EU health care - true story

Bit of a strange one, but here we go. I am now on long term, prophylactic, anti-coagulation medication. I take 2.5mg of Apixaban twice per day to prevent the reoccurrence of potentially fatal blood clots. I've been pretty well disciplined in my medications since being hospitalised with this condition, but as a result of some catastrophic preparation, I found myself arriving in Hamburg yesterday afternoon for a 4 day workshop without my medicine.

Calm head required, My first thought was that I should get to a pharmacy and simply buy the drug, I doubt that's possible in Germany - they tend to be quite strict about these kinds of things, but lets see how that goes.

I started to google the cost of the drug in question using my phone in the taxi, expecting that I might be getting hit for 40-50 Euros.

Shat myself... Immediately started thinking about whether I should just run the risk of going without.
Interesting topic that - can you afford to go without life saving medication, food, water, shelter???? Indeed, why do progressive governments think that medication should be available to all as a matter of priority?

Anyway, there was the worst case scenario, maybe up to 500 Euros as a reminder not to be a twat, or possibly just die and avoid any embarrassment...

At 17:40 I presented myself at an Apotheke to explain in my very unreliable German the situation I was in. Massively in my favour was the fact that the drug comes with a wallet card explaining your status and dosage, however it's still a prescription drug in Germany - in the UK, for some drugs it is possible that a pharmacist can offer a short term fix in emergency situations. Through some limited conversation with the Phamarcist, I learned that it was exactly as the case in the UK, this was a prescription only drug, but no emergency procedures available to me. She kindly directed me to the nearest Medical practice, thankfully on other side of the road, where after some form filling and presentation of my EHIC (thankfully having taken time to put my 'Patient Alert card' in my wallet, I also remembered to pack my European Health Insurance Card) I was invited to sit in the waiting room. A few more laughs with the receptionist and I found myself meeting Dr. Maas who very quickly produced a prescription - No Charge!

Rushed down to the Pharmacy at 18:20, with it closing at 18:30. Presented the script only to be told it wasn't in stock. So I raced down the street to the next pharmacy where I was also informed they would need to order the drug. "Shit!" thinks I, this place closes at 18:30 and I need to be in a workshop a long way from here at 08:30 tomorrow morning. But, lo, I've misunderstood, I just need to come back around 21:00 when the drug will have been delivered and the pharmacy will open for me if I have the correct papers - how do I get these I wonder? - she prints them for me - how much does it cost?  - 5 Euros please -  For the papers?  - Just for the drugs. - How much for the emergency Service? - What? - the emergency Service, how much? - we don't charge if you need medicine... - of course...

If I was English, I'd be asking my MPs what the fuck they think they're playing at?

Long term anti-coagullation

I finished a 6 month course of Warfarin therapy in July and honestly felt better than I have done in years. Besides the fact that I'd torn my hamstring, my cardiovascular fitness was returning and a lot of minor aches and pains I've endured over the last few years seemed to have disappeared. I was ecstatic and couldn't wait to get back to 'normal' living.

6 weeks later and having enjoyed a few weekend parties - my contemporaries all seem to be turning 50 this year - I really started to feel like I was heading back down the same road that led me to hospitalisation. Without having anything too specific, I simply wasn't feeling the same way that I had done. The only empirical evidence I have for this is that my apple watch estimated VO2 max dropped from 43 ml/(kg-min) to 38 ml/(kg-min) over a few days and stayed down at that level, having not been so low since I was just out of hospital.

With a bit more digging into my family history it's become very clear that there is an issue on our male side. I knew that we had suffered too many sudden young deaths, but I hadn't appreciated that other 'healthy' relatives had also suffered strokes too, so the basis on which I'd had my 'end of therapy' review was probably void.

Back to the doctor and one week of using even just a prophylactic anti-coagulant, I'm already feeling better again and the VO2 max score is climbing steadily once more.

