My heart attack journey - pre op

October 2024 By Dave, PinkUk.

Some of you may remember that PinkUk founder Dave had major heart surgery earlier this year after a heart attack at the age of 62. In a three-part series, Dave explains what kept him going in the 19 days he was in hospital, his love for his spaniel Stanley and how the UK's National Health Service is still such an amazing British institution, whatever anyone says.

Part 1, Pre op | Part 2, Post op | Part 3 Recovery (Publishing in December)

The start

I woke up on Saturday 2 March 2024 with a sharp pain across my chest. I thought, this feels like a heart attack, not that I have had one before. Then I reassured myself, it can't be, as there is no history of this in my family and I'm quite fit for my age. Later in the evening the pain was still there so I thought I'd better ring 111 (the non-emergency number in the UK). By mistake I rang 911. At least I know that if you ring 911 it goes through to the emergency 999, which is a good idea. After an apology I rang 111. They said that I should go into Accident & Emergency (A&E) straight away. The reaction in my head was, I could not do that, as what was I going to do about (Stan, my mad Springer Spaniel)? So I decided to go in the morning and assumed that I would be back home in a few hours, and Stanley would be OK.

The trip to A&E

I woke up on Sunday morning feeling very exhausted. I walked to the bus stop and caught the bus to the hospital, about a twenty-minute ride. When I arrived at the hospital's main reception I was feeling very exhausted, still thinking it couldn't be a heart attack. I must have been looking a bit rough as they asked if I was OK and if I wanted a wheel chair. I answered that I'd like a wheel chair, and they wheeled me to the A&E department. I thought, I'm going to be stuck here for a few hours. Fortunately, it was not that busy and it wasn't long before I went into triage – the stage where they ask you all the questions about your symptoms.

The triage nurse said in a slightly derogative tone, “What are you doing in wheel chair?” I said, “I don't feel very steady on my feet and the receptionist at the front desk put me in one.” He did not like that for some strange reason. Anyway, they did the normal things, checked blood pressure and took some blood. Then I was put back in the waiting room where I thought, yes, I'm going to be here for hours.

Half an hour or so later someone came back and said that the blood tests confirmed that I'd had a heart attack; I asked how do they know that from the blood test? They explained that when you have a heart attack some chemicals are released into your blood stream and those chemicals where found. I was, naively it turns out, thinking that they would just give me some pills and I would be on my way.

Instead, I was wheeled along a corridor to the resuscitation unit; I think it was being used as a sort of holding pen. When I arrived, there were people in wheel chairs and trolleys everywhere, even all down the corridors. I joked with the nurse who was with me asking had there been a plane crash? He didn't see the funny side and answered “No, why are you asking?' “There are bodies all over the place.” He eventually laughed and said “This is a quiet compared to what it's normally like".

They placed me on another trolley and wired me up to a monitor. I watched it; my heart rate was OK but the blood pressure was looking unusual. The team were paying me a lot of attention, and a nurse explained that they were going to take me to the cardiac ward; they were just waiting for a bed. This reminded me of when I went to the hospital a few years ago with crippling back pain after a fall. The staff didn't think it was very serious (including the triage nurse) and I thought I should have gone to my GP. As soon as the X-ray was done, they were running round like mad chickens, as I had broken my back (but that's another story).

As the team busily set to work, I noticed a bit of a commotion around an older woman patient on a trolley near me. It appeared she had stop breathing and staff were rushing around and pulled some curtains over. I don't think she made it. I then started to feel my situation might be a bit more serious than I'd thought and that maybe I wouldn't be home in a few hours after all; but at least I will be home tomorrow. An hour later I was wheeled on a trolley up to the main cardiac ward. I asked the nurses how long I'd be in and they said, “We don't know but you will be staying overnight”. I was aware that Stanley was ‘home alone' and needed letting out so I rang my very good friend Rob who lives quite close by and asked him to come and get my keys for my flat and look after Stanley. Thankfully, Rob was around and could check on him.

Depression and anxiety? Yes, and not just for me

The cardiac ward was full but looked very pleasant with free access to WiFi. It also looked as though I was also the youngest patient in the ward at a mere 62. I soon fell into uneasy sleep for the night. The next day (Monday) they gave me some blood thinners and put a camera in a blood vessel in my wrist, feeding it all the way through to the blood vessels that supply blood to the heart. I was watching this on the screen; it was quite amazing especially when it got to my heart and I could see it pulsating. After the procedure, they suggested that I needed to have a stent put in. A stent is a tube that is inserted into a blocked passageway such as an artery. “But we are going to consult with the surgeons,” they added forcefully. A few hours later the surgeons arrived. They explained that a stent would only last about five to seven years. They said that it looked as though I had damage to a few of the blood vessels that supply blood and oxygen to the heart and recommended a quadruple heart bypass. This would last at least 20 years, they said, plus I would feel a lot better and be back to what I felt like five years ago. I had never heard of a quadruple bypass before, only a triple. They explained that they could not do the procedure until all the blood thinners were out of my system, so I would need to wait eight days. So I asked if I could go home and come back eight days' time'. “No,” they said, firmly. “You will have to stay in, as your heart needs constant monitoring in case things get worse and you have another heart attack.” I then rang Rob and asked him if could look after Stanley for the next few days which fortunately he could do.

