What’s that then?
Mel and Griff going head to head in, “Alas Smith and Jones” (1984 -98).
This was one of Mel Smith and Griff Rhys-Jones ‘strap-lines’ in their wonderful spoof of, “Alias Smith And Jones”, a USA Western series, derived from my favourite ever film, “Butch Cassidy and the Sundance Kid”, starring Robert Redford and Paul Newman (1969).
Well actually 132 – 85 is my first blood pressure measurement (systolic over diastolic) taken last night at some god-forsaken hour during the middle of the night at Victoria Hospital, Kirkcaldy. Why? Why indeed?
Always blame it on the curry whenever you get the opportunity! But in truth, that is entirely accurate. Elaine and I were celebrating my first tentative consumption of solid food for nearly 6 weeks by having take-out! (Papadoms, Vegetable Pakora, Chicken Awadi and Chicken Tikka wings starters; Chicken Tikka Masala, Lamb Desi, and Chicken mains; and Pilauf rice and two Plan Nan breads plus sundries). I guess I had a little too much, too quickly, too soon! Some triple combo that one!
Now bear with me here, we two didn’t have that (big!) lot all alone, it was also shared amongst our favourite brother- and sister-in-laws, Derek and Tat, who had just driven for 7 hours through pouring rain and huge, huge road traffic delays eg Forth Road Bridge closure en route from their journey from Bradford to Ceres. By the way, all of our in-laws (of any persuasion) are our favourite in-laws. We love them all dearly and they have all been tremendously supportive to us, especially during these last couple of months since the onset of my illness.
Ok, to return to the plot, 135 – 82, how did this come about?
Within two hours of consuming my special, small portion of curry (at least a little of everything!), I was in agony, pain throbbing in my upper gullet, some spreading to my shoulder from my neck, gurgling and white frothy ‘retch’ all contributing to my demise! I contacted the emergency weekend Cancer Patient service and was provided superb advice and was told that an ambulance and paramedics would be arriving within minutes. They did.
I was met by the marvellous H and M who quickly sorted me out, and informed me that I was being checked for signs of a heart attack . Everything seemed clear but because I was having pains down my arm they advised I should be taken to accident and emergency for further tests to rule out cardiac issues and cement in there, right then, the culprit, the curry. I was a victim of my own minor recovery!
Elaine came with me in the ambulance, as the in-law celebrations had somehow caused three of them to have three bottles of wine amongst them (less one glass – oops!), so she couldn’t drive. Anyway … cutting a long story, longer ….
I was kept for overnight observations and suspicions that I may have had a heart attack. It turns out I hadn’t – the good news, but the bad news was that my (heart damage marker protein) Troponin levels were ‘just borderline’. I think that means I was marginally above the normal band which has fuzzy edges at around 14 -20ng/ml? My values were 23 (4:00 am) and 29 (9:30 am), not a sufficient increase 12 hours after the suspected time of the now-spurious heart attack. All good! Heart of a twenty something, still!
Here’s a graph of what the medical team are looking for when they measure Troponin in your blood (should you also be unfortunate to have a suspected heart attack):
So, Troponin what’s that then? (Rhys-Jones)
Troponin is a complex of three regulatory proteins (troponin C, troponin I, and troponin T) that is integral to muscle contraction in skeletal (striated) and cardiac muscle, but not smooth muscle.
Here’s a diagram of how Troponin is supposed to work together with Myosin fibres and Calcium ions (Ca2+), in the muscle tissue of your heart.
[Clinician Update, “How to Interpret Elevated Cardiac Troponin Levels”. Vinay S. Mahajan, MD, PhD; Petr Jarolim, MD, PhD
Author Affiliations From the Brigham and Women’s Hospital, Harvard Medical School, Boston, MA. Correspondence to Petr Jarolim, MD, PhD, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02115. E-mail firstname.lastname@example.org
[“Cardiac troponin (cTn) testing is an essential component of the diagnostic workup and management of acute coronary syndromes (ACS). Although over the past 15 years the diagnostic performance of the previous gold-standard assay, creatine kinase-MB, has not changed appreciably, the ever-increasing sensitivity of cTn assays has had a dramatic impact on the use of cTn testing to diagnose ACS.1 Here, we present 3 recent clinical cases from the emergency department with acute chest discomfort that exemplify the challenges introduced by high-sensitivity cTn assays:
a 48-year-old man who presented to the emergency department with chest discomfort lasting 2 hours and a 3-day history of flu-like symptoms whose ECG showed diffuse ST-segment changes, a 60-year-old woman with a medical history of heart failure who presented to the emergency department with chest pain lasting 1.5 hours whose ECG was nondiagnostic, and a 54-year-old man with a medical history of diabetes mellitus who presented with chest discomfort lasting 1 hour whose ECG was normal.” Etc, but those scientist- medical saddos amongst you can read more by going to the full article.]
Well that’s me done. I came home at 12:30pm and told I as strong enough to go for next blood transfusion in Ninewells tomorrow (today now!) and to meet Dr P, my consultancy oncologist, as well as to look forward to having my second cycle of Chemo on Tuesday. Great!
I’m off now, CYA again tomorrow. A bit of science; a bit of gossip lots of empathy and affection; some politics – but there’s much more to come! But ….
Before I go here’s some music for ‘ya’. This is a transition album if ever there was one, “Turning Point”, by John Mayall (Vocals, harmonica, slide guitar, telecaster 6 string guitar, tambourine and mouth percussion!), and his band of Jon Mark (Acoustic Guitar), Steve Thomson (Bass) and Jonny Almond (Tenor, Alto saxophones, flutes and mouth percussion!). Whence the electric blues guitars in previous sequence Mick Taylor, Peter Green, Eric Clapton?
It was always about the mouth percussion for me, oh, and the sax (yes, not sex)!
Check out the tracks, “California and Room to Move”, especially impressive mouth vocals and of course, Sax!
Why am I keen to note this? Well, when I swallowed my curry I got the impression I was squeezing something through my blocked stomach. Could I have dislodged some cancer (preferably dead stuff?) through or off? Must check this out with Dr P today!
“long live the NHS – but not as you know it!”
Bye for now.