A Change for the Better.

There’s stuff that happens and then there is Bad News.

Doctor Northcote had completed his diagnosis.

Until that point the most frightening thing I had heard was: "Thatcher has won again": "Rangers are odds on for nine in a row": "Bush has been elected for a second term". There had been other major events in my 54 years. The deaths of my father and most recently my brother Des saddened me but did not frighten me. Why? Because I was protected, nothing manifest, just a subliminal belief that is the prerogative of the apparently healthy. This belief is arrogance and I had it in spades.

I had it right up until that nice Dr Northcote said; "Not what I expected Tom - looks like you will need a triple bypass".

A change of perspective:

"What does not kill you makes you stronger" observed the eminent German Philosopher and all round nutter, Nietzsche. Before I was aware of Nietzsche’s snappy summary, my mother, a less eminent but more practical philosopher had observed: "It’s character-building son". (Adversity being the "What" and "It’s"). I believe then and now that there is merit in this philosophy. However, up to that point, adversity had meant obstacles to achieving what I wanted; qualifications, job, money, house, life abroad and all the practical problems of 30 years of marriage and two kids. This was different. For the first time adversity was not something I could work harder to overcome and it just might kill me.

Despite the build-up to Dr Northcote`s diagnosis this was not something the invincible arrogant "me" was ready for. I offer this experience as testimony to the other "me’s" out there.

How did we "Me’s" get like this?

As with most things, women are more aware of the human condition than men. (The exceptions being football and peeing highest up a wall). They have regular reminders of pain and discomfort and a potential life-threatening experience with each child. Also in bringing up children there is regular contact with the medical profession. All of this and most importantly their innate common sense sees them taking more real care of themselves.

Men on the other hand drop off the medical radar after their BCG injections and come back into it when they break a bone or have some serious organ malfunction or life-threatening illness. This lack of attention to physical health is a combination of arrogance and fear. Arrogance in knowing that "I don't get sick" and the fear of finding out that "I might be sick". Women are smarter and braver than that.

Like most men I had limited first-hand experience of Blood, Doctors or Hospitals. My one invasive procedure had been the removal of a tooth when I was 23. Hardly preparation for the good Doctor’s diagnosis.

I was one of those self righteous people who seldom needed and never took a sickie. I looked down on those that did as weak and indulgent and by definition lacking in character. This may have been OK if I had stopped at the work-shy but I took it too far. I had a deep and unspoken belief that sickness itself was some kind of personal weakness.

Sad, ah, but there you are. I tell you this as an insight into my prejudices and stupidity in case you recognised the symptoms - of course, I mean in someone else?

In the autumn of 2005 all this foolishness was stirred, shaken and flushed down the loo. Thankfully, at the time of writing, I did not follow it.

Strange the things you notice

If you have been lucky enough to avoid a life-threatening illness you will almost certainly have had a life-threatening event - a near miss in a car, in-flight plane troubles or even a particularly hairy passage on a boat. The event may have been life-threatening but the fear only lasts a short time and in some cases the experience can be exhilarating. These events quickly become stories that can be discussed with mates and even laughed at. A life-threatening illness is different. It is hard to talk about and even harder to laugh at but you have got to try. It is important to remember people (men mostly ok, me) are uncomfortable talking about illness. It reminds us of our mortality. So keep it light and upbeat.

Another thing; once diagnosed you start noticing things you had not noticed before like the preponderance of funeral cars on the drive to Ayr. Has there been a major epidemic that is being kept under wraps or have they always been there. No matter how hard you try to push your new-found illness and its associated fear to the back of your head it fights its way to the front.

There was also the inevitable feeling of "Why me?" Thankfully, I did not dwell long on the question as the answer is simple: "Why not?" We are very lucky to have good health and wealth in one of the richest countries in the world. We have been dealt a very good hand.

The calm before the storm

In 2004 Sheila and I took over The Shorehouse on the Island of Arran. It had been a 26 bedroom hotel which had been converted to 10 self-catering apartments. So, more time to ourselves and a bit of sailing on the quiet days. We sold the house in Ayr and set the kids up in flats. It was a positive change after 30 years in the computer industry and something we had been planning for some time. In 2005 we added a little power boating business to the stables and I was on the water most days and life was good. I had climbed Goat Fell in April and I walked and did some rowing every day. I had lost weight that I needed to lose and I felt as fit as I had ever done.

A wee touch of indigestion

Each morning after breakfast I pulled the dinghy down to the water’s edge in preparation for the day’s boat trip. One morning I noticed a slight discomfort in my upper abdomen which I put down to indigestion so I changed the routine to have breakfast after I moved the dinghy and the indigestion reduced for a while. However, I started to notice that any significant exertion through the day brought back the indigestion and it was becoming more severe. Also, if I stopped the exertion, the discomfort would reduce.

