Thursday, November 09, 2006

Wherever you go in the world...

there are universal constants, undeniable truths that will never change.

The sun sets in the West.

Beer gets you drunk.

Quantity Surveyors are boring.

And, most pertinent of all...

Hospital food is crap.

Anyway, it rained the other day. I missed it, because I didn't wake up in my private room in the hospitel (hospital/hotel) until it was gone. I opened the blinds to see strange marks on the car park tarmac which seemed to suggest that precipitation had occurred. The sky was white, misty and almost chilly-looking. The WIFE confirmed that, Yes indeed, it had rained that morning and it was that "really fine stuff".

Oh, yeah. I was in the hospitel because last Sunday, the day after my last posting, the day I was meant to fly to Doha, I had another episode of the dreaded Atrial Fibrillation. I thought about sitting it out and letting it go back in its own time, but since I was unsure of why it had happened this time (there's usually a definite trigger), I went to the local health centre. The doctor there was very nice and reassuring. He did an ECG on me, and told me what I already knew - I was in AF. Between us we half decided that my new diet might well have been the trigger this time. I'd been on a form of the Paleo diet since the 1st November, which was 4 days ago. Something didn't ring completely true to me, though. I was feeling quite good in myself up till Sunday night. I had got over the initial slight dizziness and my appetite was adjusting. More importantly, my ectopic beats (skipped beats that can be a precursor to AF) had reduced by a significant amount. What else could it have been, though: the ginger and lemon tea the night before, or the large diet pepsi consumed at lunchtime the day before, maybe even the handful of walnuts eaten as an evening snack? I was confused.

The doctor decided to send me to see a cardiologist at a new hospital in the Bur Dubai area, near Port Rashid. We got directions and more reassurance, and with the WIFE driving, we headed along the SZR towards the hospital. We landed and I booked into the ER. Another ECG was performed, then I was transferred up to a small white, functional room in the Intensive Care/Cardio Care Unit. That may sound alarming, but they have the best equipment for dealing with matters of the heart. Well, maybe not broken ones, and we all know that Padme Skywalker died because of a broken heart.

I digress. I told the WIFE to go home with the GIRL because the BOY needed to be picked up from school. She knows the drill by now, and so do I. I was soon covered in wires and needles were stuck in various places on my hands and arms. I ended up with 2 IV drips this time, one in each hand. They tried a drug on me, but it only slowed the fast rate down, so they ended up putting me under for a few minutes and zapping me with the defibrillator. I've had it before, and it invariably works. The best bit is being gradually more drugged up with various legal substances, which make you feel like you've had a bottle of wine in 30 seconds, then the oxygen mask descends and they add the real knock-out stuff. It was ever so slightly disconcerting to hear the nurse ask the anaesthetist if it was 50 millilitres, and the anaesthetist replying in a loud panicky voice that, No, it should be 15 millilitres, but before I knew it I was having a strange dream about being inside a computer or something, and then I was awake and back into blessed Normal Sinus Rhythm. It's hard to describe the feeling. It's one of utter relief, after being in AF and on edge for several hours. It's as if a huge, not agonising but naggingly painful splinter has been removed from your bum. Lying there with AF is pretty crappy. People can tell me it isn't life-threatening in itself, etc., but when your heart is doing a dance like a drunk uncle doing the birdy-song in your chest, it isn't nice. I always end up praying to God, and making deals with him about how I'll be good from now on, even though I'm a sworn agnostic with a leaning towards (without the utter certainty of) atheism.

I thanked the man who put me to sleep, who was a genial Libyan chap with an impossible name who had lived and worked in various UK locations for a good deal of his career. He melted back into the hospital hubbub as quickly as he had arrived, and I was left wondering what time I would be let out. Wishful thinking is what they call that. The cardiologist came and spoke to me and told me he wanted to keep me in ICU overnight, then transfer me down to ward for observation tomorrow. Blimey. In the UK, I've been pretty much sent home 2 hours after going back to NSR. The last serious obs and tests had been over 2 years ago when the AF had resurfaced. Not this time, though. This doctor wanted to watch me and prod me and poke me, so who was I to argue. The only worry for me was the insurance. Would they cover it? Would I have to pay it and reclaim it? I rang the WIFE and told her the good news. She was also surprised that I was staying overnight.

So I spent that night in that small white room. No TV. Nothing to read. I did get some food, nd it was pretty good, but then all food tastes great when you've not been allowed to eat for hours. I didn't get much sleep. The automatic blood pressure monitor inflated every hour through the night and then the nurses came to take more blood every 6 hours, and with all those wires and tubes, I defy anyone to sleep well under those conditions. In fact, they should use it at Guantanamo Bay as a new form of torture. OK. Maybe not. Anyway, I was ready for some more of that magic bottle of wine in a syringe from The Affable Sandman of Tripoli.

