The mysterious shoulder pain

Healthy Athlete Had A Heart Attack Anyway 2025-10-16

• TLDR Too Long; Didn’t Read;
  At no stage did I ever feel that I was in severe pain and for 99.9% of this story, I felt really great. 2 days after leaving hospital, I feel even better than I've done in months despite some pretty impressive bruises and a fizzing cocktail of drugs forcing my body to adapt to some new and weird Chemistry. The medical team never used the phrase "heart attack" and so neither will I.

  I hope my story helps someone.

Jump to: Ride 2 | Ride 3 | Ride 4 | A&E | Cardiac Care Unit | Day-2 | Diagnosis | Angiogram | Recovery | Day-3 | Day-4 | Hindsight

Monday 6 October 06:50

I turned the light on in the cold, quiet garage, looked at the bike, mounted on the turbo trainer, and started the boot up procedure - towel, water, shoes, warm jumper. I fired up the tablet, clicked shoes into pedal, started the Zwift app, selected group ride and was spinning my legs freely with 3 minutes to go before the 07:02 start. This was my first group workout of the winter and my fitness has slipped a bit, so the plan was to be steady, be consistent and don’t go too hard. I expected younglings in the group to leave me in the dust, and to finish about the middle of the pack in the Zwift - Power Check #3 - Climb Control workout.

The warm-up raised my heart rate (HR) and breathing rate until I was breathing deeply but not heavily. The preliminary segments were at higher intensity, riding at 200W for 90 secs followed by gentle spinning, in which I was scarcely out of breath. The first training segment at 20 mins was a short steady climbing effort that I completed perfectly under control at a steady power of around 220W for a 223W average. This was 10% off my expected level and I was just fine with that.

Now half an hour into the training, I was feeling strong and under control. I started the final training segment aiming for 240W and realised that was just into the red zone, so backed off and was aiming to stay at around 235W. Overall I averaged 231W for a maximum heart rate of 164 and an average heart rate of 132.

Pretty pleased with that workout. It was steady, not crazy and I reached a body pain of about 6/10. all the power, cadence and heart rate numbers are totally consistent with the last few years of riding and for the rest of the day, I felt really good. Full of energy, not tired, not breathless and no pain.

Most importantly, I achieved desired result of being left in the dust by younglings cranking out 400W during the training sessions. I have no desire to work that hard any more.

Tuesday-Thursday

A couple of yoga sessions to persuade my joints to behave like stretchy rubber instead of crusty breadsticks.

Friday 10 October 07:02

Click! went the light. The cold bicycle was waiting for me. I went through the turn-everything-on ritual I was looking forward to climbing Zwift - Trollstigen at 100% in 50min or less to make my 9am meeting. I was feeling awake & ready, just like Tuesday and began my usual steady warm up.

After a couple of minutes, when I started to spin faster, I was strangely out of breath. This wasn’t unusual on cold mornings, but the bad stitch developing in the depths of my left shoulder was strange. I eased off and resorted to turning my legs over at very modest 140W which is my normal go-easy pace.

The stitch was pretty sharp and deeply embedded in the fold between my left shoulder and the shoulder’s cup. I guess it ranked as about 5/10 on the body pain index. Definitely something I would ignore in a race, but this wasn’t a race and I’m trying to be sensible. When I pressed deeply into the stitch with my thumb while breathing deeply, there was some respite and the pain stared to dissipate down to a 3/10. It felt strangely similar to the relief I would get while jogging after I’d pushed too hard during a 10k or half marathon and got a stitch that way.

Unfortunately I was on the bike, not running. I never get stitch while on the bike.

Sitting upright, breathing slowly and deeply, pedalling gently at a steady 85rpm (my low power sweet spot cadence) wasn’t shifting the stitch. At 7mins 30secs into the ride, I got off bike and did some yoga. I started to feel better, the stitch was easing, but curiously there was no chest pain at the time. With hindsight, this might be because I couldn’t tell the difference between the mild heart-problem chest tightness and the almost-new heart rate monitor that I was wearing snugly. I got back on the bike and maintained a low power until 50mins.

By this time, all pain and discomfort had gone and I felt genuinely fine again. I got off the bike to shower before my meeting feeling a little confused about the ride. My power was really low compared to my normal quasi-constant 235W when climbing; the stitch felt weird; butI felt really great and full of life as I stepped off the bike. For the rest of the day, I felt really good. Full of energy, not tired, not breathless and no pain.

