Dames in White Cotton

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I’m sitting in the TV room of Wellington Hospital’s Cardiac Unit doing a crossword when an alarm goes off.

This is far from unusual. Every hour of every day in this unit there are beeps and bops and dings – Heart-rate monitors, drip bags running low, someone needing assistance.

But this alarm is a bit more urgent – not so different as to be concerning to patients, but unmistakeable if you know what to listen out for.

It doesn’t sound good.

Within seconds I hear fast footsteps and three nurses run past my door, heading for one of the other wings, a few seconds after that there is the rumble of heavy, trolley-based equipment being rolled in the same direction.

It REALLY doesn’t sound good.

A few minutes pass with no further urgent noises and one of the nurses I saw running past walks back to her station past me.

She smiles, but it’s one of those looks where the mouth smiles, though the eyes tell a different, far more concerned, story.

I don’t envy the staff here.

They are wonderful, funny, talented, smart, beautiful, professional and capable, but the job they do is not one I think I could do myself.

They are literally dealing with life and death and in cardiology the difference between those two extremes can be a single heartbeat.

“The average age of nurses in New Zealand is 52” I am told by one of my caregivers as we chat on the way to a scan.

Growing up in Napier I can believe that, as you invariably knew someone whose mum was a nurse and in somewhere like Hawke’s Bay, where nursing jobs seem more secure / long-term, the nurses could mostly be described as “Mum age”.

At any hospital you go to, you become accustomed to the Junior Doctors / Registrars / House Surgeons being all about the same age as Doogie Howser (some of them are too young to get the reference).

But the first thing I noticed when I arrived in Wellington Hospital was that the nurses all seemed so young – The average age in the cardiology ward here would be around 25-30 (my initial estimation was closer to 18).

This is no indictment on their level of skill or professionalism, of course, merely an observation of their youth.

It is also a indication to the depth of their character, given the serious nature of their job and the physical, psychological and emotional toll it must take on those so young.

So I asked some of these young nurses what drew them to the profession:

Theresa* (Not her real name) is 23 and has been qualified nurse for a little over two years.

Her father had a history of heart problems and succumbed to heart disease when Theresa was 15.

Having watched her dad go through these issues wasn’t the sole catalyst in her becoming a nurse, but she says it certainly helps her empathise with the patients she treats and their families.

She tells me she has had only one patient exhibiting the exact same symptoms as her father and they passed away on the 8th anniversary of his death.

“That was obviously hard, but if you let these sort of things get to you too much, this isn’t a job you should be in.”

Theresa says she loves helping people and the things she has gone through in her personal life creates an empathy with those she looks after.

The nature of her work and her family’s experiences have certainly changed her perspective on life – She no longer “sweats the small stuff”.

In 2010 Florence* (Not her real name either) was studying biomedical science at university, but started to get the impression that while this was something she really wanted to do, like so many other tertiary students, actual career options on completion of her degree were rapidly drying up.

So, in the space of a week before Christmas, she applied to take up nursing training because it combined two things she loved doing – interacting with people and her interest in biomedical science.

She passed, but while there were plenty of newly qualified nurses and plenty of positions, there wasn’t the funding within the health system to place all graduates – 50% of her qualifying class got jobs straight away.

She now works on-call across a range of wards – Cardiology, Medical, Oncology, Orthopaedics and Urology and Surgical disciplines, waiting for her ideal permanent position to come up.

“I know I’m going to have an awesome career, I just don’t know what I’ll end up as”

And when Florence says this, like all her colleagues I talked to, she radiates a certainty, a determination and a passion for their work that makes you certain they will do wonderful things and those they look after will have the best possible care, because they care so much about what they do.

I read a newspaper article the other day about New Zealand’s ever-developing cult of “#Celebrity” (yes, the headline included its own hashtag) – Those half-pie, “reality” TV, 15-minutes-too-many-of-fame “stars” famous for, well, nothing really.

I thought “We MUST be able to do better than this!”

There are people out there doing FAR more for others, who are FAR more deserving of attention and praise than those being deified as a by-product of scripted reality, product placement and creative editing”.

There is already a song dedicated to “(K)Nights in White Satin.”

