The Lone Arrhythmia

Well, that was fun, wasn’t it boys and girls?

First of all, let’s cop to this – I’ve been a complete hypocrite today.

Nono, I mean in addition to my usual hypocrisy. Thing is, I’m a socialist by inclination, and a liberal by nature, and I’m not remotely ashamed of either fact. I regard the National Health Service as one of the best ideas of the last hundred years, on a par with feminism and equality. The idea that no-one should die or suffer unduly for want of medical care or the money it takes to get it is, to me, a statement of political will for the benefit of everyone, something we barely recognise in this jaundiced, politically fuck-weary age.

I have a mother, though.

A Valleys mother, who is about as far from being a socialist as it’s possible to be while still recognising that UKIP is a party for Martians, and who, having worked for much of her adult life in the NHS, knows what’s what with its inner workings.

 After my recent double cardiac palaver, she called some people.

‘You’re seeing the cardiologist Wednesday,’ she said. ‘It’s all sorted. Shut up – you’re not waiting nine months.’

I pointed out that I was on the non-urgent waiting list, so clearly I didn’t need to see a cardiologist Wednesday, and that in any case, there’d be nothing he’d be able to tell me that we didn’t already know, because unless I presented with a chest cavity doing the rhumba, my heart seemed to function perfectly normally.

It was however forcibly impressed on me that I wasn’t so much going to see a cardiologist Wednesday for my peace of mind, as I was for hers.

You’d think that by the age of 43, I’d have worked a way around that one, but I haven’t – d can still do it to me too: by making me believe, however briefly, that the course she wants me to take is doing her a boon, she can make me take better care of myself:

‘You can’t possibly be warm enough.’

‘I’m fine, honey.’

‘Well here, take another blanket.’

‘I don’t need another blanket.’

‘You’re making me cold just looking at you. Take another blanket.’

‘Well, OK…’

Idiocy of the highest order, I know, but part of the desperate-to-please kernel of my character.

So anyway, I was going to see a cardiologist – privately (ptui!) – on Wednesday.

Today was Wednesday. I saw a cardiologist.

He was useful, in all fairness.

For the first time, I had an explanation from the horse’s mouth, as it were. Everything conceivable about my heart, it turns out, is just fine and dandy. Except I have a ‘lone’ Paroxysmal Atrial Fibrillation.

 ‘A lone one?’ I asked, trying not to smirk as the image of a heart with a mask on, riding a white horse into the distance took centre stage in my mind. ‘What does that mean?’

‘Means there’s no reason for it,’ he explained. ‘None at all as far as we can see. It’s just blech – a thing you have.’

‘Well,’ I said. ‘T’riffic. So what happens now?’

‘Well, you’re on the Betablockers. The arrhythmia is one of those things that grows more and more dominant over time, until eventually it’ll be permanent.’

‘And what the hell happens then?’

‘Oh then, it’s just normal. With the Betablockers, you probably won’t feel it.’

‘O…k,’ I said.

‘The real danger is a stroke,’ he explained. This had been mentioned to me before: it’s why I’m taking the Betablockers. ‘You know what a stroke is, yes?’

I thought I did, but it turned out I didn’t, really.

‘In your case, what’s happening is that instead of the atria of your heart doing this-’  He squeezed both hands in a downward motion. ‘-they’re doing this.’ I swear as d is my witness, he did jazz hands.

‘I have a jazz heart,’ I muttered under his continued explanation.

‘What that means is that the blood that should be going from the atria to the ventricles is kind of sitting about getting bored. D’you know what happens when blood sits about getting bored?’

Monopoly? I thought, but didn’t quite say. Pizza Hut? Finally cracking open Game of Thrones, Season One? I dismissed the thought – if my blood was that bored, I think I’d probably be dead.

‘It clots,’ he said. ‘Which means when our atria finally stop doing this-’ – Jazz hands again – ‘-the clots go down into the ventricles, and then when the ventricles pump, the clots go out into the body. Now, they can go anywhere,’ he said, and I thought I know they can, I’ve seen House, ‘but if they go to the brain – that’s a stroke.’

