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One in 1,000

Sonocardiogram machine.

One in one thousand.

That’s how many people die during an angiogram, according to the warning on the consent form I had to sign. This is a rather distracting thing to learn just a few moments before you undergo the procedure.

How dangerous exactly is one chance of death in a thousand? Well, it’s more than 160 times safer than Russian roulette. That sounds… good. On the other hand if one breakfast in a thousand was lethal, you’d be dead within three years. So breakfast needs to be way, way safer than that.

These are the thoughts that pass through your mind as you lie on a narrow operating table, while someone makes a hole in your wrist and slowly threads a fine tube up an artery in your arm all the way to your heart.

Now that’s quite a novel sensation. If I had to describe it in one word, the one I’d choose would be… wrong. Not painful as such, just… wrong. That is not a place where you should ever feel something moving. It was a challenge to stay calm. And yet you had no choice. If my breathing became more anxious and deep, it moved my heart too much. So I had to maintain even, shallow breaths while undergoing one of the weirdest sensations – and weirdest situations – of my life. They were injecting X-ray dye directly into my heart.

And that’s where it got really interesting.

“Of your three coronary arteries,” said the cardiologist, “two are fine. The third however is almost completely blocked, so we’re just going to pop a stent in there.”

Well, that’s quite a bit to take in at once. For a start I turn out to have heart disease, when I was still steadfast in the belief that I was having this (one chance of death in every thousand) procedure just to rule the possibility out. I was almost sure it’d turn out to be a duodenal ulcer or something. But it’s much easier to fool yourself than it is to fool medical scanning devices.

But the real headshot – they were putting a stent in now? Well I suppose it makes sense. I mean, as they’re literally here inside my heart already. Doing it again would raise the risk of death to one in 500, which clearly does not have enough zeroes after it. But… right now?

I know, when I was signing the consent form they did say something like “… and if we find a blockage we can insert a stent”. But I’m sure I didn’t hear the words “while we’re at it”. Unconsciously I’d expected some kind of consultation, with nice diagrams and maybe even counselling, before taking such a big step as having metal scaffolding inserted in my heart.

And maybe it was like that, twenty years or so ago when stents were new technology. But now they seem to be taken for granted. Hell they’re made in a factory down the road, by people I know personally. It’s all quite normal now, my head says. But my heart…

My heart was straightway overruled. It was a little painful – actually it felt exactly like one of the attacks of angina I had so easily dismissed as indigestion – but I am a cyborg now. Well, a slightly cyborg.

I’m writing this while recovering in the cardio-pulmonary ward. It’s all been very fast and a little unreal, but apparently I got here in the nick of time. If the doctor hadn’t sent me in just as soon as I described the symptoms, and if they hadn’t processed me through the system about as quickly as possible – just over 24 hours is not so shabby for heart surgery – I would almost certainly have had a heart attack. And probably sooner rather than later; that artery was 95% blocked.

But even the disease was sudden. The pain had only become a regular occurrence in the last two weeks, which is why I had put it down to gastric trouble induced by festival worries. Can heart disease really strike so fast, or were there earlier warning signs I’d missed, months or even years before? Things like the unexpected shortnesses of breath, sharp headaches after exertion, even the temporary memory loss I had two years ago?

I wonder how many of the various illnesses I’ve had in recent years were ultimately due to a heart under pressure. And in what ways I will now feel more well, thanks to a bit of metal in my chest. I look forward to finding out.

2 replies on “One in 1,000”

Secrets of the heart. We swallow hard against them every day, forcing them deep inside us. There they sit, growing heavier, festering. Given enough time, they cannot help but crush the heart that holds them. Patrick Rothfuss ,
Good Luck with your recovery Richard

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