Chronicles of the Heart – The Angina Dilemma and other stuff…

Angina is often described as a severe, crushing, chest pain. And it can be, as I know all too well. It can also radiate from the chest to the shoulder, jaw, and down the left arm – useful for eliminating severe heartburn which can be just as painful, but doesn’t radiate.

What confuses the issue for me, though, is that instead of radiating from the chest, it can present as stomach, back, or shoulder pain independently of any chest pain. As I can get such pains in the normal course of events, just how do I tell them from atypical angina?

True, I could take a hit of my GTN spray, and suck on an aspirin, just to be safe, but the GTN side-effects can be nasty – if I cough soon after a squirt, it feels as if my lungs are being ripped out, and that’s before Headache Central comes online! For me, GTN is a last resort, used if resting fails.

I’m thinking, though, that side effects notwithstanding, I need to take GTN at the first signs, possibly with a shot of codeine linctus to lessen the risk of coughing (I find it hard to imagine that pain of such severity can happen without damage of some sort).

There’s also the worry – and considering all that’s wrong with me, trust me, I know it’s not logical – that if GTN works it confirms angina, which might indicate CHD or might just (just – ha!), be a worsening of my heart failure. It’s even less logical when you consider I’ve had bouts of angina since the mid 80s (diagnosed, then, as oxygen-deficiency induced, which made sense). Still, at 3.30 in the morning – the time at which most people die, apparently (or so I’ve read**) – logic doesn’t count for much.

**As my nocturnal crises always seem to happen around that time, I can well believe it.

And I had another last night – a repeat, almost, of the day I was hauled off to hospital – but without the bleeding so possibly a very bad asthma attack rather than pulmonary oedema. Didn’t feel that way, though – it felt exactly like the latter. (And, interestingly, with hindsight, the carbs and grease trigger might have come into play. I’d had a tub of full-fat cottage cheese, a regular bedtime snack as it helps me sleep, but I was still hungry so had a couple of slices of bread (home-made), with Clover. I’ve already identified cake and Clover (carbs and fat), as a trigger, this combination was also carbs and fat, so I shouldn’t be too surprised at my reaction.

Managed to get to the living room (where I keep my inhalers and big Volumatic spacer gizmo – I have a second set bedside but with a much smaller, less effective, spacer – the Volumatic seems to be hard to find these days – must try and find another for the bedroom though). The Volumatic allows me to inhale half a dozen squirts of inhaler in one breath – invaluable when breathing in is at a premium.

Three things that I need for medical support if I’m to survive these repeated attacks:-

1. Domiciliary oxygen is a must for these emergencies. I don’t care if it’s by cylinder of by concentrator – I NEED it!

2. I need what I had in hospital – Salbutamol and Atrovent nebules – very effective in combination.

3. I need a GP who will prescribe these without bitching and whining about the numbers when it comes to oxygen (I’m not asking for it full time, but for emergencies), or pissing on the idea because of the cost. Without oxygen and additional drugs, like these, I am simply not going to survive.

Nor do I want to spend what’s left of my life being shuttled in and out of hospital, with its attendant risks of infection and the seemingly endless fuckwit attempts on my life. One day I won’t spot the drug overdose, or the air bubble in the i-v line…

I have the knowledge to be able to handle this, safely and effectively, at home. I should be supported in that.