Heart to heart

Owing to health problems HOT columnist Sean O’Shea has not been frequenting his usual haunts of late. He discusses some of his encounters with the health service, the mixed blessing that is modern medicine and some of his hopes for the New Year.

What would you think if I sang out of tune
Would you stand up and walk out on me?
Lend me your ears and I’ll sing you a song
And I’ll try not to sing out of key.

Oh, I get by with a little help from my friends…

Sgt. Peppers’ Lonely Hearts Club Band, The Beatles

The story goes that during the birth process I managed to get myself entangled in the umbilical cord which reportedly was wrapped around my neck like a hangman’s noose. Perhaps I had a premonition that the world into which I was being expelled was not likely to be a barrel of laughs. After a perilous wait, and while the doctor struggled to disentangle the cord from around my wind pipe, I heralded my arrival by giving vent to a somewhat constrained scream. It was not to be my last.

My cries brought a smile of relief to my mother’s face so thereafter I continued to cry and occasionally to gurgle, then to babble and then to coo and then to  mimic my mother’s smile – as this seemed to please her. However, since then I have experienced occasional difficulties breathing.

One such episode several years ago preceded an admission to A & E and some major surgery for the removal of a cancerous tumour from my bowel. I learnt that hospitals can be both healing and dangerous places in which to spend one’s time.  I was on nil by mouth for what seemed like months and so was unable to either enjoy or complain about the hospital cuisine. Then I contracted MRSA (meticillin-resistant staphylococcus aureus) a bacterial infection that is resistant to a number of widely used antibiotics and was placed in isolation for what seemed like many more months.

Recently I have again found it difficult to breath and began to experience palpitations. So on a grey, wet Monday morning I made my way to my local GP surgery and joined the queue. There is an appointment system of course but on Monday this is a bit like the buses. Whatever the designated time, you wait patiently and are grateful to be transported to your required destination.

Medical nemesis

I’ve a habit of carrying a book in my shoulder bag to engage my mind during periods of enforced idleness. While waiting to be seen on this particular morning I was re-reading a serious tome called Medical Nemesis (1976) by the late Austrian philosopher and cultural critic Ivan Illich 1926-2002.

In this blistering critique of the medical profession and pharmaceutical industry Illich introduced a new word iatrogenesis which has since become an accepted part of social science parlance. Little did I know how intimately I was to become acquainted with its meaning. The GP calls out my name:

GP: Hello Sean. You don’t mind if a student sits in?

SOS: No, not at all.

SOS: Oh doctor, I’m in trouble.

GP: Well, goodness gracious me.

SOS: My heart beats much too fast.

GP: Mmm. What are we to make of that?  (To student) Could you take Mr O’ Shea’s pulse?

 The student tries to take my pulse.

Student (nervously)  Can’t feel any pulse.

GP: Well, Mr O’ Shea must be dead then if he has no pulse!

The doctor smiles and takes my pulse.

GP:   Mmm. Let’s see if there is any heart beat.  My… quite a dance. Irregular heartbeat and pulse rate, atrial fibrillation/arrhythmia…  (To student) What do you make of it?

Silence…

Looking quizzically at the doctor I thought to myself … perhaps you should take the student’s pulse.

GP: Well, Mr O’ Shea or more specifically Mr O’ Shea’s heart is, in laymen’s terms, definitely out of tune, off- key, discordant, decidedly hitting a clinker. Atrial fibrillation (AF) and we need to check out what else may be amiss.

He turns to his computer and taps out a referral to a cardiologist for further tests and assessment and prints a prescription.

GP: Meantime take these meds. (He hands me the prescription.)  You should be seen in a few weeks. Too-da-loo, Sean, pecker up!

Iatrogenic illness

From the Greek for healer (iatros) and origin (genesis), the word iatrogenesis means an illness induced by a physician.  Examples of iatrogenic illnesses are the common side effects of prescription drugs and their sometimes adverse reaction with each other.

My prescribed meds included a beta blocker some of whose side effects are feeling tired, headaches, stomach upset and nausea.

In case this wasn’t enough to be concerned with they also included a possible wheezing and whistling sound when breathing, inflammation of the airways, bronchospasm (tightening of the muscles around the bronchial tubes) and infections of the throat and mouth. Needless to say I succumbed to the full panoply of these side effects and was back in the surgery within a week. I had to get a lift from a friend as I could hardly walk.

I was taken off the beta blockers prescribed antibiotics and put on a diuretic and a variety of other heart meds. The diuretics increase the likelihood of gout attacks and within a further week I succumbed to a severe attack of gout which immobilised me for weeks and still hasn’t entirely subsided.

I couldn’t do without the diuretics. Further medication to combat the gout was likely to interact adversely with the heart meds so I declined the treatment. I explained to my GP that as an erstwhile Catholic I was accustomed to a certain amount of suffering for my sins, and I’d prefer to put up with the gout than risk further side effects from the potential toxic effects of the available treatments for that particular ailment. I also told him that I intended to make some lifestyle changes dietary and otherwise. And yes, that would have to include a radical reduction in my alcohol consumption. Cheers!

By the end of the third week I felt like the old lady that swallowed the fly –

 There was an old lady who swallowed a fly.
I dunno why she swallowed that fly.
Perhaps she’ll die.
There was an old lady who swallowed a spider,
That wiggled and wiggled and tickled inside her.
She swallowed the spider to catch the fly.
But I dunno why she swallowed that fly.
Perhaps she’ll die.

There are those who maintain that Illich overstated the case against the medical profession thus overlooking its positive features. While the jury may be out on this issue I feel fortunate in having a good humoured GP and am grateful to continue breathing. This now seems in large part due to the meds which I have been prescribed in spite of their toxicity.

If restored to normal rhythm further investigations will be required to determine the nature and extent of my heart’s impairment. The Grim Reaper has laid his bony hand on my shoulder on a few occasions and I’ve survived. Yet, and while fully respecting that he’s the one who calls the shots, I say to him this Christmas that I’m not quite done with making a nuisance of myself. I would like to view the salt waters and enjoy the sea air at the Fisherman’s Beach just a little while longer. I would like to savour a jar (alcohol free lager!) and warm my extremities by the log fire at the Stag Inn. And I also look forward to interviewing some more of Hastings musical talent in 2014.

In hard times I wish all my colleagues at HOT, and all readers of this unique and feisty little magazine a Happy Christmas and New Year.

SOS

December 2013

 

 

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