Saturday-Monday

Some Yoga a DIY while pottering around the house. I felt full of life and genuinely great.

Tuesday 14 October 08:03

I was alarmed by Friday’s strangess, but I was feeling really good, so I decided to go shopping on the electric bike. I reckoned that if I got into trouble, I could gently turn my legs and still get home. I did my pre-flight checklist: fully charged phone, water bottle, bike lock and keys in the bag, gloves on hands and garage door closed. The grey clouds overhead did not look threatening, but double-gloves was in order as the air was distinctly chilly.

I set off to the shops to buy some nails . After the first couple of minutes, I could feel the stitch gently, but persistently coming back, probably a 2/10 on the body pain scale. I followed my plan and dropped my leg power to around 100W, clicked the electric motor up to its maximum setting, breathed deeply and enjoyed the lovely autumn scenery as I very gently got some fresh air and some nails at Screwfix. This time, I could feel a phantom indigestion-like sensation in my chest (1/10 pain index) and my fingers were suffering from Raynauds syndrome, so I’ve no-idea if they were numb from any mild cardiac symptoms. For the rest of day, I felt great.

Wednesday 15 October 07:30

75mins of core and hip focussed yoga. I’m gradually becoming less stiff after 4 years of yoga. I felt excellent all day.

Thursday 16 October 08:13

08:13 Zwift

I was still confused about the strange sensations but I was also feeling really good. I planned a sensible flattish route with multiple escape-options if symptoms reappeared. I pointed the electric bike towards Sainsurys knowing that I could escape after 4.6km to do a much shorter route and be home in under 40mins.

4.6km later, I stopped to stretch out. The stitch was about a 2/10 in my shoulder, a phantom uncomfortable feeling was hovering in the middle of my cheat (0.5/10) and a very slight numbness in my left hand.

I took the short, flat route home. The stitch feeling stayed at 2/10, the chest feeling was about 1/10 and my hands succumbed to the cold and went yellow thanks to Raynauds.

Three times in 6 days is not coincidence or diet or bad luck or being a wimp. Time to call the doctor - something’s not right.

11:15 Contacting the Doctor

I documented my 3 strange rides in an online form requesting a doctor’s appointment. I included the extra information that my father, both my grandfathers, 2 uncles and an aunt had died of heart attacks between ages 50 & 70.

11:36 “Ring Ring” went the phone

Technically my phone didn’t ring, it played “Moonlight Sonata” to prove it wasn’t a spam call. The calm melody contrasted with the polite, short, yet firm message from the Doctor (GP): “Go to A&E now. Tell them your GP has requested an ECG and Blood Tests”.

Oh dear, I thought. I’ve been expecting this message since I was 14 and my dad did not return from golf one Sunday. Physically, I felt great. Really great. No pain, no anxiety, just hungry. Emotionally, I felt no stress at all. I knew what I had to do and so I made a plan. My watch said “heart rate 56 bpm” and typically the Accident and Emergency department took about 5-6 hours from entry to exit. The plan was simple: light lunch, drive to A&E, wait.

My wife and I ate a light, I drove to A&E, parked in the car park and joined the A&E process a little after 14:00

14:00 Royal Surrey Accident & Emergency Department

I was amazed at the calm, polite and tolerant professionalism of every member of staff. The advantage of feeling wonderful and having no pain of any description is the time it gives you to observe the 100 or so people sitting, standing and pottering in the waiting room. I sat there feeling like I was probably wasting resources that could be better spent on the people that I could see who were genuinely ill.

The builder with the bleeding bandaged hand; the old man with speech difficulties in the wheelchair, unable to walk, being tended to by his family; the young lady in clear distress trying unsuccessfully to ward off a seizure as her boyfriend stroked her hair and talked long-practiced words quietly into her ear while she rocked backwards and forwards over hunched knees crying; the Polish(?) couple who both seemed to be invisibly injured and almost crumpled into each other’s arms looking isolated and scared; the loud guy in the corner who looked like he hadn’t slept in a week complaining to the involuntary audience around him about the long and insufferable wait; and me. Smiling. Quiet. Alert.

