Angina - This is Getting Old

October 31, 2019
Not again! A few days ago we were walking the Fort to Fort trail in Fort Langley. Soon into it, I felt some minor tightening in my chest. I recognized the feeling but there was no real pain and it did not get worse, even after continuing the walk. In fact, by the time we sat down for a coffee, the feeling was gone. It returned a little on the way back but was not serious. I knew I had to keep an eye on this.

That night was Lauren’s birthday and I did not want to cause alarm or put a damper on things, so I took it easy. I did tell Joanie later that night, and since the next day was Halloween, I suggested perhaps going to the hospital on November 1. However, I think I already knew what was happening, but also that it was in the early stages, so it was difficult not to think about it and stress a little, or a lot. After all, we had a big trip to Australia  planned for late January and I couldn’t let health issues get in the way. My fellow travelers would be upset if I keeled over before the trip I had planned for over a year. After the last trick or treaters left, and we had reached our usual limit of five, I decided to confide in Joanie that perhaps we should go to Emergency NOW.

Surprisingly, we arrived at the Royal Columbian hospital ER to an empty waiting room. I beat the little kid who had fireworks shot at his face. I was soon admitted and moved to a room to wait for medical staff. While I would be loath to complain, it still took a total of an hour and a half to get moved to a bed. I did wonder when the admitting nurse asked me why I was there, and when I said I had chest pains, she said “Of course, you look like a typical heart patient.”  What does that mean?  Was my Australia trip in more danger than I imagined?

My temporary bed was placed right in the heart, pardon the pun, of ER, with the central nursing station nearby to one side and staff hooked on steroids coming in from the other side. I was immediately hooked up to monitors with wires. This involved suction cups plastered down on my chest hairs, making for a nice reminder that I was still alive and could feel pain every time I tried to move in bed. One lead went across my chest, threatening to choke me if I ever tried to lie on my side.

Any illusion of rest was soon taken care of. Nurses talked to each other in full volume the entire night. A crotchety fellow was in a bed a few feet away, separated only by a curtain. He was a pleasant enough fellow when his mouth was closed, but I think his goal in life was to create conflict. First he complained that my daughter was visiting beside my bed. He was told visiting hours in ER are 24/7. He also refused to cooperate with nursing staff asking him to do certain things. Things boiled over at about 2:30AM when he called over the nurse in charge. He bitterly complained about the staff talking loudly in the middle of the night and not doing any work, making it impossible to sleep. Her answer was somewhat surprising. She said the staff were on night shift, so for them the middle of the night was the middle of their day. Huh? He said they were not doing any work, but just sat around talking about Christmas presents. She was feisty and would have none of it, so he called her a half wit. In the morning a doctor came to see him and he claimed he had not slept a wink, even though I swear I heard snoring besides his farting. He also got into a fight with the doctor. He was on record as a recovering alcoholic but he objected to that as well as the bad treatment and wanted to go home right away. One nurse threatened to call security if he did not cooperate.

That was only one of the distractions. A lady behind the curtain next to me soiled her bed several times, each time needing clean sheets and diapers. She was nice about it, apologizing for the mess. At 3AM she threw up, loudly, very loudly. This was followed by moaning and apparently messing her newly cleaned bed again.

Across the narrow walkway from my bed was a machine in the wall. It was used to send blood sample, etc. to different lab locations using a vacuum tube. It sounded like the old pop machines dropping your selected pop can down onto a metal tray. This was used throughout the night. Then there was the intercom, spewing out messages frequently and the nearby printer which did not have a silent mode.

I think all of the noise was designed to see how much your heart can take. Just to be sure though, they attach a cord to your finger, the one on the opposite side of the monitor so it too can drape over you and prevent shifting to a comfortable position. The monitor sends out regular beeps. I soon learned one beep that happens when one or more of the monitor cords becomes disconnected. This did not seem to matter to anyone. I guess they needed the bed because before the end of that first night, there was a huge waiting line down the hallway in admissions and people were left in beds in the hall. I learned to find and reattach the cords myself. How else would I find out if the old kook next to me would get hauled off.

I spent much of the next day in ER. I missed breakfast in case they could squeeze me in for an angioplasty but finally got lunch at 1PM, just when the woman beside me started vomiting very loudly again. By dinner they finally found me a bed in the cardiac area. Dinner was already waiting for me. If food comes, you know you are not going to get your angioplasty any time soon, and after about 5PM, forget it, you are in for another night.

The room I was in was filled with three recovering open-heart surgery patients. Most of them had had operations and pacemakers 4 to 5 days ago but most looked in rough shape. I on the other hand, was limited to walking to the bathroom but for the rest, felt great. This was generally a much quieted place, except for the guy across from me, who looked like he could be a retired proper British professor who was often vomiting, gagging or calling for help getting out of bed and onto his bedpan.  He had a pacemaker that was old and not working properly any more. One day the nurse convinced him to wear mesh underpants, and he reluctantly agreed. For the umpteenth time he called the nurse to complain that the underwear took too long to get off. As she went off to get something, this proper gentleman suddenly muttered, “Aw, fuck, I just shit my pants.” It was a real challenge for Joanie and I not to burst out laughing out loud. There was a man down the hall in another room who sometimes moaned very loudly.