I don't want to be on long term medication, but this is the right decision. Perhaps I was starting to clot again or perhaps it was psychosomatic? Perhaps starting to enjoy alcohol again is detrimental to my overall health and actually I now suffer week long hangovers? Perhaps the fact that I had not taken care to make sure I was getting a 30 minute daily walk done was a factor? In the end, the risks are a little bit too severe for my liking - take a wee pill every day or drop dead suddenly with the possibility of just having a heart attack or a stroke as the lighter alternatives. I'm on long term anti-coagulants now and my ambitions to train in Tae-Kwon-Do or play some masters rugby are parked.

UKCC Level 2 - Scottish Rugby

Accepting that my future involvement in rugby is much more likely to be from the sidelines, I embarked upon the Scottish Rugby UKCC Level 2 course with some like minded fellows down at Kilmarnock RFC last weekend.

First impressions are that the SRU have made a considerable investment into the support for coaches and coach development. 2 very fine rugby 'educators' were on hand to take us through some rudimentary rugby concepts and to understand the SRU blueprint. We discussed coaching techniques and how the SRU see the game being played from a top level down. The emphasis very much on Mini-Rugby being fun for all and Youth rugby being a developmental game; not one for coaches and clubs to simply hunt for trophy glory but for the much greater ideal of player capture, development and retention.

I have to say that the volume of resource available is incredible, almost daunting, but the Scottish rugby portal on Hive hosts a wonderful array of coaching video and self-learning cards for coaches.

Further to what the SRU have been up to World rugby also have created a 'passport' site where coaches can manage their learning, with superb resources for First-Aid training, Concussion management, Protecting rugby from gambling problems, coaching, officiating and generally understanding the game better. The passport site allows a coach to self-learn and work towards certificates, some of which are mandatory homework for the UKCC Level 2.

I've spent at least 12 hours doing online homework for this and will be back down at Kilmarnock on Sunday for another practical coaching session, where I will need to demonstrate that I've found a way to address the critique I received for last Sunday's practical session. I don't expect to fail, but my goodness I'm impressed with the level of detail in the course and the level to which we're expected to understand Strength & Conditioning, psychology and player development. It's a long way from the 3 laps around the pitch warmup and endless passing drills I endured as a kid.

Very impressed.

Hamstrung by stupidity

Fuck Fuck Fuckity Fucking Fuck!!!!!!

Was really starting to feel great. Genuinely benefitting from a wonderful break in Sardinia, chilling with the family, catching plenty of rays, dipping into the pool daily and even getting up for some early morning Body Balance - very cool class that is a mix of Yoga, Pilates & Callanetics with a very chilled out set of background tracks to work to. Doing it from a shelter just after sunrise looking out to sea added to the tranquility.

All of this tranquility and peace may explain why when the lovely Rachel asked if one of the parents could join in the football to even up the teams I reluctantly stuck my hand up and took my place in goals... Of course it could have been the tranquility, but it wasn't was it! Bloody stupid ego of a man who should know better is much closer to the truth... 2 stunning saves later and I'm dreaming of a comeback... Here they come... Change of direction, attempt at acceleration, foot slipping on uneven surface... Twang!

Just like that, another 6 weeks of rehab and the echoes of a doctor's voice in the distance reminding me that after 6 months rest, I shouldn't expect my body to be as it was before I was ill...

Fuck Fuck Fuckity Fucking Fuck!!!

6 Months later

Nice review meeting with a hospital consultant this morning. Under normal circumstances I think we would have just stopped the Warfarin, shook hands and parted our ways, but with the sudden death of my brother last year and no post-mortem, there remains a concern that this could be some genetic condition at play.

Warfarin days are over though, so that's the good news.

Next stage is to return to hospital in 4 weeks time, to allow system to be cleared of Warfarin, and get some more blood tests (D-Dimer) which will further inform the decision as to whether I need to adapt a prophylactic medical regime or can return to unmedicated status - which is my preferred option, of course.

Still, that been 6 months sans-alcohol. I've not really missed it to be honest, and with my new found knowledge of Alcohol-free beers, could this become a lifestyle choice???