• 14:10 Weight, blood pressure, heart rate, offered pain medication
• 14:30 Triage - asked questions by a man who could have been Geraint Thomas’ voice double and typed like he hated his keyboard more than being asked “Are you English”. I told the story and was offered more pain medication. I refused.
• 15:20 Bloods - called into the Nurses room where a canula was fitted in my right arm. Many different vials of blood were removed for different tests.
• 16:30 ECG - sticky electrodes on the chest (no shaving) and an ECG reading was taken by a student nurse learning the machine
• 16:40 Friends - Met some friends from the village, one of whom had just been pulled over by the dog and was in a sling looking like the elbow might need a cast. Told them my story they responded “You BLOKE. You’ve become a stereotype”. They weren’t wrong.
• 17:15 Doctor - he told me there were abnormal signs in my blood and the ECG, but needed to do another ECG to be sure. After that he would consult with a consultant to discuss the best course of action
• 17:30 ECG2 - I was given blood thinning and anti-coagulant and some other pills to take, and promptly knocked the water cup into the ECG machine (yes, old-duffer mode turned up full!). Another ECG machine was found and a slightly different arrangement set of sticky patches used by the same nurse and a slightly longer reading taken while I breathed steadily
• 17:45 Doctor (again) - Confirmed the anomoly would require that I get admitted to hospital overnight for observation and that the local team were negotiating for a bed
• 18:58 Ambulance - I’m put into the ambulace by some lovely drivers. I said that I felt great and could walk. The pointed out that I was to be kept on a heart rate monitor just in case, so I lay on the gurney and was trundled away while discussing the driver’s potential holiday plans in Australia. I still felt fit and bouncy and wonderful.
• 19:45 CCU - Turns out the Coronory Care Unit is prepped for the high risk patients why might need emergency care within seconds of a heart attack. I was still really calm & relaxed, not because I was in denial, I’d had no painkillers or relaxants, I just confident that should my minor heart attack become a major incident over night then I would be treated by the best, nicest possible people.
• 20:00 tests - the two hours at the CCU were a whirlwind of blood samples, ECG tests, being wired up to a remote heart monitor, form filling, registering on a number of computer systems, interviews, temperatures, blood pressures and, some time around 9pm, I was asked “Have you eaten?”
• 21:40 just cheese - I don’t eat a lot of meat, but with hindsight, the vegetarian sandwich option was exactly as described on the outside of the packet. At least the coffee was OK. Nothing was going to stop me from sleeping.
• 23:00 sleep - I say sleep. The nicest, wonderful, friendliest folks were loverly to be with, but I was on a regime where something needed doing every 30-60m to keep me safe. Every snatched hour of sleep was genuinely deep & wonderful.

Friday 17 October

01:50 Doctor

“Good morning sir, are you awake?” said the consultant.

I clawed my way out of a disoriented, deep sleep and stared the tall doctor in the eye. “Yes”, I said unconvincingly. He looked like it was midday for him and was alert and interested. The ward was quiet, the neighbouring ward had some shouting in the distance and I shuffled up in bed as he asked “Why are you here? What’s your story?”

“Nice.” I thought. He’s offering me a blank slate to write my story on with no preconceptions. I hadn’t expected that. From decades of practice, I shifted my brain from midnight mode into I’m just in another time zone - it’s actually midday for me too mode. I took a deep breath and chirpily told him the same story that I’m writing here. He looked down and the notes and numbers and graphs and he nodded.

“Get some rest, you’ll be having a minor procedure this afternoon.” he said, and walked off to the next patient.

• 03:00 “Are you awake?” said a small voice at the edge of my consciousness. “Yes”, I replied before my brain had caught up with my mouth. A young nurse was standing in the gloom in front of what looked like a giant sunflower sticking out of a tall garbage bin. “X-Ray time”, she said.
  
