Intermission
intermission ( noun )
- a pause or a break
- a period during which action temporarily ceases
- an interval between the parts of an entertainment event (such as the acts of a play)
If you have been following my Blog you will know that I have not posted an update since mid-May. This lack of an update was due to a lack of riding, brought on by a need to stay close to my home due to a family situation.
This first Intermission has not been a major impact on my GLMC Grand Tour as the June / July / August period is Winter here in Oz, and is a time to sit at home, staying warm and watching the mighty Sea Eagles play football on cable TV.
However, a second "Intermission" has developed and this was completely unexpected and may have a significant impact on my Grand Tour.
In mid-June, I visited my usual doctor, known here in Oz as a General Practitioner (GP), for my annual medical check-up and routine blood tests.
My GP, who has managed my health profile for some years and who I trust, requested the required blood pathology screening, which all up was about 48 individual test results.
As an aside, here in Oz, we have universal medical coverage for all Australian citizens and all these tests were paid for by our Federal government.
After the test results were received, I had a review with my GP, who was pleased with the results as all 48 were, more or less, within the "normal" limits.
What I would call a "clean bill of health".
However, for some years now my GP has been suggesting that I should consider using blood pressure medication, because although my blood pressure was within acceptable limits, it was elevated.
The trouble is once you start using blood pressure medication you are on it indefinitely and this was something I wanted to avoid.
Previously, after much discussion, I had been able to gain my GP's agreement to "monitor" this aspect of my health while it was within an acceptable range.
This year was different as my blood pressure had jumped up another 10 points and was now over the magic 140 clip level.
My GP stated, in a polite but no uncertain way, that "monitoring" was now no longer a option, and I was prescribed blood pressure medication and asked to have a review with a cardiologist.
There was no great rush for this cardiac review as I had a "clean bill of health", so I arranged for it to be done in late July.
Fast forward to Thursday last week, and I presented myself at the cardiology clinic, where an ECG was performed before the meeting with the cardiologist.
This is when things started to go downhill.
- "Good morning," said the cardiologist
- "Good morning," said I
- "When did you have the heart attack? " said the cardiologist
- "What heart attack ? ” said I.
The cardiologist was not convinced and immediately scheduled an ultra-sound and a physical stress test. Immediate as in within the next 30 minutes.
The radiographer informed me that we would do the ultra-sound first, then the stress test, and proceeded to cover my chest in some funky KY jelly substance before taking sound images of my heart.
It was then that the radiographer started making comments like "hmmm . . ." and "ohhhh …. " combined with the occasional shaking of his head.
I don't have a medical degree but I do know that these are not good signs when you are undergoing a medical examination.
"Wait here, I'll go and get the cardiologist," says the radiographer. I am not sure why he thought I was going to jump up off the bed and run out of the building.
In due course, the cardiologist and radiographer reviewed my ultra-sound images together and both were now saying "hmmm… and ohhhh. . …. ".
About now, things really turned to k-rap as I was informed that they had decided to skip the stress test altogether and that I should just wipe off all the funky KY jelly and meet with the cardiologist again.
I guess I probably had that "deer in the head-lights" look as I realised that the light at the end of the tunnel was in fact, a freight train headed straight at me.
As luck would have it, my cardiologist is the Director of Cardiology at a large teaching hospital here in Sydney. A doctor with a pleasant personality, who is easy to converse with, and most importantly, knows what she is talking about when it comes to cardiology.
The cardiologist explained that it would seem that I had experienced a "silent heart attack".
A silent heart attack has few, if any, symptoms and people who have had one might think they've had heartburn, the flu or a strained chest muscle, or have no symptoms at all.
They either die on the spot or just continue on blissfully unaware of what had happened. Fortunately, I fell into the second group.
But a silent heart attack, like any heart attack, involves blockage of blood flow to the heart and damage to the heart muscle.
The cardiologist went on to say that the likely cause would be one or more blocked arteries supplying blood and oxygen to the heart and these needed to be addressed "now", as in "right now".
At this point, I realised that they had probably cancelled the stress test as they were concerned I would have another heart attack while being tested.
The cardiologist made a couple of quick phone calls and before you can say "Holy Molly, Batman", I was scheduled for a coronary angiogram with possible multiple stent insertion and/or multiple coronary artery bypass grafts at 11:00 the next morning.
Within 2 hours, I had gone from having a "clean bill of health" to being told I may be having open-heart surgery within the next 24 hours.
In due course, I presented myself at the Hospital at 09:00 the next morning and by 11:00 am was laying on the operating table taking deep breaths in and out as my cardiologist examined my heart's arteries from the inside of my chest cavity.
The only "pleasant" thing about this situation is that I was asked what music I would like to listen to while I was in the operating theatre, and as a member of the Flower Child generation, I chose Jim Morrison and The Doors.
I mean, if things went pear-shaped, I may as well "check out" to the sounds of one of the greatest bands of my generation.
My favourite Doors songs are The Alabama Whiskey Bar and Crystal Ship, although Riders on the Storm and LA Woman are equal as good.
Looking back now, in some ways it was surreal for me to be lying there chilling out to the sounds of Jim Morrison, while a team of highly-trained medicos were trying save my life.
After what seemed like "forever", but which was less than 20 minutes, the cardiologist informed me that there were no blockages in any of my major arteries, that no stents or grafts would be needed, that she had finished and I could go home in a few hours.
Now this may seem like a good result, but in reality, it is the reverse because now we don't know what originally caused my silent heart attack.
A blocked artery would have been a "smoking gun", but without a definitive reason, we are not sure what steps to take to prevent a re-occurrence.
The likely cause is now considered to be diabetes, although all my blood tests suggest that I am not diabetic, so I can see more blood tests on my horizon.
There will be no need for further surgical intervention, but daily medicines are now a fact of life for me. Did I mention my reluctance to take medication on an ongoing basis ??
I will have a follow-up review with my cardiologist in 3 weeks when my life's new "road map" will be laid out.
I don't yet know how long this second Intermission will last, but in the meantime, I have been told to just "enjoy life".
I wonder if that includes motorcycling ??
UPDATE 17 AUG 2023
Following on from my favourable angiogram at the end of July, where no evidence of blocked arteries was found, Type 2 Diabetes was considered as the next likely candidate for the cause of my heart muscle damage.
So, my GP scheduled a Glucose Tolerance (GTT) blood test, and a Haemoglobin A1C (HbA1c) blood test.
The GTT identifies abnormalities in the way your body handles glucose (sugar) after a meal, while the HbA1c test gives an indication of how much glucose (sugar) there has been in your blood over the past 3 months months.
Both tests came back as "elevated" but just within the "normal" range, so I don't have Type 2 Diabetes. My GP explained that my "elevated" results are likely due to being a Baby Boomer ( old age ).
Now that we have more or less eliminated the top 2 candidates, the next candidate on the "baddies list" was a viral infection of my heart muscle.
This situation is not very common, but it does happen, and the only sign of viral heart infection may be flu-like symptoms for some people, while most of the time there will be no symptoms at all.
I'd say "bingo, we have a winner" as that description fits my circumstances perfectly.
Unfortunately, there does not seem to be any definitive tests to prove that there has been a viral infection, short of performing an autopsy.
Usually, the body will just heal itself and you may never know you had a problem. However, sometimes there is residual damage to the heart muscle that may or may not improve over time.
This morning I met with my cardiologist, and we went over all the test results, and another ECG was performed, and the conclusion was . . . . . insert extended drum roll here . . . .
" take these 2 tablets twice a day, try not to fall off your motorbike, and I'll see you again in 12 months time ".
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