Eurostar to Amsterdam and ICE to Bremen today. Provided I have all the necessary documentation. Check: negative covid test, vaccination certificates, Bremen passenger locator form, Portugese EU residence certificate, Invitation from Bremen University. What have I forgotten?

Panning my next caminho after walking from Porto to Santiago de Compestela. What a joyful experience meeting so many lovely people.

My continuing journey of recovery from heart bypass surgery. ¹

Thirteen weeks marks the end of ten days quarantine in the UK. Yesterday I had my second vaccination at a walk-in facility. My first was AstraZeneca and the second Pfizer Biontech. I enjoyed the freedom from quarantine and walked 12k yesterday.

I’m feeling healthy and ran a little yesterday without getting breathless. I had been worried and too upset to tell anyone that one of my grafts failed during surgery. The day I left hospital the surgeon told me I’d had a small stroke during the operation. I worried what the implications were and the likelihood of other grafts failing. Any research online made me more worried. The surgeon told me all four chambers of the heart were working well and I shouldn’t feel any negative effects from the failed graft.

Apart from hereditary factors I wonder what life style factors contributed to my atherosclerosis (arteriosclerosis). Through out my life I have not been a big meat eater. Now I’m more or less vegan. I do not eat any processed food.

I don’t know the answers.

Finally, my leg has healed after thirteen weeks.

My continuing journey of recovery from heart bypass surgery. ¹

Just over twelve weeks have passed since my surgery. Last week I drove from Porto to Santander, and caught the ferry to Portsmouth. I arrived early and stayed in Sardinero.

My early arrival allowed me to visit Integral labs in Santander, and have an antigen test at €40. Only requirements are to turn up with passport, and within thirty minutes test done and results printed.

Brittany Ferries check; passport, Covid-19 test, Passenger locator form. I travelled on the Chinese built Galacia which is internally fitted to a very high standard. The thirty hour crossing is broken by free dinner on Saturday night, and free breakfast on Sunday morning.

I booked the day two, and day eight PCR tests with Abicare Health Solutions at £128.

Now, I am languishing at home, seeing out my ten day of quarantine.

Heart bypass – a coronary artery bypass graft (CABG) x5

Nine weeks, tomorrow, since my surgery. I had the first check up at the hospital today. Good progress being made and more rigorous testing booked for September.

The leg wound should have healed by now and I have this vacuum creating gizmo on my leg to speed the process.

Time really heals and I’ve noticed significant improvements. I can sleep comfortably on both left, and right sides. Coughing, and sneezing is not excruciatingly painful. I can breathe deeply and clench stomach muscles. All of which hurt earlier in my recuperation.

I’m walking in Porto, and Porto has incredibly steep hills. In the last week I’ve averaged 7.3km a day.

Heart bypass – a coronary artery bypass graft (CABG) x5

Nine weeks, tomorrow, since my surgery. I had the first check up at the hospital today. Good progress being made and more rigorous testing booked for September.

The leg wound should have healed by now and I have this vacuum creating gizmo on my leg to speed the process.

Heart bypass – a coronary artery bypass graft (CABG) x5

I’ve walked and slept my way through May. I weigh 10kg less than before my heart bypass. I’m fearful of food and only eat home made vegetable soup, salads and tofu. I’ve given up coffee and wine doesn’t taste like it used to. I’d say I’m > 90% vegan.

After nearly eight weeks my leg is beginning to heal. I’ve had some distracting aches and pains that I haven’t felt like sharing. Everything seems OK now and I’m seeing the cardiologist for a checkup next Monday.

My Humanitarian Action assignments are nearly all completed. I’ve had some interesting assignments on the European Union refugee plan, Fair Trade ethics, and International Humanitarian Law.

My son started his first full time job in London on his 23rd birthday. He sent me this photo. I haven’t seen him for nearly a year, although we chat frequently online.

To comply with the time limit constraints that my car insurance allowed me to be in the EU, I took my car off the road in February and cancelled the insurance. I received a £50 fine today from UK Government for not having a Statutory off Road Notice (SORN).

I was insured with LV who limit EU insurance to six months. I have reinsured with Saga who offer full year EU cover.

A coronary artery bypass graft (CABG) x5

I haven’t posted lately as I am frustrated with the pace of my healing. I still have to visit the health centre twice a week for my leg wound. Half the scar has healed cleanly but the remainder languishes behind the bandage.

Right now I’m working on an essay about the EU, refugees, Frontex, Border Control and the UK Home Office. However I allowed myself to be distracted by these sailing boats and I am looking forward to being out on the sea.

A coronary artery bypass graft (CABG) x5

Another visit to the health centre. I’m on first name terms with the security guard, receptionist and nurse now. The dressing is getting smaller and the fibrin reduced in size on my leg wound. The wound looks worse than it is because of the scab and should heal cleanly. The saphenous vein was used in the graft.

