This year, during my family holiday, I discovered how Hertz – and many other car hire companies – have crafted a process involving dark patterns to trick stressed travellers into paying far more than necessary for their car hire.
I’ve used Hertz several times over the years, particularly in the 2000s, so I expected good service, a decent car, and straightforward business.
Let’s start with the booking process. It was perfectly fine and straightforward online. The price seemed reasonable, and as the holiday approached, I was actually looking forward to seeing what car I would receive. I even found a potential car upgrade at a slightly lower price when I went back to check some details. Happy days, I thought.
Car collection was quick – no big queue – and the chap at the counter was affable. I was juggling kids and feeling the usual airport stress when he said, “You can have your wife as an additional driver for free, and you don’t have to worry about the excess.” I thought, “Oh wow, that’s great! Romana, do you have your licence?”
He handed me the rental slip, I signed, and at no point did I realise what had just happened.
Great, I thought.
The car, however, was a bit of a disappointment – a somewhat battered Jeep Compass plug-in hybrid. Not ideal when staying at a caravan site. But I coped, thinking it wasn’t worth the hassle to switch cars. Then, midway through the holiday, the engine check light came on. I called Hertz, and they said to drop off the car for a replacement. Brilliant. Except the woman at the counter seemed grumpy about it.
No worries. New car acquired, off we went. It was a Mini Countryman Cooper. Worse spec, but a much better car.
But this isn’t a car review. It’s about how Hertz deliberately created a system that, if you’re not paying attention, can significantly boost their profits.
By my estimation, a rental like mine would typically generate about €40 in profit for Hertz. But through clever design, they turned that into about €450 by breaking the usual patterns.
Step one: when the customer is stressed, offer things that sound helpful but are actually upselling excess waivers and other add-ons.
Step two: sneak in a Fuel Purchase option for €73. I brimmed the car right next to the airport when I returned it, but I won’t see that money back either.
Step three: hand the customer a docket with tiny print (which my ageing eyes now struggle to read without glasses), and ask them to sign here, here, and here – all while chatting away – and with no workflow difference when accepting or rejecting. €430 added there also.
My rental slip that caught me out.
So, because I was busy with the kids, wife, and general airport stress, I signed without paying proper attention. I never usually buy these optional extras.
With taxes, it was just a smidge under €600 in total.
But this time, I accepted the charge. I think I was tricked into it, but there’s nothing I can do. I contacted Hertz, complained, but was told, “No, you signed, you pay.”
And it’s a brilliantly designed system. When you decline, you sign. When you accept, you sign. You get used to signing every time. It’s easy to slip in an acceptance instead of a decline, and then you’re stuck.
So a rental agreement that was supposed to be under €500 turned into €1,133.35 once taxes were accounted for. I’m gutted. Money is already tight this year.
Well done, Hertz and your desk chap. You tricked me out of a substantial amount of money. You win. You’ve increase your profit on this rental by a factor of 10, so even if I don’t use you again for a decade, you’re still ahead. I rarely get tricked, but you managed it.
All I can do now is what I usually do when life hands me lemons—make lemonade, vent on my blog, and move on. I’ve paid my “stupid tax” for 2024. It won’t happen again.
It’s a cleverly designed process they’ve created, clearly aimed at getting people to pay extra at the desk. And it’s not just Hertz that does this—I just expected better from them. They’re supposed to be one of the better firms.
If you were designing the process with the customer not making mistakes in mind, you’d make them specifically write accepted.
The ultimate test as to whether this is sneaky is whether people ever find themselves doing the opposite, and not taking out such cover and extras when they do, in fact, want them.
Having a coronary artery bypass isn’t much fun and comes with challenges. Four years later I thought I’d describe some more of my experiences.
In my previous blog post, I described the adventure of having a heart attack and the five coronary artery bypass grafts that resulted. That procedure saved my life and actually restored my quality of life and fitness, within six months, to about the level of five years before. Today I’m as fit as I’ve ever been as an adult. So everything’s fine, right? Well, it’s a bit more complicated.
Let’s not mess about here, having a heart attack is a traumatic and terrifying experience. So is having a major operation with a risk factor measured in percentages. My risk of death was given as a bit under 2%. Which doesn’t sound too bad, but if you were told one in fifty planes crashed fatally, you’d perhaps be rather scared about flying, right?
