HEART TO HEART

So far only my Family and a few very close friends know what the late Seamus Heaney and the late David Frost have done to me.Oh! And about umpteen Health professionals.

It all began a couple of months back when the Irish Poet Seamus Heaney died of a Heart Attack aged 74, closely followed by the English TV Journalist David Frost who died two days later at 74 of a Heart Attack. It occurred to me, that at 73 yrs. of age, the two events might suggest a little caution. So, I put the suggestion to my excellent G.P. and he arranged for me to have a Stress Test at Hornsby Hospital with an associated Electro Cardiogram.

I lasted about 7mins 40 seconds on the tread mill, at progressively faster and steeper settings, ending up running up hill. The Doctor supervising the test noted a possible problem, and recommended a CT Angiogram. This called for a referral to a Cardiologist .The test was done in due course and indicated 3 locations of calcification on the arteries around the heart.

Back to the Cardiologist for his take on the results. Not what I wanted to hear.

The test had shown calcification of the main artery leaving the heart - and additional calcification of a lesser degree in two other places. He said that on the basis of these results, there is a 16% chance of an "adverse event"(read heart attack, stroke or death) within the next ten years without intervention. That intervention would take the form of a triple by- pass. This should promise a 15% minimum increase in life span and a 25% increase in physical capability after a thorough recuperation.

However, before definitely proposing that course, he wanted me to have an Invasive Cardio Angiogram. This proved to be an interesting exercise in which a miniscule probe is inserted through a puncture into a blood vessel in the groin under mild anaesthetic and then maneuvered up into the heart's arteries for an inside look via ultrasound. All the while I was laying there surrounded by Doctors and nurses in large numbers and an X ray pad on the end of a robotic arm was dancing around my chest like something out of a Disney space movie.

The result confirmed the earlier tests, showing one blockage - the main artery out of the heart at 75% blocked at its mouth or beginning, and two others further out, blocked at 60% and 50% respectively. The Cardiologist, not one to miss a chance to be more cautious, announced that the 16% was now 20%! And that he was now decided that the by- pass surgery should take place, but....just wanted to do one more Stress Test under his personal supervision before sending me to the Heart Surgeon. I did the Stress Test. He acknowledged that I did better than he expected, but confirmed that the surgery was required.

The Heart Surgeon proved to be a very impressive man - late 40s early 50s, very trim and disciplined, nice manner and good gentle sense of humour. He is married with several children and so has his feet on the ground - no airs and graces, though he is obviously used to speaking with authority and having things done professionally as he wants them done . He agreed with the Cardiologist but just wanted me to undergo an Ultrasound Examination of the Carotid Arteries (in my neck) to ensure that the problem was not present there also.

He had me fill out the Royal North Shore Hospital Admission Forms and leave them with him.

I had the Carotid Ultrasounds done and delivered the results to him after showing them to my G.P. The latter commented that they presented no problem for the Surgery .Then I received a call from the Hospital to attend a Pre- Admission Clinic last Monday. I did that, seeing about eight different people in 5 hours, and all with their different areas of interest. Seems that I proved acceptable. I was presented with piles of material to read, other bits to sign and a very helpful booklet on the whole subject including preparation, the operation and recuperation. (It seems they have done this before!)

The Cardiologist was appalled, and the Heart Surgeon amused, when I told each of them that from all that I had read, Bypass Surgery seemed like a planned catastrophe! No doubt it is a massive attack on the body I have been occupying these last 73 years, but a necessary one to avoid one of those " adverse events" and , after recuperation, to rev the whole thing up a bit. So there you have it.

I am in the hands of the Hospital and the Heart Surgeon as to the date of the operation, but it seems it will be fairly early in the New Year. The timing after that is 1 or 2 days in Intensive Care, then about 7 days more or less in the Ward, then about 6 weeks progressive recuperation back to virtually normal - which should be reached after 3 months or so.In the meantime, a very heavy burden on my dear wife Robyn, who will have a very heavy load to carry especially in the earliest stages of the recuperation.However, we have the assurance of help from family and our dearest friends.

I am determined to do my level best to get to the situation of normality as soon as prudently possible. I will keep you informed.

THE VERY BEST OF HANDS

SUNNY SYDNEY FROM THE AIR LOOKING
SOUTH TO BOTANY BAY

This is where I grew up, in the Western Suburbs off in the top Right Hand Corner of the above picture. But this story starts with that clear blue Aussie sky! And the relentless Sun which beams its UV Rays down on this big, bold and brassy town. I lived here from my birth in 1940 until 1982 when we moved to Brisbane after my appointment as Queensland Manager of the Banque Nationale de Paris ( formerly the Comptoir Nationale de' Escompte de Paris and now BNP Paribas).

Through all those years, I had been fairly careful to avoid sunburn apart from one or two occasional accidental incidents each decade or so. My German - Celtic - Anglo constitution left me with a complexion prone to sun damage. When I was about 6/7 yrs old, the local Doctor who later proved himself of no use whatsoever in relation to my poor Mum's health, had issued the warning that I was to be kept out of the Sun, wear a hat and cover my face and nose with white zinc ointment!

Now, if you know ANYTHING about young boys, they do not usually like to "stand out"by looking different. So the very thought of wearing the sticky muck of Zinc Ointment on my nose and cheeks, was anathema to me . If it was put on I wiped it off, and I would not volunteer to put it on. AND I have NEVER been a hat person!!! ( Though I own both a bash hat - for lawn -mowing : now History, and a Beret : French style awaiting a suitable occasion!). But, by and large I did , generally keep out of the Sun although...... Well, for many years I suffered no apparent ill effects from this life of daring!