  A minute later, I was standing with my chest against a target while she hid outside my screened off empire. There was a whirr, a click and a sound not unlike a cuckoo returning to a vintage cuckoo clock. The nurse reappeared and carted off the machine. Delicious sleep awaits.
• 03:43 “These beds are crap” came a loud shout from somewhere in the distance
• 04:00 I’ve redacted real names here, so my co-star will have the pseudonym Mr Dementia. “You can’t unplug that Mr. Dementia”, came a voice from another, calm, restrained, but audibly frustrated voice near a distant bed. “Those leads are important. No. You can’t go through there, that’s another patient. Please combe back to your bed Mr. Dementia It’s 4am and everyone’s trying to sleep. No you can’t unplug that either, that keeping your pump going”… sleep took over as the one sided conversation continued
• 05:50 Gentle morning chimes drift into my brain and hushed conversation are approaching. I guess 6am is the start of day 2.
• 06:00 “Are you awake?” said a small voice that accompanied the ECG / blood pressure trolley. I offered my left are and was rewarded with a blood pressure of 120 systolic / 70 diastolic at a heart rate of 42bpm with a blood oxygen of 97% ox. These are numbers I recognise as a little lower than my usual numbers. The aspirin and other blood thinning tablets might actually be working!
• 07:00 I’m presented with a breakfast order form. Such choice!
• 07:45 A phlebotomist appears with a machine resembling a portable payment machine from a restaurant. A prick to the index finger, an exchange of jokes about whether the science or the spelling of phlebotomy is more difficult and I discover I have a blood glucose 5.3 mmol/L which is refreshingly boring.
• 08:00 coffee is delivered by a lovely lady who promised food soon.
• 08:20 Salivating like a tiger inspecting a piglet, I watched the tray of muesli, bread, croissant, juice and yogurt being carried to me as I sat with my claws retracted hoping not to disgrace myself by devouring the feast in an homage to the closing scene of the Fantastic Mr Fox.
• 09:00 There is a crisis. Mr Dementia has lost a slipper. The hunt is on and has turned into the world’s slowest management team away-day bonding exercise. In a show of collective spirit, everyone is moving about to level they are able in the search for Mr. Dementia’s slipper. Each person, on hearing the call for action, checked Mr Dementia’s feet because, well .. you never know, do you? Nurses check bedpans, patients checked cupboards, Mr Dementia seemed to be trying to escape while everyone was distracted. While being led back from the door, a nurse discovered the object of our collective endeavour in Mr. Dementia’s dressing gown pocket. Team building was done for the day. We laughed, nobody cried, Mr. Dementia sat proudly in his chair and fell asleep while doing a perfect impression of Grandad from the Simpsons.
• 10:00 Change of wards. I am moved from the critical care ward to a general ward that is significantly busier and has fewer nurses. It’s quite the spectacle compared to the calm of the other ward.

12:30 Procedure revelation

Lunch is served, but there is still a lock of information about whether or not my procedure will be today. Apparently there were a number of emergencies in the queue ahead of me, so there is a small chance that I’ll have to wait until tomorrow. I have a lovely conversation with a cardiac nurse about the angiogram procedure. They will insert a catheter into my right arm’s artery via the wrist. A fine wire will be inserted to inspect the arteries that provide blood to my heart to diagnose what the issues is. There is a likelihood that I have heart disease and my arteries may be restricted or possibly blocked. If that is the case then they will insert a small balloon and inflated it to widen the tubes that provide blood to my heart.

Apparently the blood marker troponin is present in high quantities in my blood indicating that my heart muscles are, or have been, struggling. I was told that should there be constrictions in the arteries then the surgeon may insert a stent in the artery to keep it open.

“Can I watch what’s going on?” I asked. “Of course” she said. “There’s a large TV screen where the live X ray feed will be visible and pain relief and sedatives are at your own discretion. The whole procedure lasts between 20 and 90 minutes.”

I thanked the nurse profusely and was strangely enthusiastic about watching live pictures of my own heart being mended by an expert as I watched. I pinged the family and we made a plan that they should set off at 15:00 unless I tell them that I’m going into theatre. If that’s the case, they should set off later, at about 19:00.

