Welcome to My World

What an exceptional time to be alive. The world interconnected in a waking nightmare, with the worst (most likely) yet to come.

Coronavirus, COVID-19, novel coronavirus, SARS-CoV-2, The Rona (in Australia anyway), whatever you want to call it, has brought the world to its knees. It’s invisible, it’s not biased, it's deadly and we still have no way to beat it. The best strategy is not to contract it in the first place. Wash hands, quarantine, wash hands, stay away from people (at least 1.5m), wash hands, don’t touch your face, wash hands, cough and sneeze into your elbow, wash hands - oh I said that already. I need some hand cream pronto!

The other side to all this is the mental impact and toll this is having on us. There’s still stupid people out there living in their own bubble thinking they can’t be affected nor do they have any social responsibility to others – let’s leave those fuckwits out of this. No doubt the rest of us living in reality and particularly being in the vulnerable part of the population, have clued into our own sense of mortality and existentialism, if we hadn’t before. (How can you not be when coverage and infection are so widespread; or simply just by sensing the eerie vibe out there?)

I was talking to a friend a few months ago who unfortunately had a very bad car accident. She thankfully survived with minimal bodily damage. The accident should have been fatal but thank whatever out there, dumb fucking luck, it wasn’t. I could tell immediately that she was just falling over the edge into the long dark spiral of PTSD (she was approximately 4 weeks post-accident, which is the common amount of time before PTSD kicks in). She was frantic, contemplative, shell-shocked, in disbelief, depressed yet elated. I just listened to the outpouring of information. She couldn’t comprehend that the night before the accident could have been the last time she ever tucked her daughter into bed. What can you say to that, to any of it? Most times the best thing to do is shut the fuck up and listen. Unsubstantiated meaningless niceties, wisdom or positivity don’t cut it. My husband piped up eventually to break the desperate silence. He told her if anyone can understand how she feels, that I can. I know down to the deep dark core of her soul exactly how she feels. I’ve been her. I should have died at least twice now (fuck I’m losing count) from a congenital heart defect and cardiac arrest, but I didn’t. I’ve been on this PTSD train before, toot toot all aboard. Perhaps I should have reveled in the fact that out of my friends, I wasn’t alone anymore. Instead I was sad that she must go through this. The only thing that gives me some solace is that I’m available to her if and when she decides she needs me.

People experiencing this pandemic in quarantine from their own houses doesn’t compare to having a near fatal car accident, or cardiac arrest. But what these experiences have in common is that they force people to pause, to take stock, to reflect on themselves, their lives and the world around them. I feel confident that most people out there whether you've been directly affected by COVID-19 or not – yes I’m talking to you – have now experienced this moment: where a sudden existential dark emptiness casts over your mind and seeps into the middle of your chest to take residence in your soul. It’s that dreaded moment of dawning, or rather setting, where you realise within the being of your cells that one day, you will die; and at the same time just how precious and finite life really is. It’s one of the truest and breathtakingly bittersweet moments in one’s existence. The first time I felt it I must have been no more than nine years old. I was sitting on the grey carpeted floor in my bedroom contemplating all that is life. Naturally I came to that unsettling conclusion. And just like most people, I shook it off and kept going about my business.

We all know this truth intellectually, but to understand it in the depths of your soul is something else. It’s the unique experience reserved for people having gone through a near death experience, having been in war, tending to the sick and dying, being the sick and dying. And now it’s for the masses, televised and transmitted to your lounge room 24/7.

All the things you’re feeling now, during this pandemic, that’s me, feeling those things and having those morbid thoughts all the time.

Welcome to my world.

It’s a waking nightmare we’re all living, it’s difficult to comprehend our new reality. You distract yourself and go to sleep and try to escape it and maybe you’re lucky and you do. With my PTSD, there’s no escape. I’m living trapped in this endless cycle of mental and emotional exhaustion where at times the only choice is to become numb. I stay awake to try to distract myself from thoughts of death, what if scenarios and that creeping existential dark emptiness that keeps seeping through me trying to drown me every chance it gets. I’m too scared to go to sleep in case I don’t wake up again. Eventually when I do sleep, my anxieties and fears pervade my sleep to form nightmares. Sometimes I wake suddenly in the middle of the night gasping for air to violently, as quickly as possible, fill my lungs to know that I’m alive; and then I’m too scared to go to sleep again because I’m so grateful to be alive and terrified of dying all at the same time. When I wake up for good, I’m thoroughly spent, zombified, groggy, fatigued. Having more sleep to fend off the fatigue makes it worse because the nightmares are so vivid and visceral, they exhaust me further and for longer.

