to reception where I bumped into a patient I had been chatting to the previous evening who was waiting for the paper shop to open (it never did). Sam arived about 9. 30 and we were home about 2 15 .
Flecainide.
Funny stuff and I was never on it for long in my early days and only as a PIP. I have been told that people have hallucinations with it so here is my experience. Apparently it can prolong the QRS complex by affecting the AV node and the delay between the top and bottom parts of the heart was what was seen on the traces. I did not experience hallucinations but did notice a strange thing. Normally when I close my eyes all I see is dark red. This time a whole new world opened. I could see intricate moving patterns, crystal clear images and swirling mathmatical formulae and hieroglyphics , fields of flowers growing before my eyes. Open them and it was gone but close again and it started. Hells bells have I gone back in time to the sixties? It made going to sleep a real problem as I was more alert with my eyes closed.
Its all gone now thanks goodness and I feel better by the day although still heeding me own advice. That's a first as well.
B
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