• 13:30 Time drags. I read my book and drink litres of water (quite literally). The ward is busy with each patient receiving a bit of care, and I get used to the main protagonist of the action. I will call him Mr. Angry. He seems to be dissatisfied with his bed and is resuming his chorus of “This bed is crap” while nurses and support staff attend to patients needing medicines, toilet facilities, tests and, in a few cases, attention. I am pleasantly amused by real-time photos sent by my children of their shopping exploits in Lidl. I am more nervous about the prospect of being seen to enjoy the bizarre snacks they’re selecting than I am about the impending procedure.
• 14:58 “Mr Devlin, I have to prepare you for your procedure” says the nurse. Scramble, scramble. Herman stops everything to get me prepped for the procedure. Gown done up in-front says Herman, handing me the flimsy thing with missing strings.
• 15:15 I’m lying in bed in a gown with my knees clamped discretely tight like some maiden graduating from a 1930s finishing school in Switzerland. My book is engrossing and time flies by.
• 15:30 WhatsApp from my daughter is insistent that I don’t flash the nurses. Right-oh.
• 16:15 Two porters appear trundling a machine to take my blood pressure. I’m wired to my telemetry with the transmitter poking out the bottom of the gown. They look at me, look at each other and say “That’s on the wrong way round, please reverse it”. I look at the mess of wiring poking out of the bottom of the gown and decide within milliseconds that there’s only one solution; time to get naked. I suppose technically it’s not flashing if I’m instructed to get naked, but the complete disinterest of the nurses reveals that a 60 year old hairy bloke covered in wires is marginally less interesting that one of those 1970s pieces of art with nails and string and shapes.
• 16:20 We’re off, down several ramps and corridors until we get to the holding pen. Despite the interesting noises coming from the operating theatre, I lose concentration and doze.
• 17:15 A porter arrives to trundle me into the theater via every wall and pillar en route like some damaged shopping trolley at the local supermarket.

17:15 Angiogram

The view as I entered the room is amazing. There is a huge aluminium beam running along the room with another, shorter beam mounted on runners so that the heavy X-ray arm can go almost anywhere in the length and breadth of the room. The X-ray head itself appears to be on gimbals giving it complete freedom to rotate at almost any angle. I probably spent the first few minute figuring out how the machine worked rather than paying attention to the people speaking at me. Oops.

“Would you like a sedative sir, are you in pain?” I was asked. “No,” I replied “I’m not in pain and I’m keen to experience everything. I want to learn how all the mysterious phantom pains in my chest relate to reality”.

The physiologist pulled down my gown and asked if I objected to being shaved. I replied “No” and for the next minute, I felt the same love and care that sheep number 1 million would feel as it reached the front of the line for shearing in New Zealand. The physiologist, obviously well practiced at this, proceeded to removed the hairs by unwinding long lengths of micropore and using me like a velvet jacket for de-fluffing practice. The whole process resulted in about 3m of hairy, fluffy micropore on the bench. It’ll probably get sold as a prop in some real-crime TVT drama to help fund the NHS.

Things were getting busy. The team were all doing different things and I was being prepped. Antiseptic was being smeared on my right wrist while the physiologist was plugging 12 ECG leads into the fresh sticky patches adorning my freshly shaved body. A quick injection in the wrist distracted me from the fact that everyone I could see appeared to be wearing a cute samurai overcoat and suddenly the surgeon was there.

Catheter

“Are you ready?”, she asked.

“Oh Yes,” I replied, “if it’s not too distracting, could you tell me what’s going on as we proceed please. This is the most fascinating thing I’ve ever done”.

“Of course”, she replied whilst simultaneously giving me a look that suggested she was questioning my sanity, which is fine. I’ve got used to that look over the years. I suppose, with hindsight, I wasn’t going to do anything other that lie there breathing deeply and regularly to make things as easy as possible for her. She was the one trying to literally thread the needle in a strong beating heart that was leaping around my chest cavity like an unrestrained tennis ball at a Wimbledon final.

Suddenly, I felt a weird sensation in the middle of my forearm like someone drawing a line with a cold silicone spatula from my wrist to my elbow. I’m sure there was no audible thunk, but the sensation suddenly stopped and the nerves in my funny bone felt like I’d just bashed it on an edge.

“I’m sorry,” apologised the surgeon, “your arms are skinny, I’m afraid we’re just going to have to push on through”.

“Go for it”, I replied and then experience, possibly the most weirdly unpleasant 300ms of my life. Not painful, but totally unexplainable whole-body nerve twanging. Imaging the cold silicone spatula being pressed into your forearm, going directly over your forearm and ending up in the middle of your tricep and then inside your shoulder joint.

I have to emphasise It was not painful. It was just unpleasantly wierd and over with really quickly.