It takes time, work and kindness to oneself to unravel this cycle, to fight the PTSD and come out the other end as a highly functioning human being; to seek out the light as you move away from the darkness.

Another friend’s mother suddenly passed away about a month ago overseas. She had visited Australia some months prior where I distinctly remember my last interaction with her. I had gone to pick up my daughter from their place and she asked if I wanted a coffee. I wasn’t particularly in the mood for a drink but accepted regardless because I thought to myself I’m not sure when, if ever I’m going to see her again. Probably a morbid thought for the average person, but this is now my modus operandi, it has been most of my life, but more pronounced since my first cardiac arrest. Most interactions I have, I make a choice to treat it as being potentially the last one. Because one thing my congenital heart defect and cardiac arrests have taught me, is who the fuck knows what’s in store for any of us? As shocking as the news of her passing was (she was super healthy and active, nor too old), I was grateful we had that coffee together where I got to find out about her life and love of bike riding through nature, that essentially, I shut the fuck up, listened and got to have a genuine connection with her over that handful of minutes. All it takes is a pause, to be authentic and show someone that they matter, that they’re just as human as you are. A smile, a laugh, an inquiry or some banter with the checkout person in the supermarket to make a difference and to potentially make a person’s day, or yours one day down the track. To live without regret that you’ve said and done everything you’ve wanted to, that you’ll be remembered as that kind person, not the asshole. For me it’s simple: it’s to tell my family and friends I love them when we chat, or when the mood strikes; to hug them just that little bit longer and to take in their scent (creepy I know, but you take what you can when your immediate family lives abroad and interstate); the weekly phone call;  it’s the good morning in passing; the kiss, hug and eye contact hello when my husband gets home from work; and it’s the kiss and hug goodnight as I tuck my daughter into bed. If you're wondering, I smell her also, the most out of all people, my husband a close second. They’re the only things I can control and that matter the most to me because when the end comes, we can only hold on to the memories we made and the last interactions we had with people.

The world is so strange right now. It’s scary but it’s also beautiful and hopeful. Breathe in the air, it means you’re alive. Hug your loved ones or yourself, because you love them. Talk less and listen more, because we’re always learning. Take joy in the micro things because as big as the world is, we should all just stay home in our little universe for now. And remember, you’re not alone, we’re all in this together and we’re taking it one day at a time. As for today, I’m glad I’m still here. This is our world now.

Rhythmic composition in yellow green minor (1919), Roy de Maistre

The Roller Coaster of Congenital Heart Disease (or Pushing a Boulder Up a Hill)

I'm still alive. Barely. This has been a shitty year.

I'll get you caught up since we last spoke in February 2017. I ended up getting (what seemed on paper) an awesome job at a prestigious organisation. It wasn't in reality: neither awesome or prestigious; and I never got the chance to truly do the job I was hired for. A more accurate description is chaotic, a lost cause. I was there for approximately 16 months. Why did I stay there that long, after I had gauged the level of chaos within four weeks of having arrived? I don't give in that easily. I'm a dog with a bone. If you have a problem, I'll work my ass off to try and fix it because that's who I am. Maybe I shouldn't get that emotionally involved or have such high expectations of organisational structures or people? But that's not who I am, I don't put up with half-arsed and I care about the quality of work I produce and the impact I have on others. I want to contribute, make life better for others around me and leave my corner of the world that little bit of a better place than what it was before. 

It was weird, that place was so seductive, its people with such compelling stories and promises, with a decent job description, pay and benefits package and the promise of things getting better. I was lulled into a false sense of security that preyed on my loyalty, hard work ethic, commitment and natural inclination towards problem solving. It was like an abusive relationship: I kept on going back because I was promised things would be different next time, but they weren't. In fact they kept getting worse.

Something I haven't experienced before is the chronic stress element. It differs from standard stress, where you get pushed for a short period and then the valve is opened to release pressure and you get back to an even playing field again. Instead, chronic stress builds up over an extended period of time, constantly rising until something massive, like Chernobyl happens. There's warning signs, but you're so used to the stress and long hours (because that's your standard level of operation now) that you ignore or try to poorly manage the warning signs...and then BANG!

