Angioplasty – the sequel

So, I hadn’t actually envisaged a rematch with the redoubtable vascular team at Aberdeen Royal Infirmary, but time and tide have their effects on the frail human system, and it became clear that I needed more work done. This was evident some while back but our very own pandemic intervened in quite unexpected ways.

(See the prequel here)

On my eventual return on 23 Feb 22, I found a much changed environment. The short stay ward had only recently been able to be reopened – I know huge amounts of reorganisation had to be made throughout the NHS to accommodate the fluctuating and devastating demands of this contagion, separating out staffing, infrastructure and resources to Covid and non Covid areas. This had resulted in a big backlog of non-urgent procedures, as well as a serious loss of staff through illness, isolation, death, retirement or change of career, there were no familiar faces.

To my surprise I was instated as the sole patient in the ward, with two nurses staffing it. Sounds like a schoolboy’s dream, but it had just the same level of reality to it. Other incoming would-be patients had also been thinned out by the same factors as the staff, and for many it is a long haul to get into Aberdeen from some remote areas. Shortly after arrival, I was dozing contentedly when it became necessary to consolidate resources, I found myself moved to a section of the next door women’s short stay ward, re-deploying the nurses where they were more needed, obviously a sensible course of action, but a slightly unsettled night ensued for me, partly because there seems to be more interaction on a female ward than on the taciturn male counterpart. However, the bedtime tea, toast butter and jam on offer is still a delightful high point of anyone’s stay in ARI.

Next morning at 10 I was wheeled away (background trumpet sounds of cavalry arriving !), to more specialised scrutiny and attention in the vascular surgery theatre. I was pleased and reassured that the same routines were in place – checking and rechecking of IDs, introduction of theatre staff and their roles, and a run through of what each participant was to expect. I hope I played my part well, with a bit of my gallows humour, popular in critical situations. There is more than one way to skin a cat (me), and we were to try out the obvious route of entering the left femoral artery spaghetti junction via the left groin. Previously I’d had entry though the right side, across the torso and then down the left leg. After maybe half an hour of prep and stymied attempts, it became apparent that the angle of entry was dangerously acute, so our losses were acknowledged, bleeding stemmed and mopped up, then a fresh attempt was made on the up and over route, which proved to be the key.

The technology monitoring progress was easily of astronaut calibre, keenly observed by the interventionist radiographer, with similar jaw dropping skills, who explained and described for would-be vascular surgeons and myself, the obstructions rapidly identified and cleared – a bit like Google maps, I thought ! (Turn left in 3 centimetres . .) What then followed was progress below the knee – which was previously deemed too labyrinthine – to discover a tangle of calcified arteries where they split into three different routes, surrounded by veins of returning flow. This was the heart of my problematic ulcer on the left calf. Tiny balloons expanded the arterial vessels and as fresh volumes of blood coursed southward, the ulcerated area stung like mad, just like your finger ends when you come in to the warmth from a really cold day. Because arteries have muscular tissue around them, we compared it to knocking out a dent in a car’s wing ! The whole op took around three hours, and declared successful, so champagne was quaffed metaphorically all round. As if !

On return to the ward, I had to lay flat and still for a further 4 hours giving me time to reflect on many things. Not least was the overlooked fact that many of the nursing staff were now from the Philippines, Mauritius, India, Southeast Asia and elsewhere that had taken the place of many of the former more local staff, for the reasons stated above. We had gone through two and a half years of disruptive pandemic, during which all these people had found their way into work, too often on double shifts and ministered to those in need with good humour, attention and care, no matter their own personal and domestic tribulations, strictures and losses.

In my own little way I would like to offer my sincere thanks and admiration to them, even though a few little delays had made me feel quite nippy at times from some pain, and nicotine withdrawal. These people are literally the lifeblood of our NHS, and further, of our country’s most successful social health service in the eyes of the world.

I reflected too, that for too many people in the world this type of life changing medical attention would be ruinously expensive, maybe $30K or simply not available at any price. And, please, don’t bitch about the food, its pretty good, even when you’re not that hungry !

#GrampianNHS

#vascular@ARI

#nhs.scot

#ward301ARI