Health.....

[PeterC]

On 12/19/2018 at 5:09 PM, Hamish said:

 

And in the recent past I have had some long days in the garage, in out and under my tr  and I certainly felt long forgotten muscles. 

H.

Me too. Resolved with 2000 IU per day vitamin D3. Aches that used to last days either did not arise or cleared up in 24 hrs

Peter

[PeterC]

8 hours ago, JohnD said:

I have an interventional investigation forthcoming, which I am assured will include sedation, but which I would rather like to watch.  It's called cardiac ablation.

Earlier this year, I had several episodes of 'feeling funny', during which I had a very fast heart beat.     When one occurred during an operating list (!) I nipped out to the anaesthetic room, slapped on some electrodes and took my own ECG.      I thought it was SVT, supraventricular tachycardia, which is a tad worrying, but after wearing a monitor for a week, I was told it was paroxysmal atrial fibrillation (AF).  I won't explain these terms - you can look them up as well as I!    You may also be reassured that I had already intended to retire completely from practice at the end of the summer, so no risk to my patients, 'cos I don't have any now!

My treatment choices included cardiac ablation, in which the accessory pathways in the heart that trigger the AF are cut, my cardiologist tells me by a laser!   The laser needs to go down a catheter, like Nick's but there ain't no natural opening, so it goes in through a needle into the vein in the groin.   That is the bit that the sedation is given for.  Then the catheter is passed up through the veins into the left atrium of the heart and through (!) the wall into the right atrium where it can do the business.      I was a bit surprised to hear that a laser would be used, as while it would work well through clear watery solution, blood is a bit thick.   But they inflate a tiny balloon on the cather end with heavy water, press that against the atrial wall and fire the laser at the wall!    Yes, I said HEAVY water, deuterium oxide!  None of yer ordinary H2O!   Apparently D2O passes the laser better.

All this is done under the image intensifier, live X-ray movies!   And I'd rather like to watch!     

There's an eight month waiting list (!) so meanwhile I'm on betablockers and anticoagulants, to inhibit the AF and protect me if I get one.  Roll on next June!

Just went for my annual racing licence medical, and the GP (never met him before) seemed a bit surprised that there was no prohibition for such as I, but still signed on the dotted line and accepted my fee.  Now have to wazit and see if the MSA  Motorsport UK raises any objection - but they shouldn't!

JOhn

John, Check out magnesium deficiency. It doesnt show up in plasma [Mg], and most modern diets are deficient. Many K and Ca channels are Mg-sensitive or MgATP reulated. Peter

[Scooter]

On 12/20/2018 at 12:11 PM, Rod1883 said:

John - hope you don't mind me asking, but as a medical person, have you any advice on how to control/treat my vasovagal tendency? It's something that at the moment I can't control - anything to do with needles etc and I'm in a cold sweat and passing out!

Rod

Brandy

[Rod1883]

Close - I prefer Armagnac!

[JohnD]

Rod1883,  my apologies!   I never replied to your question!    As I am no longer a doctor - retired and gave up my registration - and even more because I am doubtful about remote consultation, It would be unwise for me to make any suggestion on treatment.   But the NHS is your friend!    It publishes online a booklet about needle phobia and how to overcome it!   See: https://www.cnwl.nhs.uk/wp-content/uploads/Needle-Phobia-Booklet.pdf

It does use some forbidding wording, for instance "anxiety hierarchy" for goodness sake, but stick with it, they explain what they mean.    And what they suggest is what I would have, if I had been still competent!     The procedures they suggest are tried and tested in anxiety, so have a good likelihood of working for you.

Good luck!

 

But I came here to report on the procedure I had last week, my 'ablation', to stop my intermittent ("paroxysmal"!) atrial fibrillation.     Spent a day in the Blackpool Victoria Hospital's cardiac day ward, and the night after.      Really excellent in every way, exactly what the NHS tries for and despite what you hear, largely achieves.    Admitted by nurses first (I went for a Pre-Assessment  visit in out-patients a week or so ago), then by the doctor who would do the procedure, then by the consultant.     Changed into, not a gown, so embarassingly done up down the back, but pyjamas like theatre blues, with Velco seams along the legs and arms.  Ver' sexy, no?