And then the was the guy who had the bed space I had my eye on. My bed was right near the door and with the curtains drawn all the time, for six days sunshine was just a distant memory. (Yes, it was apparently quite sunny during my stay.) I hoped one of my roommates might get discharged and I could move up the ranks. This one guy had his bed right by the window and could look out over New Westminster and see people who were not in open-ended gowns or nurse outfits. He only had one visitor during the time I was there, but I learned a lot about him. He spoke loudly on the phone with buddies every day. He was totally into fixing up old cars and selling them, and made several purchases while in the hospital. He lived alone but was going to stay with his brother. He doubted his brother would take real care of him, so he actually preferred to stay in the hospital as long as possible. If we had exchanged bed locations, perhaps he might have had more incentive to leave. He had some odd views on spirituality even though his brother was a Christian pastor.

After five days, I was still waiting for my angioplasty. I guess that was good because it meant that I was in better shape than all the other patients getting in ahead of me. Angioplasties were done all day long, one after the other. The man in the bed beside me was a nice Chinese man whose family always greeted me when they traipsed in. I heard him say on the first day that he was probably going home the next day, but then he complained about headaches and other things, and his discharge was delayed. This seemed to happen every day. On night five I enjoyed the rhythm of his snoring, starting already before 9:30PM, but the next morning he complained that he had barely slept. He was still there when I left, but word was that he could go home the next day. Sure!

The cardiac ward had a rest period every afternoon from 1 to 3. Being the time of day when the sun is shining nicely on otherwise dreary winter days, this is also when all the curtains were drawn and lights went out. Visitors were not allowed to stay. Except the guy with the window view who had his brother visit one day for the entire rest time. Neither thought to speak softly, so I could follow their conversation word for word. Of course, wanting patients to perhaps nap did not stop staff either from talking loudly down the halls, popping in to poke and prod and ask questions over and over. The British fellow across from me was asked one day what day it was, and he responded, "Who cares."

What is sad is how people take advantage of invalids. As I lay in my bed, my family decided to go for a walk, and visited the Dutch Store down the street. Here they found the largest chocolate letters I have ever seen. Since I was not there to protest, my family got the biggest chocolate letters ever for Christmas.

One of the things that I learned to entertain me was tracking the emergency codes announced over the intercom. We learned the different codes. “Code White in the Psych Ward” was popular. Another violent patient. Code Yellow, missing person, was also a regular. Code Blue seemed popular. It was sad to hear a Code Pink in the pediatric ward. One night at around 1AM there was a Code White down the hall. I could hear all the commotion. A patient was flipping out and needed to be restrained. Staff came running down the hall. Very exciting!

I did find that no one trusted anyone else in the hospital. I had the pleasure of being woken up at 6AM so some student could take blood samples, blood pressure, etc. Then, just before I could fall asleep again, the nurse would come to do the same thing because she was ending her shift. Chances were the nurse starting her shift would also take a crack at me. No one seemed to trust that the readings taken 30 minutes earlier could be right I guess.

On day 6 I was woken at the usual pre-dawn time. (Why would anyone want to wake up early if the only thing to do that day was to lie around.) I was told they got a call from the operation room that I might get in first thing this morning and staff would come to prep me. I barely got in a text message to Joanie who wanted to be there when I went in, and a two operation staff came to get me ready to move. Within 15 minutes I was wheeled to the operating room, and 15 minutes later I was on the table, ready to go. The cardiologist talked for a few minutes, and said he would be entering through my right wrist.  He gave me a needle that I did not even feel, and soon I was able to watch the screen as he explored my arteries and pumped me with a dye that made my entire body hot. I could feel it travel up from my feet and take over my whole body. He found a collapsed artery that had already been stunted twice. He inserted another stent, an object that looks like the spring in a ballpoint pen and holds the artery open. He said it was a triple layer. Hopefully this stent was superior to the previous stents which were inserted years ago and did not keep the artery open any more. I did not feel a thing. I was back in my room within 45 minutes. Strangely enough though, this operation threw me for a loop. It was my fourth one, the last one being 9 years earlier. Each time I felt great afterwards and assumed that the problem was fixed and over. However this time I asked if it was unusual to have to have more stents. He said no, I had 9 years between and hopefully I will not be back for another 9 years. Also, at some point you cannot keep putting in stents, but need to do open-heart surgery to do a by-pass. I did not need to hear that! This was probably not the last time? Unlike other times, it took me weeks afterwards to feel confident again and not be obsessed with feeling possible chest pains.

I was discharged later that day and was home for dinner, with my daughters treating me to my favourite meal, Dutch “boerenkoel”. I slept well beyond 6AM and no one poked and prodded me all day!