With an event like this you come face to face with your mortality. The evening before the operation, Romana brought our chidren to see me. I hugged them hard before they left, but I also wanted them to know I was OK. No tears. But in a way I felt oddly calm. I knew my chances were better with the operation than without. But without the operation I was almost certain to be alive at the end of the next day. You have a fear horizon.
That’s… hard. For me I went into a different mental state. I always imagine it’s that mindset that a meditating Buddhist monk might go into. I was calm and collected. I thoroughly expected, when I was told about the need for a bypass, that I’d be a gibbering mess on the day. Yet most people I met facing this situation seemed to be the same. We know our choices are limited and this is our best chance. So off we go. But let’s not pretend that it also doesn’t scare and scar you. We may seem brave. We may be brave. But what choice do we have?
The ascendance from survival
You can read about my waking up on that previous post, if you like. I’m mentioning it here because it marks the start of the new life. A life which is separated into the before, the after, and the now. The initial week you focus on moving, and managing the pain. There’s a lot of support available, the nurses are wonderful, people visit you. The odd one might nearly faint when they see nearly a metre of stitches.
You go home. My in-laws were staying and helped keep the house bustling during the day, which was honestly a help. We can’t communicate well as they don’t speak a lot of English, but they were always there with cups of tea and help with cooking – stuff that’s still difficult in the first few weeks home.
The operation then changes you. Different people react differently to these events, so I can only really talk about how I felt, and how I still feel at times. Please indulge me, or feel free to ignore me! I do this sort of writing because it’s good therapy for me. It gets those feelings out. Other people have other ways. I’ll try and break up the feelings into types, and describe how they pan out over the four years from the event. I’ve not sought out a diagnosis for any of the following, or treatment, so bear that in mind.
Anxiety
Let’s start with the big one and most common for survivors that I’ve dealt with. The fear. The feeling that every twinge is the start of the end, every bit of shortness of breath is the start of new heart trouble because maybe a graft is failing or new plaques are being deposited. Thing is, having had your sternum pulled apart hard, your pericardium sliced open, your arteries and veins harvested… well, it’s pretty natural you’re going to have all sorts of aches and pains and periods of struggle. You notice everything new. Can’t help it.
So we live in this state of increasingly intermittent rather than constant anxiety. It does get better too. I hold on to that. After a year the panicky moments are every couple of weeks. After four years, they’re every month or two. Still there though. I’d been doing some new exercises with weights. The next day my chest was aching and I had a moment where I thought it was a heart attack before I remembered I’d been working out my chest muscles.
Other things come in to play with anxiety also. I suffered a frozen shoulder following the operation, and that is painful and annoying. It eased off six months later, but you find yourself worrying that you’ll never have a pain free day again. And no, you can’t take ibuprofen if you’re on blood thinners despite it being the usual go-to drug for pain relief for things like this. Ah well.
And sometimes I’ll be puffed out because I have asthma, but I’m never sure… worsening asthma marked the decline of my heart health. Is this asthma or is it my heart? Take the inhalers and see if it improves and when it does you do feel this mental relief kicking in!
Depression
This is a very normal reaction to these events. Sometimes you can work through it, sometimes you can’t. I’m pretty certain I had a period of mild depression as a consequence. I still relapse and seem to have a bout of a week or two every now and again in this weird, empty space – I’m either too sensitive, or struggling to enjoy anything or do anything that is outside of routine. Then I’ll have a period where I’m super focussed and really get stuff done. When I’m in it I kind of resent hearing “let’s meet this week” or “there’s a birthday party for one of the boys’ friends this week and they’ve asked us to go along.” I always say yes. But I don’t want to. I want to be left alone. Half my current life I don’t want to talk to people, listen to them or do anything with them. But I do it, because it’s better for me than being alone, even if I prefer being alone. Mad eh?
I still sometimes like and need to be alone though. Last night it was relatively warm, Romana was studying a presentation she had to give, I’d done my chores, kids were in bed, and I curled up on the bench in the garden, with the cushions, and headphones on listening to some good music for an hour and not even glancing at my phone (which was now in do not disturb mode), and it was honestly one of the most enjoyable things I’ve done in a while.
Anger & self pity
I’ve put these two together here. There’s that “woe is me!” feeling which feels like the other side of the coin which is “you’re so f*cking happy and healthy and yet you drink and smoke and don’t exercise and do everything wrong! Feck off!”
