Monday, March 04, 2013

On This Day In History........

Tis that time of year again when I remember the skills of Mr. Nair, or Mr. Ramanpillai Unnikrishnan Nair MBBS, MS (Genl), FRCS (Eng & Ed), FETCS to give him his full title.

20 years ago today, Mr Nair tinkered with my ticker's plumbing by replacing a few parts of blocked piping from near my heart with bits cut from a length of good piping from my left leg.

As a result, my heart is still going (fairly) strong but my left leg withered and died !  Joking.

I used to look at statistics for how long such grafts would be expected to last but I gave up many years ago.  Most people had bypass surgery in much later life than me and so would die 10, 12 or 15 years later from various causes not always related to their surgery.

Last December, soon after the 20th anniversary of the heart attack that necessitated the surgery, I made email contact with Mr. Nair to both thank him for what he had done for me and to just let him know I was clearly one of his many long term success stories. I also shared my concern that I might be on borrowed time.

I got the following reply the next day.....................

Thank you very much for writing to me. I am very pleased to hear that you are doing well. 

Please don't get too anxious that your grafts are 20 years old. I had to operate on an ex-patient last year who had had a triple graft 21 years earlier and this time he needed an aortic valve replacement. When he had the repeat angiogram as part of the pre-operative investigations, all the three grafts were found to be in excellent condition. So it rewards you to look after yourself by being regular in health activities and diet, which can prolong the lifespan of the grafts. I hope this case history will give you some reassurance.

I retired from the LGI in March and have in the last few months stopped seeing patients privately as well. It is very kind of you to write to me to show me your appreciation, which I will cherish with gratitude.  

Not many cardiothoracic surgeons would have bothered replying but as well as being a wonderful surgeon, Mr. Nair was a lovely man....and only 5 years older than me !

As I've said before on this blog, I went 'private' for my surgery for several reasons.

1) I had free private cover (BUPA) through work.
2) The NHS waiting list for my surgery was 6 months.
3) Mr. Nair said I probably didn't HAVE 6 months.

So it was a no brainer really !!

I've still got the itemised bills from all parties which I then passed on to the insurance company who then sent me their payment details. The total for everything, including the tests before surgery and the physiotherapy afterwards came to £15,991.

Normally I'm a fully paid up NHS patient so back then it was an eye opener to see everything itemised from the actual surgery fee to every aspirin I was given, from x-ray charges to sticking plasters. One item always peeked my interest.........

Fogarty Softjaw 6mm Spring Clip..........£25.98.

Apparently this reduced-force spring clip minimizes vessel trauma while maintaining occlusion so hopefully not an item sourced from B&Q.

The thing that got me was that it came under the bill heading of a prosthesis it still inside me ?  I know my chest was cracked open to give access to the 'working area' and that metal wires were later used to hold it together short term while nature did it long term. 12 weeks after the surgery I flew to America for a holiday ( far as work was concerned !) and I remember half hoping I'd set off the metal detectors at the airport !

I didn't.

I took some video of my time in the hospital......just in case I didn't make it.  A sort of living will thing.  I remember talking to the camera a few hours before being taken for the operation and it was quite surreal doing so. I also took much happier footage after I'd come out of the ICU and was able to walk a few steps. I filmed my left leg where the long 'angry' line of the cut (from just above the ankle bone to mid thigh) was held together with numerous staples and also the lesser scar on my chest.  The leg one looked much worse and hurt much worse too. Go figure.

Sadly that video tape from 1993 has gone AWOL and that's a shame. I may have loaned it to someone, never got it back and now I've no clue where it is.  As the footage before the operation was kinda personal, I'm not even sure I would've loaned it out so maybe, just maybe, it's in the house somewhere.

Anyway.....20 years ago eh ?!!  Doesn't time fly ?  At least it's time I've been given and the great thing for me is that for the last 12 of them, I've been retired and so better placed to enjoy them.  Wooohoooo.

And once again, thank you Mr. Nair. Enjoy your retirement too !

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