Taken to the "lab" which was a between an X-ray room and operating theatre, moveable couch/table to lie on, with a circular boom around it that carried not one but two X-ray tubes!    Front to back and sideways (!) views at once!   Six video screens, showing the X-ray image intensifier pictures, data and pressures, that I could just about see.    I didn't ask that they adjusted them better for me - though it more important that the operator could see them - but it is weird seeing a beating heart with probes in it, and knowing it is your OWN HEART!

A drip needle in my arm, and then some local anaesthetic in my groin, and a needle into the big vein there (femoral).     I want to tell you that I felt NO PAIN!   None at all, absolutely pain free!  Experts in charge!    They passed the probe into my heart to do a preliminary investigation, and then asked me to swallow a temperature probe after spraying my throat with a local anaesthetic and telling me to swallow it.     Again, pain free!     Although I did have a slightly sore throat for the next 24 hours.

And after that, they gave me some sedation and I can't recall a bloody thing, until I woke up in a bed on the ward!     Damn!   I wanted to watch!    But maybe I had already irritated them with medical jokes that they had heard many times before, and just wanted to shut me up.       I had a medical G-clamp on my groin, a giant clip that pressed an inflatable cushhion over the puncture site, and I was strictly told (you know what nurses are like - I do, I was married to one!) NOT TO GET UP OR SIT UP!   So I didn't.

Afterwards, I was visited by the consultant and team, to tell me how it had gone (another star for the NHS), and the next morning by the Nurse practitioner who specialises in this game.    More strict instructions (yes, matron!) on what and what not to do, including that the overnight bag I had packed was far too heavy for me to carry!    It only had two books and three magazines other than a change of clothing in it!    But I promised and kept the promise.   And apart from some bruising, not as bad as I've had after giving bloood, my groin site is absolutely fine.

I'll be seen in out-patients again in three months time and must continue to take all my tabs, plus an extra one for a month.    Then and only then, I may be able to get rid of some of them.

The ward was clean and well-decorated, the staff were delightful and helpful - I wanted a newspaper the next day, and the hospital paper shop was some way away - so a nurse auxiliary volunteered to show me the way!   Even the food was good!     Absolute 5-star NHS treatment!    Hooray for the NHS!

John

 

[BrianR]

John

Great to  hear some positive news about the NHS treatment. I've  always held the view that medicine is not an exact science and medical staff work hard and to the best of their abilities to effectively treat patients. Unfortunately todays society has in some cases too high an expectation from medical staff, in some cases promoted by lawyers  and the media ( good news is not news).

The sad thing is that politicians and NHS management are incapable of supporting the front line as they should do.

Brian

[Sidescreen Vicky]

John,

Firstly, very best wishes for a speedy recovery from your operation.

Thank you for posting such an interesting account of the procedure and I'm glad you were looked after so well.  It is always good to hear such a positive view.  How long is it before you know if the procedure has been successful at sorting your AF?  Did they give you any statistics with regards to the success rates for treating the condition, or whether the heart can revert back into AF afterwards?   

Vicky x

 

[JohnD]

Thank you, Vicky!     Recovery is hardly the word!   Although as I said I was given dire warnings about activity, lifting etc, for 48 houirs and to "return to work" only after a week, I've been behaving normally ever since, while bearing the  precautions in mind.       They are most concerned that straining would cause the vein puncture to 'pop' and bleed, so I've lifted nothing heavier than an engine block so far (joking!).

I was in two minds about having it done, as ever since I got advice and drug treatment (beta-blockers and a platelet inhibitor) I've had no episodes of AF, none at all!     But talking to the consultant, he was keen to do the ablation as the AF can 'break through' and is then more likely to be irreversible.     The procedure has a better than 95% success rae in preventing any more episodes, but can be repeated if necessary.

