ANGINA - Fun with my Echo-Cardiogram

I am NOT a medical person, so my blog entries are only from a ‘normal patient’s’ point of view . . .
This is about how Ultra-sound is used to see ‘real-time’ heart activity. Medics use it to check the ‘structure and movement’ of the patient’s heart muscle. [http://www.heartsite.com/html/echocardiogram.html & http://en.wikipedia.org/wiki/Echocardiography ].

I had one yesterday at Homerton Hospital [http://www.homerton.nhs.uk/ ]. You lie on a comfy bed for a half-hour while the cardiologist uses a probe (a small thing with a stethescope-type end) to look at the heart from outside the rib-cage; they take readings from various points on the patient’s chest and back, and it’s all stored on the hard-disk drive as a ‘film’. We had a great time, chatting about all sorts of things (heart ‘procedures’, education in our respective home countries, teenagers’ behaviour in various places we’d lived, etc, etc.). After what seemed like no time at all, he said ‘Sit up, it’s all done’. He showed me clips of the moving film; it looked like a pulsating bit of tissue, back and forth, back and forth, symmetrical valves opening and shutting in perfect syncopation. The Echo-CG doesn't just look at the outside of the heart, it gives pictures from half-way through, like a sliced-open view. How cool is that !!

The cardiologist explained that from his tests he could say that I had “ . . . come to the hospital in time.” One of the tests I’d had early-on was for a particular ‘protein marker’ in the blood, which if it had been there would have shown that I’d previously had a heart attack (http://www.dukenews.duke.edu/2001/11/troponin1101.html ). That protein wasn’t found, so they concluded that I’d not yet had a heart attack (heart attacks can damage the heart, which is a muscle and therefore can be damaged, just like any other). So I had no apparent tissue or nerve damage from that possible cause; the various valves and other bits were in good working order.

I am very confident now that I’ll be able to get on with my cardiac rehabilitation, which I started this week. Cadiac Rehab is exercise and diet and ‘lifestyle advice’, in my case at the local Sports centre [http://www.aquaterra.org/islington/Sobell/ ], and it’s paid for by the NHS. I’ll try and generate a new blog post on the rehab. It is hard work, but it is a lot of fun (something to do with the instructors).

Before & After ECG's

The top ECG shows my heart rhythm at rest the morning of the 'procedure' (operation, to you and I). Blood Pressure BEFORE was something like 130 over 90.




The bottom ECG shows my heart rhythm within an hour after the successful procedure. Blood Pressure was something like 120 over 73 after the procedure.

To put this in some type of perspective, before I went to hospital my blood pressure was something like 155 over 97. It meant that my heart was working a lot harder BEFORE, just to do the same job, pumping blood around. Lower blood pressure means a more relaxed heart. And, the big picture about blood pressure is at http://new-you.tv/portal/web/new-you/high_blood_pressure?gclid=CIrQmaagv5UCFQ6HMAodWjUSRg , courtesy of the nice people at British Heart Foundation.

ANGINA - My story

I didn't realise how ill I was, and it took ages for me to get around to seeing the doctor . . . I guess I didn't want to make a fuss. In retrospect this was very silly of me. But read on . . .