16 months of chronic stress and three heart incidents later, I accepted my reality: either that place was going to kill me, or I quit. I did the latter and I've been off work and recovering from my last incident for five and a half months already. I'm still angry though. I'm angry at myself for putting up with bullshit and not being kind to myself. I'm angry at the organisation and its people that didn't perform their duty of care. 

I sometimes forget that I have limits, that my heart and energy levels aren't as strong as someone who was born without heart issues. I forget because I can't sit idle waiting for my condition to claim me. I want to live my precious life and enjoy it just as much as anyone else, I want to challenge my mind and offer value to others without constantly thinking about illness or death.

But now I'm giving myself time to decompress and reflect. I'm learning my lessons and implementing strategies to better manage myself and my health. That's the beauty and often frustration of life: the power of retrospect and growth as an individual. Its a gradual, cumulative and an imperfect process.

I was incident free for over 3 years post having my defibrillator inserted. Then the job with the chronic stress happened and so did these incidents during extreme and prolonged periods of stress and exhaustion:

• Cardiac arrest, one appropriate and successful defibrillator shock to revert ventricular tachycardia  - six months into the job
  
• Atrial fibrillation, hospitalisation with transoesophageal echocardiogram (TOE) and cardioversion - nine months into the job
• Cardiac arrest, six consecutive and appropriate defibrillator shocks, with sixth successful in reverting ventricular tachycardia; cardiothoracic surgery for defibrillator replacement, medication change, rehab - 16 months into the job

There can never be definitive reasoning as to why these incidents happen, but doctors have a good idea. Stress and depression don't help, studies link these clearly to arrhythmias, particularly atrial fibrillation. Having congenital heart disease doesn't help - fucked heart from the get go, which puts patients into a higher risk category of having more complications or issues throughout their life. And finally scar tissue from open heart surgery can also cause arrhythmias. Or maybe it was a virus that weakened and affected my heart? Take a pick, I've had it all. And the severe stress and exhaustion made it so much worse.

People particularly in this modern day and age want a quick fix, a one pill solution, a reason they can grasp onto and fix. The best unsolicited advice I got from a family member recently was to fix my diet. I guess I shouldn't eat that donut or worry about all the other factors that come into play? Fuck it, I'm eating the donut.

One of the hardest things in this life is to live with uncertainty. People try to help, to simplify, to process.

There's limitations and doctors aren't gods. We're also all different constitutions that have our own way of ticking and working with genetic and environmental factors coming into play. The way modern health has advanced and information is disseminated makes us have a collective cultural mindset of being invincible and immortal. We're not and we don't have all the answers. Nature and life are both a beautiful and ugly miraculous mystery.  

I've been here before. I've been through this. I've got this. This wasn't my first cardiac arrest and it's probably not going to be my last.

I get moments of emotional weakness and complacency too. After my first out of hospital sudden cardiac arrest in 2014, I satiated my uncertainty by convincing myself that it was most likely a one off random event and the defibrillator was my insurance policy. I know better now. It's my survival mechanism. Until other heart complications; or other health issues or old age get me, just like any of us.

The last year and half has been at times a horrible nightmare; and at others a beautiful ethereal dream. 

In their book 'A Beginner's Guide to the End', Miller and Berger briefly talk about major chronic diseases and their patterns. They describe heart disease as having the pattern profile of a roller coaster. That's right, with the constant ups and downs, with good periods and bad ones. Where you're in hospital feeling rubbish and terrified for our life one day and the next you're recovered (for now), elated and discharged to go home to resume your normal life.

That's been my year. And here I am again, picking up the pieces and getting on with it. But it's alright, I've got this. I told you: I've been here before. 

It's familiar, but I wouldn't say that it gets easier. The darkness in my mind is real, with the insomnia and the sheer terror of going to sleep because I think I might die during the night. And the anxiety is taken up a notch or five now. Not only from the panic of dying, but I'm also emotionally paralysed from entering the work place again because I'm traumatised from my last job. 

There's a Greek myth that stuck with me recently: the story of the great Corinthian King Sisyphus. He was so cunning that he captured and escaped death. For this, he was eternally punished in Hades to push a boulder up a hill, which would then roll down upon reaching the hill's summit. Push, roll, repeat. For eternity. A fruitless and laborious task. A lesson in how we are unable to avoid the inevitable. Death and taxes come for us all.

