Wednesday 21 September 2016

Hooray!




I don’t normally use many exclamation marks, they are often unnecessary and it is easy to overuse them.  Today I make an exception.  I have just come back from Worcester, and got the all clear from the arrhythmia clinic.   I have been extra careful the last six weeks, in fact over seven weeks, since the implant; during this time.  I have not been allowed to vacuum, mow lawns, lift anything with my left arm heavier than a book, or to raise the left arm above shoulder height.  Even putting on a jacket or tying a tie needs concentration to keep the left arm below shoulder level.  One of the doctors put the fear of God into me if I didn’t observe these restrictions, how the electrode could become displaced, when the device would need reinserting. 
         However this morning, with great speed and efficiency, the cardiac technician had her machine talking to my implant.  “All good, no runs of fast beats, just what we want.”.  Then she mentioned something not included in the mass of literature provided at the initial consultation.  She made my implant vibrate.  This is rather subtle, a gentle buzz by the ICD, easy to miss if I hadn’t had the test.  If this happens it is not serious, but the clinic should be informed so that they can check and make adjustments to the implant if necessary.  So my next appointment is six months away; I can mow lawns, dig veg patches,and do wall press-ups with both arms.    Hooray!  This is an Oyster Bay day. 

Saturday 3 September 2016

Heart failure misnamed



Heart failure by another name would sound less bitter

I wish I could write a witty line to parody Shakespeare.  I believe, however, that this sentence contains good sense.  Heart failure sounds deadly serious, almost terminal.  I shall never forget, following a day in hospital after an attack of atrial fibrillation and a battery of tests, the visit to the consultant cardiologist to review treatment.  I learned I had heart failure.  Both my wife and I were shattered.  I knew I had COPD and got short of breath on too much exertion, and knew I had an irregular pulse.   But the diagnosis of heart failure was new and devastating.  I am a doctor, however, and soon recovered a sense of perspective.  
I read up about heart failure.  I read the British Heart Foundation booklet and the excellent book I have mentioned before, Kasper and Knudson’s "Living well with heart failure."  It is subtitled  “The misnamed, misunderstood condition.” Their title “Living well with heart failure” carries this positive connotation. Heart failure is misnamed I believe because the word failure is so negative, almost terminal.  Heart failure, though serious, is compatible with a happy and useful life when treated effectively.  The problem is that the misnamed term is so well established that it won’t be shifted easily, and there is no obvious alternative.  Comparable to COPD, I would tentatively suggest CCD as a less emotive term than heart failure, and I hope sufficiently accurate.  CCD would stand for chronic cardiac dysfunction.