My PFO closure
After the investigations following my stroke identified a patent foramen ovale, or PFO, I was eventually called to Leeds General Infirmary to have it closed. I hoped it would finally allow me to put the stroke — and the fear of another one — behind me.
My wife dropped me at the door
The procedure took place during the Covid period, which made the experience very different from how it might normally have been.
My wife drove me to Leeds General Infirmary, but because of the restrictions she couldn't come inside with me.
She dropped me at the hospital entrance and I went in on my own.
I was very nervous.
I'd spent a long time waiting for this procedure and wanted it done, but suddenly I was actually there.
I tried to arrive “match ready”
I knew I was going into hospital for a heart procedure, so in the days beforehand I tried to approach it almost as though I was preparing for an important sporting event.
I wanted to arrive in the best condition I could.
I tried to sleep well, eat well and keep exercising beforehand.
In my mind, I was trying to get myself match ready.
Of course, being physically prepared didn't stop me being nervous once I was actually sitting in the hospital waiting for the procedure.
Then I read the consent form
Before the procedure, I had to go through the consent process.
This was probably the point when some of the risks became much more real to me.
I remember the form highlighting potentially serious complications. My recollection is that these included things as frightening as another stroke and even death.
Obviously, medical teams have to explain the potential risks of a procedure before you consent to it.
But reading those possibilities when you're the patient who's about to undergo the procedure is different from understanding them in the abstract.
I knew complications were possible because they were written there in front of me. But I don't think I ever really expected that I would experience a complication myself.
I was offered something to calm me down
The staff could obviously see that I was nervous and suggested a sedative.
I accepted it.
It worked.
I became much more relaxed about what was about to happen.
A nurse accompanied me and kept chatting to me about ordinary things. That small talk helped too.
Sometimes it isn't a complicated medical explanation that makes you feel better. It's simply having somebody beside you talking normally.
The operating theatre looked like a spaceship
One of my strongest memories is entering the room where the procedure was going to take place.
It looked incredibly high-tech.
Everything seemed bright and white. There was a narrow operating table and a huge screen.
It felt less like the sort of operating theatre I'd imagined and more like walking onto a spaceship.
The procedure itself wasn't as bad as I'd feared
The procedure involved accessing my heart through the groin.
I remember the medical team checking the local anaesthetic around that area. I could feel scratching sensations as they made sure everything was sufficiently numb.
With the sedative having taken the edge off my nerves, the actual procedure wasn't as bad as I'd imagined it might be.
After all the anticipation, the procedure itself wasn't the part that caused the biggest problem.
Then I wouldn't stop bleeding
Afterwards, there was a problem with bleeding from the access site in my groin.
It wouldn't settle sufficiently for me simply to go home as planned.
Because of that, I was kept in hospital overnight on a private ward so that I could be monitored.
I hadn't gone into the procedure expecting a complication, so this was an unwelcome reminder of the risks I'd read about on the consent form earlier.
The checks looked reassuring
I stayed in overnight and had further checks the following day.
I remember having an ECG and, as far as I understood at the time, everything appeared reassuring.
Eventually I was able to leave hospital and my wife came back to Leeds to collect me.
After the stroke, all the investigations and then waiting for the PFO closure, I felt that an important problem had finally been dealt with.
I thought I could finally move on
Emotionally, I felt relieved.
The PFO had been identified as a possible route involved in my original stroke and now it had been closed.
In my mind, I felt that the danger of another stroke had been dealt with.
I also hoped this would eventually mean being able to finish the medication I'd been taking since the stroke — particularly apixaban.
At that point, I didn't know that my heart rhythm would later become an important part of the story.
PFO closure does not mean that somebody has no future stroke risk or that medication should automatically be stopped. Those decisions are individual medical decisions.
I went for my first run
Exercise had always been important to me, so naturally I wanted to see how I felt when I returned to running.
Roughly a week or so after the procedure, I went out for a run.
Almost immediately, it didn't feel right.
Running felt laboured.
Then I reached a hill.
I couldn't run up it normally.
Something had changed
That feeling on the hill was very noticeable because I knew what my normal exercise capacity had been.
I'd exercised regularly before my stroke. I'd returned to running afterwards. I'd rebuilt my confidence and got back to a good level of fitness.
This felt different.
I couldn't explain exactly what was happening, but I knew running felt considerably more difficult than it should.
I'd gone into the PFO closure thinking it might represent the end of the cardiovascular part of my stroke story.
Instead, it eventually led me towards another question.
The loop recorder was still there
Fortunately, I already had something monitoring my heart.
The loop recorder implanted during the investigations following my stroke had spent a long time looking for abnormal heart rhythms.
For a long time, it hadn't revealed anything particularly significant.
Eventually, however, it picked something up following exercise.
And that would move the focus of my story from the structure of my heart to its rhythm.
The next chapter
A high heart rate associated with running would eventually lead to further questions about atrial fibrillation and atrial flutter.
Looking back at my PFO closure
At the time, having the PFO closed felt like an ending.
A possible explanation for my stroke had been found and something had been done about it.
I was relieved and wanted to get back to normal life.
What I couldn't have known was that my first few attempts at returning to running were going to reveal another part of my health story.
Decisions about PFO closure, medication and returning to exercise need to be made individually with the appropriate medical professionals. My experience shouldn't be used as somebody else's recovery timetable.
When AFib and flutter entered the story
I had gone into my PFO closure hoping I could finally put the stroke behind me. Instead, returning to running showed me that something wasn't right. Hills became difficult, my heart rate became part of the investigation and eventually atrial fibrillation and flutter entered the picture.
BACK TO MY STROKE JOURNEY