After a few days of applying Nivea the wound better.

For the last few nights I have been able to lay on my left and right side – previously it was too painful – it shows I am recovering.

I wonder if my sternum is wired with titanium? I dared not find out about open heart surgery before my operation. That was the right choice for me. Some of the photos I have seen since, haunt me.

A coronary artery bypass graft (CABG) x5

I walked just shy of 10k yesterday. My walking speed has increased and my breathlessness improved. I visit the health centre twice a week for a new dressing on my leg. The nurse told me there was fibrina in the wound. Google translate told me that this translates to fibrin.

More research required. Fibrin is a fibrous protein that together with platelets forms a clot over a wound site. No problem – part of the healing process.

I went by metro to Estádio do Dragão and walked to the vaccination centre. I have Adante card which for €40 euros a month allows me to travel freely on buses and metro.

A pot of tea, less than 1 euro, half the price of tea in Matosinhos killed a little time before my appointment.

At the vaccination centre the organisation was perfect. The staff were friendly, and helpful. The injection; Astra Zeneca, painless and no symptoms overnight.

A coronary artery bypass graft (CABG) x5

I’m back in my feet! Trying not to push myself too hard. I’m cheating a bit - Porto is really hilly - I’m using the Metro or Uber to get to the health centre or campus and walking downhill as much as possible.

One more visit to the health centre for my leg wound.

A coronary artery bypass graft (CABG) x5

Walking – slowly – up to 8k a day. Walk too fast and I get breathless. No pain, except sneezing which is kinda ouchhhie.

Visiting the health centre later today for a new dressing on my leg wound. I had the staples out on Monday.

Back to study, and had an exam on Monday about the work of the priest Raimon Panikkar. Panikkar held three doctorates: chemistry, theology and philosophy. He was born to a Hindu father and Catholic mother. He embraced Catholicism, Hinduism and Buddhism while remaining a Christian through his life.

I watched this Ted Talk. It is pretty inspiring so I wanted to share.

I’m enjoying reading the perspective of Raimon Panikkar

‘Religion is not an experiment, it is an experience of life through which one is part of the cosmic adventure.’ Raimon Panikkar

https://www.raimon-panikkar.org/

My recovery continues apace. I returned to my studies on campus today using the Bolt taxi app which has a discount incentive.Tuesday classes: Health, Politics and Law. So much nicer than Zoom classes and so nice to see everyone.

Walking

I walked from UFP to Polo Universitário metro which is mostly gently downhill. Metro back to Matosinhos Sul. Just shy of 5k today.

Food

Fresh pumpkin soup, sushi and salad. Green tea.

Memories

In ICU my pulse plummeted to 29. I remember there was a kerfuffle and a pacemaker was sourced. I awoke and asked about the pacemaker and was happy to be told it hadn’t been needed. In ICU you abdicate responsibility totally.

Thirteen days since my bypass operation and I’m walking three to four kilometres a day. I have to walk slowly and rest. On fine days this is such a simple pleasure.

I’m avoiding coffee and will wait until I see my cardiologist in June before I have any – or perhaps I will give up – of my favourite way to start the day.

Food

Fresh vegetable soup; pumpkin, leak, onion, garlic, carrot is my favourite this week. Freshly squeezed orange juice for breakfast.

Can anyone advise me on the best place for salads in Matosinhos?

Stitches out today

I’ve been using Uber but recently tried Bolt as they had a generous introductory offer.

Ulysses

I’m using the Ulysses writing app to publish this blog now and hopefully there should be fewer typos.

Rotunda anémona

She Changes, adorns a new net

Art by Artist: Janet Echelman https://www.echelman.com/project/she-changes/

Hospital São João 2021-04-13

CABG (Coronary Artery Bypass Graft). I didn’t know the term. Now, it is all too familiar. My surgery was seven hours and I was in ICU for two days. ICU holds the darkest moments – imagined – or real.

One conversation that I know was real before I had the operation the surgeon asked if I wanted a general anaesthetic. I am sure he wasn’t joking. He said it was an option. I went for the full unconsciousness.

I’m not sure of memories, some scenes I try not to recall. Tramadol made me hallucinate and fit. Other drugs bloated me so much that I couldn’t eat. Medications were changed at request.

Post ICU – the nights were long – sleep was difficult. Ennui endured. Alarm bells rang, while patients shouted in pain or for attention.

I’m eternally grateful for all the staff that contributed to my recovery and to my surgeon Dr Benjamin Marinho who came in on his day off to say good bye. At our initial meeting, he said, ‘don’t worry, thats my job’.

I will never forget the Portuguese NHS that helped me when I needed help, when they could have so easily denied it to me. The hospital would only let me fly back to England on a medical flight which was impossible.