It’s time we had more praise for our “Dames in White Cotton”!

Hello From the Inside

“Hello, Can you hear me?
I’m in Wellington Hospital dreaming about how life used to be
Just weeks ago I was in Hawke’s Bay feeling young and fit and free,
I’ve forgotten how it felt before the world fell out from under me..”

(Sorry, Adele, Please don’t sue!)

Shortly after you last you heard from me, I was flown down to Wellington Hospital by Hawke’s Bay Air Ambulance for the next stage of my “Adventures in Tachycardia”.

My own private plane!

My own private plane!

The flight was very nice, with calm weather and we enjoyed magnificent views of Hawke’s Bay, the Central Plateau volcanoes, Wairarapa, Kapati Coast and Wellington. We could even see the dark, almost-equilateral triangle of Mount Taranaki on the opposite coast to our own.

It added further levels of perspective and scale to what were massive personal issues.

A similar course of events to what happened in HBCCU ensued over a day or two, culminating in the scheduled MRI scan which revealed….. Not a lot more than we already knew:

There is a growth on / as part of the wall of my heart on the left ventricle, but they were still unable to tell what it is.

The next step was to get a biopsy, but there are issues there too:
(Please note, the following descriptions are what I have gleaned from information available to me and reflect only my interpretations of said options)

Option One:
To get an internal biopsy, they could go in through the femoral artery in my leg and up to my heart and take a tissue sample that way BUT, as I’m 6’8″ tall, the distance from my groin to my heart (via artery – don’t be smutty!) is a VERY long way.

The longer the wire, the less control you can have guiding it to take a small tissue sample and, as the left ventricle looks after your extremities (fingers, toes, etc.) there is a lot of pressure in there, which makes maneuvering even tougher and increases the chances of hitting / scraping the inner walls of the heart (not recommended at all) or missing the growth completely.

Option Two:
Making a small incision between a couple of my ribs and doing explorative key-hole-type surgery. More invasive than going through an artery, but a far shorter distance.

Even from this direction, the growth is still quite tricky to get to (a lung and some other stuff in the way) so they’d still be going in reasonably blind.

Option Three:
Open-heart surgery – Crack me open like an Easter egg.

Obviously this way is massively invasive and pretty over the top action for a small biopsy.

While they had me open, they might as well remove the growth, but not knowing fully what it is, its structural make-up, or just how it is interacting with the heart is far too risky.

It takes about three months for your ribs to heal from this sort of procedure, so recovery time would interfere with any further treatment and vice versa.

But before any of that, they devised on more option:

During an MRI scan they inject you with a dye / “Contrast” which helps show up different things like blood flow. The growth showed up more when this contrast was added.

Sooooo….

Option Four:
Put me through a full-body “PET” scan, inject me with the contrast that the growth showed up on (or similar) and hope there is another growth somewhere on me that lights up in the same way, but is far easier to get to and take a biopsy of that!

I’m starting to feel like an episode of “House”.

In the meantime I’m still an enigma.

Surrounding these occasions of high tech medical marvelry are long periods of bugger all.

Doing absolutely nothing can be horrifically exhausting.

But there are highlights.

As has been said, there are patients here far worse off than me who need stents, multiple bypasses, valves and pacemakers. Due to their issues being more blood-flow related, for their own safety they are not allowed to leave the ward.

While still monitored 24/7, I’m allowed a bit of a longer leash and can go for a wander down to the hospital atrium / cafeteria / shop and have even been for a a wander outside into Newtown, but only within 500 meters of the hospital because, while it hasn’t returned in two weeks, there’s still a chance that the VT could return and drop me there and then.

No one wants to play medical chicken.

When not on one of my brief “free range” breaks social media has not only helped keep me insane, but has been an invaluable window to the outside world (watching or reading mainstream news and media at the moment is enough to tip you over the edge..).

I’ve been very thankful for visitors, too.

My wife came down for three days last week (Toddler in Frame remained at home – the logistics and demands of bringing her down were a little too much under the circumstances and, being so young, isn’t too keen on hospitals in any case).