These aren’t helpful emotions. But they exist and they’re real. And need acknowledging. And this tendency to anger means that when people get under your skin you have to decide whether they’re actually a positive impact on your life or not. I had a friend who was perfectly lovely and supportive in many ways, but the 2019 general election was coming up. She was very Momentum in politics even if it doesn’t quite chime with her middle class lifestyle, but that’s fine. The problem, the big moment, came when I’d posted something on Facebook about the Lib Dems who I support. She described Jo Swinson as “that vile woman.” And I flipped out. Had a go at her, blocked her, and that was that. She wasn’t the only person I did that to either.
I don’t miss these people I cut out, really. They had toxic personalities to me at that moment in time, and you know what you don’t need when you’re recovering from a major life event? People who are toxic. To you. They might be perfectly lovely people overall. People don’t get into Momentum or the Lib Dems or even the Conservatives, generally, in order to make the world worse. Sometimes they do, but that’s not usually the intention for most people. But those people can be terribly toxic to you. And I’m still recovering, so I don’t have the capacity to cope with that substantial difference of opinion.
I’ve got this! syndrome
Here’s an interesting one, and there’s probably a proper psychological term for it. But I just describe it as “I’ve got this! syndrome.”
A belief that I can deal with all of this. That all I have to do is eat perfectly, exercise perfectly, behave perfectly, care for myself perfectly, take the medication perfectly, be a perfect husband, be a perfect boss, be a perfect dad, a perfect patient, and everything will be fine.
Which is, quite frankly, delusional. There are no perfect people. Myself included.
This knowledge, sadly, doesn’t seem to stop me. I go through phases where I decide I’m going to run faster and further than ever before. Then I realise that in doing that, I’m skipping quality time with the kids, not doing laundry or jobs around the house… or I go camping with the kids and feel that I ate badly and didn’t do my run for the weekend… or I switch to alcohol free beer and then realise that actually it’s still full of simple carbs… or I think sod it, have the chocolate, but now I have to run extra hard, only to find that the extra hard running leaves me sore and exhausted the next day.
It’s probably PTSD
I guess this is that post-traumatic stress problem that people talk of.
So why don’t I get help?
Because I’m functioning, frankly. I’m not so depressed that I can’t get by. I’m not so anxious that nothing happens in my life. My kids are happy. I think my wife is happy. I think my colleagues are mostly happy. But each little setback, even if nothing to do with my health, sets me on a path of questioning and trying to work out how to be better, stronger, smarter, more organised, more caring, more focussed, better at caring for myself, better… better… better. Because that’s how I get over this and make the most of the 5-30 years I probably have left.
About that 5-30 years
All things being well, there’s no real reason why someone who’s had a bypass like me, following a heart attack (myocardial infarction) with relatively little damage to the heart shouldn’t live another 30 years. Maybe more. An active and full life. I’ve come across people in amazing shape, aged nearly eighty, thirty years on. They look amazing.
But I also see some people pass away. Some of my grafts were from veins and they’re just not so tough and have a high chance of failing after ten years. I could get really unlucky and they could block and cause trouble in a bad way. Which could kill me.
Who knows, eh? I certainly don’t. Nobody does. I just keep taking the pills and hope for the best. Speaking of which:
Now the good stuff: The weird disappearance of my xanthelasma
So, xanthelasma are interesting. I had a couple of these. Here’s a before and after shot:
Excuse the ropey shots used – I never set out to document the disappearance of these things, but there you go. I had them, now I don’t.
Xanthelasma are made of cholesterol, and are, in fact, an indicator of risk of cardiovascular problems. The fact they’ve gone is actually reassuring. I can see that my cholesterol levels in my blood, from blood tests, are about half what they used to be. This is potentially great news. I’m hoping it keeps me safe.
With blood pressure, we all know that high blood pressure is bad for the arteries. It damages them, and is linked to stiffening as well.
In this case you can see that I’d started logging my blood pressure in the top part of this chart in early 2019, half a year before my heart attack. Then I kind of lost interest. It was a bit high-ish but not so high as to be of any real concern. I didn’t worry too much.
But the heart attack came! I started logging everything as soon as I came home, and you can see how I did it very regularly by the density of data points. Sometimes I was measuring two or three times a day.
You can track it along until March 2020, when I came off beta-blockers. You can see that the blood pressure readings became a little more varied, with more readings above 120/80 – my target is to keep below that. The trend didn’t really change, but over 2021 I’ve noticed that if I’m over 120/80 it’s by a very small amount. Most typically I see readings around 110/70 which is exactly where I want it to be. Ever since then it’s been much the same, but I’ve zoomed in to show how my desire to measure my blood pressure quite suddenly tailed off. Because I felt a lot better. You get the odd spike, but they often go with a bit of relaxation.
