Medical Merry-go-round etc.

October 3, 2025 ~ quantumdreamer ~ Leave a comment

This morning I have had my pre-operative blood {oil level} check. As a part of this I will have a full blood group determination done. In case I need a transfusion. Despite having had a number of surgeries I do not know my blood group, aged 61. I could get a surprise tomorrow.

My mother was AB negative and my father was O type. Which means that I should come back A or B. AB negative is rare ~1%, my mum would have had to have shagged someone of a non O type of blood for me to come back AB too. If I come back O I have been swapped at birth. Something I have long suspected. 😉

This has the potential to alter my perception, a weird kind of lottery.

The amount of medical administration we have been doing is large. I have a preoperative X-ray and a day of appointments with physio, anaesthetist etc. next week. I’ll even get a tooth fitted to my titanium jaw implant. If I take bis-phosphonates for osteoporosis I can’t get any more tooth or hip implants. After the hip op I will have two bionic hips so the osteoporosis hip-fracture risk is low. Titanium does not break easily. The bis-phosphonates are likely to be delayed.

Hip op sounds a bit like hip hop.

I think I am mentally ready for the surgery. It will be around six months before they do the second joint. It might be strange being able to tie shoelaces and put socks on unaided. There will be a weird in-between. I can’t wait for the sexy anti-clot stockings and daily heparin jabs. They prescribe laxatives to go with the morphine.

Piss holes in the snow pin hole pupils are on the cards.

I should be out of the opium den by Christmas.

There are a few “must dos” left before the blade. But most is in hand.

Here there is a bit of last minute.com flurry mentality, there must be hectic dramas it seems. Place back of hand on forehead and swoon. We have tried to buck this trend and get things done in a more leisurely planned and timed manner. Of course there could always be that last minute spanner, but I hope we have built in time to flex and not rush about like a March hare on amphetamines.

But as we all know the best laid plans of mice and men often go awry. There are only so many contingencies which make sense…

We will know what at-home adjustments need put in place after the appointment next week…This gives us time to execute.

I am curious to see what the outcome will be. I have a good idea about the pain etc. because of the prior hip fracture repair. My guess is that the healing will be easier. I had to wait three days immobile to get the pin fitted in my hip which can’t have been good for prognosis.

We shall see…it will be what it will be…

A Fly in the Ointment – ECG ST Segment Depression

August 6, 2025August 6, 2025 ~ quantumdreamer ~ Leave a comment

Earlier this week we learned that the specialist machine doing CT angiograms is very busy at the big hospital in Saint Brieuc. They are backed up and will not be able to do the study before the date upon which my hip operation is scheduled. This means that the risk is less quantified. They are possibly worried a little about how I might respond to being hacked open and losing a few wine glasses of blood while someone saws off the head of my femur and whacks in a Titanium implant.

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The added concern comes from my recent resting electrocardiogram (ECG) in which the ST level was depressed below the isoelectric point.

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The ST segement is seen as potentially diagnostic for a number of conditions, lowering is correlated with these things.

Causes of ST segment depression:

Myocardial ischemia

Hypokalemia

Digoxin

Cocaine

Left ventricular hypertrophy (with concurrent T wave changes)

Bundle branch blocks (with concurrent T wave changes)

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I can exclude the three middle suggestions unequivocaly.

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The depressed ECG ST wave form is characterised as above into three basic types. My ECG has a lowering of about 1 mm and is most like the horizontal depiction above

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Bearing in mind that I have spent decades looking at spectroscopy traces on chart paper, oscillosocpes and computer screens it is easy for me to spot “anomalies”.

Whenever I see ECG traces the first thing which comes to mind is, “why is the data so shite?”

Is the test human not grounded, is there a floating earth?

Can’t they do better, develop better machines, improve protocol?

Verbally the cardiologist wanted to check for myocardial ischemia or ventricular hypertrophy. The latter can come from being overly athletic in which case it is ok or it is simply that the heart if gettting old. Back in the last century I had strong athletic tendencies.