Regrets... I’ve had a few

5 months since being hospitalised with Multi-Focal Pulmonary Emboli I’m back into an exercise program. I left hospital bursting with vim & vigour and was somewhat surprised when the Doctor insisted that I take 3 weeks off work then a staged return to work. I really couldn’t believe I was that ill... Actually if you’d told me 2 months earlier I might have believed you, but by the time we realised what was wrong the blog clot was splitting and I’m eternally grateful that the fragments lodged in fairly benign places rather than taking the opportunities for mischief that they had.

It didn’t take long for it to sink in though that there had been a significant hit on my health. Everyday life was wearying - possibly a wee bit psychology involved in that too? Up in the morning and ready to take on the day very quickly dulled into tired afternoons. I tried to lose some weight and took to walking, which was wonderful. For some reason Spring came to Scotland exceedingly early this year, February was fabulous and I made the most of it. The outcome of which was that I quickly escalated my walks too much and ended up with a spot of Plantar Fasciitis.

Regret 1 - Should have invested in better shoes for walking.

For all that the heel pain of P.F. Makes the mornings a bit miserable, it’s actually fine once you’re up and about and just requires a bit of stretching and taking care of your feet - I had the time, so no problem.

Having previously played rugby for too many years, I have a few wee niggles here and there that will always be with me. I’m missing a ligament in my shoulder that means I need to keep it conditioned so that the muscles provide the necessary stability. Those muscles have a habit of atrophying more quickly than the others and if I don’t maintain it, I end up with an unstable and painful shoulder. It really doesn’t take much to maintain them either, but as I was in complete rest, I didn’t...

Regret 2 - Should have added a daily movement routine to my schedule. Just running the joints through a sequence of moves designed to ensure the stability was maintained. No need to view it or manage it as ‘exercise’; no need to get tired or stressed (physically) by it, just keep things ticking over by moving those joints, maybe even tai-chi style... think that's what I might recommend rather than anything even as stressful as Yoga.

Regret 3 - Whilst doing that sequence of joint mobility exercises should have introduced some moves to make me less right sided. See the above comment on tai-chi, damn! Should have thought of that, it always seemed a bit of a weird thing to be doing, but actually kicking myself now that I didn't do that.

The move I’m using just now to return my shoulder to form is a bit like Saturday night Fever dance move. The Physio calls it ‘drawing sword from scabbard’ but I’m definitely more John Travolta than Braveheart, so ‘Staying Alive’ it is. She’s given me one of those rubber bands to add resistance, but honestly, just doing the move on it’s own and twisting the hand at the end so that the palm faces upwards is enough.

See a video version of it here

Most of the problems I had with it in the first instance I’m sure are to do with the fact that my brain didn’t know which order the muscles should be firing in. Getting there though.

Regret 4 - See all of above but apply it to the left knee, which is only slightly less damaged than the left shoulder

Regret 5 - Should have learned to juggle

Regret 6 - Should have played more guitar

Regret 7 - Didn’t make enough use of my Busuu account to practise languages

Regret 8 - Should have played more guitar

But here we are. Nothing to be done about what I didn’t do. I’m now back on the machines at the gym (cross trainer is nice and easy, rowing machine a brute) and I’ve been in the pool getting a few lengths done, so we're well on the way to recovery.

In the interest of balance, I don't regret stopping the booze for the last 5 months. It was pretty easy for the first couple of months as I felt so shitty anyway. After that it just seemed to come down to reminding myself that I didn't drink when people offered - which is more difficult than you might imagine, but with the negative impact of a bang on the head when on Warfarin, the internal debate doesn't take long to reach a conclusion.

The Recovery - a wee bit of perspective

I was discharged from hospital on 27 January after 5 glorious days of complete rest.

If you ever find yourself in such a position or are in anyway the type of person who gets a bit restless or fretful, then I recommend that you read 'My Name is Doddie', the biography of Scottish rugby legend published last year as part of his efforts to raise money and awareness of the mind bogglingly awful condition that is Motor Neurone Disease. They way the big man is dealing with this cruel card he's been dealt would bring a tear to a glass eye.

