Rehabilitation

I am still feeling much better than last time.  So much so that I have not bothered to record my recovery walks on Strava or even to use an HR monitor.  I left the hospital on the afternoon of Wed 4th Oct.

Thu 5th Rested

Fri 6th Into town back to the local supermarket and home. 3 miles

Sat 7th Rainy walk through the park and streets. 2½ miles

Sun 8th Walk through the park and streets. 2½ miles

Mon 9th Stayed in all day for fridge delivery

Tue 10th Took car to Kwik-fit, walked to surgery and collected the car. 3 miles

Wed 11th Walk around the Ashgate fields. 3 miles

Thu 12th Took car for service, walked to town, back home and then to collect car. 4 miles

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Prescription pre-payment

On Thursday 5th October, I received a notification from the NHS that I had incurred a penalty charge for claiming a prescription for which I had no valid prepayment certificate.  I knew this was not the case, and had the email receipts for all my certificates stored in my Outlook account.

There were a variety of methods available to challenge this: webpage response form, email or phone.   The link to the web page did not work; using menu for the pre-payment certificate site, I found a beta version of the page, but decided not to risk it.  I thought it would be better to phone.

I had all the information ready: certificate number, receipt reference, payment reference and date and time of email responses. The call handler asked for my personal details to verify identity, but said that he could not process any of the details that I had as he had no access to these.  I would have to either complete the webpage or send an email.  He also pointed out that if I did not receive an answer within two days, I would have to resend, in case my mail had been lost in the system.

I failed dismally to be polite in response.  Not his fault I know; but what was the point of the call centre if all they could do was point me to the same email address as the letter.  The fact that the webpage did not work and he seemed to be telling me that the email system may also have problems did not fill me full of confidence.

I suspect that prescription fraud is rife and this contractor has managed to reach its (easy?) targets by penalty charges and so have not needed to develop a useful system to manage the problem.

Recovery

I am feeling much better than after the maze procedure, but the bruising is quite extensive, but not particularly painful.  I am very tired, so decided to  take next week off work; the was pre-agreed with work, so not a problem.  My sick note runs out tomorrow, but cannot get an appointment with the Doctor until the 16th, but I am assured there will be no issue with backdating it.  I explain that this will be OK, but I have an appointment at the Northern General Hospital between 10:00 a.m. and 12:00 p.m.  I am told this will be taken into consideration and will be allocated a phone appointment in the afternoon.  I checked later; the appointment is for 10:55 a.m.

Apologies to the sensitive for the picture of my thigh below.

I have similar but lighter bruising on the left leg and another on my right wrist from the blood pressure sensor.

 

Bruise

Migraine aura

I was aware that procedures involving a trans-septal puncture sometimes result in patients getting a migraine aura; as an occasional migraine sufferer, I was prepared for this.  During my lie flat recovery period I noticed that I was getting a dull area of vision in the centre of my field of view and if I looked at a bright part of the ceiling, just off centre, I could see wavy lines that looked a little like floating cells.  I assumed that this must have been the aura phenomenon people talk about.

My migraine auras look nothing like this. For me a migraine starts with a blind spot in the dead centre of my vision.  A few minutes afterwards the sight there returns and I get a visual disturbance just to the right and below centre.  I know that if I take a couple of paracetamol before this appears I can avoid the migraine.

My migraine aura is difficult to describe, but it is a little like a jagged teardrop on its side, filled with little square boxes.  Each box is filled with lines, some vertical and some horizontal, like a TV test card.  The lines are alternately very black and dazzling white but sometimes give an impression of being blue or red.  Each line flashes, with the black and white changing places a couple of times a second.

I had dozed throughout the day on the effects of General anaesthetic, but had had a deep sleep between 10:00 p.m. and 1:00 a.m.  At 2:00 a.m. I was awake and suddenly noticed a vision disturbance; there was a tiny black cross in the centre of my field of vision.  After a short while, this had disappeared and was replaced by something similar to my migraine aura.  It was the same as far as the flashing boxes of lines were concerned, but instead of the small teardrop there were two long lines spreading from the bottom right hand corner of my vision going two thirds of the way across and up my field of view.  This lasted two hours before going back to normal; it didn’t result in a migraine headache.

I was fine with this as I had read about it and knew roughly what to expect, but I imagine it could be terrifying to someone unaware of it.

Still in hospital

I was not taken for an echocardiogram the previous night, so I assumed I had misheard and I was programmed in for 8:00 a.m.

The EP came to see me at 9:00 a.m. and told me that it should have been done the previous night, but they were still waiting for an appointment.  He was not expecting any issues, so as soon as I had the echo I could go home.

After several prompts from the nursing station they finally brought a portable echo station down from the ICU at 3:00 p.m. and used me as a teaching aid for a medical student.  I finally left at 4:15 p.m.

Second ablation

Another £25 taxi to get me to the hospital for 7:00 a.m.  I was admitted and all details completed quickly, everybody seems to remember me, the nurse at reception seems particularly pleased to see me.

By 7:45 a.m. I am gowned up and wheeled off to the waiting room outside the catheter lab.  The admission nurse here also remembers my name, but can’t quite place me.  He suddenly realises that I was cancelled from a couple of weeks previously.  I suspect that the Dr in charge of the clinical trial has had a word and ensured that my procedure goes ahead; there are only four days left in the six month window.

I am walked into the cath lab.  I am surrounded by highly technical equipment, lots of white shiny stuff, 50 inch monitors and banks of electronics making ping noises.  I am surprised to use a supermarket style hop-up as a ladder to access the operating table.

It took quite a long time to be prepared, but everything was calm and reassuring.  I was given the anaesthetic and suddenly it was 12:15 p.m and I woke to find the catheter sheaths were about to be removed.  Everything appeared to have gone well.

I wasn’t looking forward to the next four hours of compulsory lying still.  However, I barely noticed it, I was in and out of consciousness and the time was up before I knew it.  I was cleaned up and moved to a normal ward bay.

The Electrophysiologist came to see me and was very happy with how it how gone; he had discovered electrical reconnection on two of the pulmonary veins, so ablated these and performed a CTI for Atrial Flutter (which I wasn’t aware that I had) and a box lesion set on the posterior atrial wall.

It was a long procedure, so he wanted me to stay in overnight.  I would need an echocardiogram at 8:00 p.m. to check for fluid around the heart; as long this was OK, I would be allowed to go home in the morning.

ECG trace a bit wobbly, but no AF and no ectopics.

AF trace 05-10

Accreditation visit

I was able to attend the accreditation visit today and dealt with the auditor myself.  My colleagues were very relieved, but I found it stressful.  It turned out to be quite simple, just a two hour visit; I sailed through, very little in the way of actions and should be able to complete them all the next day.