I was discharged from Hospital São João on 20 April 2021 and took an Uber to my apartment by the sea in Matoshnhos.

Vocabulary learned this week: sternotomy, ennui, quintuple.

Reinforced this week: kindness, hope, compassion, friends, family.

Best bits: humour, a gentle pat on the back, human tenderness, engaging meaningfully with others.

It has been exceptionally frightening at times, pure theatre at others. My friend Tim who was in the year above me at school had a stent fitted after we did the Devizes Westminster canoe race in 2010. His arteries were 90% blocked. I’m guessing mine were blocked too. We have both been lifelong endurance athletes.

Its amazing what you can achieve even with badly blocked arteries. The problem is that it is difficult to identify heart disease accurately wthout invasive procedures such as an angioscopy (please correct me if i am wrong).

Afternoon tea at the Vagas bar in Matosinhos. This is the view from my apartment. From here I can see the ships come and go to Puerto de Leixões. Surfers are on the water from dawn to dusk. The sunsets are often beautiful.

Here is a precise what3words address, made of 3 random words.

View Larger Map | Get Directions  ///surround.shelved.noting 

A great end to the day with my neighbour cooking me dinner.

The bruise is coming out from my angioscope. A small camera is inserted into an artery. There is quite a lot of poking around to find the way into the artery. The camera is then pushed around to my heart. This was where they informed me that I had an unusual architecture that meant a stent could not be fitted.

As the camera crossed my chest the surgeon said, ‘don’t move suddenly as the camera can break off in your artery.’ I hardly dared breath, closed my eyes and tried to focus on managing the pain.

I am feeling the ennui of waiting, however I feel optimistic and my mind seems to have stepped in to protect from negative thoughts.

Cardiology internment – day 5. The second Covid-19 test yesterday marked my fifth day in Hospital São João. Extraordinary emotional ennui emerging.

The hospital is kept immaculately clean and the rooms cleaned daily. Clean pyjamas and sheets every day. Humour lightens the day. My limited Portuguse often causing confusion.

This was my diary entry.

1. Return to UK when possible.
2. Have COVID test
3. Healthy lifestyle

I realised that returning to the UK even if possible was merely avoidance. The hospital would only release me to a medical flight. With no direct flights to the UK it would have been a logistical nightmare. I’d been presented with an opportunity to have surgery done in one of the best hospitals in the world.

I don’t align with any religion but consider myself spiritual. I remember thinking when I came to after the operation that I must make the pilgrimage to Santiago de Compostela because of the link with São João and after all I was in Hospital São João. Its only 225k and will be good for my recovery in a few months.

Angina

Near the end of 2020 my arthritis improved and I decided to do my first run. After about 500 metres up a slight hill I fell over breaking my thumb in the process. I wasn’t sure if I had tripped or fainted. I was acutely aware of the pavement centimetres in front of my face.

I walked a lot, 10k most days. Occasionally I’d experience a chest pain, a pain difficult to describe but one that feels disconcerting. I’d have to sit down and with time it would pass.

When my classes moved online I moved to a fishing port, Matosinhos in what had been an Airbnb.

On fine sunny days I swam in the sea. I ran intervals on the beach but could only run 30 seconds before my chest hurt. I tried different walking speeds and quickly determined that once my heart rate got to a > 100bpm I was likely to experience chest pain.

I visited the private hospital CUF and was referred to a cardiologist. Ultrasound on my heart revealed no problems, ECG no problems, ECG stress no problems. A 24 ambulatory heart rate monitor showed worrying blood pressure spikes.

Occasionally I would awake in the night with a chest pain. This concerned the cardiologist. He recommended a CT scan, where iodine is injected into the blood and scan done. In this case it was an impressive looking Hitatchi CT machine.

The cardiologist showed me the 3d image of my heart and pointed out the calcification and fat deposits. They would contact me soon.

I was prescribed new medications including emergency use nitro glycerin. I’m scared of 0300. Forty years ago I had a girl friend, a nurse that worked nights in Tooting Hospital. I always remember here saying patients died at 0300.

With iodine still being cleared from my system by drinking water I awoke at 0300 with chest pain. When the pain didn’t go away I took my first nitro glycerine tablet. Minutes later the pain receded and I could sleep. This repeated at 0500.

That morning the cardiologist called me and said that next time I experience chest pain I should call 112. A heart attack with my symptoms would be unrecoverable.

I decided a better plan was to Uber to ER where I was assessed and admitted.

I was asleep in a reclining chair at about midnight and when my negative COVID result came through they admitted me. I slept until 0630. The wards are for one or two persons. I’m sharing with xx year old xxxx. I haven’t spoken to her. I still don’t know anything. They gave me tea, biscuits, and water when I arrived. Smart blue pyjamas too.

Welcome to my Matosinhos lockdown diaries