Much ado about nothing

 Michael - Thursday

I have a friend who says you should never go to see a doctor – they always find something wrong. She’s a medical practitioner herself and has spent more time seeing doctors than she’d choose to, so maybe she has a point.

The first chapter of my story starts with a visit to my new GP to have a couple of skin issues dealt with and a prescription renewed. Since he’s a thoughtful and careful doctor, he asked me about my general health. I mentioned that my heart occasionally went into what I’d been told was an ectopic rhythm—a sort of double beat—that only I had noticed despite a plethora of ECGs and even a visit to a cardiologist some years ago. It seems to occur after too much wine (which does happen from time to time but I don’t consult doctors at that point). Although they never said so, the doctors probably suspected that the problem was more in my head than in my heart.

Normal ECG
Mine was different...I guess...

Nevertheless, my GP whipped out his stethoscope, listened for a few moments, and then muttered that he did hear something unusual. A resting ECG was called for. He considered the printout seriously for rather more moments and then pronounced that I was in atrial fibrillation, atrial fib to its friends. In atrial fib the upper chambers of the heart do their own thing without reference to the beats of the ventricles, the lower chambers responsible for the real pumping work. That didn’t strike me as a good idea at all, but he explained that this condition was not uncommon and that if one was going to have a heart complaint, this was the one to have. That struck me as a little like saying that if you're going to be poisoned such and such a substance is the best to use. His recommendation was that (a) I should immediately start on blood thinners because atrial fib can cause blood clots and thus strokes, and (b) that I should see a cardiologist as soon as he could obtain an appointment for me.

In the next chapter, I visit one of the top cardiologists in this area who practices at a cardiac unit in a town called Mossel Bay about an hour and a half drive along the coast from Knysna. (That’s regarded as a ridiculous amount of time to travel in this part of the world although taking that sort of time to reach a hospital in the same city wouldn’t be unheard of in many large cities.) The cardiologist did a suite of ECGs and ultrasounds and followed that by pronouncing the good news and the bad news. The good news was that I was no longer in atrial fib implying that it was episodic and could probably be controlled by drugs. This avoided needing a procedure like cardiac shock treatment. I was glad of that. However, the bad news was that the stress ECG had revealed an abnormality in the ventricle beats at high heart rates. This could indicate coronary artery disease. He prescribed an angiogram which could be used to obtain a complete picture of the arterial blood flow around the heart and to insert stents to open the blood vessels if needed. And if stents were inadequate, they would have all the data they’d need for the bypass operation.

I thought about my friend’s comment. I’d visited my GP to sort out a few small lesions on my face and the way things were going I was going to end up with a heart transplant. Seeing my lack of enthusiasm, the cardiologist was at pains to point out that the procedure was quite standard nowadays and very seldom led to serious problems such as a heart attack on the table. For some reason this didn’t increase my enthusiasm one iota.

Normal coronary arteries
Mine did look like this...I guess...

I have only good things to say about the hospital, the nurses, and all the staff who were efficient, responsive, and considerate. Even the food was good. And I didn’t have a heart attack on the table. I was awake for the whole process and actually managed to whip up some interest in the processing issues involved in the amazing images of the vessels around my heart that I was seeing in almost real time. Best of all, my arteries were all in good shape. I left the hospital the next day with a huge sigh of relief.

In the final chapter, we jump five days from the angiogram to last Saturday when I start developing a sore throat, stuffy nose, and headaches. Let’s face it. Hospitals are not great places to be in the middle of a covid wave, let alone our latest omicron-driven one. Hospitals are full of sick people. That’s why they go to hospitals in the first place. Despite the efficiency and care I mentioned earlier—to say nothing of the patients having covid tests before admission—one is exposed to doctors and nurses who work with patients, including covid patients. They are taking that risk every day.  

By Monday I was no better and coughing a bit. I was also—to use Caro’s wonderful word—quanked. I was supposed to visit Stan at his place in Cape Town and have Christmas lunch with him and two other friends. That was no longer a possibility unless I was cleared by a covid test, and I was pretty sure what the outcome of that would be. In fact, by that stage, I wasn’t too concerned about the outcome. I wasn’t desperately ill, I wasn’t getting worse, my oxygen level was fine, and I’m fully vaccinated. There’s even some belief that omicron is a great covid immunity “booster” in its own right, and while new covid cases in South Africa have rocketed, hospitalizations and deaths have hardly increased.

So I tried to get a test. It turned out that because of the pressure on testing, I needed to be referred by a GP. My new GP was away. My previous GP had recently died. I began to wonder if they only tested people who were not likely to have covid i.e. those wanting to travel overseas or being admitted to hospitals. What does that do to the statistics?

It took me two days before a friend’s GP kindly gave me a phone consultation and signed off on the form. His comment was that omicron was so contagious, and so mild in practice (if you were vaccinated), that I really shouldn’t bother about whether I had it or not. Everyone would get it sooner or later anyway and almost all of them would be fine. Nevertheless, I had the test.

It was negative.

Happy Holidays everyone!