I have a number of Wellington Twitter friends and some of them have been to visit too, bringing supplies (PIZZA!) and even loaning me some tech to help do some writing (hence this update). So thanks, Laurie and Annette! 🙂

I’ve even had workmates, who were in Wellington to see the Te Papa Dreamworks and World War One exhibits pop in to visit, which is very nice and shows that my work still cares.

But I have to give special thanks to my old school friend Lisa and her family.

Lisa lives just up the road from the hospital and has been wonderfully supportive, helpful and gave Mrs in Frame somewhere to stay while she was here.

So here I am – still in a holding pattern, but grateful for the help and care I am receiving.

The big question is, when they do eventually figure out what it is is that growing on my heart, “What’s next?”

Owner of a Broken (but not Lonely) Heart

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When last we saw our ruggedly deluded protagonist he was in the Coronary Care Unit of Hawke’s Bay Hospital having been defibrillated after having Ventricle Tachycardia for over 12 hours.

The day after I was admitted to hospital, the cardiologist visited to check up on me and let me know what was going on.

The news was good and bad.

Good in that I was alive and very fortunate to still be here after such a long cardiac event.

Bad in that I would be in hospital for about a week or so to ensure the VT didn’t make a reappearance, and if it did, I would be in the right place for immediate treatment (so technically “good”).

I would likely end up being fitted with a mini pacemaker-like device called an ICD (“Implantable Cardioverter-Defibrillator”) that would shock my heart back into line if it started miss-firing again.

So that was kind of bad (operation, pain, more recovery), but also good in that I would then have new awesome cyborg parts!

But more shockingly to me, I would not be allowed to drive for six months.

SIX MONTHS!!

I love my independence and my work is a 15 minute drive away, with un-flattering hours, so not being able to drive anywhere for half a year was a bit of a blow to say the least.

Hell, not being able to bugger off out of the ward and go home to my wife and daughter for a week was a big enough blow.

The driving ban was mainly precautionary. If I was driving and had another VT event I could blackout / die at the wheel, crash and cause untold carnage – hardly the sort of picture NZ’s health system would like to paint – so while crippling it was understandable.

I was scheduled to have various tests over the following days, so the main thing I had ahead of me was lots of waiting.

In Coronary Care “Waiting” is practically a competitive sport, because everyone is doing it.

But the gold medal is for Humility and everyone in the ward deserves a medal for that, and not in a wishy-washy NCEA, “Everyone gets a prize” way.

In Coronary Care the level of humility is a wonderful thing.

There are people needing stents to open blocked arteries, new heart valves, pacemakers, heck, even multiple bypasses – medical conditions that so little as 20-30 years ago were still largely lethal.

But rather than focusing on their own problems, the constant theme and saying amongst patients is: “There’s someone out there worse off than me”.

That is quite something.

The other thing that being in this situation opened my eyes to is the kindness of others – There’s a lot of help, love and chocolate out there.

My wife and daughter visit regularly, of course, which is a necessity for my sanity, but also bitter-sweet because then they have to go again and I’m once again alone.

I was only in the ward for a day before my work colleagues sent me a gift basket full of goodies – fruit, sweets and a crossword book to fill in time with.

One of my wonderful nurses sensed I was getting cabin fever and offered to escort me down to the cafeteria while she got some lunch. It was only a short trip, but just being able to re-enter the “big, wide world” for a bit was gloriously refreshing.

My wonderful Facebook and Twitter friends – many of whom I have only met 140 characters at a time were offering their good wishes, help and more food (I like where this is heading!).

Attitude and positive vibes are a large part of being in a situation such as mine, so these well-wishers have certainly been a big, positive part of the process.

And I would need it, because there was more news on the horizon and it wasn’t too good.

During one of my scans they noticed two things:

1/ My heart was a bit bigger than usual – I wasn’t too surprised by this, because I’m 6’8” tall, so a slightly larger heart made sense in that there was more body to pump blood around

But, more concerning:

2/ A growth had been picked up on or near my heart – they couldn’t quite tell its proximity, but it was obviously of concern. This could explain an increase the size of the heart and the dysrhythmia, from the heart being irritated.

I couldn’t feel anything different – in fact I felt (and still feel) fine, which added to a general sense of detachment in not knowing it was there at all – The tachycardia might have been a good thing after all.