My heart on the telly

Suddenly there was my beating heart pumping away about once per second on a TV screen about 1m from my eyes. Quite literally an out of body mental experience as I could feel it beating in my chest and seeing it moving around and squeezing away. I was amazed at how much the heart moved around like it was trying to escape the shackles of my rib cage. Nothing at all like the boring, controlled animations that I’d seen since childhood.

Wires appeared on the screen and being moving backwards and forwards in real time. They looked more like annotations overlaid on the video because they were sharp and clear without the 3D volume that the heart presented.

I felt super calm, there was no pain. The unpleasantness of the catheter had dissipated, the local anaesthetic was doing its job and the room had entered an almost militaristic level of precision and control. The surgeon was shouting out positions for the X-ray so that she could match what she was seeing on the screen with her mental model of a chest cavity. The X-ray head danced and rotated really fast and the sound of high-power servo motors winding up and braking gave a sci-fi movie vibe to the soundscape. One of the cranial positions blocked the view of screen and I had the same feeling you get when a person stands up in front of you at a major plot point in the cinema. Despite these stupid emotions jumping into my brain, I tried to keep everything from the next down in a super-calm Shavasana, slow breathing, hyper relaxed post-yoga, zen like state.

Investigation

I felt nothing as various fluids were pushed into my artery and the blood flow was suddenly highlighted in real time on the screen. I think these 5 second clips were then captured and replayed to minimise the amount of unfriendly goop being squeezed into my body. The surgeon had this loop on one pane of the screen while positioning the angiogram probe along an invisible path that she could see inside her head on the other screen.

It’s difficult to express the incredible level of skill and coordination that every member of the team was exhibiting. I’ve spent a lot of my professional life working with teams trying to achieve real time TV broadcasts that look perfect and effortless and it’s REALLY HARD to do. This team was trying to locate a moving target in my heart that was 2mm x 5mm in size using a bit of wire at the end of a 1m hose pipe while the heart was jumping around like a 3 year old on blue smarties and Fanta. It was a genuine thing of beauty to witness.

Problem found

“Every time I touch it, it closes”, said the surgeon with a vague tone of frustration. “Are you OK?” she asked.

“I can feel the shoulder pain coming on really slowly and then it goes again”, I replied. “There’s also the weird indigestion feeling that I’d get at 2am some mornings. It’s coming and going”.

“Are you in pain?”

“No. It’s fine. I’m more fascinated than anything”

She later explained that the main artery to that bit of the heart was very constricted and that every time she touched it, it would fully close leading to the shoulder & chest symptoms that I was getting. There was one extended period during the insertion of the first stent when the blockage lasted for maybe 30-60 secs. I can’t remember precisely because I was looking at the screen trying to figure out what was going on. There was a brief period where I was becoming dizzy towards the end of that process and suddenly there was a clack as the balloon used to expand the stent was retracted. The sensation was like finishing a really hard 200m swim set. Suddenly there was oxygen spreading outwards from the core of my body. The dizziness was vanishing and my very core felt like some super-hero serum had just been injected.

After the procedure, she explained that somehow I had managed to create my own heart bypass. This explained why the video showed a flat, pathetic artery across the top of the heart and a much longer, thinner artery that went down to the bottom of the heart and back up to where the pathetic artery should have fed. The long tube was getting thinner and thinner as it progressed. She said that this was unusual and it’s hard to say when it appeared, it could be short time or a very long time.

Stents

I heard many numbers being called out, in the end, I figured out that the size of stent was being discussed. In my case they put in 2 stents that were 3.25mm in diameter (325/15) to support the collapsed artery that was showing, according to the notes, 0% flow. As an engineer, this seems like a pretty good long-term solution to the problem as it should provide support along the poor quality piece of artery that will last a decent amount of time.

As soon as the stents were in, I saw a nice wide artery with blood flowing through the middle of it. My general feeling of oxygenated well-being got even better and there was nothing more to do except remove the catheter and apply a tourniquet over the hole in my wrist to stop me leaking.

18:45 Recovery

I was taken back to the ward to my little spot in the corner. Blood pressure, heart rate and temperature were taken and I was hooked back up the wireless telemetry system for monitoring. I was fitted with an anti-coagulant drip that would minimise the chances of any debris that came off my furry arteries causing clogging problems. Fingers crossed.

