As I said in my last post, I felt so much better, within about a half hour after the ‘event’. Blood pressure taken at home, was somewhat high, mine is always very low, and that was another thought I had when I had the syncope, that perhaps my pressure had bottomed out for some reason and that was the reason I couldn’t feel my pulse. And now at home, the pressure reading of 138/86 was considered high by me. BUT, I was feeling better. My host wanted to take me to the ER. But he told me that going there would mean that I would have to wait for 6 to 7 hours to be seen by anyone, because of the fact that it was a weekend. And if I were to be seen at all, it would be by an intern managing the ER, because the Attendings and the Consultants did not do any work over the weekend. And because I had started feeling good, and because I was sure that it was a vasovagal syncopal event, and because doctors are the worse patients, I opted to wait till Monday!!
My classmates from medical school came to visit me on Sunday. Originally the plan was to meet them at the Kew Gardens in London and spend the day with them and with their spouses. But on Saturday, I called and talked to them and informed them about the setback that I had and they all came over to see me in Middlesex where we were staying with Adila and her husband Arif. It was a good reunion, and we all were laughing about the vasovagal syncope that I had, and how I was pretending to draw attention to myself etc. etc. They took all of us out to a South Indian restaurant in South Hall, a predominantly vegetarian venue. Had a great lunch amidst lots of laughter and camaraderie.
Later that night, Arif took me and M for a ride to Central London to see the city by night. Stopped at various landmarks and I was in and out of the car taking pictures of different things and places. While I realized that I had no pain or symptoms of angina, I did feel some discomfort as if there was a feeling of buzz in my chest. I had felt that for many months prior to the event, and also the shortness of breath. I always put it behind my thoughts; considering those symptoms to be age related.
Anyway, to make a long story short, Arif called the consultant on Monday morning, and tried to get me in. Of course there was no way to get in on such a short notice that same day. So I was given a 4 pm appointment on Tuesday, the 4th of July… three full days after my spell. The best thing was that this guy’s office was on WIMPOLE STREET! Do you all remember the Barretts of Wimpole Street? Robert Browning and Elizabeth Barrett Browning the poets of Wimpole Street?? OMG! I was so excited to go to that street, not to see the cardiologist, but to just walk on the ground of that hallowed street.
The Cardiologist was a young Indian man. He did an EKG, and drew some blood for electrolytes. The EKG was normal. I saw it, and it did not look any different from the ones I have had before. We had a long chat and he concurred with me, that it was probably a vasovagal episode due to the stress of travel, jet lag, irregular hours of eating etc. BUT, just before I left his office, he said, “DR. Ali, just to be safe, and for our peace of mind let us do a Troponin level.” At that all kinds of bells started tinging in my head. I just stared at him, as if to say, “How dare you!”
Troponin is a very specific cardiac enzyme, and tells you if there is an injury to the heart. The normal range is 0.01 to 0.03. Anything over and above is considered a suspicion or a definite cardiac event. So I subjected my self to another blood draw, and thanks to National Health System, the results are not seen immediately as we have here. (We get our results within 15 minutes to an hour) But the doctor told me that he really didn’t expect any problem and that I could go back, and he would call us the next day with the result of the blood work.
I was feeling fine on Wednesday morning. So Adila and I took off to go shopping. I had not done one iota of any kind of shopping for my children or grandchildren. I was excited to get a few things at the specialty stores there. We were in the store about 10:30 and had just started selecting a few clothes, when Arif came barging in to the store. He had driven from home and was looking for us in different stores. He looked at us, and said,
“Zakiah, I have bad news for you. The consultant called a few minutes after you left. You have had an MI. Your Troponin level is 2,500!! At first I thought he was joking. Two thousand five hundred?? I had never seen that high a result ever! Then he reached over and hugged me, saying, “I am sorry dear friend, but the consultant is very concerned, and he is arranging for a room at the local A&E (Accident and Emergency) hospital, and you will be transferred to the cardiac hospital in London proper for an angiogram and stents.”
I think I was out of my own body at that time. I was in a zone. I couldn’t think, couldn’t speak and couldn’t focus on anything. We got home and I talked to the consultant myself, and told him, “Listen, I do not want to go through the procedure here. I will start myself on Beta blockers and Ace inhibitors, continue with aspirin, and go home and get things done in my country. The guy said, “I very strongly advise against that. I will not allow you to be taking such a dangerous step.” Pfffttt!
Let me finish this tomorrow. Isn’t this so horrible?? What a nightmare!