The growth is unlike anything my cardiologist has seen before which, believe it or not, I take as a good thing, because it means its not something he knows is immediately bad.

I was the headline act in HB Hospital’s weekly teleconference with their Wellington coronary specialists, who are equally intrigued – at this rate I might be the Mr April centrefold in the next edition of The Lancet!

But mainly I just hope I survive.

So I’m on a bit of a roller-coaster at the moment – Ups and down, highs and lows and even the odd corkscrew.

I don’t know what to expect, other than next week I will be flown down to Wellington Hospital by Air Ambulance (My own private plane, Woo-hoo!) undergo more tests, a biopsy and.. who knows?

Sometimes in quiet, dark moments the bad things and possibilities creep in. Other times I just miss my family, or being able to simply get out into the big wide world that I can see through the window next to my hospital bed.

But I’m keeping positive as much as I can.

There are others out there worse off than I am.

Not for the Faint of Heart

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It’s been a while since I’ve had time to sit down and do some writing, but now I find I have a fair bit of spare time and not a lot to do, because I’m in the Coronary Care Unit of Hawke’s Bay Hospital.

Last Saturday I was playing cricket (well, when I say “playing” I mean I fielded for 30 overs and umpired for another 30 – total number of times I physically exerted myself = <5). We lost by one run, but rather than being stressed or nervous I was a bit bored and disappointed that I didn’t get to bat. It was very hot and I had been out in the sun all game, so when I felt a bit crap sitting down in the dressing rooms after the game and noticed my pulse was going a bit fast I thought I just had heat stroke. I went home, had dinner, went to the clubrooms for our club’s regular after-match speeches and came home. Toddler in Frame had a broken night, so I was up and down a few times to give my wife a break and still felt ill, but managed to have some sleep. On Sunday morning I was feeling a little better, but not a lot, so went to the medical centre, where the nurses quite quickly had me on a bed, hooked up to monitors and soon afterwards two St John’s Ambulance staff arrived and I was taken to the Emergency Department of Hawke’s Bay Hospital.

Not a good sign.

My heart was indeed racing – going at around 200 beats per minute – my usual rate being closer to 80-90bpm.

I was suffering from something called “Ventricle Tachycardia” and had been, it seems, for over 12 hours – There didn’t seem to be a member of the medial fraternity who wasn’t reasonably impressed by this over the next few days. They kept saying it must be my “youth and fitness” that helped me stand it for so long.

I have no idea what those two words mean.

If I had been in one of those whiz-bang medical-soap-drama TV shows they would have been running around, yelling I was in “V-Tach” (in America) or said I was in “VT” (everywhere else) getting “Crash carts” ready and “paddles charged”.

As we are in New Zealand, things, while still very professional and serious, felt a bit more laid back (this could have just been the drugs, of course). I was put into an ED bed, hooked up to even more wires and lines and given drugs to try and slow my heart rate but told, if that didn’t work, they would more than likely sedate me and shock, or “Defibrillate” (yup, that thing they do with the paddles – “CLEAR!” to people whose hearts had stopped) – my heart back into its regular scheduled programme.

I got the shock, but sans sedative.

Because after around 14 hours of VT my body decided it had had enough of this medical marathon and my blood pressure dropped, I suddenly felt even crapper (No bright light, or long tunnel, btw, just REALLY dizzy and sick)

The ED staff sprang into action and Renee, the head ED doctor said “Ok, Andrew, we’re going to shock you now”, I had just enough time to grunt a “Huh? / Ok” and someone hit me in the chest with an ethereal, electrified baseball bat.

For the record (and not solely for theatrical effect) I did lift off the bed with a loud grunt.

What passes for “normality” in the Emergency Department then resumed, my heart rate returning to a more regular rate and things quietening down.

A guy in the next cubicle came in with the same thing as I had, but had the time and benefit of sedation before he was zapped and had no recollection of it.

After some blood tests and a chest X-ray I was eventually moved to the Coronary Care Unit of the hospital for overnight observation, hoping / expecting to be released the next day.

Things never quite seem to work out that easily in real life.