At that point, all the staff went over to treat other patients and I was left to reflect on how a “Not Right” feeling can result in heart surgery and recovery in less than 48 hours. I know the UK’s NHS has issues, but my experience is nothing short of miraculous. Wonderful people doing amazing jobs at short notice and being spectacularly nice while they’re doing it.

• 19:00 The tourniquet over the entry wound is starting to throb now. It also looks like the canula in my right arm wasn’t put in quite right because there quite a bit of bruising appearing, probably as a result of the pressure in my arm from the tourniquet. Only 6-7 hours until it comes off.
• 20:15 The family came to visit and brought chocolate. I think this whole process was infinitely more stressful for them than it was for me. With hindsight, I was probably most at risk driving to the hospital. Since then, it’s been a rapid sequence of distractions for me, but they have to just wait, without much information other than my clumsy WhatsApp typing.
• 21:15 Change of nursing shift and the night nurse came to find out who I was and how I was feeling.
• 22:10 “How’d that tourniquet doing?” asks the nurse. “Throbbing like an arm hangover.” I replied. She takes a look and sees that everything is clean and no leaking and uses a syringe to gently remove about 10% of the pressure. The relief as a small amount of blood start to flow in the arm is immense. I relax and everything is lovely.
• 22:30 Rattle rattle, it’s pill time. Statins & anti coagulants for me. Yummy
• 22:40 Mr Angry man is still shouting about his bed being crap and his back hurting. I have a suspicion that the drugs he’s on might be dulling his concentration abilities. He’s very loud and not a great listener.
• 23:00 I hear the, now familiar, sound of the bloods & pills trolley coming around. The throbbing from my right arm is getting a bit strong. The surgeon also predicted that the volume of blood marker and other good that has been flushed through my system will result in a headache later tonight. She definitely knows her stuff. The headache was firmly on the launch ramp, so I took a couple of paracetamol (tylenol) and realised this was the first pain medication I’d had this year.
• 23:10 “Please stop shouting Mr Angry”, asked the nurse politely. She didn’t really call him Mr Angry, but I fell keeping his real name anonymous is important. “I’m not shouting” roared Mr Angry indignantly.

00:30 Saturday 18 October

“Are you awake sir” asks the very polite, diminutive nurse. I feel like I’m climbing out of a deep well of sleep back into the world of consciousness. “I need to take your blood pressure.” she states. I remember how to smile, I remember where my left arm is, I’m feeling very tired but also wonderful apart from the throbbing

• 00:40 Mr Angry start a reassembly of his be project with one of the nurses. His orchestra of loud noise is enhance by Mr Vomit providing harmony and percussion from the wings.
• 00:53 Mr Angry is now shouting about his gown cords strangling him. Seems unlikely, but he seems to have unique skills in finding the most benign of problem rage inducing.
• 01:00 “Are you awake sir” asks the nurse. My watch tells me I was asleep for 5 minutes. It honestly felt like hours. She unplugs my anti-clot drip which I had forgotten was in. She then inspected the tourniquet and said that she’ll take a bit more pressure out of it, but the blood thinners that I’m on mean it’ll have to remain until morning. “Ok”, I mumbled and was asleep before she left the cubicle.
• 05:42 I was awoken by the blood pressure stealth ninja who was standing silently by my bed. In reality he might have been playing a tuba at full volume and I don’t think it would have made much of a difference. The reading was 110 / 69 @ 44bpm which is possibly the most normal blood pressure reading ever taken from my body. I smiled and lay back to listen to the sounds of the ward waking up.
• 06:19 Rattle rattle - the pills trolley appeared and a voice from behind it offered me pain killers. I declined. A small cup with aspirin and a proton-pump stomach protection pill was presented as part of my new schedule.
• 06:22 New nurse, new razor, new shaving patches and another ECG. I think my chest is going to look like some noughts and crosses board of fur (dark squares) and flesh (slightly palid pink squares). I’m sure nobody will care, least of all me - as long as the ECG starts telling some good new stories.
• 06:50 I was discovering that “Being a good boy” and drinking lots of water was good for my blood stream, but my bladder had other ideas and was protesting. Time to get up, brush my teeth and take pity on my bladder.
• 07:00 “Try to hold it in!!” shouted the nurse sternly to the 80 year old who was walking to the bathroom making noises like someone walking over wet cement in crocs. I’m sure Mr Squits did the best he could. In some parallel universe the cleaning team that appeared 5 minutes later would probably have smiled at him.
• 07:20 “I can take this off now”, said the day-nurse. The relief was tangible as the pressure in the tourniquet vanished and my arm relaxed.The throbbing from the middle of my forearm vanished leaving a dull ache.
• 07:30 Another blood pressure reading - quite elevated compared to the earlier one. Pills?