In hospital, I put my feet up, read a little, watched Peaky Blinders on Netflix, moved around the room to have my meals with different views and went to the toilet occasionally. I had frequent checks on my blood pressure and oxygen levels, a bit of fussing over changes to the medications that had been used to treat my misdiagnosed heart attack and changed my compression socks daily. In the end, the hospital realised that if they didn't kick me out they might run into a tea shortage well before Brexit even started to take effect, so as soon as my INR finally reached the minimum acceptable level I was out on my ear.

In that time my resting heart rate dropped from 75 back down to 60. In the 5 days after leaving, it crawled back up to 65 and has stayed around that level pretty consistently since, up to 68 briefly and down to 63 occasionally - funny wee vagary of the Fitbit, you can often be relaxed with a HR below what it records as your Resting Heart rate, something to do with how you sleep I believe, but I often see it a few beats below 60.

There really isn't a lot of information out there about what you can expect in the next stage. Take it easy is the main thing, don't exercise too vigorously for a couple of weeks, but no way of knowing when you can get back in the saddle - and this is what you really want to know in the early stages.

Most recovery plans I've been offered aim to get the patient up to walking for 40 minutes a few times per week, whilst I'm looking to set my bar a wee bit higher than that and after 1 week was pretty much walking 40 minutes daily - albeit, I was feeling the effects of that initially -  getting up to 1 hour in the 2nd week and by the 3rd week easily able to get out for a good 2.5 hour hike every couple of days.

What you can't really account for is just how much rest you also need at this point. I left the hospital feeling revitalised and full of vim & vigour and feeling desperate to get out for a run or a bike ride, almost fantasising about doing circuits or lifting weights. Just a week of having a fairly easy time of it at home showed me that this condition isn't just as simple as take some medicine, feel better, get back to training. There's a real need to come to terms with the predicament that has just been survived. There's also a need to realise that the body has had a bit of a kicking and could still yet suffer unwanted long term consequences if you get the recovery wrong. On the other hand though, there is a tremendous amount of good to be gotten out of a period of more gentle exercise. The walking has been uplifting. The need to have a more stable diet has been beneficial too, although it has highlighted my terrible discipline when it comes to peanuts. I'm allowed alcohol if I want, but actually there are too many risks associated with head knocks, so I've just completely knocked the drinking on the head and I have barely missed it at all - I'm now a fizzy water with a wee dash of cordial guy. I can do press-ups no problem and I quite like doing them, but I think I need to spend some time working on my flexibility, so I'm going to avoid strenuous exercise for another few weeks and focus on yoga type stretching - I am a tree! I am the mountain! I am the soft breeze!

In the meantime, I'm really enjoying getting out for my walks. It's good to reacquaint myself with the city and the parks that I'm lucky enough to be surrounded by. The weather this year is freakish though and at the end of February, 1 year on from us enduring the 'beat from the East' it's now way too warm. The flowers are already out in force - not sure how the next deep frost will affect them, but in the meantime I'm enjoying this very early start to Spring and am much more aligned with my need to recover physically more slowly than my ego would like, but even that has taken a few weeks to accept.

Deep Vein Thrombosis - the signs

Having established that I'd probably suffered a DVT sometime last Autumn, it slowly dawned on me that my body had been screaming this at me, but I'd ignored it.

In October at some point I had what I assumed was a calf cramp. I haven't suffered such an incident since I was in my 20s. Back in those days I did occasionally wake up in excruciating pain during the night - these are known as nocturnal cramps and the NHS have a page here, back then they were probably caused by the effects of rugby training in the deep mud that passed for Anchor Playing fields in Paisley. I brushed this incident off without considering fully that it's about 25 years since I had my last cramp like that, even if it did take a few days to feel like my calf was recovering - I put that down to old age - and I certainly hadn't been putting any great stress on my calfs in recent weeks.

