National Thrombosis Week | 1st – 6th May 2017| Prevention & Protection from Venous Thromboembolism (VTE)

Martin Yates

Once upon a time, 14 years ago, aged 50, while briskly walking to our local pub with the wife, one pre-xmas eve, with the frost around and minus 2c temps, I got an 'ouch' in my chest, being a bit unusual, and as the missus was a Practice Nurse, she said "we need to check that out". Fast forward 3 weeks and via local GP and then cardiac consultant at Ipswich Hospital, I'm diagnosed via Angiogram with Angina that defines cardiovascular disease (furrying up of arteries) and 2 weeks later, at Cambridge private hospital, have Angioplasty which gets me fitted with 3 stents in one of my cardiac arteries...problem solved...or so we thought.

Fast forward again to last September (2015) and while cutting the grass (1 of 4 lawns), which meant heaving around the mower a bit for nearly 2 hours, I get another 'ouch' in chest together with a vice like squeeze. I mention this to the missus (now retired but still with her medical hat on) and again I get "we need to check this out", so off to my GP who, given my history, books me to see a different cardiologist in Ipswich Hospital. 5 days later, another more lengthy/detailed Angiogram done and he gives me 2 choices "do you want to live or die soon?...your stents are now 90% blocked and you have 2 other arteries similarly blocked, you are destined for heart attack but don't know when"...I vote for the former and a few weeks later I'm at Papworth saying to myself in pre-med (looks like a warehouse at Amazon…not nice surroundings, needs a woman's touch re design/furnishings) "what have I volunteered for, I feel fine?"

October 17th and 4 hours after entering theatre, I wake up and I’m told I've had a triple bypass (CABG)...amazing, didn't feel a thing and 2 veins have also been harvested from each lower leg plus a mammary artery diverted...all I know about them is a scar on my chest and both legs and two beautiful 1-2-1 dedicated Indian nurses attending to my every wish 24/7 (well, most of my wishes!)

5 days later!!...having been ordered to drink lots of water, get out of bed every day and walk 2 floors with fashionable white elasticated stockings on both lower legs and a draught up the backside, I'm discharged on Wednesday.

Now at home, walking about, sitting in upright chair, being looked after my dedicated private nurse (the wife) and although wanting a kip in the afternoon, I feel great...or so I thought.

Now Friday evening (7 days after major op) at 2am, get woken gasping for breath, can’t talk and breath at same time and a stabbing pain in my right side of chest...mmmmmm, this is worrying. Wife confirms and she drives me to nearest hospital (Bury St. Edmunds) as it's quicker to do that than dial 111 for a diagnosis or 999 for a ambulance trying to find me 'in the sticks'. Walk into A&E, give them my symptoms and recent medical history and within minutes they take blood samples and fire up the CAT Scanner as a possible PE diagnosis then hit me with a Heparin injection and wheel me eventually, into the Cardiac Care unit.

However, they are not 100% sure of diagnosis being a PE and CT Scan not providing obvious confirmation, so I ask them to get a consultant involved, but as it’s early hours of Saturday now, none available so I TELL them to ring the cardiac support unit at Papworth (as 2 + 2 = 'major surgery increases risk of clotting') and we have success, the 3 Consultants there get a CAT Scan image networked to them and it’s confirmed I have a small horseshoe shaped blood clot in lower left lung (or hospital acquired VTE) and they give me more Heparin plus put me on Rat Poison (Warfarin)...but due to a major problem the nurses and doctors have trying to find any veins in me they can take blood samples from (I tell them my local GP's Practice Nurse had same prob so my wife cuddles me in bed in morning to warm me up before she takes the samples...the nurses at Bury hospital decide they are not going to do that!!...pity) so I get switched over to Rivaroxaban

2 days later, with great 1-2-1 nursing in the cardiac ward, I’m moved to the Chest ward (a very depressing environment, everyone around me appears to be dying of lung cancer or being told they’ve got it and not very sympathetically) and another 3 days later, without any leg socks or 'education' to drink more water or get out of bed and walk about, I'm discharged home.

Since then, 'side effects', either from heart surgery, PE or more likely the drugs I'm on. Three months after op, Cardiac surgeon at Papworth dismisses burning sensation as a possible side effect and signs me off re cardiac treatment as 100% ok and no need to be on Rivaroxaban for and also have lung volume test re having had a PE (how does one know when the clot has gone, I ask the Registrar? "the body will get rid of it" is the answer!...but when I ask? answer). Wouldn't it be common sense to have another CT Scan to see if it is still there?

Now late February and I'm woken up at 11pm with increasing pain in my lower right lung area as if someone is stabbing me in rib cage, gets worse if I take a deep breath, but no breathlessness and can talk easily without gasping, but given my recent background, I self admit myself back to Bury hospital A&E as it feels like last we go again.

3 hours later, after giving them my symptoms, background and one blood test then lying on a bed in a cubicle (it's now 2am), I'm 'diagnosed' with skeletal/pulled muscle, not a PE (otherwise blood tests would have shown that up) and sent home. Over the period of a further 2 weeks, I keep getting this stabbing pain only (like a 'stitch') yet I've been careful not to lift any heavy weights (but I'm not sure the cardiac rehab exercises I go to each week, which includes lifting weights, could be aggravating my situation)...and the confusing thing is, the CT scan diagnosed a clot in LEFT lung but I'm always getting pains in my RIGHT lung area...did someone get their left confused with their right when they wrote the DIAGNOSIS ON THE ct Scan image???...mmmm, me thinks yes.

Now early March and I’m still getting some occasional pain in left chest but deep breathing doesn't hurt and have cut all the 4 lawns without problem and feel great majority of time, (apart from fearing a trip to the loo)

And during this whole saga, I've been inundated with leaflets from both hospitals and cardiac rehab team on various subjects that it made me 'leaflet blind' (too much information) and I would strongly recommend that 'less is more' and issued at the relevant time.

Now mid March and no pains anywhere...Awaiting visit to Urologist and lung capacity test. In meantime, I plan to re-tax my motorbike and get back enjoying riding that, now that I'm in a fitter state, chest muscle wise, to lift the bike should I drop it, though I hope I don't have a serious accident, as still on anticoagulant.

My GP also tells, in discussions he has with PE Registrar and Cardiac Consultant, that I can come off Rivaroxaban on April 1st (my birthday).