The next morning I rang work and the WIFE and the BOSS and told them the score. I was going down to the ward and was likely to spend at least another night there. Finally they released me from the drips and monitor wires and I performed a very unsteady stand up routine that wasn't funny at all, and managed to walk around for a bit. They wheel-chaired me down to the ward, and I was in for a bit of a surprise. Being used to the good ole' NHS, I expected a large ward full of old men in ill-fitting pyjamas surrounded by bored relatives. But of course, all healthcare is private here, and I got my own private hotel-style room, with a separate lounge and 2 TVs and a wardrobe empty fridge. A minibar might have been too much to expect, in hindsight.

So I ate increasingly poor food and drank water and watched The Golden Girls on TV. The family came and went, soon getting bored of seeing Daddy in a open-backed dress. The vital sign checks and blood pressure tests carried on at 4-hourly intervals, but just before bedtime (Ha! You're always in a bed in hospital) they noticed my BP was up a bit. They took it again to check about half an hour later and it was down a bit. The next morning, as I waited for the doc to come and tell me to go home, they took my BP again, and again it was high. They started getting a bit more urgent about it, getting doctors involved, and another 2 checks later, they were asking me about hypertension and family medical history and all kinds of things. Hmm. Me - Hypertensive? Don't be so bloody stupid!

I was given a really nasty dissolving tablet to stick under my tongue and promptly wheeled down to the Cardio Outpatient clinic where they performed an ultrasound scan of my ticker. After 10 minutes of prodding with a gelled-up device, the doctor told me that I was definitely suffering from hypertension and my heart was showing signs of it that indicated a long-term problem, maybe going back 3 or more years, and which has avoided detection until now. He told me that the high BP was making my heart work harder, and it was now over-muscly, like some mad keen body-builder. The problem with big muscles is that they get stiff and eventually weaken. Oh bugger. But then, it dawned on me, and the doc was alluding to the fact that the hypertension could be the major factor behind my AF. It's not often you are happy to find out you've got a condition, but this time I was, because if it's true, I have found out what has caused all this crap I've been putting up with for the last 6 years. Now I can treat it. Now I can beat it.

I knew what was coming next. The doctor told me I had to stay another night. He told me I had to go on medication. He told me to go on a diet. He told me to exercise! Well, duh! The list of drugs was growing. Anti-arrhythmics, anti-cholesterol, anti-aircraft, and now anti-high blood pressure. It's kind of at odds with what I'm trying to achieve with this Paleo diet, because they are yet to dig up the remains of a Homo Erectus branch of Boots the Chemist from 100,000 years back. C'est la vie. I went back to the ward with a strange sense of elation mixed with terror. Now I know what has to be done. If I do it right, and lose the requisite weight and lower my cholesterol and blood pressure, I should be able to get off the meds within a year or two, one by one.I knew that from now on I held my destiny, or at least a great deal of it, in my own hands. I have been given control.

I left hospital yesterday, and was glad to get away in the end. The hotel-style room had impressed me to start with, but after 2 days in there, I was bouncing off the walls. The TV was my only companion for much of the time, and it was starting to grate with its repeats of Roseanne and Different Strokes and straight-to-video movies. I did see a couple of good ones late at night, mind. The doc gave me a final pep talk and told me that while nothing was outright banned now, I had to remember the simple golden rule - the more legs an animal has, the worse it is for you. It's like Orwell's Animal Farm in reverse - 4 legs bad, 2 legs good. No legs even better (Fish, that is). I wonder if this was a case for cannibalism, although I wouldn't eat myself given the choice.

It's kind of fitting that this has happened now. I came to Dubai for a new beginning, a new life, and all that guff. I was worried about my health, naturally, but carried on as normal, eating and drinking crap and living the luxury, lazy, expat lifestyle. My weight got to its highest ever, and my stress levels also got higher. I now realise that this has been a factor all along, and along with the obesity, it is a potent combination. I had a really bad stress-out session the day before my latest episode. That probably sent my BP through the roof and kicked the AF off. But every cloud has a silver lining. The thoroughness of the medical care here has impressed me, especially my cardiologist, who has been encouraging and reassuring and also frank with me about where I am. I now have a positive outlook, and feel ready to put right the years of abuse my body has suffered. I have gone right off fatty and sugary foods. I'm not a puddingy person any more, as my dear Mother says.

Oh yeah, and the insurance wasn't a problem. I showed my company insurance card, signed a couple of forms and didn't have to pay a penny. Suh-WEET.

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