Starting the treatments

As you will have noticed, I am not religious about blogging on a daily basis. I had intended to be, but life intervenes. Especially, the treatment itself intervenes - in that I have felt very tired after the first few sesssions. However, it is now Sunday and my last session was actually on Wednesday. Today I actually didn't feel tired when getting up, which is nice!

Back on Monday was my first session. I met the lovely Dee, the nurse who will do the sessions on Mondays and Tuesdays, and she explained how it would work in practice. I surmised that all I had to do would be to relax and preferably go off to sleep, at which she laughed and said if I could sleep through this I deserved a medal. I had seen the video and it didn't look too bad - but really there is no way to describe it so that when you experience it you won't be surprised.

A lot of time went in the initial setting up (ECG review, sizing up for the clothing and the cuffs, etc) so it was some time before we were actually ready to turn the machine on. First things were the tights. They look a bit like salopets for ski-ing except that they are sheer. There are seams on the insides of the legs which mean that they fit snugly into the cuffs. These cuff things are a bit like the cuffs used to measure your blood pressure except they don't just cover an area of about four inches on your arm, they cover your calves, thighs an buttocks - they are big. They have to be wrapped quite tightly onto your legs and butttocks so that there is minimal movement between the relaxed and the inflated states. Like BP cuffs, they are wrapped around the limbs then held closed by Velcro. A great deal of care is taken to make sure there are no creases or pinched parts, if there are the skin can be whipped off in a very short time. For me, they fitted perfectly although there was quite a lot of spare cuff beyond the Velcro seal (in a subsequent session we used a smaller cuff and that worked even better). I did notice a tendency for me to be making sure that the old crown jewels, which hang close to the edges of the thigh cuffs, were not in fact being trapped in any way!

The cuffs have quite big corruguated pipes from each limb section to the connections on the bed itself and these pipes tend to dictate how you can arrange yourself on the bed. In the event, I found myself spreadeagled on the bed, the back support was raised a little above the horizontal and covered in pillows into which I sank happily (at least, happily whilst the machine wasn't running!). After a series of final checks about all being snug, not pinched and everything relaxed, Dee started the machine.

The machine itself consists of the bed, with the cuffs as described above, and with a control monitor which lets the operator know what is happening and allows adjustments to be made to the pressure being sent to the cuffs. If you have read any of the references  listed on Google, you should have a reasonable idea of how it works but if you didn't this is a potted summary - based purely on my own understanding and of course it may well not be completely accurate!

• ECG-type connections are attached to three points on the chest. Another monitor is clippped over a finger. These are intended to give the machine an acurate reading of how the heart is beating. This is very important because the pulsations generated by the machine have to reinforce the heart working, not oppose it. 
• After the heart makes a beat (i.e. pushes blood out into the aortas), it relaxes. Almost immediately, the machine inflates the cuffs which causes blood to flow back to the heart through the veins and it seems to also create a bit of a "backwash" in the arteries which obviously can't actually re-enter the heart because the valves are closed. This latter means that more blood is diverted into the cardiac arteries around the heart, i.e. it increases the supply of blood to the heart tissues.
• The machine then allows the cuffs to deflate before the next heartbeat, and the process is then repeated. It was interesting to note that the interaction with the machine caused my heart rate to increase a fair bit, especially in the first few attempts.
• As the process repeats, the blood supply to the heart becomes significantly higher for a time. The whole concept of the treatment is that this increased blood supply causes the cardiac arteries to widen and even to produce new branches to cope with it, thus improving the availability of blood to the heart tissues generally - thereby reducing the incidence of angina. (Angina is basically caused by trying to get the heart to work harder than the existing flow of blood can support. Increasing the blood availability means the heart can once again work harder, which is what is needed.)

That's (sort of) the theory - so how does it work in practice? Well, Dee explained that we would proceed gently to begin with so as to allow me to get used to it without going into shock. So we went through a few cycles with the cuffs only pressing gently when inflated. She then inreased the pressure a bit and I began to become more aware of the pressure pulses. It was a bit disorientating because of course you have never been subject to pressures on your body where the cuffs are, let alone a rhythmic, pulsating pressure which you cannot control (and indeed you must not even try to control!). You do, though, become more used to it - maybe resigned to it is a better description. What I did notice was that after five minutes I was becoming fairly desperate for a pee, so we stopped and we unwrapped all the cuffs and I nipped off to the loo to empty the bladder. Considering that I'd emptied it (I thought) just before the treament started, I was a bit surprised to see how much came out! Perhaps the pressure causes the kidneys to operate more effectively, I don't know.

OK, so I got back to the couch, Dee wrapped me in again and off we went for the second time. This time we did a further ten minutes and the pressure was higher. This, it seems, is a Very Good Thing because the higher the pressure, the more effective the treatment becomes. Dee, at least, seemed to be very impressed with the level we had achieved on the first day (though I accept that she may have been trying to make me feel a bit better about it). I wasn't so sure - I was and still am a bit ambiguous about how I feel on the subject. It is a fairly violent treatment even though it doesn't really hurt because of the care taken with the wrapping. It is, however, very uncomfortable and you really do need to concentrate on letting it all happen and not try to control it or to do anything other than lie still and let it all go on. After the ten minutes, we called it a day and Carol drove me home. I felt a bit, well, "shaken up" I suppose is the best description I can manage.

Next day, I have to admit I wasn't really looking forward to doing it again but I decided that this was a bit feeble on my part so back we went, off down the M3. This time we managed a ten minute session followed by a fifteen minute session. I managed to relax more easily and we got up to maximum pressure during the process. We tried making the wrapping not so tight around the thighs but I don't think that was an improvement, it caused more movement and the pressure was still just the same. My heart must be improving markedly, I'm sure (though we still hadn't managed even a half an hour session yet). Actually, I hadn't felt any angina on either of the days. Of course the weather was warmer and that helps, still it was a good sign - especially if you are looking for one as urgently as I clearly am.

Wednesday was fairly uneventful other than the fact that I had noticed that I had stiffness and discomfort in both shoulders, which I attributed to the shaking they had been subjected to. We managed a ten minute session, then a twenty minute session. We then tried raising the back rest higher so that I was more sitting up than lying back. This caused more pressure around the waist but less shaking of the shoulders and so it should cause less shoulder pain. We might keep it in for the next session. That night, for some reson, I was unable to relax enough to sleep easily, something which is most unusual for me. (My eldest, Stuart, has stated that I could sleep for England and in truth I rarely have had any problem with it.)

As I was still very tired next morning, Carol let me sleep on - so we were late getting moving. We could have been late getting to the Clinic but they apparently agreed that sleep was more important and cancelled that day's session (all this while I was still asleep). I did feel tired all that day and indeed it wasn't really until Saturday that I got up in the morning feeling fresh enough to face the day properly. I'll need to keep an eye on that, clearly.