Oh dear. Lately I find myself consciously refraining from answering the casual 'Hello! How are you?' with a tedious recitation of my heart health. I promised myself as a teenager I would never be one of those dreadful old people banging on about their health (well, lack of health, actually) and I continue to be determined to not be one.

So, I joined an online heart health forum to use as my space to mourn-complain-seek comfort and managing tips (love the tip about using a trolley in the supermarket or chain store to lean on - anything to avoid a Zimmer frame, eh old girl?). Now when I met someone in the shops or in the library vestibule or the church car park I am not tempted to respond to 'How are you?' with a complete rundown of my latest consultant appointment/ache/outright pain/meds schedule...

Now. Here's where I stress (and really, this part should be highlighted - if, dear reader, you are inclined to 'eye-ball glaze over', read this following part and then go off skipping the rest of this post): NEVER 'SOLDIER ON'/MAN UP/BE BRAVE/KEEP A STIFF UPPER LIP SO YOU WON'T BE THOUGHT A MOANER; ABSOLUTELY NEVER OMIT OR LIE OR MUMBLE OR OTHERWISE MAKE LIGHT OF SYMPTOMS YOU KNOW DAMN WELL ARE GERMANE AND IMPORTANT FOR THE GP AND CARDIOLOGIST AND ALL OTHER HEALTH CARE PROFESSIONALS TO KNOW!! Never. Ever. So when they ask - do you get chest pain only when you exert yourself, or does it happen when you're sitting/lying there doing absolutely nothing - ANSWER MEDICS QUESTIONS TRUTHFULLY!  Not doing so will mean they don't have the information they need to decide what is maybe going on and which tests will help them know for sure what may be/is wrong, and that means you won't get the right treatment AND YOU COULD DIE. 

A quick word about terminology. In the USA where I first had my 'fun' experience with pericarditis, once it became apparent to the medics I was having it again (ok, and again, and again, and again...) they told me I have 'idiopathic chronic pericarditis' most likely owing to the Rheumatic Heart Syndrome (RHS) developed as a child predisposing me to 'all sorts of things'. swell. groovy. not. Now I'm in the UK I have to learn to say 'recurrent' for 'chronic', and leave off the 'idiopathic' until they know for sure the recurrent aspect isn't down to a discoverable reason. Now, I can use the 'RHS' as it's called that here as well, but there are some other terminology differences between the UK and the US and using the wrong ones for the country I happen to be can be a real problem getting proper medical attention especially in an emergency - which is one of the reasons I booked an appointment with the GP to get some answers to  questions I didn't know to ask the cardiologist when I saw him 18th June.

Yesterday afternoon I saw the GP and she told me I should order a MedicAlert bracelet to wear 24/7/365. The engraving my GP wanted is: Angina, Recurrent Pericarditis - she said when I fill out the online forms I will have a space on the e-record to note the RHS, and the pericardial effusion, and the aortic valve scarring (and when she said that 'RHS' part she made a point of saying 'And you do have it, it's officially official we agree with the US diagnosis') but the only actual engraving should be the angina and recurrent pericarditis. Apparently here in the UK they say 'recurrent' for chronic - and they now also agree with that diagnosis.

The angina can't be noted just now as stable (angina pectoris) or unstable as 'they' still don't know for sure which it is, or what has caused it to be a constant since around 1999. Hence her instruction it should be on the bracelet as 'Angina' without specification so First Responders have a hint should I collapse on the pavements. Likewise the recurrent pericarditis - if it's acute it could squeeze my heart and they need to know to do an echo to discover if that is why I've collapsed.

Paul and I walked to the health centre for the appointment; after the appointment we meandered home on foot - stopped in a few shops, chatted with encountered neighbours, and got home last night just in time to 'put the tea on'. A few hours later I had interruption-free time to concentrate on ordering the bracelet.

BLIMEY, who knew? I struggled two hours completing the online forms to order the bracelet (really, does it all have to be so exhaustingly complicated, really?), finally got through all the virtual paperwork with the end result I am now a fully paid up member of a 'get the info to the emergency medics quick' organisation, and am awaiting the arrival of the bracelet. The engraving is as the doctor ordered with the MedicAlert 24/7/365 contact phone number also engraved on the bracelet disc. All the First Responder and/or hospital has to do is ring the phone line noted on the disc and they will have all my information to hand.

Right. In all honesty the thought of having to wear a MedicAlert bracelet is simultaneously galling and reassuring. Reassuring in that should the information be required in an emergency (NHS number, name-address-date of birth info, conditions and meds, cardiologist and GP names and numbers, ICE designee - my husband of course), all the info is all on an e-record - if the First Responders and/or hospital have an working phone line, and if the computers don't go down. Really, it IS reassuring, I feel as though I will regain a bit more independence with that bracelet strapped around my wrist - for example, I can now feel confident to use my 'over-60s' bus pass to go off to Dundee or Aberdeen on my own without the worry no-one will know what's going on if I drop in the shops:)

But. It's galling - I've known most of my life I have a 'stoopid little heart thingie' and for all of those years until now I've managed to avoid prescription meds and things like MedicAlert bracelets. But now I need the meds and the bracelet, and did I forget to mention the worst-so-far?

The 'worst-so-far' is the cardiologist said on 18 June if I'm not able to say the angina only-only-only happens on exertion at our next meeting (scheduled for late October 2019), he's going to order a cardiac catheterisation.

OH BLOODY DEAR!

Right, so I've been a bit under the weather since March and yesterday I heard the results of some testing done since (finally) getting myself into the GP to (ahem, yes, I know, my very bad) register at the new surgery.

Hmm. My 'stoopid little heart thingie' reared its pointed little head after round one of root canal treatment in early March. Long story short, it looks as though (according to the cardiologist) it is coincidental that I apparently suffered yet another bout of pericarditis about five days after the root canal treatment, so no order for prophylactic antibiotics despite the echo also showing some 'trivial' (according to the cardiologist, his word, that 'trivial') scarring on my aortic valve (rheumatic heart back in childhood). yea.

The fluid in my pericardium is so minimal he's 'going to watch it' rather than 'go in after it' (oh thank-God because really, pericardiocentisis is a wretched procedure to go through). No constriction, and no sign of endocarditis so all in, a reasonably good result and I've been given his permission to formulate and implement my own fitness programme. 'See you in the autumn', he said as he showed me to the door.

I am not going to complain about the service rendered by NHS Scotland, all things considered they reacted to my presenting that day to the GP surgery with unusual rapidity according to just about every lab tech and nurse I encountered. I will say, however, had I been whisked that day to an echocardiogram they would have seen what I know was pericardial constriction - it was nearly a month after that first visit that I was having the echo and by then I was so much better I told the tech I felt a bit guilty taking up her time.

So I now start a self-managed fitness regime hoping to have some real results to show-off when I see the cardiologist in the autumn.