Following my last myocardial (heart attack in plain English) a couple of years ago I was recommended to have coronary arterial bypass graft surgery, endearingly called a "cabbage" (CABG) by the cardiology people. Now, this involves opening up your chest and grafting in a few extra arterial branches onto the heart by using a few lengths of vein which are nicked from other parts of your body. You are then sown up again. During the process, of course, your heart gets stopped and other amazing things are done. The people who do it are of course wonderously skillful and they lose very few people whilst actually doing it. It does, though, take quite a while to recover from the procedure to the point where you can move around easily and freely without hurting. I was reasonably happy to do this but there was a problem in my case which made me more reluctant - my kidney function had already been badly compromised by a very long and not very successful stenting procedure following the first attack. The odds on my surviving a CABG without seriously impairing this further were uncomfortably short, which would have meant me having to go onto a dialysis machine at regular and frequent intervals. Not ideal in any way, really. So I put it off.
Unfortunately the heart started to deteriorate and I started to get angina fairly frequently, especially in cold weather. This angina, for me, feels like someone has taken hold of my heart and is squeezing it (other people have different sensations, apparently). It eases off if I use a spray but it's not pleasant and if it gets too bad I'll probably have another myocardial, which may do some serious damage this time. So as it has been getting worse I reluctantly contemplated doing something about the CABG. Then I came across a reference to EECP in an article about something completely different and for some obscure reason I decided to follow it up. Thus I learned about Enhanced External Counter Pulsation. (If you are interested there are a lot of articles on it if you just Google "EECP" including a short video of someone having the treatment at the Dove Clinic near Winchester.)
We then came up against the issue of paying for it. At £8k for a course of 35 treatments it is of course much cheaper than a CABG. However, although there are numerous studies about its effectiveness in improving angina none of them are the "double blind" studies much beloved by medics. I'm not sure quite how you could even do blind testing on this process but that's another issue, of course. Cardiac theatres already exist in the NHS and PCT's need to keep them occupied, so anything which doesn't involve cardiac surgery doesn't get much consideration, at least in the South of England. Up North there are a number of NHS hospitals which deliver this procedure but I decided I really didn't want to move to Manchester and leave Carol to run the shop here by herself! So we applied to our local PCT (Wokingham) for funding. Unfortunately our PCT is the second worst funded in the country so it isn't easy to get anything unusual funded by them. Although they didn't reject it out of hand (they did ask for some more information) in the end they decided against it. So it was either pay for it myself or go back to the CABG route which of course they would pay for (and also for the subsequent dialysis should it prove necessary) even though the total outlay was vastly more than for EECP. So we decided to dig into the retirement fund and get it done ourselves.
That's a brief summary of how I came to be doing this. In my next posts I will deal with how it works in practice and how effective it turns out to be in the end.
