Notes made in the Cardiac HDU on 30/5/12, transcribed after I got home
Brought here from Addenbrookes after I started a heart attack in the audiology clinic. I had cycled there in a hurry over Windmill Hill, and as I continued felt, not chest pain, but a sense that my back was all tense and wrong. What I now think of as a shiny soreness on the inside of spine. My breastbone was also extremely tender on the outside. It needed rubbing and pushing to relieve the tension. I wanted to straighten my back and breathe more deeply. My spine felt hunched up between the shoulder blades. Breathing was raspy and metallic. My jaws ached, top and bottom, at the front.
None of this was particularly violent or incapacitating, but it would not recede or let me feel normal. Approaching Sawston, about nine miles on my journey, I had an odd sense of seeing myself from above and thought: “What a cliché – a middle-aged man who’s trying to pedal away from death”
That made me happier, but I still felt so wrong that I stopped in Sawston to ring C and say things were very odd, then pedalled on more slowly.
None the less, I was sure that this was just a spasm in my back, brought on by sitting wrongly on the bike. I had had almost the same symptoms the day before after and during my presentation a a group of Swedish editors, a tightness in the spine that could not be relieved by twisting or stretching.
But this time, in the audiology ward, I had a constant urge to push and rub my breastbone, There is still a weepy red patch at the bottom, four days later, where I rubbed right through the skin. I must have looked a bit bad, because they blood pressured me and took my pulse, before taking me down to A&E in a wheelchair, which I thought at first was over dramatic. but in the 15 minutes or so I spent waiting in a queue there, while the male nurse dealt with an aggressive Scottish drunk, I started to feel really bad, and the pain changed character so that sometimes my upper arms felt encased in squeezy cold metal mesh and sometimes the soreness was poking and prodding at my back, as if someone were pushing a broomstick upwards against it from the inside.
The people around my wheelchair started moving faster. I was given some paracetemol. This was useless. I was asked if I was allergic to anything — this was almost the first question asked by anyone who took me over in the next six hours,. i must have answered it ten times. I was given some kind of clotbuster. There was an aspirin, too, dissolved in a little cardboard cup.
My surroundings, once I was wheeled out of the A&E reception, began to look like the industrial cellars in a video game: black, grey and green, in fluorescent lighting. I remember a sudden drenching of sweat, like a thunderstorm, and then, as I was being lifted from wheelchair to trolley, a blast of dry heaves which everyone ignored. I was given an ECG and a black African doctor said over my shoulder to someone else that he didn’t like the sinus wave. That’s when I really knew what was happening. What seemed essential and possible was to behave courageously and deal with the pain. I asked for something for it, and somehow — did they set up a drip? — was given diamorphine. After five minutes, I asked for more, and was given it, without quibbles. The second dose really moved the pain away, a bit, but did nothing for fear and weakness. I did not think I was going to die.
By now flat on my back, rolled onto a stretcher, somehow. Movement was painful. Oxygen. Felt good, or seemed to relieve the scraping pressure inside. The plastic mask rasped on my nose in the ambulance. Sirens? I think I remember a bit of sirens. No sense of where we were. All the same bumpy trolley surface until lying in a large green-black echoing room in Papworth. A lean ?Irish doctor with steel-rimmed spectacles gave me a local anaesthetic in the groin and then for a long time all I could feel was a series of varying pressures there, and sometimes hands moving down by right knee.
Another, invisible, ?Scottish voice talks with clipped battle of Britain vowels about stent sizes to the doctor fixing me. Everything seems calm, decisive, practised, and reassuring.
Unknown time passes with the pushing and measured movements on my thigh.
The sensations of active pressure and pain recede a bit. Weakness, alarm, and fear. Then the doctor holds in front of my eyes a transparent plastic dish an on it maybe a centimetre of soggy crimson thread. “That’s the blood clot.” He says. “That’s what I pulled out of you.” He explained that he had stented me. That was the most vivid moment of the night. I was by then together enough to ask how he had got it out, and he said he had some kind of suction device.
They wheeled me up to the recovery ward. There was a huge tree outside the window whose foliage dipped and bobbed as a squirrel moved round in it. The room was full of a brassy, beeping monitors. I learned quite quickly to identify the tone mine made when I fibrillated or missed a beat, and for a while observed as my thoughts wandered round; every time they touched on work my heart stuttered. Somewhere around dusk a trolley came round with tea, and two digestive biscuits. They crumbled in my mouth like a sacrament.