Ten key things I do to try and help recover from the bypass
So now for a little list of the things I try to do to help myself. They don’t always work:
Exercise. I’m told this is the single best thing I can do. So I try and do at least three solid bouts of exercise which substantially raise my heartbeat each week. I also now try and incorporate some more strength exercise – sit ups, press ups, pull ups, etc. So long as my shoulders don’t hurt too much.
Cut out toxic people and walk away from disputes. I always stood my ground in a dispute in order to ensure a negotiated settlement was the end, or the other person would give up. Now, sometimes, I just think “nah, sod it. I don’t need the argument, and I don’t need these people. Step away.” I still need to be better at this, but watch out for it.
Eat reasonably well. Still like some treats though. I’m largely vegan, so I avoid dairy. I really enjoy a peanut bar with a bit of chocolate as a bit of a treat. But the rest of the time it’s wholegrains, plenty of protein, not too many simple carbs, no sugar in coffee, no sugary fizzy pop, no alcohol, no deep fried food, no cheesy food.
On the point of no alcohol, I still allow myself the odd glass. On very very rare occasions I’ve been known to have two glasses of wine. Needs to be a good reason though. Because alcohol is bad for you. Yes, even red wine. I could link to studies, but if you don’t believe me you’ll find the outdated studies that say it’s good for you, and if you do believe me… well, you don’t need further evidence do you?
Break work into chunks. I sometimes use a visual countdown timer, just to get things started. I allocate myself twenty minutes to at least start a task, and see what I can achieve in that time.
Self-care. If I can, I take time to myself. If it’s been gloomy I’ll allow myself six minutes on a sunbed (with sunblock on the scars) to give me a little boost. Not very often, but seems to lift me. Other things can include getting a haircut, going for a walk, or treating myself to something enjoyable.
The pills. Oh the pills. I take them carefully and religiously! Very occasionally I forget one, but it’s rare. They keep me alive. I also supplement with magnesium (it’s a mild calcium channel blocker and can help with relaxing) and some other multivitamins as feels appropriate.
Appreciate the people around me. They matter. They give me the support and grounding that I need.
Try not to think too much about work. You’re either working, or not working. It’s OK to not be busy when working and to be thinking. Don’t work eight hours, then think about work for another five hours, never quite present with other people.
Have things to actively look forward to. Your things, not the things you’re supposed to do. A mild bit of selfishness is OK – in fact it’s healthy. Just don’t make it pathological. If you’re spending more time playing golf than with you’re family you should probably tweak things or deal with why you prefer that to family. But enjoy yourself. Give yourself space for pleasure.
So that’s it. I just saw my word count and 2800+ words is far too many, really. If you’ve made it this far without merely scanning, then well done you! Take care 💖
Have you had a bypass operation? How did you recover? What tips do you have?
A year ago, I was sitting, shorn of all body hair and waiting to go in for a five or six hour operation. I knew the next two weeks would be hell.
It’s hard to explain the odd calm that came over me as I sat there, waiting for the biggest operation of my life. I didn’t feel happy. I didn’t feel miserable. It wasn’t as if I’d been feeling terrible. I’d just had one bad morning two and a half weeks earlier where I felt rough, then more rough, then really really rough, then fine again.
It’s weird. You see heart attacks on TV and you get this idea of a mad bad event where you keel over, clutching your heart in agony. But it doesn’t really work like that. The night before I’d felt tired. In fact, for a few years I’d been feeling like hard exercise was a challenge. It took me an age to warm up for a sport, and then I’d be fine. But the first half hour was a chore. And if I’d eaten I was basically useless for an hour or so.
I put it down to age and asthma.
I wish I hadn’t. But thankfully, I got lucky, in a way.
So driving along to work I felt this tightness in my chest, a tiredness, and a general malaise. So I decided, as was sensible, to pick up some vitamin tablets on the way to work. That’s what you do when you’re tired. Take vitamins, and get plenty of sleep. That was my plan. But by the time I got to the counter, I felt even worse and decided to mention the chest tightness to the chemist. She very clearly said I should go to the walk-in centre and get checked out. Instead, of course, I decided I’d get it checked out at some more convenient moment. But by the time I got back to the car I realised I was very out of breath just walking slowly.
