Pre-op assessment

Went for my pre-op today.  Just a lot of repeat tests - weight, height, blood pressure, blood tests, electrocardiogram, then a talk with a nurse and a lot of boxes to tick - do you smoke? are you allergic to anything, etc.  Then an examination by a doctor, then a talk with anaethestist.  They all stressed what a big operation it was - it will take about 3 hours - and how long it will take to recover.  It will be 4/5 weeks before I start to feel better, and 6 months before I am back to normal.

I was more or less prepared for all that - I knew what I was in for, but I think it rather shocked Sylvia who got a bit emotional.

To describe what will be done (if anyone is interested).  I will have a cut horizontally across my abdomen, then they move aside the muscle and other things that may be in there, till they get to the aorta.  Then they cut open the aorta where the aneurysm is, insert a tube made from synthetic cloth, then sew up the aorta and staple it to the good part.  Then sew my tummy up again and I will be left with a big scar sideways across my body.

The biggest risk is to my kidneys as my aneurysm is very close to the renal arteries.  So there may be some kidney failure - hopefully only short term.

If there is no bed available in intensive care on the day of my operation, there is a possibility that I may not be able to have it and I would be sent home again.

That would be awful wouldn't it - all hyped up for the op and then it doesn't happen.

So all being well, I go in next Tuesday (27th) and the op will be on the 28th.  As I have said before - you have to weigh up the 2% chance that something will go wrong during the op against the 10% chance that the aneurysm will rupture causing instant death. (Well almost instant, I believe it takes 4 minutes to bleed to death).

This will be my last post before my op as there is no wi-fi in hospital.  So if you want to know how I am getting on you will have to phone Sylvia.  But I will be back with how I feel about October 5th.

D-day is Sept. 28th

Just been to see the consultant - Mr Northeast.  The date for my operation is September 28th.  It will be an open repair as the aneurysm is too close to my kidneys for them to put a stent in from the groin.  In any case, because I am so young!!!! they do not like to use a stent as they are unreliable and often need renewing.

I should be in intensive care for a couple of days, then stay in hospital for another 4 or 5 days.  Then I should be able to come home and look after myself, but I cannot drive for 4 weeks.  Will probably feel ill for 4 weeks as well.

98% chance of successful operation, 2% chance of dying during the op.

Chances of aneuysm bursting causing my death about 10% at the moment.  The longer I leave it the higher the percentage.

Other risks of the op. are possibility of infection - only 1 in 100 get an infection and none ever in High Wycombe hospital (according to the consultant).

Possibility of blood clot going down into my leg which might cause my toe to go black and drop off!!!!  Don't like the sound of that! 

Slight possibility of kidney and/or bowel problems after op.

Oh well - here goes.  Better have it now and get it over with.

Angiogram Result

Well, that was a horrible experience.  Anyway, it was soon over and I'm feeling fine.  There was only minor thickening of the artery walls, so I am all clear to go ahead and have the operation now.  They did the angiogram through my wrist artery,  Most people have it through the groin area, but they did not want to hit the aneurysm so decided to go through the wrist.  I felt it all the way up to my shoulder!!!

Sylvia stayed with me overnight last night, just in case the incision in my artery started to bleed again.  But it didn't, all is healed and apart from a plaster over the incision I feel fine.

Now I have just had a phone call from Mr Northeast, the vascular surgeon who will be doing my operation and I have to go and see him on Monday 12th Sept to discuss the next step.  This is where I start to get cold feet!!! Do I really need this operation?  I am feeling fine these days.  But I suppose it is because I am so well that the operation will have a better chance of success.  Better not to wait till I feel ill again.

Angiogram

Just got back from a few days staying with a friend in the Pyrenees and found a letter waiting from the hospital.

I have to go for my angiogram on Wednesday 7th September at 7.30 am.  The procedure takes about 30 minutes but I have to stay there and rest for 2-3 hours afterwards and have someone stay with me till the next morning.  Then I can't drive for 3 days.    All sounds a bit scary - I thought it was just a test to see if my arteries are narrowed.

Anyway, I had a lovely time in France with Richard and Margaret - very emotional and nostalgic with memories of visits there with Roy.  So now I'm ready for whatever the NHS throws at me.

Cardiology Tests

Just got back from Amersham Hospital after my cardiology tests.  Didn't know what to expect but very pleased as I have now had a very complete heart check up. 

First they did an ECG, then I had an ultrasound check of my heart.  Than a chat with the cardiologist about my condition.  Everything seems to be OK except for the indigestion-type pains that I keep getting and my family history of heart problems.  So he arranged for me to have an angiogram at Wycombe at a later date.  Then I went for a chest x-ray.  Then we came home.

Amersham is a lovely hospital, all new and clean. And the staff are extremely helpful and there was absolutly no waiting.  Although we were there for just over 1 hour this time, there was not sitting about waiting for your turn.  It just took that long for all the different tests and whipping my shirt and bra off and on again then moving to the next department and then shirt and bra off and on again three times.

Sylvia had driven me there and we did some shopping in Tescos before leaving Amersham.

Now I have to wait another two weeks for a letter with an appointment for the angiogram.  But very pleased to wait because I am off to France for a week on Thursday to stay with my friends Richard and Margaret who have a house in the Pyrenees.

Cardiology Appointment

Next pre-op appointment is with the cardiology department at Amersham hospital on Tuesday 23rd August at 9.30 am.
At least I know where Amersham hospital is now and how easy it is to get to it.