AF is commonly treated when it persists by "cardioversion", giving the heart the same sort of electric shock as in cardiac arrest, but carefully timed to the correct part of the cardiac cycle.      This stops the fibrillation and allows the normal pacemaker mechanism to take over again, but requires a short anaesthetic as it's quite painful!    And anaesthetics are dangerous - ask me how I know!

John

[PaulAA]

Excellent outcome, John.  Glad it went well and that there is nothing but positives to report.

I had a short and unplanned visit to A&E two weeks ago.  Severe chest pains, radiating to neck and down arms, culminating in tingling hands.  Lot of stress at work, etc. and assumed the worst.  Result was that heart is okay, but the episode turned out to be another stage in a long-term gastric problem (and I now have the delightful prospect of another gastroscopy...)

My visit wasn't quite as edifying as yours, but my cold heart was melted by the young doctor who told me off for referring to the internet for a cod-diagnosis. 'You're slim, a non-smoker and young, so no reason to worry about your heart'.  At the grand age of 56, the 'young' bit certainly melted my heart.

Paul

[JohnD]

Paul, they had plenty of evidence to back up their recommendations.     And what's more, the evidence was from humans!     Us non-human primates have been the victims of too many medical experiments over the years, and still are!

Made me quite reassured:

JOhn

Edited July 22, 2019 by JohnD

[Nick Jones]

42 minutes ago, PaulAA said:

slim, a non-smoker and young

Yeah..... nice...… but not a reliable indicator of heart health. I recently had a call from an old friend in the US, from his hospital bed, having just had two stents fitted following a heart attack.  He's 4 years older than you but otherwise fits the description and as a regular runner/cyclist/walker considered himself a fit man.  So you did the right thing for sure.

Hope the other matter is easily resolved.  There are worse things than gastroscopies.

John, good to hear your procedure went well.  Here's hoping it does the trick.  Will mention it to a friend who is currently in AF having recent relapsed after something like his 3rd cardioversion.  Just in case it is suitable for his condition.

NHS is much maligned, but unjustly most of the time.  For acute care especially its a world-beater.

[JohnD]

The current craze for exercise was started by one Jim Fixx, who wrote The Complete Book of Running (1977), but sad to say, he died of a heart attack while jogging, at the age of 52.

Exercise, non-smoking, keeping your weight down, all help but aren't the whole answer.

John

 

[PaulAA]

4 hours ago, Nick Jones said:

Yeah..... nice...… but not a reliable indicator of heart health.

This is true.  But she was a very pretty doctor and compliments are so few these days that I feel the need to record them.

Paul

[PaulAA]

4 hours ago, JohnD said:

Paul, they had plenty of evidence to back up their recommendations.     And what's more, the evidence was from humans!     Us non-human primates have been the victims of too many medical experiments over the years, and still are!

Made me quite reassured:

JOhn

Agreed, John, and it makes a change from humans making monkeys out of us:

 

 

[Nick Jones]

20 minutes ago, PaulAA said:

This is true.  But she was a very pretty doctor and compliments are so few these days that I feel the need to record them.

Paul

 Can relate...…..

[PeterC]

20 hours ago, PaulAA said:

Excellent outcome, John.  Glad it went well and that there is nothing but positives to report.

I had a short and unplanned visit to A&E two weeks ago.  Severe chest pains, radiating to neck and down arms, culminating in tingling hands.  Lot of stress at work, etc. and assumed the worst.  Result was that heart is okay, but the episode turned out to be another stage in a long-term gastric problem (and I now have the delightful prospect of another gastroscopy...)

My visit wasn't quite as edifying as yours, but my cold heart was melted by the young doctor who told me off for referring to the internet for a cod-diagnosis. 'You're slim, a non-smoker and young, so no reason to worry about your heart'.  At the grand age of 56, the 'young' bit certainly melted my heart.