I blinked for a second. ‘And that’s why I’m taking the Betablockers, yes?’

‘No,’ he said, ‘you’re taking those to minimise the effect of the irregular rapid heartbeat.’

‘Right,’ I said, not following.

‘You need an anti-coagulant to stop the blood from clotting.’

I raised a hand. ‘Erm… I’m a klutz,’ I mentioned. ‘I bang into things pretty much all the time. I also have a close personal relationship with the floor. I fall over really more than you’d think was possible.’

‘I’d try to avoid doing that in future if I were you,’ he said, as though under the impression I had some say in the matter. He explained the joys of Warfarin to me, by the end of which, the best that could be said for the pain in the ass blood thinner was that it wouldn’t actively come and punch me in the balls when I wasn’t looking.

 ‘Or there’s this bright shiny new thing,’ he said, not in fact adding that I’ve taken a massive kickback from a pharma company to get you to be dependent on for the rest of your life. I swear I heard that in my heard though.  He explained it was virtually side effect free (if you didn’t count the potential to bleed out of every known orifice, and some places that are barely orifices, like my eyes), and that it didn’t carry the ass-pain burden of regular blood tests that Warfarin did, and that, best of all, I could continue to eat green vegetables on it.

‘Gee. Thanks,’ I may have actually muttered.

So as of tomorrow, my blood will be as thin as a politician’s promise. Should you punch me, I might fill up like a black pudding full of blood. Should you cut me, I will not only bleed over your ass, I will geyser like a Tarantino extra. I like to think of it as training to be Russian royalty (though I’m guessing that’ll be an allusion that’s lost on some of you?)

‘Plus,’ he added, enthusing like he was going after his bonus, ‘the really good thing about this new drug is that there’s far less likelihood of it causing a haemorrhage.’

‘A what-now?’

‘Well…’ he said. ‘It’s blood, you see. If it clots, you can get a stroke. If it’s too thin, you get the risk of haemorrhages.’

‘Brain…haemorrhages?’

 ‘Well, haemorrhages anywhere, really, but yes, brain haemorrhages tend to be game over. But you sort of have to decide what you’re more scared of, strokes or haemorrhages.’

‘Ah,’ I said.

‘But I can’t make the choice for you,’ he said, smiling and sitting back, knowing he’d made a sale.

Still, at least my impatient relative is happy. Disappearing-wise, have walked round the lake several times today (five, I think, though to be honest, the revolutions really do tend to blend into one) and have walked 8800 steps, amounting to 592 calories. Foodwise, have had a McDonalds porridge and an apple. Will be getting on the bike after dinner – oh yeah, Heart-Boy also confirmed the earlier GP assessment – all sorts of moderate exercise, good and groovy. Insanity – hell no!

‘Overexertion could trigger the fibrillation,’ he said.

‘But I’ve only ever once had an event after exertion,’ I explained. ‘The rest of the time it’s been walking into places. Walking through places. Sitting on a tube. Walking out of places. Bending slightly over.’

‘I know,’ he said, smiling enigmatically at me. ‘No real cause, but you might as well avoid the risk.’

‘But-’

‘Solo,’ he said, nodding. ‘On its own. Without cause.’ I swear he shrugged.

Normally, when you go to a specialist, you expect to understand your condition more thoroughly and draw comfort from it. And to give him his due, I feel I know more about the thing, and if anything it’s given me a sense of fatalism – there are risks of heart attack, risks of stroke, now, apparently, risks of brain haemorrhage, but essentially, the fibrillation will get more and more, and eventually, it’ll just be my own little bucking bronco, Hi Ho Silvering away inside my chest – but for the most part, I’ll neither know about it nor care. This is what we call a pathway.

Oh and finally, one little tip for any fellow socialists. Pay. But pay once – my next appointment with this consultant will now be on the NHS, but if I have any issues with the medication, I’ve got a named consultant, and can go and see him. It’s evil that we should have to do this kind of thing, but if you pay once, it sort of works to get you eventually the sort of treatment on the NHS that you should be able to get without paying at all.

Fight the power, comrades! Or, if you can't fight it, at least sidle up to it slyly and kick it in the shins.