Carotid Arteries OK

Just had the ultrasound scan of my neck arteries and they are perfectly OK.  So that's another hurdle passed safely.  Gosh - I'm so healthy - why did I have to go and get an aneurysm!!!  Just got to wait to hear from the consultant again now.  That'll probably take at least 2 weeks.
It was perfectly easy to get to Amersham hospital, my appointment was for 9 am,  I arrived at quarter to and was out by 9 oclock.  I had parked in Tescos which was a 10 minute walk to the hospital.  So I then went to Tescos and did some shopping then came home and had my breakfast which I couldn't eat before I went due to nerves.

US Doppler Carotid Arteries

I have appointment for my first pre-op test.  Ultrasound x-ray of carotid arteries on Thursday July 28th at 9.00 am at Amersham General Hospital.
No idea where that is, but I am sure someone will help me.  Sylvia will be away in France, so I shall have to drive there myself.  As long as parking is easy I don't mind, I will find it OK with the help of Google maps.

Tuesday 24th May 2011
Last day of holiday in Sri Lanka. I have pain in my chest - indigestion I think.
Cannot do justice to the final Gala Dinner because of indigestion.
Try to get some sleep between 10 and midnight when we have to leave the hotel for airport. Could not sleep.
Wednesday 25th May
Flight leaves at 6 am (2 am English time). 10 hour flight. No sleep.
Arrive home 2.30 pm (6.30 Sri Lankan time). Dog tired. No sleep for 24 hours.
Go to bed at 6 pm and sleep for 12 hours almost non-stop.
Thursday 26th May
Still have pain in chest. Go for Ramblers walk. Home Group dinner in evening. Feel very bloated but manage OK.
Friday 27th May
Slyv takes me to doc and waits for me.
New doc finds a lump in my tum. Prescribes something for indigestion for pain in chest and refers me to HW for CT scan.
Bank holiday weekend 28th to 30th May
Philip here for weekend. Pain in chest gone and cope with everything OK. Very tired.
1st to 6th June. Feel OK most of the time but very tired with back ache and runny nose.
Letter from hosp. appointment for Monday 6th June.
Dr Helmer. Very nice. She also found lump. May be in sigmoid. Referred me for blood tests and CT scan.
Tuesday 7th JuneGo Hosp for blood test. Only had to wait 10 mins. Very good
Feel OK, but depressed, not knowing what is the matter. Hope I get the scan soon - especially before I go to Spain.
Monday 13th June
Feel fine - no sign of the cold I thought I had yesterday. Had letter from hosp. Scan is on Monday 20th. I have some revolting stuff to drink before I have it. Went to see doc. He said to see him on Wednesday 22nd to get results of scan and make sure I am OK to fly to Spain on 23rd. Thank goodness at last I feel better. Cycled to library and back via Manor Road. No problems. Lovely warm day.
Thursday 16th
Sylvia's birthday. Raining all morning. Didn't go out anywhere. Sylvia came for lunch and we had salmon, new pots and green beans. She brought some cheesecake for pudding.

Wednesday 22nd
Went to see GP for results of scan. GOOD NEWS. There is no tumour and I have absolutely nothing wrong with my digestive system. However - not so good news is that I have an aneurysm - 5.5 cms. He will refer me to a vascular consultant who will tell me more about it. So all the tummy troubles I have had since Sri Lanka were probably an infection, or maybe my gut objecting to all the spicy food I had been eating.
Thursday 23rd.
Drove to Gatwick and flew to Spain. No problems. Feel fine.
Had lovely time with Pete, Sharon and Max. Max's 10th birthday on 26th. We all went out for super meal. He will have his celebration next weekend when he is going to the Water Park at Torremolinos with two of his school friends. (They couldn't go this Sunday because of a church procession they had to attend.)
Tuesday 28th
Flew home. Plane 1 hour late due to lightning strike at Gatwick control tower. Picked up car 10.15 pm. Arrived home 11.30 pm.
No news of my appointment with vascular consultant.
Thursday 7th July
Still no news about appointment. Sylvia phoned the hospital but they said they had never heard of me and my name was not on their system at all!!! So she phoned the GP who said they had sent the letter of referral on 24th June, so they phoned the hospital. They phoned Sylvia back to say the appointment is for Monday.
Monday 11th July.

See consultant - Mr Northeast team - very nice girl but I can't remember her name.

My aneurysm is 5.5 centimetres which is the borderline when they consider intervention may be necessary. (It should be 2.1 cms but they can grow to 13 cms before they are found). So there is no emergency for an operation.

 

This diagram is very general. My aneurysm is mostly on one side of my aorta, not evenly on both sides. This makes it more difficult to treat by endovascular stent-graft.

There are two ways to repair an aneurysm, one is endovascular - inserting a stent-graft inside the aorta from the groin area. The other is open surgery. Obviously one recovers quicker from the endo system.  But there is always a risk of the stent leaking or moving or malfunctioning in some way and it entails lifelong checks and 6 monthly scans.  With the open surgery the operation is more risky, but once it is done then that is it - all finished.  Main risk is post-op infection.
However, which treatment I have is the decision of the surgeon.
I will have to go for some pre-op tests - scan of my neck arteries to check I am not likely to have a stroke  and check of my heart.
I expect to hear back from the consultant by Friday and start the pre-op tests in a few weeks time.  I hope I don't have to wait too long - but I know it is not an emergency so I may have a long wait.
Meanwhile I feel absolutely fine.
So I am now in the hands of the medical profession - and of course the Lord.  Please pray for me that the doctors and surgeons know what they are doing and that the hospitals staff clean the wards properly so that I don't end up with an infection.
So many things to worry about....... but I am thinking positively.