It all started about a year ago . . . in July the two of us went on a walking holiday in the Lake District, which involved trotting up and down hills across fields and meadows, and taking lots and lots of photos. We enjoyed ourselves, and went on to stop in Manchester and then Bridlington, always walking and seeing lots of scenic views. In September I bought a new pair of trainers (Asics, just the thing for joint support on hard surfaces, for an overweight runner) but I found that I could only run/ jog for 100 metres before I was out of breath, with tightness in the chest . . . this went on for a few weeks after which I stopped, thinking I was just too unfit and should try something easier. I was feeling depressed about this, but life being what it is, I got so busy doing college one day a week and working four days a week as a teacher that fitness slipped right down the agenda. What I didn't do AND SHOULD HAVE DONE THEN WAS TALK TO SOMEONE . . maybe even the doctor. So, fast-forward to May/ June, I’d been taking public transport to work and college, and I found I had to stop and rest when I walked to the Underground station, after 200 metres.
At this point I felt alarmed because I had never been so unfit before. I still didn't notice the increasingly fast progression from being able to do normal activities (swimming, cycling, running) slowly, to not even being able to walk from A to B.
In July I went to the GP, and things REALLY changed with the ONE HOUR time-slot he gave me. He asked the right questions, and he then worked out how serious my case was. I had an ECG at hospital; they said ‘Everything’s OK, but come back after your holiday’. So, when I got back from Cornwall I went to hospital, where they kept me in for a day to get ready for the ‘treadmill test’ (walking up an incline, faster and faster until you get chest pain). I didn’t last long (three minutes) but with that and lots of blood tests, readings of this that and the other six times a day over a week, they had all the information needed to say that I had ANGINA . . . and they could fix it, because I was on the Fast Track Cardiac Care programme [ http://www.heart.nhs.uk/Heart/Portals/0/presentations/step_up_the_pace/step_up_pace_programme.pdf ]. I went to the Heart Hospital at Harley Street [ http://www.uclh.nhs.uk/Our+hospitals/Heart+Hospital.htm ] on a Monday morning, had the procedure at 13.00 h and was back at the original hospital again by evening. I had an Angiogram [ keyhole surgery, a catheter put into top of leg and pushed up to heart along artery , see http://www.bhf.org.uk/living_with_heart_conditions/top_bhf_publications.aspx, the booklet download called Angina ] with three Angioplasty’s [ tiny steel mesh tubes, stuck in where the artery is clogged up, and these are enlarged to help the blood flow faster ]. You are conscious the whole time, and you can see the entire procedure (operation, to you and I) in ‘real-time’ on huge TV monitors overhead; it sounds weird, but works fine. I was sent home the next day, with three types of meds. The Cardiac Rehabilitation nurse had advised me there is an exercise and diet programme for recovering heart patients, and I am due to join it [ http://www.whittington.nhs.uk/default.asp?c=1677&t=1,3918,249,400 ].

NOW IT'S DIET AND EXERCISE, AND LOWER STRESS . . .

AND STILL HAVING FUN . . .

WOW . . . so far, two weeks after I returned home it’s a new lease on life, much better mobility, no more acute chest pains, no more stopping going up stairs.
That’s the story, and there is only one more comment to add. This made my hospital stay very enjoyable, and made me think again about the commitment of regular medical staff, as well as the specialist doctors and nurses I met.
Starting with the GP’s and the support staff at my usual doctor’s group practice office, and running through my stay for a week at the Homerton teaching hospital in the University College Hospital NHS group, and my ‘procedure’ at the Heart Hospital, I felt that my treatment and well-being was at the centre of everyone’s concern. Yes, there were another 34 patients in the Acute Care Unit, and they all had various treatments and procedures, but I felt the analysis and treatment given to me was the very best. I thanked all the doctors and nurses, and the lovely support staff as well. I’ve just rung the press office at the British Heart Foundation asking them about how my blog might be useful for others awaiting treatment for heart conditions; I’ll e-mail them my blog-link, in case they might want to add it to a ‘case study’.

Yes, if you want to find out more about heart complaints, go to www.bhf.org.uk. They’ve got lots of downloads on diet, conditions, treatments, exercise, smoking, and on and on. I have printed out the full-colour poster on ‘Foods to watch out for’, 'Foods to eat occasionally’, and ‘Healthiest choices’.
I’ve started my Cardiac Rehabilitation programme today, and hope to write a new blog about this. There’s likely to be yet another blog about how I’m losing weight [ BMI of 33 at present, calculated at http://www.nhlbisupport.com/bmi/ ] but I know I need to drop from 215 pounds to 163 pounds to get the CORRECT BMI of about 24.9. Your comments are indeed welcome. I am sorry there’s no pictures in this blog, but more later . . .

I love these shots . . . what d'ye think ??

These images are in the exhibition but haven't sold yet. The square one is a medium-format fllm negative shot of Spitalfields, London, June '08. The 'underbelly' shot is a DSLR shot of Heron Quays DLR station, and the reflection shot is colour transparency (Fuji Velvia 50), taken at Canada Water, Albion Channel. Both shots below taken on 06 September '07.

Hey, I actually have a photo order book . . .

These four sold today. The square one is a medium-format film negative shot of Finsbury Circus, City of London, June '08. The rest are shot with the Canon 350 DSLR, 24-105 mm lens. The biplanes were part of an air-show at Clacton, Essex last August, the boat is beached in St Osyth, near Clacton, last August, and the weird clouds are at 1/3100 second from a high-speed train zooming in the Midlands last July. They were all sold as surface-mounted images.

Open Gardens on 20th & 27th July . . .

It's really the flowers and the lively juxtaposition of the hundreds of plants in a typically suburban garden which attracts people. My good friend Don opens his garden to the public every summer, as part of the big 'Open Garden' scheme nationwide. There is, as well, the jacuzzi, the teas, the cakes, the plants for sale . . .