However, a couple of days later, Rob rang and explained that Stanley was very distressed and not happy at all. He was just sitting at the front door waiting to come in, not eating and hardly drinking. As you can imagine, knowing this made me terribly upset. All I could think about was Stanley and constantly worried. By the way, Stanley is the most important thing in my life, he was a naughty bugger when I got him. He's a rescue dog who had worked his way through three owners; but now the bond between us is unbelievable. He comes almost everywhere with me – we're inseparable. So, I had to see him. There wasn't a choice in the matter. I was thinking that if the nurses refused to let me see him, I would discharge myself, then re-admit myself. I wasn't worried about the operation or my condition, but Stanley was worrying the hell out of me.

The next morning, when the daily doctors' round came, I told them, “I have to see my baby boy,” explaining that Stanley, who is a ‘Sprocker' spaniel - a cross between a Springer and a Cocker - will be thinking that he had been abandoned again and asking himself why had I done this to him? This had happened three times already in his life. I told them that he was not eating, hardly drinking anything and is just “sat at my mate's front door waiting for me”.

As I said this, I started to break down and cry. Through my tears, I pointed out that I wasn't worried in the slightest about the operation as there is no point worrying about something I have no control over. The head nurse said, “I can see that this is really stressing you out.” Then to my utter surprise, she turned round to all the other staff on the ward round and asked “Are dogs allowed in here?” The reply was “I don't know”. She then turned back to me and said, “Yes, we can have him in, I am making a ‘command' decision about this.” As they left my bed bay, another nurse stuck his head round the corner and said (in a very camp way, I should point out) “Bring him in everyday, as long as I can see him”. This was a total surprise to me.

All I thought this meant was that I'd be taken down to the hospital entrance to see Stanley once. But it turned out that I'd got approval to have Stanley up in the ward! As you can imagine, I was straight on the phone to Rob to sort it out. He said “What, I can bring him up to the ward?”, I said “Yes”; he then asked “Are you sure?” “Yes!”, I repeated. He was as surprised as I was.

In preparation, the head nurse reserved the waiting room and even put a note on the door saying “Reserved. Please do not use. A guest is coming – Stanley - Woof! Woof! Woof!'. Later that day Rob arrived with him. As soon as Stan saw me he went crazy; I just broke down in emotion. You can see this from the video above. You'll notice that I am not talking much in it as I was so overwhelmed. It was probably the most emotional time of my life, that I can remember. This led me to the conclusion that he meant a lot more to me than I thought. When Stanley got back to Rob's later that day, he was back to eating, drinking and sat in their living room with Rob. Altogether he was a lot happier a chap. Each time he visited me over the next few days, he knew straight away where to find me. After his first visit he was nearly pulling Rob's arm off and leading the way, bonding along with excitement in anticipation of seeing me. All the staff loved him. When happy, he is also a very excitable chap. I still get emotional each time I read this bit.

The week before operation

During the week I was waiting for the operation I was feeling very tired, so much so that I dozed off most of the time. I only had an hour or so when I could concentrate enough to do anything on my laptop. During that week I was seeing patients coming and going; then finally someone was admitted into the ward who was younger than me; I was no longer the youngest patients in the ward being a mere 62. Some people were waiting for their operations and some were recovering post-op. There was quite a lot of banter on the ward with discussions about the operations. Apparently, the worst day was the third one after the operation and I would find out how true this was. Most people also say that the worst pain is in the leg where they have to remove a vein. Some patients waiting for elective surgery (so not emergencies) were having a very hard time. They would be admitted into the ward and stay overnight ready for their operation, then in the morning get told, “We are very sorry but an emergency case has just come in so we can't perform your operation. You will have to go home and will be informed at a later date of a new appointment for your op.” This must have been horrible. It made me realise just how much pressure the National Health Service is in. Finally, I received news for when my operation would be: afternoon on 12 March, still few days away.

What the operation involves

I'll step back for a moment to explain what a quadruple by-pass operation involves. Forgive me if some of the details are not quite right; it's from what I understood at the time. NHS coronary artery bypass graft for more info

Your heart is a basically a large muscle that pumps blood round your body. To do this it needs a blood supply which is carried to the hearts in blood vessels. My condition meant that they had become blocked, which causes the heart attack. A bypass is just like a road bypass round a town. The surgeons build a pipe that bypasses the blocked vessels. So, in my case I had all four blood vessels blocked, so I needed four bypasses (a quadruple).

In order to build the bypass, they needed to get some blood vessels from somewhere, so they harvest some from another part of your body, so not to cause any rejection issues which is a risk if the tissue is not from your own body. They planned to take one from my chest (internal mammary artery) and the other one would be the main vein which runs down a person's left leg (known as the saphenous vein)

As well as having these two veins taken out of my body with, the one in the leg from the ankle to the groin. Then using a get a circular saw, they and make an incision cut down the middle of your stomach to gain access to the heart.

Squeamish alert: so for those who love the Alien sci-fi horror films, it's a bit like in the first film when the creature busts out of actress Sigourney Weaver's chest. So then the surgeons actually stop your heart. They do the surgery business and, then wire you up to the mains for the electric shock to restart the heart again. Then they pull your sternum together using titanium wire and stick you back together. It took 10 people 6 hours to do the operation. What is most amazing thing is that if things go well, you can go home in five 5 days. (IF)!!

So the big day, the 12th, finally arrived. That morning, I had my legs, chest and pubic hair shaved ready for the operation later that day. I was wheeled up to the operating theatre. I noticed that most of the other patients looked very worried as soon as they came in. But the only time I became a bit nervous was when the nurses laid me on a slab outside the theatre, as they administered all the cables and began to anesthetise me by IV. I realised it was all about to happen. All I could think was that cobweb on the ceiling may be the last thing I ever see…

Part 2, Post op

Dave's tribute to his mum