Arran’s medical service is excellent. They get you when you arrive and put you down for annual MOTs thereafter. I had one of these coming up and I thought I would wait and mention it then.

After going through the normal stuff I informed the nurse of my indigestion. My blood pressure, heart rate and ECG were fine. My indigestion theory was holding up.

The Doc told me that an ECG stress test would deliver a more complete diagnosis. The test on the NHS would take 6 to 8 weeks. Deep down I knew I was kidding myself with the indigestion theory. So as a life-long Labour supporter, I went private. I saw Dr Northcote, Consultant Cardiologist, the same week.

A wee touch of angina

Dr Northcote was great. I gave him my symptoms and my indigestion theory. He dismissed the latter out of hand and told me I had angina.

My only previous reference to this condition had been a sick joke from 20 years back. So he explained that the discomfort was caused by a lack of blood and oxygen to the heart normally caused by a blockage of an artery or arteries supplying the heart. The condition is normally progressive and can end with a complete blockage followed by heart failure.

I knew what normally happened after that.

The symptoms are treatable with heart surgery or angioplasty. I had no idea what angioplasty was but given the alternative, I liked the sound of it.

Angioplasty is a procedure which ends with a metal tube (stent) expanding the artery at the point of constriction, restoring a normal blood flow to the heart. It is done under local anaesthetic by inserting a lead wire through an artery in your arm or leg. Not great but better than the alternative. I clung to this as the cure of choice.

Please forgive any inaccuracies in my description of the symptoms or the cure. They are my interpretation. Seek your own medical advice.

Bad News Good News

I was sick but I was fixable.

The process of getting fixed

The next stage was a stress test which consisted of running on a treadmill while wired up to an ECG machine. I lasted 8 minutes. I asked the good doctor if the results confirmed his diagnosis. He told me they didn't but not to worry as I still had angina. Not sure why, but I was strangely comforted by his certainty.

The stress test is followed by an angiogram; I know, more big words. Basically, dye is injected into your arteries to show the flow of blood into the heart. This was the definitive test. It would show the doc where the stents would need to be placed. Up to this point the assumption had been stents.

On completion of the tests and while I was still in theatre Dr Northcote gave me his scary diagnosis "Not what I expected Tom. Looks like you will need a triple bypass". I have never been a good poker player and cannot be described as inscrutable. I felt shocked and frightened and I am sure that’s how I looked. I still looked like that when I was wheeled back into my room to give Sheila the news. She is a better poker player than me but she was still upset. After about 10 minutes of mutual reassurance Dr Northcote reappeared and said he had gone over the pics with the Heart Surgeon (Mr Craig) and they both concluded that surgery was the best option however, on further review Dr Northcote thought that he would have a reasonable chance of placing stents in the offending blockages but he still thought the most certain course of action was surgery I never heard the last bit. I clung to the stent option like a Ranger supporter clinging to the chance of winning the league.

After further discussion with Mr Craig and Dr Northcote, Dr Northcote agreed to try the stent option.

Anyhow, I had five stents implanted over two procedures. The one artery that was giving me the problem was 98% blocked and the others were precautionary/preventative implants. I felt immediately better.

It’s good to be back

In summary, I am "fixed". I was physically "fixed" the day after the first procedure. Not "fixed" by my old illusion of "full health". I have seen a moving picture of my heart’s arterial blood flow and, although massively improved, it is not in the first flush of youth and I may need to go back for more work at some point, assuming I am given the chance. So, I take pills to lower cholesterol and thin the blood. I watch my diet and I exercise regularly. I just walked up Goatfell at the weekend. Before the procedure I could not walk for the paper without a rest. So, I am fixed, I am fit. Nietzsche’s maxim would suggest that I am stronger. I am not sure about that but I think I am a little wiser.

Lessons learned

• Enduring pain is nature’s way of saying you need to be fixed. Endurance is not a test of character but a test of common sense.


• Get a regular health service check. You do it for your car and your lawnmower.


• If you cannot get a fast diagnosis on the NHS go private for the price of a package holiday. If your condition is life-threatening the NHS will click in. Failing that, spend the money.


• James Taylor is right "Shower all the people you love with love, show them the way that you feel..."


• Cholesterol is essential to your health. Too much of the wrong type is a killer. I have heard of people being told that 5.2 is OK because it is the UK average. The UK - and Scotland in particular - has one of the highest rates of heart disease in the Western World. Pick a country with a lower death rate as your benchmark.


• Diet can only reduce your cholesterol levels by 15-20%. If your levels are very high, diet will not get you there. If your diet is good, you're over 50, have a family history of heart disease and your cholesterol is above 5, insist your doctor gives you drugs to reduce cholesterol levels.


• There is no shortage of time to do all the things you want to do until someone tells you there is: Don't wait for that discussion.


• Time is your main asset. How you spend it is your main decision.

After much deep reflection I agree with Linda Smith:
The Hokey Cokey IS what it’s all about

Tom Tracey