I also noticed that my ankle was slightly swollen, socks were leaving much more pronounced marks around my ankles at the end of the day and I did consider that I might need to see the dr. about why that might be happening, then of course the swelling disappeared of it's own accord, so I did nothing about it - it seemed harmless.

Both of these signs are pretty major indicators that there was a DVT causing a blockage in my leg. Hindsight is a wonderful thing!

Deep Vein Thrombosis - the causes

So having come to terms with the facts of Multi-Focal Pulmonary Emboli and addressing the immediate dangers of the condition, it's time to review how this has come to pass.

Having reviewed the scans, the cardiologist was able to identify certain characteristics about the clots quite accurately and this led to the conclusion that a DVT breaking free from my leg was the most probable cause.

Normally I'd associate DVT with long haul flying and I must confess I've probably been a bit blazé about those concerns. I fly long haul not much more than once a year, but certainly make sure that I get up and about when I do. I never wore compression socks though and I do enjoy a few drinks whilst I'm being served them.

Actually there are more than a few contributing factors to DVT, of course. In my case, I frequently fly short haul, but when you travel from Glasgow to go anywhere, more often than not it's a short flight to Amsterdam, before another flight to your final destination - In the worst period last year I took 14 flights in 15 days.

The issue with long haul flying seems mainly to surround the fact that you can find yourself seated for 3 hours or more, here's the bit that bothers me now, for although most of my flights are cramped into cattle class short haul jobs where the flight time might be no more than 90 minutes, you can sit on the plane for 45 minutes before taxiing and take another 20 minutes at the other end (try landing at an outer runway at Schiphol), suddenly those short haul adventures are much closer to 3 hours seated than you think.

Beyond flying though, recent months have seen me slumped at my desk in the afternoons. From quite active mornings, as in getting up and down from my desk occasionally to make a cup of tea, the afternoon can go from the lunchtime van delivery - it arrives in the car park at 12 noon daily - to having sat at the screen for anything up to 4 or 5 hours solid. During the Autumn period, my Fitbit was warning me that I was inactive. Reviewing the records, I slipped into barely doing any exercise at all for 2 & 3 weeks and my belt got accordingly tighter.

Simply sitting at my desk getting fatter could be a major contributing factor to the development of this DVT.

Why post this part of the story? Well, I have had a Fitbit for a number of years. I got around to viewing it as a bit of a waste of time. Basically it reflected whether I'd had an active day or not. If I walked into town for lunch, I easily scored my 10k steps. If I took lunch from the van, I barely scored 7k steps. But looking at the Fitbit daily, isn't the only point. It is actually a very good indicator of long term trends, so whilst I was failing to score any stars for 1 day per week, who cares, but start failing for 3 or 4 days a week, then start stretching that out to 3 & 4 week periods... well it's not rocket science is it. Getting heavier AND spending more & more, longer & longer periods in a sitting position is not a good trend, but that is what I was doing and I have the records to prove it...

The other thing that my Fitbit was also screaming at me was that my resting heart rate had made a step change from constantly below 60 to sitting above 75 for a period. Like a true eject, I just ignored this and assumed it would rectify itself once I started exercising again - Should have gone straight to the Dr. with that information alone.

This isn't an advert for Fitbit - other activity trackers are available; but if you invest on one, you should at least make use of the information it provides you!

A very Cardiac Christmas tale

It's been quite a journey recently - and not much of a fitness one either!
In December 2018 I was in Paris for work when I noticed I was struggling for breath as I walked up a hill chatting on the phone. Quite unusual for me (the breathless bit rather than the chatting), but maybe just a cold or 'something' getting to my chest, I postulated.

Returning from my business trip I was greeted with the news that my younger brother had died suddenly, just 2 months shy of his 45th birthday. It would be fair to say that over the years we have taken very different approaches to our health and he had required some emergency surgery in the summer to resolve Perforated Duodenal ulcers, which he had allowed to go untreated for too long. Nevertheless, he should have been on the road to recovery, but some questions over his attitude towards the lifestyle changes he was going to need to make for a full recovery. There remains an unresolved concern that he may have suffered some kind of cardiac issue, but in the absence of a post-mortem for whatever reason, we shall never know.

