A very stressful day, yesterday. I have known him for 41 years; three of us did everything together, at school and after leaving. We saw literally thousands of bands and formed our own. He was found dead after a fall on the saturday evening, and I found out just before work today. I have been surprised at the level of grief, much more than when my father died. Not sure why; perhaps a bit of guilt that I hadn’t seen him so much over the last couple of years, when he had a few health issues that I didn’t really know about, perhaps my own mortality is worrying me. Probably the Bisoprolol is showing its depressive effects.
Coupled with having to take my mother to her sisters funeral today, it was all too much. Dry January ended much wetter than it was supposed to; 3/4 of a bottle of wine gone.
I received a call from research nurse at NGH. I will need to have an echocardiogram and see Dr Stephen Hunter about my place on the trial. This meeds to be done with an ECG on the morning of my consultation with Dr. Hunter. Although he is available every wednesday this can’t be done until 1st March, so my appointment is further delayed.
I received a text from the surgery asking me to call in; my GGT levels are back up. My file had a slightly more detailed recommendation from the Doctor than that on my patient record, so the receptionist read it out to me. “Normal, but slightly high, retest in three months.” The normal limits for GGT are 8-61 and I am double the upper limit; not sure that counts as “slightly” high.
My results are showing a remarkable correlation with the 90 day moving average of units (no reason for this calculation, 90 days was taken at random). It seems to me that the alcohol must be affecting the levels, but the Doctor’s advice is that there is no problem and I may just have naturally high levels of GGT; perhaps both are true. I will take this graph with me next time I visit. Appointment for next blood test set for April.
I didn’t sleep last night; it could be stress from work or worry from the thought of the procedure; things are moving faster and seem much more real. I have no idea which it is.
Its 2 p.m. and I am still waiting for a phone call, I am nervous and excited, although it may not even happen today.
I had not previously thought too much about the mini-maze; from what I had read, I thought it was only offered where catheter ablations had failed. It turns out to be similar, but with keyhole access at the side of the chest instead of the leg, general anaesthetic rather than sedation and the use of cardiac bypass. Seems quite frightening in comparison. I still plan to follow the trial route.
Appointment with electrophysiologist at the Northern General Hospital, Andreas Kyriacou. Strange that the cardiology department should be placed in an area where the parking situation is likely to produce excess stress; after arriving at the hospital gates with half an hour to spare, the parking situation meant that I literally walked into outpatients at my allotted time. In contrast to Chesterfield, it seems that the average age and weight here is much lower.
Apparently my chances of successful ablation are reduced from 80% to 50% as I have now been in persistent AF for more than a year. Obviously this change didn’t happen overnight on the anniversery of persistent AF, but it is very frustrating as from March last year I was pointing out to everyone I came into contact with in the NHS that I needed an ablation sooner rather than later. I had thought that the process: test, wait, test, further wait, test, another wait etc, was designed to fix the low percentage of easy cases while incurring little cost, and put off the higher spends until later. Unfortunately, it makes the other cases harder and more expensive to treat. It also allows the disease to develop further and given the increased inputs required from procedures and medications as well as the side effects such as lethargy and weight gain potentially causing other issues, this must be much more expensive for the NHS in the long run.
It seems that there are two treatment options for which I am a suitable candidate: catheter ablation and the mini-maze procedure. I could choose which procedure I would prefer, but there would be a three to six month wait for catheter ablation and a longer wait for the mini-maze. I do have some luck; there is a research project underway at the NGH to assess recovery rates between the two options. If I choose instead to be on the trial, then I would be randomly selected to have one or other of the procedures, and waiting time would be significantly reduced. Also, a follow up ablation would be automatically scheduled after three months, rather than join the queue again. For me this is not a difficult decision to make, the earlier the intervention the better.
I will be contacted by the hospital, either tomorrow or the day after. If not, I should ring them on Thursday; this haste is very refreshing after the last months of dawdling.
In spite of the doctors belief that my GGT is not alcohol related I plotted a graph of units consumed against GGT readings. It looks to me like a perfect correlation between the GGT points and the 3 monthly moving average of my daily units intake. (There is no logical or statistical reason for selecting a three-monthly period for sampling; I used it as it shows an apparent correlation). I will have to see how the week of drinking over Xmas has affected the result in my next tests, if there is a rise on the previous result, it will implicate alcohol.
I received the details of my appointment with electrophysiologist at the Northern General on 16th January. I am ridiculously pleased, because this seems close (although my referral was October) I am still waiting for the notification of my next cardioversion, but this is likely to be the second week in February.