Daytime - day 3

• 08:30 Another fine breakfast
• 09:30 I was feeling superb, pain free, perky and full of energy. I even had enough energy to prevent myself from being energetic and remembered that the first 48 hours were critical to the stents bedding in. I got up and had a one handed shower while holding the Heart Rate telemetry pack in the other hand. I got dressed and packed my bag, copnfident the readings from the machines would allow my to go home today.
• 09:50 My bed was cleaned and I was told that the surgeon’s notes said that I could go home today
• 10:30 Black coffee and email inbox on my laptop. What a way to spend Saturday
• 12:30 Lunch came and went. No sign of a doctor to discharge me with my long list of meds.
• 14:00 I asked a nurse again about discharge
• 15:50 Apparently there is only one doctor on call for 3 (or maybe 5) wards at the weekend. The doctor has been super busy treating people who present as sick, so I’’m not going home today. Ho hum.
• 17:30 The family come to visit. Unlike other visit, we seem to be rather ebullient and noisy.
• 18:30 Dinner arrives and the family watch me eat a healthy meal
• 19:15 The family departs and I settle back to read my book
• 20:00 I spied that the heart rate telemetry machine had run out of battery, so i sneakily unplugged myself completely (Bad boy) and had a really good shower to make my skin tingle and look forward to a good sleep.
• 21:00 “Is there a reason you’re not wearing your telemetry”, asked the nurse looking stern. I sheepishly explained the joy of an unplugged shower. She didn’t look impressed, so she plugged me up and attached a charger to the unit. We spent a good 20 minutes discussing literature that explore cross-cultural communication and she recommend that I read Clarice Lispector . I now have a new author in my to read list. Yay!
• 23:00 Blood Pressure take and I followed the beckoning call of the Sandman and slept deeply

05:50 Sunday 19 October

“Are you awake sir” asks the very polite, diminutive nurse. I feel like I’m climbing out of a deep well of sleep back into the world of Groundhog day. “I need to take your blood pressure.” she states. I feel like I’m waking up in a nice hotel and the world feels great. I wonder if it’s the drugs, the extra blood flow in my system or just the removal of hidden stress that’s been lingering since the age of 14 when I came to understand what “Genetic heart issues” meant.

• 0640 aspirin statins tummy settler
• 0715 coffee ☕️ jaffa cake 🎂
• 0745 ecg
• 1200 lunch
• 1229 discharge but missing Meds
• 1242 canula removal

Hindsight

• Tubes: It seems that the “3am” indigestion that I’d been getting since I was 50 has the same feeling as the angioplasty baloon being inflated and the flow being reduced to a trickle. The pictures of the fuzzy arteries certainly showed lots and lots of heart disease. Thank you genes. When the flow was stopped for a prolonged time (3+ seconds), the shoulder pain and indigestion like feelings rose quite quickly, but decayed quite slowly.
• Sensations: I had refused any pain relief or sedation because I wanted to experience the sensations with as much clarity as possible. I adopted the post-race deep relaxation state and focussed on steady deep breathing and being as floppy as Mr Blackadder with the pub tart. All the sensations were horribly familiar. The trapped wind sensation that relieved itself with deep steady breathing and swallowing, the phantom pain in the left shoulder,the wierd phantom gap appearing between lungs/stomach and colon/legs. the unrelenting strong slow beat of night-time heart with an underlying shadow that feels like warmth but now feels exactly like a catheter scraping over the top of my heart.
• Debrief: Apparently I had made my own auto-bypass with the main route into my heart being severely blocked, but a secondary route looping all the way around the heart and entering the bottom had come into existence. This is quite rare. Dr Shannon pointed this out in the before blood-flow picture. The after-flow picture show a stented, volumious flow main feed with the secondary loop still present, but not carrying as much blood. she showed the cloggy scans of the inside of the arteries and how she didn’t stent the secondary feed as it was clogged but working