I was in hospital again yesterday. This was scheduled, following the appearance of Bob and a few friends. Bob was the pet name for a pointy lump next to my clavicle and above my ICD. He was at risk of puncturing through the skin. You can learn about Bob's appearance (or if you are a bit more hip, get the low-down on Bob) here: healthunlocked.com/bhf/post...
On Friday morning, I arrived in good time for my 9am appointment. At 9:15am, a nurse appeared and mumbled something into her facemask whilst beckoning me forward. She took me into the day care ward and showed me to a bed, where I began unpacking my essentials for the day. I noticed that I was surrounded by elderly women. Good, I thought. We'll be able to have a decent natter.
As I reached deep into my bag for my Donald Trump loo roll, the nurse reappeared. She stared at me, looked down at her piece of paper and then back at me. "You're not Tina, are you?"
Panic. Was this a bad dream? Maybe I was hallucinating as a result of no breakfast? I felt my stubbly face but wasn't convinced, so I dug out my bus pass which confirmed my identity as a 46-year-old man. After a bit of faffing, she escorted me to my allocated bed in the male section of the ward. They had put me next to a bloke who'd evidently had a potent curry or two on Thursday. I began to think that I wouldn't need any sedation. The flatulent emissions were doing a fairly good job of slowly asphyxiating me.
He was taken away for his surgery and the rest of the morning passed fairly smoothly. My allocated nurse ran through the procedural bits and bobs, including my meds and allergies. I discovered that they aren't really interested if one has an allergy to Max Bygraves songs or if you are intolerant to e-scooters. Please take note of this, as you may find it helpful if you are ever admitted to hospital.
Two consultants appeared around lunchtime to examine the wound area to be "revised". This is the medical term for redoing it. It's a bit like realising the patio slabs aren't level, so you need to dig them up and try again, or just shove some decking over the wretched thing - you never wanted it in the first place. Either way, after some prodding and poking, they agreed that it needed revising to prevent it puncturing the skin and risking infection. Infection around ICD leads is a not a nice thing and can cause all sorts of complications, so I was totally cool with the plan of action.
The senior consultant said "It's quite rare to need a wound revision, so you are a bit of an unusual case." He told me that the subcutaneous sutures were a bit exposed under my skin, which had resulted in the pointy regions (which were very sore).
"You are quite lean. There isn't much padding to hide the sleeve and sutures which keep the leads in place." he added.
"Do I need to eat more pies and chips?" I asked.
"No, please don't do that."
"What about deep-fried Mars bars?"
"Only with gravy." He winked and toddled off, leaving me to sign the consent form.
We were ready to rock.
Off we went to the catheter lab and, once again, it was bloody freezing in there. I had two blankets across me to try and keep in what little body heat I had. This was my third time in such a place and on each visit, I've ended up shivvering with pale extremities.
Aren't beta-blockers fun?
The surgeon appeared and said "We probably won't sedate you, unless you really want it? We'll just do it under local." This was brilliant news! It meant I could remain completely alert and be able to chat during the procedure. It was less positive news for the team, as I could remain completely alert and be able to chat during the procedure.
Actually, they were utterly brilliant and talked me through their preparations. They explained what the various patches were for, including those large super-sticky icy cold ones (diathermy/plasma and emergency defibrillator electrodes). What a load of tosh. I'm not falling for that. It is a well known fact that they are used for torturing hirsuit people post-surgery.
Next, they disabled my ICD. This was to avoid the plasma/diathermy cutter from confusing my ICD and it delivering a shock. When someone is doing fiddly work, it's most inconvenient if the patient jolts about, so I thought this was a sensible precaution.
In went the local anaesthetic and the surgeon began her work. She talked me through what she was doing during the entire procedure. She exposed the internal sutures and snipped them, one-by-one, before explaining how she was digging a bit deeper to re-stitch the four sleeve wings against the muscle.
"Any holidays coming up?"
What is this? A barbershop?
She was very pleased with the result and prodded me several times to prove that there were no more protrusions. As she stitched me up, she requested an X-ray to check that none of the ICD leads had moved during the procedure.
I talked a bit of physics with the radiographer, noted the X-ray machine voltage and radiation dose (90kV and 0.35µGy/m^2, if you must know). Physicists are interested in this sort of detail. I asked if he'd let me see the image of the ICD leads in my heart and he said "Well, you own your heart. It's your property, so of course you can see it!"
I'd never thought of it like that before. He turned the screen for me to see.
Oh my goodness. There it was. My heart X-ray! It was displayed on one of those enormous panoramic wide screens hanging from the ceiling on a robotic arm. The image showed the leads in my right atrium and ventricle. I could even make out the little screws which secured the leads into the walls of my heart. 🤯 I was totally absorbed with the picture on the telly and stopped talking. I studied my internal circuitry whilst they cleaned up around me.
My ICD was switched back on. We said goodbye to each other and they began wheeling me towards the door. It was at this point, that my day became a little tarnished. It's such a shame when a minor bit of detail takes the shine off an otherwise excellent experience.
As we approached the door, I listened. Nothing. I strained my ears to cut through the background noise, but no, still nothing. Not one person asked "something for the weekend, sir?" Is this normal or are times changing?
And then the pain started. I need to be honest about this in case you ever have to go through this. I hope you don't, of course. It was mild at first, but grew as they wheeled me back to the ward. The pain spread and I had a weird and excruciating throbbing in my head. It was at this point, I realised that the Spotify playlist on the nursing station had switched to BTS. When it moved on to Stevie Wonder, the pain subsided.
It was now 4:30pm and I was given my first cuppa of the day. Magic! And I tucked into a couple of sandwiches.
I was allowed home early evening and enjoyed a good sleep in my own bed. We had a curry on the way home, so I self-sedated quite nicely.
Today, I've been researching which of the local chip-shops do Mars bars. No luck yet - I'm still looking.
3 leaded icd defibrillator 
pacemakers and ICDs
Icd implant 
ICD Procedure
Risk of ICDs and living with an ICD
