The Day I Thought I Was Dying
Dr Vernon Coleman MB ChB DSc FRSA
At six oíclock in the evening the other day I really thought my time was up.
I had spent a couple of hours working in the garden in the Cotswolds, had dinner and slumped down in an easy chair with a coffee and a Richard Stark novel. I wasnít particularly tired. I certainly wasnít exhausted.
But, suddenly, I felt strange.
I checked my pulse. It was fibrillating so fast I couldnít begin to count it.
I checked my blood pressure and pulse with a machine we have. My pulse was 156 and upwards and my blood pressure alternated between absurdly high and absurdly low. The machine lit up with all the little warning lights with which it is fitted.
I had no chest, jaw or arm pain but I had a great deal of wind.
And I realised that the pain and fibrillation were entirely my fault.
Since I managed to conquer my once crippling IBS I have been getting a little millennial (the new word for `cockyí).
A couple of weeks ago I started eating rough, brown, wholemeal bread packed with seeds. It was wonderful to taste good bread again, after years of eating nothing but white bread.
Doctors, relying on what they have been taught, supplemented by what they have read in medical journals and medical textbooks, still believe that IBS is best treated with a diet heavy in roughage. This is like trying to treat diabetes mellitus by telling patients to eat more sugar.
The professions donít take IBS very seriously because there is no effective pharmacological remedy available. The healing professions are, I am afraid to say, dominated by the needs of the pharmaceutical industry. The result is that modern medical care is dominated by, and run for, interventionists in general and drug companies in particular.
Because IBS is neither a dramatic disease, nor a fashionable one, doctors remain blisteringly ignorant about it.
I have lost count of the number of patients who have told me that their doctor has told them that their wind is not caused by IBS because `the tests came back negativeí. Thatís clever of them because I know of no comprehensive and effective tests for IBS. The diagnosis has to be made on the basis of the symptoms and signs.
I have for years been aware of the problems which IBS can cause. A few years ago, I was the first doctor to notice that intestinal wind can cause kidney bleeding. I had first-hand experience of this since I very nearly lost a kidney to doctors who were keen to rip out what they thought was a cancerous organ. Only my insistence that a scan be done had saved one of my favourite kidneys from ending up as someoneís breakfast.
I had forgotten that IBS is not a disorder to be treated lightly. It is, as much as any disorder, a disease for life.
As a result I overdid things.
I ate four slices of the good, brown, rich bread and the next day I was bloated and suffering. Unusually for me it was my stomach, rather than my large intestine, which was most bloated.
And now I was fibrillating and genuine hospital material.
Antoinette wanted to call an ambulance but I wouldnít let her.
I felt certain that my crazy heart antics were a result of the massive amount of wind that was in my intestines in general and my stomach in particular.
The stomach and the heart share a common nerve supply (the vagus nerve or tenth cranial nerve) but although doctors recognise that burping may, rarely, be a sign of cardiac dysfunction they do not recognise that cardiac dysfunction (including palpitations and fibrillations) can be a result of intestinal wind.
If there is no suitable drug therapy available then the problem will not be recognised. Doctors and nurses are dedicated to the interventionist philosophy. Doing something is their default. And, sadly, too many patients are eager to accept whatever treatments are offered.
It took about six hours for the fibrillations to slow and for my heart to start beating normally again. I was exhausted, inevitably, and yawning frequently too. I even had left arm discomfort.
(The vagus nerve also triggers yawning. To the orthodox professional, yawning is therefore a sign that a patient is having a heart attack. And the vagus nerve can cause pains in the left arm too.)
How many people, I wonder, are being treated for heart disease when their initial signs and symptoms were caused by wind?
And how many patients (let alone doctors) know that all the drugs used to treat irregular heart beats have potentially alarming side effects Ė including irregular heart beats. And death.
This is yet another undiscovered health scandal.
The older I get, and the more I know, the more I realise that medicine really is still in the dark ages. We have to remember, I suppose, that it isnít all that long ago that doctors claimed that smoking was good for the lungs.
Given my symptoms I would be lucky not to end up with a fistful of prescriptions for heart drugs. Statins, of course. Something for the high blood pressure I donít usually have. And a few expensive delicacies for the heart irregularity.
The problem, you see, is that the medical literature shows a single case of a man in his 60s who complained of wind and turned out, on investigation, to have problems with his cardiac arteries.
(Please donít ask why they checked out his cardiac arteries when he complained of wind.)
Now, you might imagine that it might be possible that a man of that age might suffer both from some sort of intestinal disorder and a heart problem.
But doctors like to tie things up neatly. And so it was concluded that the wind from which he complained was a symptom of his heart disease.
And so thatís it.
According to medical literature and medical teaching, wind is now a symptom of heart disease.
So I didnít go the hospital. I changed my diet back to what it had been to get rid of the IBS.
Of course, I could have been wrong. Even without chest pains I could have been enduring a silent heart attack.
I rather hope not.
Still, it is worth reflecting that if I had gone along to the Accident and Emergency department of a hospital I would have doubtless ended up with a fistful of prescriptions for drugs which might well have killed me.
And, I have no doubt that my theory about vagus nerve interference would have almost certainly attracted nothing but sneers, raised eyebrows and a diagnosis of dementia.
However, after getting rid of the wind my symptoms improved dramatically.
The fibrillation disappeared.
Copyright Vernon Coleman November 12th 2017
Note: Vernon Colemanís sixth diary will be available as an e book early in 2018.