I was having a heart attack. I didn’t know it yet. I looked at my Fitbit on my wrist and it said my heart was doing a nice old 70 bpm. Normal enough for me. So why was I puffed out? Must be an asthma thing. But I decided that I would go to the walk-in centre after all. I drove, feeling increasingly out of sorts, parked quite badly, and shuffled in to reception.
A few hours later, I was hugging my wife in A&E at the Royal Liverpool Hospital. I was worried, but not terrified. The doctor dealing with me said “I’m concerned but not worried.” That was a relief. The diagnosis was swinging between heart attack and pericarditis. I was atypical. Relatively young, slim, non-smoker, evidently in reasonable health, and moderately active for someone desk-bound at work.
But they couldn’t satisfy themselves. The A&E cardiologist said I had to go in for observation. They observed me.
Observation is boring
I was sent up to a cardiac observation ward where there were a range of folk from really quite ill and very elderly to me. By then I was feeling fine, quite chirpy, and generally comfortable. My biggest complaint was that the ward was a bit noisy, with an elderly chap who was rather confused causing the most noise. But hey, I was alive, the food was tolerable, I had my Kindle and my phone. I started to obsessively read about the heart, interpreting ECGs and so on. It’s all quite fascinating. And complex. I won’t pretend a lot of it stuck. But now I knew the possibilities.
The rather wonderful Mr Fisher, my cardiologist at the hospital there, did a series of echocardiograms. He felt that I was 95% likely to have pericarditis, in which case a few tablets and I’d be right as rain within a couple of weeks. However, there was a 5% chance of something else, so he’d scheduled me for an angiogram at the Liverpool Heart and Chest Hospital. If they found something, they would be able to stent me there and then and I’d be on the path to recovery.
95% chance of some tablets and everything was fine? OK, I cried a little and started looking forward to the family holiday we had planned.
Angiograms feel weird
An angiogram is where a fine catheter is inserted up to the heart, then a substance that can be detected using x-rays is released into the heart. This allows the surgeon to get a visualisation of the heart. It’s really interesting. And a little unpleasant, but definitely not much more unpleasant than a longer dental visit. It is surgery of a sort, and done carelessly it can do damage, so they always have someone on standby ready to whiz your chest open and do some emergency surgery.
Thankfully it’s usually very safe. It just feels odd, sitting there with this big machine whizzing around you imaging your heart, a massive TV screen to your left, and a very precise talking and unambiguous surgeon on your right instructing his team. I was anxious. He noticed that, and he said “just give him the valium. Now”. At least I think it was valium. In some ways my memory is a bit fuzzy.
Because then, as he finished everything up, he explained that a stent wouldn’t be possible and I would need what is called a coronary artery bypass graft. Four, maybe five. I… didn’t like that news. I felt shocked, scared, and unhappy. I’d gone from probably just an annoying health scare to looking towards having my chest sliced open and my heart operated on.
How do you even operate on a heart? It’s not supposed to stop. Right? Stopped heart = dead. No?
The wait
So then you just wait. And wait. They wouldn’t let me leave the hospital. I was at risk of another heart attack, the blockage was so bad, and they needed my system to flush out the drugs I’d been given when I was suspected of a heart attack. Risks, apparently. It took two and a half weeks from admission to operation. Long enough to think about my mortality, prepare some things, and do weird things like have a company meeting in the middle of the ward to ensure everyone knew what to do, and how.
It was an interesting time. People came and went. I got to know some, and would chat to them as they faced their fears. Most people were older, most were as surprised as I was. What really surprised me is that the image most of us have of people waiting for a bypass wasn’t really fulfilled. Sure, you had the smokers and the fatties. But loads of us were relatively active, relatively slim people. Not that athletic, mostly, but in a line-up of people most likely to need a bypass, you wouldn’t have picked most of us.
Sometimes I’d chat with people facing the operation the next morning and they were, usually, very anxious and worried. Some said things like “well, if I die… I won’t know it. It’s my family I worry for.” Others joked about having their last cup of tea. There’s some morbid humour, but it felt like a release too. A way of expressing anxiety with a laugh.
But the fact so many of us weren’t people who’d neglected ourselves felt terribly unfair. I struggled to deal with that.
Could’ves and should’ves
One chap, about ninety years old and looking in remarkable health, was in for a new valve. He said without it he’d likely not survive the year. With it he had a good chance of another five years. Yes, there was a risk, but as he said “I’ve had a good life.” I guess by the time you reach your nineties you come to a realisation that you can’t really have that long left, no matter what you do.
