"Thank you from the bottom of my refurbished heart"

This time it felt different!

I had been experiencing some difficulty with hills for a few months but as a fit and experienced runner for over thirty years I knew, of course, that I was immortal. Doctors and hospitals were for others and now in my 75th year, some breathlessness and vague chest pain when running, and lately walking, was par for the course surely.

Just pick routes avoiding hills - no need to worry wife and family.

But this time, at the top of a steep hill on a three mile walk the pain was different -more intense, prolonged and accompanied by weak and wobbly legs. That small voice in my brain that had been whispering 'caution' was now shouting, " It might just be your heart you old fool!"

Home again, I mentioned the episode to my wife who, after a good scolding, dispatched me to the GP who detected a 'murmur'  and referred me to a cardiologist.

So, in December 2018, accompanied by my 'support team, (wife and daughter), in case I attempted an escape, I found myself at the Cardio department at Dunfermline's Queen Margaret Hospital. After and ECG and Echo-cardiogram the cardiologist , in hushed tones, advised that I had severe aortic stenosis whereby the valve had become calcified and stiffened and was preventing an adequate aortic blood flow. Open heart surgery to replace the valve was required.

Me? Surely not! Could they not see that I was indestructible, en-route, fault-free for my century and the Royal Telegram? Perhaps they had the notes for someone else. Surely just a simple admin error about which we could all have a good chuckle and move on....

A glance at the 'support team' faces suggested otherwise as did the advice to stop work and to take it easy. I was to go home and await the call from Edinburgh Royal Infirmary and early in the new year we attended the Cardiothoracic  Department at E.R.I. for the first time. 

I was in the NHS circuit and there was, I now accepted, no escape.

However the surgeons and clinical nurses calmed my nerves with their obvious experience and expertise. I was offered a choice of replacement valves, (metal or Moo) and my options - surgery or cancel the Royal telegram. (A no brainer).

All our questions and concerns were dealt with patiently and fully and I came away that day, a little stunned, perhaps, with the realisation that this was to be major and complex surgery and a worry to my wife and family, but reassured by the high success and five year survival rates for AVR. 

With time and rehabilitation I just might be able to resume a 'normal' life. Chin up everyone - I would be back!

January saw a visit to my dentist to ensure that no nasties were lurking in my teeth and gums and then in early February I returned to E.R.I. for an angiogram. This time I was accompanied by our eldest son, another essential member of my 'support team'.

Once again the professionalism and kindness of all the staff was reassuring, as was the NAAfI trolly dispensing tea and biscuits! The angiogram via my wrist passed a dye into my coronary arteries, (my first hot flush), and showed that, for my age, my heart's plumbing was in reasonably good order and so would not require by-pass grafts. Welcome news.

In March, we were invited to attend E.R.I. for my pre-op assessment and after a difficult journey to the hospital and the almost impossible parking, our son-in-law, another valued member of the family team, delivered us safely at OP dept 3 where we joined a small group of other heart patients.

The afternoon was a whirlwind of group talks, tests and interrogations, controlled and conducted by a team of experienced nursing staff who dispatched us to various departments clutching our tick lists. Bloods, swabs and urine were taken, ECG, lung tests and x-rays were carried out and I was prodded and poked, all with good humour and explanations. Interestingly, I was allowed to use a stethoscope to hear my noisy valve, the sound I had, unwittingly, been hearing while laying quietly at home in bed!

Two and a half hours later, all test complete we stumbled out into the spring sunshine.

Barring negative test results or emergencies taking precedence we now awaited the summons to surgery.

The letter arrived - I was to present myself at ward 102, E.R.I in March.

My wife accompanied me and spent that afternoon watching me being tested, questioned and 'comprehensively' shaved. That evening, after a somewhat difficult and thoughtful farewell to wife, eldest son and daughter, I settled back in the ward and considered the day to come.

A visit from the anaesthetist with his offer of a pre-med pill or a wee 'dram', (no ice please), raised my spirits, (no pun intended) and the large glass of amber liquid helped me enjoy a decent, if intermittent, sleep.

My operation day started early with 6am tea and toast and after a final call to my wife, I donned my gown and awaited the arrival of the two kind and cheerful theatre staff who wheeled me along to the anaesthetic room. My last clear memory for a few days.

The surgery went well. As had been previously explained to me, my breast bone was bisected, (sharp saw), my chest opened, heart exposed and stopped, (first time in 75 years), and its blood pumping and oxygenating duties passed to the complex heart/lung machine. A new 25mm tissue valve was fitted, heart restarted, breast bone wired together and my chest sutured, Job done! All sounds very simple but we know that this complex and technical procedure relied on the vast experience and skill of the surgeons and the whole theatre team. (Good old NHS).

Memories of the post-op five days remain very patchy - the body's self protection?

I have no recall of ICU or HDU and only brief flashes of the first days on the recovery ward. I do remember, however, the gentleness and kindness of ward staff when it was time to remove catheter, canulars,  drains and pacing wires and their patience in helping me cope with showering etc.

On day five, having coped with the 'stairs test', later that day,  showered, washed, 'scrubbed up' and armed with a clutch of advice notes, I was discharged.

Back home, despite the good care administered by my 'support team', I was, in the early days, very surprised at how quickly I tired and how just moving around and coping with, (welcome), visitors left me exhausted. Taking a daily afternoon nap helped as did gentle walks with my family in the fresh air, and I slowly regained my strength although it took longer than I had anticipated.

Now, several weeks on from surgery, I have been assessed by E.R.I as 'fit for purpose', am able to walk up to six miles two or three times a week and have been adopted by the local Cardiac Rehab service.

From initial diagnosis through to my final discharge, I have remained in awe of the experience, expertise, professionalism and, above all, the consideration and kindness of all the NHS staff from consultant surgeon to ward auxiliary who have eased me through my 'cardiac journey'.  The NHS has many struggles and critics but when you really need its attention it is there for you, doing its very best and caring for you.

I salute and thank you all from the bottom of my, (refurbished), heart.