Friday, April 18, 2014

Front garden April 15



Angiogram commemtary

The grafts by Mr Desai from December 1995 were all in 'pristine condition, but one of them was connected to the remains of the heart artery by a length of the original artery that was all furred up and therefore not supplying blood to the heart. This was the probable cause of the angina, and it isn't susceptible to surgery. Stronger anti angina medication, Ranosaline, is added to the arsenal I'm already taking.

The procedure took two hours, partly because the faulty connection wasn't accessible via the groin, and the surgeon had to start again via the wrist.

Afterwards I was exhausted and slept the whole afternoon and evening apart from a break for dinner and a short bit of reading at bedtime when I finished Max Hastings' Catastrophe about the events leading up to the Great War and the fighting up to the end of 1914. He puts the blame for the war squarely on the Kaiser and Germany's top generals, and he sees no point at which other players could have acted to avoid it.

I put the light out at 22.00 and slept solidly through to 08.00 this morning, and very unusually for me.slept this afternoon from 15.00 to 16.00, when I wass woken up by the front doorbell.

We still have no internet connection via the router after nine days off the air, and as its Bank Holiday weekend nothing can happen until Tuesday. The current thinking of the Parliamentary IT hep desk is that the cable modem is only seeing one IP address, which explains why there is a connection to one computer with the router disconnected. If this is correct, a replacement cable modem should cure the problem, and one has been despatched by Virgin to arrive on Tuesday. In the meanwhile any urgent printing has to be done by saving to a USB memory stick and taking it to another machine which is connected to its own printer. Similarly any files needing to be scanned have to be saved to a USB memory stick and taken to the only ,achine that haqs internet connection when it needs to be emailed. The only consolation is that there isn't a huge amount of traffic over the Bank Holiday weekend,

Angiogram April 17




Tuesday, April 15, 2014

Angiogram

To be performed the day after tomorrow:

What is an angiogram?

An angiogram is an X-ray image of blood vessels after they are filled with a contrast material. An angiogram of the heart, a coronary angiogram, is the "gold standard" for the evaluation of coronary artery disease (CAD). A coronary angiogram can be used to identify the exact location and severity of CAD.

How is a coronary angiogram performed?

Coronary angiography is performed with the use of local anesthesia and intravenous sedation, and is generally not significantly uncomfortable.
  • In performing a coronary angiogram, a doctor inserts a small catheter(a thin hollow tube with a diameter of 2-3 mm) through the skin into an artery in either the groin or the arm.
  • Guided with the assistance of a fluoroscope (a special x-ray viewing instrument), the catheter is then advanced to the opening of thecoronary arteries (the blood vessels supplying blood to the heart).
  • Next, a small amount of radiographic contrast (a solution containing iodine, which is easily visualized with X-ray images) is injected into each coronary artery. The images that are produced are called the angiogram.
  • The procedure takes approximately 20-30 minutes.
  • After the procedure, the catheter is removed and the artery in the leg or arm is either sutured, "sealed," or treated with manual compression to prevent bleeding.
  • Often, if an angioplasty orstent is indicated, it will be performed as part of the same procedure.

What does a coronary angiogram demonstrate?

Angiographic images accurately reveal the extent and severity of all coronary artery blockages. For patients with severe angina or heart attack(myocardial infarction), or those who have markedly abnormal noninvasive tests for CAD (such as stress tests), the angiogram also helps the doctor select the optimal treatment. Treatments may then include medications, balloon angioplasty, coronary stenting, atherectomy ("roto-rooter"), or coronary artery bypass surgery.


Friday, April 11, 2014



Bangladesh seminar April 1, see http://www.thedailystar.net/dialogue-a-must-to-uphold-rights-18361

Thursday, March 20, 2014

Immigration Bill

Eleven contributions on the Immigration Bill Committee stage yesterday, including a win for certain illegitimate children: http://bit.ly/1l8lmHS

Haematology

Blood test yesterday:

Plt             535 (638)
Hb              10.4 (10.4)
WBC            5.3 (6.5)

There bis no explanation why the platelets have improved with no change in the hydroxycarbamide dose, but it simply means the dose is kept at its present level. It would be unfortunate if the platelets did start rising, as a higher dose would cause a reduction in the level of haemoglobin.

Tuesday, March 11, 2014

Vascular surgery

Consultation with Mr R March 5:

".... The duplex scan today confirmed that his aneurysn is now only 3.3 cn in diameter without any endoleak".

" Mr S booked him for an angioplasty of his left leg, since he has a short segment occlusion of the femoral artery at tthe adductor canal. However, I am not convinced that his symptoms at this stage justify intervention. He is not complaining of rest pain, ulceration or gangrene, ie critical leg ischaemia. I have therefore cancelled his angioplasty".

Mtr R's assessment of the risk of angioplasty appeared to be a good deal higher than Mr S's, so I have to put up with pain in the leg if I walk at a normal speed.