After more than a month in hospital I came out on 10 March with some new experiences and an increased knowledge of one of our great institutions, the National Health Service. It gave me a better understanding and appreciation of just how great a service it is. Overhearing a nurse tell another that someone was waiting for a ‘cabbage’ aroused my curiosity. I had not heard of any such description before. When I was enlightened it turned out that I was waiting for a one too. ‘Cabbage’ is health-industry jargon for coronary artery bypass graft (CABG−the acronym lending itself to the colloquialism). It amused me to learn that a junior nurse had once actually written CABBAGE on a hospital form.
I have long suffered from high blood-pressure (some of it presumably the result of white coat hypertension) and had from time to time been getting pains in my chest since as long ago as 2003, especially when cycling up a steep hill, especially after an evening of higher-than-usual alcohol consumption. This led me to believe that my stomach was the culprit, further corroborated by the fact that burping alleviated the pain. A practice doctor arranged for me to have an ECG trace and a treadmill test. I could do these at either Solihull or Queen Elizabeth hospitals which are almost equidistant from where I live and I opted for Solihull. The ECG trace was fine and the doctor who oversaw it was of the same opinion as me − that it was some kind of acid reflux. Nevertheless, to be on the safe side, a treadmill test was arranged for just over a week later, on 6 February.
The day of the treadmill test was very cold and, as is in my nature, I was in a hurry to make the appointment on time − 10 a.m. Knowing that hospital car-parks are generally privately-owned with difficulty in finding a space determined me to find alternative-parking and I remembered a spot some ten minutes from the hospital, near a friend’s house. Parking was free for two hours which I thought would have been more than sufficient for this test. I had walked my dogs, both up and down hill, for half an hour without problem earlier in the morning but I had to cross by some dual-carriageway traffic lights on Lode Lane. Just as I started to cross they changed from green to red. My mistake was to run suddenly which gave me a localised pain down the sternum and this was still there when I got to the cardio-vascular department just in time for the test. After being wired up there was dissatisfaction with the trace and I was not allowed to go on the treadmill for a while. When permission was granted the walk only lasted two minutes before the team were dissatisfied again. A consultant, Mr Sadiki, was called. He informed me he had a bed for me there and then and his advice was for me to stay. Although I promised to return there was no way I could take up his kind offer. If I did the car was going to incur some enormous penalty and it was due at the service department of the dealer’s in the afternoon. More importantly, my wife was at work and the dogs had been left on their own. Against advice I left the hospital, had a cup of tea with my friend to calm myself, and drove home. Later that afternoon my wife drove me back to the hospital. I had to rejoin a queue and it would be midnight before a bed was eventually available. Mr Sadiki was still there at 10.00 p.m. and quite encouraged with my return, which he may have doubted. I now think his decision to commit me was life-saving.
The next day I had an angiogram, where a die is injected into the artery, in this case the femoral artery. I was shown a screen of just how narrow my arteries had become. An angiogram from 2003 had not even demonstrated any need for a stent but now three arteries were found to be extremely narrow, bottlenecking into the heart. During the angiogram I talked about all my physical activities and it turned out I was in conversation with a young competitive middle-distance runner, who told me she could no longer compete because her work interfered with her training-schedule. Something did not make sense. I asked her how it could be that someone like me, who had kept so fit, was a heart disease candidate – in the year 2000 I had cycled the North and South Islands of New Zealand and from Birmingham to the Azerbaijan border carrying a tent and computer, and in 2001 from Birmingham to Bucharest through England, Belgium, Holland, West Germany, East Germany, the Czech Republic, Poland, Slovakia, Hungary and Romania with just a tent. She suggested that because my heart was strong it had compensated for the narrowing of the arteries. The two options available to me, as I understood them, were to have stents inserted, little balloon like tubes which spring open when in place and widen the narrowed parts of the artery, or a coronary bypass graft. She advised the latter for the best long-term solution as did Mr Sadiki. Neither of these operations were performed at Solihull.