The following weekend, the kids were playing rugby at East Kilbride which has a bit of a steep climb to get from clubhouse to pitch. By the time I'd jogged up to the pitch and across to join the team, I realised I wouldn't be able to speak to them. At this point, my fellow coach who also happens to be a pathologist warned me that they had seen quite a surge in Pneumonia cases in Glasgow recently. He urged me to see my doctor asap, which I guess I thought was a good idea, but I've slipped into a pretty shoddy way of expecting to be told that "it's probably a virus come back in 2 weeks if you're still ill".

On Monday whilst I wrestled with how complicated December was turning out to be with Christmas, a family wedding, now a funeral and my own health somehow letting me down, Craig once again texted to urge me to see my Doctor. I realised this was the one thing I could actually do something about, so called the GP and was invited to the surgery that morning after a phone call to discuss my symptoms. On meeting my GP, he checked the lungs and said they were clear, but given a poor family cardiac history and the fact that I live in Glasgow, where our record of cardiac ill-health is second to none, he decided to refer me to the cardiologist, put me on aspirin and beta-blockers in the meantime. 3 days of Beta Blockers and I was in the position that despite feeling grand normally I had to stop for a rest halfway up the stairs and could not quicken my pace to cross the road without stopping to catch my breath after. Strange days. Totally ok on the flat, but knackered as soon as I hit any incline.

Decided to make use of the work insurance plan and see a cardiologist privately - so on the last Friday before Christmas, just after 6pm, I get an ECG with the diagnosis that I've suffered a significant heart attack recently... Here's how the system works in the UK. Your NHS doctor can prescribe drugs which you get for free from the Pharmacy. Private consultants can not prescribe out-patients drugs - normally they write a letter to the patient's GP and make a recommendation. They can also write a private prescription, which the patient takes to the Pharmacy and pays for the medication at market rate. With the ECG suggesting 'significant' Myocardial Infraction (MI), it's straight onto extra some blood thinners to complement the aspirin I'm already on, something to address the high blood pressure I'm exhibiting and Statins to deal with the elevated Cholesterol level detected by the GP blood test (which also showed the presence of some proteins that could be indicative of heart issue). Fortunately for me I'm in the position where an extra £24 the week before Christmas is manageable, but it got me around to thinking about how much I agree with the Scottish government policy of free prescriptions and why it's important.

Quite an amusing discussion with the consultant followed where he agreed with me that even light housework might be too much of an undertaking at this time (I was only joking, but he was stressing how easy I should take things) but disagreed with my wife that I should avoid alcohol altogether, recommending that a wee glass of red wine might be just the thing to help me relax, so long as I didn't overdo it. R&R was the key!

1 week later in between Christmas & New Year and I'm back at Ross hall for an Echo Cardiogram and cardio stress test. I've done my best so far to stick to the instructions and my wife has been a superstar in making it possible. First up is the cardiogram and I sense some frustration from the Cardiologist. In the end he reveals that he's not seeing anything like the damage that he's expecting to find. The stress test goes pretty well too. In my mind I'm readying myself for the Drago lab scene from Rocky IV, as the nurse manscapes my chest and attaches the electrodes. The mood is somewhat ruined by the nurse checking everything is attached before asking me whether I've used a treadmill before - Everyone's a comedian these days! Anyway, it's quite an easy start before the incline increases and the speed steps up to a brisk walk. Although I'm way more breathless than I would expect, my heart is responding exactly as it should to the changes in stress and it's not getting out of kilter at all. In the end the doctor sees that I'm more breathless than I should be but declares that I'm fit enough to be an HGC driver. With all due respect, I've seen some of those boys and I set my bar a wee bit higher than that, so we need to look at something else.