Paul

Paul,

With signs like that I'd have been to A&E immediately, her accusation is unfair, Med studnets have long been taught to recognise that patients have gleaned knowledge form the web and may for certian chronic diseases eg diabetes know more than a young doctor. The Mayo and WebMD sites are useful for getting started. I am fortunate in having a biology background that enables me to scan the science behind my particular pathology, and the contrast with established clinical approach is astounding. Not only do the 'gold standard' drugs used globally add to the neurodegeneration , but alternative approaches to PD that have been around for ca 20 years dont get a look-in. I find that reassuring ! TG for Google Scholar.

Peter 

[Nick Jones]

Happy to report that my PSA remains more or less undetectable.  This is good.  PSA test anxiety never leaves..... but is fended off for another 6 months.

[PeteStupps]

That's good news Nick, relax for 6 months. Or at least rest that elbow for a while 

[Mark]

Great news Nick. The waiting for test results is horrible. 

[GT6MK3]

Good to hear Bud.

[Nick Jones]

Thanks all. Here’s hoping that our various other sufferers are similarly fortunate.

[MilesA]

Just passed my fourth anniversary. Same outcome as you Nick. Nine month gap last time; moving to 12 months for the next one.

Talking with my surgeon over the result, what is tragic is the pandemic impact on detection rates and speed of response. After an initial halt on surgery for a couple of months, they were working like crazy to clear the backlog. Once clear, new cases coming through are greatly reduced and patients are in a much more advanced state. Upsetting to hear at first hand what we have all been told about the pandemic impact on other health issues.

Miles

[RogerH]

1 hour ago, MilesA said:

Just passed my fourth anniversary. Same outcome as you Nick. Nine month gap last time; moving to 12 months for the next one.

Talking with my surgeon over the result, what is tragic is the pandemic impact on detection rates and speed of response. After an initial halt on surgery for a couple of months, they were working like crazy to clear the backlog. Once clear, new cases coming through are greatly reduced and patients are in a much more advanced state. Upsetting to hear at first hand what we have all been told about the pandemic impact on other health issues.

Miles

A lady friend of mine was diagnosed with Pancreatic cancer just at the start of the lock down.

Her hospital turned her away just when her chemo was to start.

I heard about her problem in June and she was dead in late August.

 Why weren't they recommending D3 from the start.

 

Roger

 

Roger

[PeterC]

The BBC stopped reporting "excess deaths" months ago. The last number I recall was 30,000 excess deaths ie deaths that would not normally have ocurred that month and that were not directly attributed to C-19.  UK must now be close to 100,000 deaths attributable to the impact of the virus directly or indirectly.

[PaulAA]

3 minutes ago, PeterC said:

The BBC stopped reporting "excess deaths" months ago. The last number I recall was 30,000 excess deaths ie deaths that would not normally have ocurred that month and that were not directly attributed to C-19.  UK must now be close to 100,000 deaths attributable to the impact of the virus directly or indirectly.

Similar story here, with obfuscation, smoke and mirrors and plain untruths to conceal the impact. Our first wave was non-existent, especially in comparison to the UK's, but the second resulted from policy errors, a failure to manage public vigilance, incompetent management and a sweeping assumption that the country had 'got away with it'.

When official figures were released by Public Health, they included only infections recorded by Public Health themselves, a test which was long, slow and required the potential sufferer to display five specific symptoms. An unknown proportion of people therefore took the test privately, which was quicker and involved the minimum of queueing. There is no quaratnine requirement for people who test +ive in the 'unofficial' private test, so no track and trace. The Govt has now given up releasing daily figures, presumably because they're busy trying to imprison judges for political reasons and squabbling with the EU over RoL...

Needless to say, the only figure to be reasonably reliable (and I use the word advisedly) were the diminshing vacancy of the limited number of ventilators available in the country.

Good to see the PSA under control, Nick!

Paul