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Another Diagnosis

Happy New Year everyone! I hope you all had a wonderful festive season. If you had asked me where I wanted to be by 2022 at the start if this year, I don’t think I would have been able to answer it truthfully. For a bit of context, I’ll have to go back to March 2020 and the start of the first lockdown in the UK. I already had a 10+ month history of high blood pressure under my belt and the doctors were never sure why. I managed to get an appointment with one of the doctors in my local practice, where I had my blood pressure checked and had bloods taken. Because my veins are thin and awkward to access it took 3 attempts to get anything, so my arms were a little bruised for a few weeks.

These appointments carried on for a few months until the summer, when I was fitted with a 24-hour blood pressure monitor. Because it was on my wrist and I’m a notoriously difficult patient, they couldn’t get many readings. But from what they did get it was clear my blood pressure was higher than it should be. It was then they decided to refer me to the Hypertension clinic at the same hospital my neurosurgeon is based at. Because of the pandemic, I didn’t get seen in the clinic until Autumn 2020. I feel extremely lucky to have been seen as quick as I did as I know people were waiting a lot longer for treatment.

Upon arrival at my appointment, I had my blood pressure taken and was fitted with yet another 24-hour blood pressure monitor. This time I had the blood pressure cuff on my upper right arm, which would go off once every 30 minutes in the day and once an hour overnight. I also had 6 vials of blood taken, and once again my veins proved troublesome for the medical team. Once that was done, I was free to head home and carry on with the rest of my day as normal. Fast forward to the next morning and I was back to drop off the monitor and get the readings. I was then told I needed an extra blood test, which went better than the day before. A few weeks later I got the report back- my blood pressure was sitting at 150 systolic in the day and 140 systolic overnight. Because of how high it was they referred me to the renal clinic to see if that was the reason for my hypertension.

Fast forward to January 2021 and I’d had more blood tests, urine tests and an MRA scan. Not even 2 weeks later I was on placement and saw a missed a phone call. A voicemail from my doctor told me to phone them back as soon as possible. My heart sank as I knew something was wrong. I immediately phoned them back. They started off with good news- they had ruled out a cancerous tumour called Pheochromocytoma, which I was extremely relieved about. However, they then broke the bad news that I had critical renal artery stenosis. They explained to me that my left kidney artery was more than 90% narrowed, reducing blood flow and increasing my blood pressure. I was then told I needed an urgent renal angioplasty to correct it otherwise I was at risk of losing my kidney. I was immediately sent for a DMSA scan, which checked my kidney function. While it wasn’t the best result for someone of my age, I still managed to have the best numbers in the clinic that day.

2 weeks later I was in hospital having the procedure done. The entire medical team were fantastic and helped calm me down before going in. Because there were times in the surgery I would have to hold my breath, I had to be awake. They did offer pain relief and sedation, which I gratefully accepted. The procedure went well and they were able to open the artery and didn’t have to leave a stent in. The worst part about the whole thing was when they pulled the tube out of my arm. It felt like they were pulling out my veins along with the tube, and it left quite a sizeable bruise for almost 2 months.

After a few weeks of rest and recovery I had to go back to placement. When I phoned the ward manager asked how I was and what I had done. I told her and explained what shifts I would be able to do. She immediately tried to get me to do shifts I wasn’t able to. I brushed it off as I knew she was a busy woman and had lots of jobs to do. Before the call ended she asked again what procedure I had done. Again I brushed it off and didn’t think anything of it. But it was when I returned to the ward that I started to feel a little frustrated. In the space of 10 minutes she asked me about what procedure I had twice. Before this I had told her at least 3 times so the fact that she had to ask me a further 2 times made me feel like she wasn’t listening to me and for a split second I felt like she didn’t believe me. I did show her my bruised arm and I think that was the moment that it finally sunk in for her.

It’s now been 11 months since the procedure. My kidney function has since improved, my blood pressure is back to normal and I have been taken off the Aspirin I was prescribed in the first few months post-surgery. I cannot fault my team at all- they were quick to spot the issue and resolve it before everything could go from bad to worse. Looking forward, I will still need regular reviews to keep an eye on me as there is a risk it could happen again, but for now I don’t have to worry about it and can carry on with my life as normal.

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