I go there every year, and enjoy myself immensely . . . there are several other private gardens nearby [ see www.ngs.org.uk ].

It is very easy to get to, via the Victoria line, or via Overground Rail. There's also lots of buses. The weather is set fair for Sunday the 20th, and . . .

Emirates Stadium panorama

Photoshopping is pretty cool, once you get the hang of it.

I went out to shoot local landmarks one summer's evening, and this was the most spectacular of the panorama's I shot. This is comprised of nine horizontally-overlapping shots taken with the Canon 350, using the 24-105 EP lens at 24 mm focal length; it was ISO 100, hand-held, autofocus and all images shot RAW. I chose one of the longest days of the year (18 Jun '07), and these shots were taken at about 20.30 h, facing away from the sunset. The final 'psd' file is 216 Mb, and was shrunk down to 72 x 20 cm for printing at about three feet long, at 240 dpi.
Obviously the image is of a sporting venue. I spend time there doing First Aid (for the 60,000 punters) on all the home matches - about thirty matches per season. This image has been printed four times now, twice for a local restaurant, once for the greengrocer (a life-long Arsenal fan) and now once more for a young lad who is soccer-mad (I've told him to sign up to be a steward - that way he gets paid to see the matches).
i am very pleased indeed with this image, and am doubly-pleased as it has been mastered in Photoshop, which can be notoriously difficult to use 'correctly'. For example, trying to get a precise 'overlap' when printing the same image onto two pages is awkward, until logic takes over.
Any comments are much appreciated. I shot this a year ago, but it is still good enough to be one of my best, out of the 600 panoramae I've created using digital media.

Riri's funeral was on Thursday 12th June . . .

Before the Funeral there was a Lying-in at the undertakers. Then there was a Wake at Riri's family home, and finally the Funeral shortly after. Many many visitors came to pay their respects and to talk to the family. They also signed the Condolence book, and wrote their messages about Riri and the events they had shared together.






Riri's uncle Martin playing the trumpet at the graveside in New Southgate cemetery, here in north London.











Riri's mom Monique wrote a few lines about him, which she has allowed me to add here.
Riri means someone extraordinary special,
a bright spark.
Riri liked fun and art, but
Riri decided he had enough.
He saw no way out of this mess.
He looked for jobs here.
He looked for jobs there.
But no one discovered his worth.
Riri felt let down by society.
His brothers went to University.
He saw his chances of a good life disappear.
So one fine day, on the 27th of May,
He leaped to his end in this world.
Riri, Rest in Peace,
Forever.



Riri's burial, lots of floral tributes and with Dan, Riri's dad, and a couple of Riri's close friends.

The service attracted far too many people to fit into the chapel. We all went on to attend a reception at the West Indian Cultural centre in Harringey, after the funeral and internment. There's more to say about Riri Wa Thea, but that's all I want to put here.
I am much older than Riri was (age 24) and it will take me a long time to understand why a young healthy man or woman would want to take their own life deliberately. Everyone who knew him loved him. And loves him still.

S U I C I D E . . .

ALL HANDS AT WORK
ON A BOAT,
MOZAMBIQUE

A friend's son (in his twenties) killed himself last week.

It seems to have not yet sunk in fully, that Riri's gone. We've dropped around a couple of times, and we end up chatting. sometimes it's about the family and the boy who's gone, sometimes it's about all the usual gossip.
We've had a few hugs, and everyone is talking. We're all terrifically polite, everyone listens to everyone else. The funeral will be next week. I can see how easily a person can slip from being angry and not communicating clearly, to self-harm, and then going further.

I found a web-site
http://www.be-foundation.org/index.asp
which seems to be addressing young people. Are they more at risk than us older persons ?? Maybe so . . .
another [ statistical ] link is
http://www.cmaj.ca/cgi/content/full/178/3/282

W H A T __ D O__Y O U__T H I N K __?__?__?

Van stolen after 19 years . . .

The van has gone. Someone drove it away while I was away for a few days. No-one saw anything. No-one heard anything. All my neighbours are amazed that anyone would want a small red van which was so old. But, it's gone.
I've got a crime report number, the insurance company isn't interested (the claim would be for less than the excess on my third-party policy) and the police will only recover my van if I agree to pay £ 105 plus storage. [ see http://www.timesonline.co.uk/tol/news/uk/crime/article1654994.ece ]
We were actually saving up for a replacement, but we're both back on the bicycles again . . . good for the old waistline . . .