It seems this being off sick thing is getting to be rather busy!
Doctor's appointments, Consultant's appointments, blood tests, cardiac rehab, medicines reviews and still sorting out insurance from the car crash, it seems that any thought I had that i'd have plenty of time to keep the blog updated was misplaced but I finally got here.
So dear reader, last time I blogged I was still inmate of Milton Keynes Hospital, so what's been going on?
You will recall I had returned from the John Radcliffe Hospital having had my angioplasty but there were still concerns. In order to detect heart attacks they test for a protein in the blood called Troponin that put simply is an indicator of damage to the heart muscle. This was the blood test they did on the Wednesday evening to confirm I'd had the heart attack and produced a level of 2.9; a normal level being below 0.4.
What was causing concern on my return to MK on the Thursday night was the latest blood test showed a troponin level of 38.0!!!
ECGs were also still flagging concerns so I spent Thursday night into Friday morning on a cardiac monitor, having more blood tests, regular observations through the night, yet more ECGs and was visited by the duty SHO. She in turn got in touch with the Cardiologists at John Radcliffe for advice.
By morning my troponin level had dropped to 19.0, still stupidly high but going in the right direction, the message from the JR was along the lines of "of course his levels are sky high, we've been poking around in his heart" but by Friday daytime all was settling down nicely, I saw the consultant Cardiologist and in the afternoon went for an echocardiogram.
This showed no permanent damage to my heart although did show something called Hibernating Myocardium, damage that should hopefully recover in time. The next day I was deemed well enough to go home and signed off work for a month, which is where you find me now.
In this time I have had my not inconsiderable number of medications sorted out as there were concerns that one of my heart medicines, a Beta Blocker was counter indicated for myasthenia but upon seeing my Neurologist, she confirmed that in the "Top Trumps" of medical conditions, the Heart always trumps Myasthenia, so it was OK to go ahead and take it. So I was now on ten different medicines and that meant I was taking twenty seven tablets a day!
One bit of good news was my Neurologist also agreed to start reducing the amount of steroids I have to take month by month, so from the first December I was only on twenty five tablets a day!
However a bit of a blip last week had me back at hospital with chest pains after my blood pressure went sky high and so I'm back on my original medication (a calcium channel blocker) as well as my new one (an ACE Inhibitor) and it seems to be doing the trick. But yes that means I'm back to 11 different medications and 27 tablets a day!
I've also had an assessment for cardiac rehabilitation and they seem pleased although the combination of Ischaemic Heart Disease (to get all technical on you) and Myasthenia Gravis does seem to fascinate the medical profession and i'm seen as a bit of an "experiment" or rather the "I've never dealt with these two things together before so we're going to have to make it up as we go along" approach. The price of a rare condition I guess? Anyway the assessment went well, they are pleased with my progress and I'm back next month to meet an Exercise Specialist.
I finally got the van back from the repairers so that's all nice and shiny again!
I also got a decision from the DVLA and have had to surrender my driving licence for a "medical review licence" which does what it says on the tin... it lasts three years and is renewable after a medical review. This does seem to be the standard approach to anyone with Myasthenia if they don't actual suspend your licence so it's what I was expecting.
The only downside is I loose my "grandfather rights" to categories C1 and D1 (3,500kg to 7,500kg vehicles). That's because they are now considered Large Goods Vehicles (LGV), I'm a bit miffed about that as I do on occasion use that entitlement. I am allowed to reapply (without a test thankfully) but will have to provide both a Doctor's and an Ophthalmologist's report; no doubt at considerable cost!
On slightly better news SERV Blood Bikes have confirmed that their insurers have no problems with my new medical status, so I can continue riding with them when I'm up to it, although at the moment volunteering in one of the groups three 4x4s seems the more attractive option.
I did get out on the bike for the first time since my heart attack yesterday, only a short 20 mile run over to Brackley as SERV were doing a collection at Tescos there, so I popped over to offer my support. Only half an hour each way was no problem although I was very grateful for my heated jacket and hand grips.