Then,about a year after my wife and I were married, and after the birth of our first child - our "little ray of Sunshine"our daughter Marianne was born, a persistent tiny sore on the upper part of my nose near the left eye was diagnosed as a skin Cancer of the least dangerous kind - a B.C.C. Arrangements were made for it to be excised  and the Specialist Surgeon Dr. John Harvey Drew did a marvellous job under local anaesthetic at a Private Hospital at Eastwood where we then lived. Through the whole operation which involved a graft, executed with brilliant precision going just to the corner of the eye without pulling the lids or causing any distortion, was carried out while the doctor and I discussed the disaster that was the Whitlam Labor Government - fortunately we were both of the same opinion.

Well, the years went by and there were no more problems . The good times rolled - a second daughter, Justine was born in 1973. But in 1974 we lost a child through miscarriage - The disaster of that loss has been highlighted by how much better such losses are handled to-day. But 1975 restored our good fortune  and  our son Matthew was born. 

SUNNY BRISBANE - URBS BEATA

In 1982 we made the move to Brisbane in Queensland . Ah! Brisbane! Urbs Beata! The Blessed City 600 miles ( 1,000 Kms ) North of Sydney,in Sunny Queensland! "Beautiful one day! Perfect the next!" Life was good a lovely and loving wife, three wonderful children a fine corporate house and car and many other benefits and so many good and truly lasting friends. And the Sunshine!

After a few years I had on different occasions a number of spots removed, but none were actually cancerous.After 5/6 years we were transferred back to Sydney when I was promoted to Deputy and then Manager of the State of New South Wales . But the Bank was transforming itself into a pure Merchant Bank and I did not have that experience - I could see the writing on the wall . We had to spend about six months in Canberra sorting out a major problem there and seizing a multiple attraction opportunity back in Brisbane, I resigned.

I took up the position of Canonical Financial Administrator of the Archdiocese of Brisbane.We were back in the Sunshine State!

We were to be there on this occasion for 25 years before returning to Sydney last year.

I kept up a steady series of at least biennial visits to the Specialist who regularly checked me out for skin cancers. In 2008 he determined that a difficultly placed skin cancer on my right shin should be excised and grafted over , and at the same time he excised another on my nose (LH side) and covered by a "flap"- i.e. drawing the skin across it. The ankle operation was very delicate to ensure that the graft would take. It worked with a week's immobilisation which unfortunately resulted in DVTs which fragmented and caused the collapse of my right lung , which later came good with medication . It also resulted in months on Warfarin that pestilential medication that requires such close monitoring! But all came good and the nose operation also worked well.

The FIELD OF ACTION

We finally returned to Sydney in 2011 (ages 71 and 70yrs) to be closer to the majority of our family and oldest friends. Here I resumed consultations with doctors and a recurrence of the nose problem and another slowly developing area on my left temple led to the present phase of corrective surgery. 

At Royal North Shore Hospital 10 days ago a superb team of MOHS Surgery experts excised the left temple BCC ( as the Biopsy proved it to be) and under local anaesthetic ( involving needles in the temple - sounds like an Asian Novel!) did what they term a "flap". This involved a long incision down the side of my face immediately next the left ear ,down to the jaw and drawing the skin over the excision wound - all without distorting the noble visage! Neat! And the scar which will be very fine will tend to be less noticeable because of its location.

Part II - the Nose - is a different exercise - Biopsy showed mercifully that this was also a BCC, but - and we are talking fractions of millimetres here, it is rather deeper than can be covered by a graft. So.... in mid September its back to the ugly chocolate brick pile of Royal North Shore Hospital where my nose will become a two act show : Early A.M. Mohs surgery to excise the BCC, then straight away up to the Plastic Surgery Operating Theatre for another more ambitious and complex "flap". As the impressive, gentlemanly, and considerate young (35?)Surgeon explained it to me, this will involve a general anaesthetic and some borrowing of living skin from my forehead to temporarily place it on my nose for 3 weeks, then a return to put it back where it belongs !! Amazing stuff. Not convenient of course - my head will be heavily bandaged for the 3 weeks and less so for a further few weeks after the restoration . But I can handle that as long as I have the promised eye holes and I can get my headphones to my ears. During this period of "wrappedture"I hope to listen to the three volume Shelby Foote  history "The Civil War" and the Herman Wouk Novel "War and Remembrance"which has been recommended and given to me as an audiobook.

It would be helpful if I can move around readily - but that will depend on the quality of vision through the eye holes!! Wouldn't do to stumble!

My greatest regret is the burden it will place on my dear wife Robyn - living with a bandage headed old guy for around 5 weeks. But I recollect we went through something similar - though more brief- years ago with the roles reversed! 

So there you have it - the long term results of occasional unprotected exposure to the Sun!!  The real "white man's burden!"to use that vicious old British phrase! 

Happily for our grandchildren - as for our children before them - hats and Sunscreen are now just part of life. Yet when I was young, I remember reflecting that it was only silly older generations that wore hats - we were free of all that fashion! We do live and learn!

I hope to prepare a "Bank"of Posts I can put up during that period with the minimum of keystrokes!


The Surgeon assures me of the "best cosmetic result!"So,just like a Hollywood Star! Without the secluded Desert Retreat to hide away until presentable! As long as the result bears a reasonable likeness to my ordinary visage! Brings to mind the story of a painter who presented a portrait of Pope Leo XIII (POPE 1878 - 1903) to the Holy Father - it was awful! When the Holy Father later received one of the Cardinals whose attention was taken by the thing, Pope Leo quoted Our Lord : "Noli Timere, Ego Sum" ( Do not fear , it is I !)