Della: I was planning on keeping this old heart of mine firmly in line, but it has been well and truly playing up again over the last couple of months. So yesterday I underwent a second angiogram (Just to take a look at things) and had my usual run of luck in being one of the statistical oddballs that attracts complications. The routine angiogram turned into a loudspeaker call-out for the medical emergency team to assist. (Sorry to bother you, poor Steve Jones in the waiting room) Fortunately I am still here with no lasting damage done, and scheduled for another angiogram tomorrow to finish stress- testing and possibly add a stent or two. I was quite blase about angiograms before this…so hopefully I will still be able to put on a brave face in tomorrow’s Cath-Lab!
Above: Della in the Bourtree Hotel Hawick May 2018 – BTW: great cheap food!
Steve: There but for fortune go you or I! I am very lucky to still have Della today. Last night I really thought I was going to lose her for more than an hour, the worst hour of my life so far. She was very sick indeed:<30 beats per minute and < 50 systolic pressure with a pacemaker wire from her groin to her heart keeping her going. I would have given her my heart if I could. Well, in a sense I did that long ago. Here I mean literally. Needless to say we are both anxious about tomorrow’s repeat which we hope will have a successful outcome! Thanks for all your kind thoughts. My turn under the knife next week!
Update 6/09: Della now has a very long stent in the LAD artery (the ‘widow-maker’). It is amazing the difference this has made to blood flow on the scan of her heart. Lots of blood vessels are now clearly (at least) twice as wide as before, ie sectional area (Pi r squared) carrying 4 times the flow! The upstream of the blockages is also improved – clearly the heart ‘knows’ when extra pumping will avail nought!
An interesting thing: My experience with plumbing was telling me that small narrowings would likely create much larger pressure/flow drops than that envisaged by the conventional (surgeon’s) wisdom. I kept on mentioning this to the specialist. He was at one point amused by my reliance on plumbing/river flow/canoeing ‘analogies’ (as he called it), but he did get the point! Fortunately.
The two restrictions in this artery were below the level which they would normally stent, but the pressure test they were persuaded to do (to prove me wrong actually) showed such a significant drop in pressure/flow after the second narrowing that the cardiac surgeon stented all the way from before the first narrowing to after the second. The improvement is astonishing – but not if you understand that r squared rule!.
I knew this from all my mucking around with irrigation fittings trying to get some acres on the Hazelwood Flats well watered from 10+ underground bores we dug by hand some years back! Not many couples have hand dug 6″ bores to a total collective depth of half a kilometre!
It seems astonishing to me that cardiologists would not normally stent until the narrowing was well over 50% (70 actually) when clearly the flow rate from a 50% narrowing would be only one quarter (ie 1/2 squared!) and that they do not follow the rules set out in Davy’s (free) Pump brochures (my source) about the effects of friction/pressure/flow on the diameter of pipes/number of junctions/bends/restrictions, etc. The circulatory system is obviously (to me) just a piece of plumbing.
This information enabled us to solve the weird situation we had (years ago now) of putting lots of water under enormous pressure into this end of the irrigation pipe only to have (pretty much) nothing at all come out that end – even though there was no blockage at all! I will send a copy of Davy’s brochure to any cardiac specialist I can. Doubtless it will save lives – if they read it.
I am now suspecting that ‘micro-vascular disease’ ie the hardening or blockage of small blood vessels in the absence of any blockage in the major vessels (what we thought Della must have if the major vessels were not at fault) is not what Della was suffering from at all. The enormous increase in size of these tiny blood vessels in Della’s heart is astonishing. Some have gone from being invisible to very thick black lines on the scan. Clearly low blood flow was allowing them to shrink away and ‘dry up’ .
I am now expecting a major improvement in turbulence in Della’s veins and arteries which should clean out lots of her plumbing – in much the same way as when I cure a pump of some suction problem it had, resulting in a huge increase in flow volume. All sorts of black gunk which had been sitting around in the pipes sluggishly for years (what the heart surgeons call ‘plaques’) suddenly comes flushing out the taps! Perhaps cardiac specialists might find a course in plumbing and pump maintenance of interest?
The two arrows on the left hand image are where the artery was most blocked – just see how much more blood is getting through after stenting beyond the second blockage. (Sorry for the poor quality image). But notice also how much more blood is now arriving at the point the blockage started. The heart sure knows its job!
Anyway, with any luck Della will be fit for hiking again soon. I will need my back fixed (next week) and possibly my knee as well. However, though we had expected a second ascent of Mt Bartle Frere (see below) and an excursion on the (Qld) Misty Mountains walk in September as well as a couple of weeks in the Wonnangatta (for me at least) while the gates are closed, some of these activities at least have had to be curtailed or postponed. But, we will be back! Another month could make a big difference. Unfortunately it is obviously also going to be a ‘good’ year for thistles, I notice as I go around the sheep!