An MRI and a cardio angiogram are next on the list of tests. The MRI (the gold standard of scans) turns out to be something of a claustrophobic yoga class, as for 90 minutes I'm trapped on a gurney in a tunnel doing breathing exercises. Each scan is taken at the end of an out breath. There's no indication how many pictures it will take (you get a beep per picture), but it ranges from 1 to 24, with 6 being pretty typical. The result is a full 3D image of the heart working and blood flow. The end result of my scan is that I am showing a perfectly functioning heart with no indication at all of any damage. The subsequent consultation with the cardiologist turned into something of an episode, with him expecting this news to be greeted euphorically. He hasn't counted on my wife working back in her mind how many times she has gone our of her way to make me as comfortable as possible on the couch with a glass of wine whilst she dealt with our unholy brats on a Christmas sugar rush. As I accept his view that this could have been some kind of myocardial virus with what I consider good grace, I note with some concern that my wife appears to be raging that I've somehow managed to malinger through the festive period and this cardiologist has been complicit in facilitating it. He points out that blood tests and ECG are still indicative of an issue, just that we're discounting Heart attack now and looking for another cause, hence why I've to get back for the Cardio Angiogram, where they will check out the state of my arteries.

 We're now into mid January, and I'm actually feeling noticeably better. Also pleased to know that I can drop the blood thinner (Clopidogrel) and blood pressure pills (forgotten already). Really starting to buy into the Myocardial virus story and feel like there has been a sudden vast improvement, although I'm still not feeling like I'll be going for a run anytime soon, but my Fitbit, which I've started paying much more attention to is showing that my resting heart rate which had suddenly stepped up to 75 from 60 in December, is now showing signs of lowering back towards that original level.

For the Angiogram I'm back at Ross Hall and the requirement is that I need to get my Heart rate constantly below 60 for the test to proceed - again there's a bit of manscaping and some electrodes connected up. Sitting just on 60bpm in the relaxed pre scan position with beautiful cherry blossom tiles looking down, they decide to apply some beta blockers to get me down a bit, soon sitting at 54bpm and the test begins. Much quicker than the MRI, but halfway through there is an injection which helps build up some contrast for the analysis. Quite a strange wee experience with a cold flow up the arm before the feeling that I'm wetting myself, although not as unpleasant as that sounds... 

Sliding out of the machine I notice that my eyes are wee bit itchy and the nurse notices too. An allergic reaction isn't unknown, so they decide I should hang about for a wee bit and they make a cup of tea. Finish my tea and I'm ready to go but the nurse says the Dr. would like a word - that's not good news thinks I, but she says something about the allergic reaction. I don't believe her, but let's hear what he's got to say.

In the background of the cardiac scan, where initial impression is that heart and arteries are in good nick, he's spotted what he thinks might be a Pulmonary Embolism - Blood clot on the lung. After a bit of discussion, where his first thought is that I should take my scan directly to A&E, they agree that I should just get a full lung scan and see whether Ross Hall can treat me. Full lung scan reveals Multi-Focal Pulmonary Emboli (blood clot on each lung) and hospital Admin have rules that as its discovered on site I should be treated immediately. Very quickly meet a new Cardiologist, who explains just how dangerous this situation is and its straight upstairs into bed to be attached to a Heparin drip 24/7 until the Warfarin Therapy becomes effective. The easy explanation is that the Intra-Venous (IV) Heparin is very quickly effective but not long lasting, whilst the longer lasting Warfarin pills are not immediately effective and require some fine tuning as the effectiveness is seriously affected by diet and metabolism. The not so easy bit to handle is that I've got some blood clots on my lungs which could dislodge and kill me or at least make me seriously ill.

The explanation for my apparent recovery is that the blood clots appear to be fragments of a much larger clot, with the theory being that the larger clot was initially blocking a major artery - making me feel really crap - before splitting to block less major arteries - making me feel less crap.

Pulmonary Embolism (PE); that's a world of trouble that you don't want to hear your doctor saying at any time. You really, really don't want to hear - Multi-Focal Pulmonary Emboli. On the other hand 5 days in a private hospital is a pretty decent way to get the headspace required to move into recovery mode and that's where I am right now.