I talked about my own misgivings. I’d been a bit plump in my twenties, and I enjoyed partying and chocolates. I’d also been a hard working type with little time to do lots of exercise. He smiled and said something like “Life’s full of could’ves and should’ves, but they really don’t matter. You have to deal with the present and make things as best you can for the future. The past has gone. Leave it be.”
He was so right.
Getting closer
As the date loomed I thought I’d get increasingly anxious, but it just stopped. I wasn’t aware of being pumped with chill-pills. I’d seen more frail people go off to operation, and I’d chatted with them as they recovered. It was clearly hard going for them, but they lived and they seemed in good spirits. It’s a very hard operation to go through, I knew that, but now it felt tangible. I also had visits from colleagues, friends and family, so each day I had something to look forward to.
I did do some morbid things. I wrote a note to my family, should I die. I have no skeletons in the closet, but wanted to ensure they knew where to find financial stuff. I knew that they knew that I loved them. I kept the schmaltzy stuff to a minimum. Just crack on. What needs to happen has to happen.
The day itself
Now, this is where it gets more interesting, really. First thing you have to do is shave off all body hair below the neck. You’re handed a quality hair trimmer, with a sterile trimming blade, and pointed to the bathroom. Bzzzzzz! It takes for ever! And those things bite! Once on the balls. I wasn’t really sure where to stop, and I couldn’t really do my back on my own, so I left that, assuming they knew that too.
My operation, schedule for the afternoon, meant no food or drink. I read a bit, chatted with Romana, and refused to say goodbye. I was coming back. I knew it. I was confident. I’d already met the surgeon, and he seemed confident, precise, and concise. I like that in a person. We talked a little about technicalities and how the procedure would be done one me, what arteries they were harvesting and from where. I’d also spoken to another surgeon who I assumed assisted. He poked me and checked how various bits of me worked. I had a breath test. I had a lot of tests. But the day of the operation itself was quiet, really.
So I knew the operation was going to be a beating heart one, without using a heart-lung bypass machine. The attachment of the grafts would be done using some weird sucker machine (maybe called an Octopus) that would stabilise my slowed down heart, but at no point would it be stopped. Amazing. Each stitch carried out between the beats of my heart on arteries just 1.5mm wide.
And then it comes. The porters arrive, you give everyone else on the ward a wave, they say good luck, and you go. All the stuff you have is bagged up and taken away. You don’t need it the next day, and if there are emergencies stuff can get lost, so it’s better if a friend or partner handles it.
Then you wait in a pre-operation room with clouds painted on the ceiling. It made me think of going to heaven, but it was better than white tiles, I guess. That was when I chatted with Romana, ensured she knew I loved her, again, and waited. And then they come for you. You say goodbye, and off you go to theatre.
There, the anaesthetist I’d met before, hooked me up to a skullcap for monitoring my brain, and started preparing me with those injection thingies. A theatre nurse chatted and joked with me. Clearly there to keep my mind off things and keep me calm. And the moment comes. The anaesthetic is injected and you’re switched off.
It really is like that. You don’t have any awareness.
I’m awake and alive!
Actually, I remember a vague moment of having something pulled out of my throat, being conscious, and then out of it again. According to Romana when I first woke I became agitated, so they sedated me again for a while. When I next woke I had a nurse talking to me, giving a button to press with instructions about how it delivered morphine and would ease my pain. I couldn’t overdose with it apparently.
I tried.
I clicked that button again and again! Not to deliberately kill myself or anything, but because it was so nice! However, it’s rate limited. Keep pressing and it just beeps. When it kicks in you feel this warmth, and the pain goes. It’s a very nice drug and I’m not surprised people get addicted.
Romana came in. I was… not really in the best place. I was in pain. I felt like I’d been hit by a truck. I don’t even know if I have the order of events right.
Click. Oh, that lovely morphine button.
We chatted a little, but I remember very little. I had an oxygen mask, I was uncomfortable. I realised I had a urinary catheter in place, so I could stay still. She left, and I think I slept.
Intensive care is weird
One thing I never realised from films, is that intensive care really is just that. It’s actually, in this case, Post-Operative Critical Care. A nurse is stationed at the end of your bed and watches you constantly in the first night. At one point I remember being woken.
“David… can you breathe please?”
I took a gasp.