He has propsed a so-called cardio stress test. They asked me if I could pedal. Maybe enough to raise the demand on the heart…we shall see.

Going left to right the power output by the human hamster wheel rider increases by 50 watt quanta B-C. This data shows the depression of an ST ECG trace as incresing demand is placed upon the heart.

“Reversible ST-segment depression is the characteristic finding associated with exercise-induced, demand-driven ischemia in patients with significant coronary obstruction but no flow limitation at rest.”

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The jury suggests that this methodology could tend the “diagnosis” either towards or away from ischemia or blood supply insufficiency. The guess was that my aging heart was just as bit too big and aged. The holy trinity of fat, fags and booze have given me their sacred blessing.

If I am losing blood during the operation the heart will pump that little bit harder.

All the articles suggest that when a stress test is done there is a medic present who is cardio-trained in case the stress test causes a heart attack…

It was mooted that an appointment for this stress test may also not be easy to come by. The pre-op anaesthesia meeting is scheduled about 1 month out before the operation.

If the ST depression is unexplained, will they go ahead or will they insist upon more data?

There is a potential fly in the ointment.

We have found that in general the French are more keen on lastminute.com than we are…I foresee a mad clustering of yet more medical appointments early autumn…

Flesh Wounds and Loyalties

July 21, 2025July 21, 2025 ~ quantumdreamer ~ Leave a comment

Cultural references rarely cross well between cultures. Similarly some are age group specific. I am sure that many of mine would lead balloon with the youth. This morning the GP suggested to the wife {during her appointment} that my upcoming appointment on Friday was not necessary and that there were people who were more needful. Probably true. So we cancelled the appointment to free it up for others. The stiff upper lip, not making a fuss, just a flesh wound mentality may not have crossed her mind. It is not rational to think like that. Couple that with my introversion seeking to avoid unnecessary social contact and…I am not important.

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What is a disaster and end of the world to some is just a flesh wound to others. I am not keen on arguing. I am already assuming that we will drop a number of lines of inquiry in the health saga. They are frills rather than life threatening. The cardiologist has said that there is an inexplicable part of my ECG that warrants further investigation, which will in due course be done. From the write up he has gotten the wrong end of the stick about our conversation. This miscommunication happens a lot here. My non-expert clinical judgment is that it is not a big deal. I am making that judgement call.

This morning’s dream had a wounded dog in it. Dogs are the dreaming symbol for friendship and loyalty. The dog gets killed by a pine marten. Because of my itinerant childhood, I have no strong sense of spatial belonging, I do not belong to a place. When people ask where I am from, I can say my birth city, Cardiff. I have a sense of home in the village of my ancestors at Beddgelert though I never lived there and a sense of childhood in Mount Isa, Queensland. That is my last stable child-memory.

The longest time I have ever spent anywhere was when I worked at Imperial College, 13 years. I have no fond memories (smoking excluded) of my time there which was largely a struggle and I have no loyalty to that institution. When we watch University Challenge, I do not egg the Imperial team on.

I have one personal loyalty and friendship only. I certainly don’t feel British, Welsh yes. I feel more Southern Hemisphere in outlook.

I know that I am a migrant here. It does not feel ex-pat, it feels migrant. I am not socially integrated here and nobody has done anything to secure my loyalty. The sense of being partially tolerated is what I feel / experience.

As things are customarily measured, I have no friends outside of this house. I owe nobody allegiance or loyalty and nor do I demand it of anyone, nor do I feel owed any loyalty by anyone.

We have invested a lot of sweat into the house and land here, but I don’t “belong” here though it is home. The other day whilst awaiting my colonoscopy I looked out the hospital window at the hillside there. It did not draw me, pull me and say belong. I suspect our time here draws to a close. If I am honest, I am marginally disappointed with my fellow Celts. There have been exceptions like the mole catcher.

I do feel more European than British, but in a pan-national sense.

Loyalty is a weird word. I do not know what it means and rarely have I experienced it towards me.

Woof…