Angiogram

Saturday 25th February 2017. I’m on a hospital bed being wheeled to an operating theatre. Eight days earlier I was admitted with chest pains that had been diagnosed as cascade Angina by my GP; who was insistent that I shouldn’t go home from his surgery but that I should go straight to the clinical decisions unit at the nearest heart hospital. When admitted, I was told that I probably would only be there for 48 hours or so. However, it seemed to be that it was one of those weeks when everyone else’s case was more urgent than mine. So as boring and tedious as life was on the ward, (one can’t go far when hooked up to a monitor 24/7) I actually felt comforted by the fact that they didn’t seem in a hurry to get to me. Add to that the fact that two guys ahead of me had gone down for the same procedure, and had returned reporting no problems at all, and I was almost feeling rather chipper.

I say almost, but I couldn’t help feeling more than a little apprehensive as I was wheeled towards the operating theatre by three nurses; one of whom I noted seemed to be more senior and experienced than the others. I’m not sure what I expected the theatre to be like but my first impression was that it seemed cavernous and pretty spartan. The walls were completely bare and the high ceiling was covered in a network of track from which was suspended various pieces of technology. The only item I recognised was the biggest flat screen monitor I have ever seen. Just below all this space age kit was the operating table and my bed was duly parked alongside this. The side rails were removed and I was asked to shuck myself over onto the table; which was no mean feat considering the amount of tubes and wires I had attached to me. My cardiologist then came over and introduced himself and briefly explained what they were planning to do. Which was to pass a catheter through an incision made in my wrist. This catheter would then be manoeuvred along a vein towards my heart, so that they could see where the restriction to my blood flow was. Then he would insert a device called a Stent that would open up the vein and allow the blood to flow normally. All pretty straightforward then; except that it turned out to be anything but.

The nurses began their routine of preparing me for the procedure. Equipment was manoeuvred into place. There was a mechanical whirring sound as a compact looking box was lowered from the ceiling into position over my chest. This was the X Ray machine that would allow them to see, via the big monitor I mentioned, what was going on in my chest. Glass screens were wheeled into place that would protect the surgery staff from any radiation. What was going to protect me from it wasn’t mentioned. I then felt a pin prick in my right wrist which I realised was the local anaesthetic being administered. This was just one of the many needles that had been stuck in me since I was admitted, so I had got used to them by now. They fitted a Cannula to my wrist and without further ado the surgeon began to pass the catheter into my arm.

From this point on, everything began to go Pear shaped. I’ve never been good with pain. So I had asked to be sedated as soon as I got in there. They were quite happy to do this for me, as it would help to keep me calm; or so they surmised. At first I just felt a pressure as the catheter began its journey up the interior of my arm, but then the pain kicked in. Not too bad at this stage; just bearable. I began to realise that my surgeon was struggling a little. He then announced that they were going to withdraw this one and try something narrower. The pain continued as it became clear that even this one was proving difficult. He then backed out and tried once more; again with no success. It seemed that by this time the vein had gone into spasm; so he announced that they were going to switch to my groin where they hoped to have better luck.

Before I came down to theatre I was given a pair of disposable paper panties to put on; presumably to protect my dignity. I now felt the fingers of the nurse who had the task of prepping the area, very delicately tearing a strip off them just down the side of my testes. In another time, place and context, I might have considered this quite a sweet little bit of foreplay; but given the circumstances I wasn’t in a position to allow myself this little distraction. While they were busy prepping my crotch area, the more senior nurse decided they were going to give me some morphine because I was in so much pain. While she was doing that I felt another needle going into the top of my right leg as they administered the local anaesthetic. The Cannula duly fitted in that area, they proceeded to pass the catheter this time up through my abdomen. It took about thirty seconds for the pain to kick in again. This time in my chest and a lot more severe than in my arm; I was in agony. It felt like hot irons were being driven into my chest. Gasping with the pain, I was trying to stay as immobile as possible. It was all I could do to stop myself leaping off the table. I think the only thing that stopped me was the thought of all the hardware that was attached to me. I realised I could go nowhere, and therefore had to somehow endure this torture. At one point, I’ve no idea why, I started to bang the back of my head against the table. Until I was urged to keep still.

Now it’s not very reassuring in this kind of situation, to turn one’s head to one side and see an expression of near horror on the face of the most experienced nurse in the theatre. It’s even less reassuring when the surgeon stops what he’s doing, steps round to your side and asks you to say where the pain is. Given the amount of hardware attached to my arms I was hardly in a position to point. So I indicated as best I could and he put a finger on my chest and asked, “is it here?” To which I gasped, “yes, both sides and in the middle.” He looked at me in some surprise and said, “but you shouldn’t be in any pain.” After I reassured him that I wasn’t making this up, he looked genuinely concerned and exclaimed,“Oh I’m sure you’re not!” And then returned to the business in hand.

While this little exchange was going on, I was administered another shot of morphine. Which, if I’m honest, had as much effect as the first dose, ie, none at all. The pain continued unabated and at some point I screamed. Although, it was more of a roar than a scream. The emotion more rage than fear. More to do with the sense of powerlessness really. There was simply nothing I could do about this situation but let them get on with it; and get on with it they did. I was very impressed, even through the pain, with the way they handled everything. The nurses called out reassurances that things were going well, they were at the right location, the stents were going in and finally that they were all finished and removing their instruments.

I was helped back onto the bed, the sides were replaced and I was wheeled back to my side ward. Once they had reconnected all my monitors I was left to recover. Some time later I was visited by the surgeons assistant; she’d popped in to see how I was getting on. So I took the opportunity to ask the question that had been swimming around in my head since the procedure, why had I been in so much pain? Her response was, that I seemed to have unusually sensitive interior organs. Which seemed to me as good as saying that they simply didn’t know.