“You’re worrying me with your apnea,” she said.
I took a few breaths. I felt as OK as I could manage.
I could only see one other person on the ward, and he would wave at me and give me thumbs up. He couldn’t take his mask off. We waved and smiled at each other. I never saw him on the cardiac recovery ward, but he could have had different conditions – they do other kinds of surgery there beyond hearts.
The next day was a bit less painful. You get x-rayed in your bed, poked, prodded and checked. My blood pressure tended towards the low side, but you could see that at the 24hr point I was getting a lot less attention, all the pipes in my chest were out, stitches put in, and I was being made to sit for a while now and again. The second night I was definitely left to my own devices for a bit.
After a few checks the next morning, it was off to recovery.
Not my best, look, just two days after the operation. But alive and happy about it!
The poo of doom
Each day you feel better. You need less and less supplemental oxygen. You start eating normally again.
I’d also heard that after a major operation, you get constipation. Had I known this I’d have been tempted to stop eating two days beforehand!
Because after a few days, you realise you have to poo. Thankfully this comes once you’re mobile again. But even walking fifteen metres to the bathroom is still tiring on the third day. The poo won’t wait. Nor should it. Because the longer it takes, the worse it’ll be.
Man, you’re giving birth.
Seriously. I sat in the bathroom. It started to come. Very very slowly. It. Was. Huge.
And a huge poo is going to be unpleasant, no matter how much time you give it. I feel for heroin addicts dealing with that. Their piles must be quite something.
I strained, but only a little as I’d been warned not to. So I had to tolerate this thing… half in, half out. Slowly but surely, little by little, it came. But it seemed to never end. I swear, I spent an hour in that bathroom, swearing, cursing, and wishing I’d never been born. And if I pushed too hard my heart rewarded me with a palpitation or to and I’d feel breathless.
The thought occurred to me… what if I died right now? A poo, half the way out of my arse and me, on the floor? That would be the last thing the world saw of me. Ew.
Deep breath.
Carry on. Wait. Be patient.
Eventually, it was over. I hobbled back to the bed, grabbed my oxygen mask, and had a nap. I’d deserved it.
Eventually you get to go home
Six days after being open and lying surrounded by dedicated specialists, I was going home. They test you to see if you’re capable of being trusted. You have to walk a certain distance, unaided, and climbing and descend a flight of stairs. A group of you go together for this test. We all did it. There was some sort of air of celebration around us. We were survivors! This thing wasn’t going to defeat us after all! Each day we were stronger!
The homecoming
Getting to leave the hospital is a joy. I’d been taking walks and stepping outside anyway. I was very keen to be moving. I felt frail and slow, but it allowed me to feel like life was going to improve.
But in spite of that, on discharge, you’re given your bag of drugs and wheeled to the door. Once you’re off in your car, you’re no longer their problem. Until then though, they have a process to follow and they’ll stick to it!
As you can see, I had the weird hospital socklets and stockings on. The compression stockings help reduce the chance of a blood clot forming in your legs, and reduce swelling. You can see from this photo that my left leg, from which a vein had been harvested, was definitely bigger than my right
And that’s it. The next phase is about getting back to full fitness, work and leading a full life. I surprised myself, and I’ll share more soon. I’m planning to discuss stress, work-life balance, family and a few more things. And this blog may even come back to life a little bit. I’m bored of helping Facebook and friends to keep their platforms populated with content that is then lost in a silo. Longer writing definitely has a place. Please feel free to join me here.
I expected more ice, it has to be said. I also packed my thermals and it turned out to be warmer than home. But, I also know how bitterly cold it can get in countries like this in Winter even if the thermometer doesn’t show it as looking so bad – driving rain, strong winds and pervasive dampness can chill you to the bone where the same temperature on a sunny day in the Alps could feel positively balmy.
This was my 40th birthday present from Romana. The hope had been to see the Northern Lights, something I always wanted to witness. Sadly the weather and conditions meant it wasn’t to be. But I still appreciated the trip and the unique experiences – it was a great gift!
I’m not going to extol the virtues of Iceland too much here – it’s a small country, with a rich culture and heritage. It’s definitely one of those places worth visiting if you get the chance.
One note, though – I expected to be hungry, but it turns out there’s six vegetarian restaurants, and most (but not all, by any means) restaurants offered fairly decent vegetarian options.
PS – some pictures are rather grainy as I had to push the camera somewhat. This is one dark country!