So here I am, call me Sisyphus. Whether I'm riding a roller coaster or pushing a boulder up a hill, I'm stuck in this perpetual loop with no control, but I keep going. Welcome to life.

Tuesdays with Morrie [an old man, a young man, and life's greatest lesson]

I don't remember the last time I read a book so quickly. Maybe the 900-odd page Game of Thrones tomes I've been reading lately have impeded speedy reading enjoyment, but I breezed through Tuesdays with Morrie within a handful of hours. The book was exactly what I needed in my life now.

I've danced around the issue of death and like most people, unless having dealt with a loved one's death face on, have managed to avoid delving too much into thinking about it, because I haven't had to. You'd think that with my recent near death experience (surviving a cardiac arrest) I'd be all over this shit. I've wanted to be but for the most part, I was so overwhelmingly happy to be alive, that I didn't want to think about death too deeply or too often. Having narrowly escaped death's bony embrace, there were so many other immediate things to deal with and think about. Primarily, how I want to live.

I knew this would be a subject matter I would return to sooner or later...in my own time, when I felt ready. I'm interested in how different cultures deal with and what they believe about illness, the older members of society, mortality and anything else related; but I didn't know where to start, nor did I have the appetite to.

One fateful Monday, strolling through Cronulla beach and its local shops, I popped into my new favourite bookshop. After having read all Game of Thrones books on a digital device, I decided to not do that again. Life's too short to be starring into a screen more than you have to, and I wanted the tactile quality of paper and turning pages in my hands again. So I popped into The Best Little Bookshop in Town and asked for help.

"What do you like reading?" asked the shop owner. I'm not sure I reply. I usually like Paulo Coelho but I've read most of his books. I bought the Amy Schumer book off you the other week. It's not something I'd usually go for, in fact, she makes me slightly uncomfortable but I liked that I read something different (that I thought I wouldn't normally like). And I enjoyed it. There was this other book I really liked but I can't remember the name or author....I like ancient history, fiction, not that much into real life stories normally. "Have you heard of Tuesdays with Morrie? It's an international best seller, but more importantly it's a great book, very popular" he replies. He gives me a brief synopsis. It's about a college professor who gets diagnosed with ALS (a terminal neurodegenerative disease that affects nerve cells in the brain and the spinal cord, where your body shuts down til you can't move or breathe anymore) who reconnects with one of his students after nearly 20 years. The book is about one last 'thesis' they write together, summarising their catch-ups in the lead up to the professor's death. It's about the meaning of life.

Perfect I thought. I'm sick of trying to figure out what the meaning of life is for me. It's a constant work in progress. I need a break. I want to find out what some other bozo thinks about it!

So I smashed the book overnight. I couldn't put it down. And then I cried...ugly crying. And then I took two weeks to read it again, slowly, with great big pauses in between for the thoughts to sink in and to cry some more. I even cried in public at a cafe when I was reading it, I couldn't help myself. I guess it really hit home as it succinctly articulated and cemented many of the thoughts I've been having on the topics of death and living a meaningful life.

Mitch Albom (author) with Morrie Schwartz. Photo by Heather Pillar.

I could go through and list the key points for you in short form below (I highlighted them the second time around), but sitting down now in front of my computer and leafing through the book, I realise I wouldn't be doing the story, author or Morrie any justice. And everyone I suspect, may get something different out of it, so if you're interested and ready to delve into something deeper, it's best that you read it for yourself. I couldn't recommend it highly enough for anyone wanting to live a richer life, but particularly people living with chronic or terminal illness/disease.

If you've already read this book, let me know your thoughts below. Are there any other profound books that affected you and you'd recommend to read?

Working Nine to Five

Excuse my 12 or so month hiatus. I've been back at work and since energy and time are both finite, there's been only so much I can fit into my days. More so, I haven't had anything I've wanted to tell you until now.

Like my psychiatrist appointments, I need some time between "sessions" to experience life and let things ferment, to give myself space for observation and to come up with new conclusions and ideas.

Getting back to work has been great for my confidence. It's given me the chance to connect with lots of new people and reconnect with some old friends. I've really enjoyed being able to delve into and focus on projects and feel the sense of achievement from completing tasks; emotions (control, focus and sense of achievement/completion) not often experienced during parenting.

After two clients and three major projects, which spanned 10 months, I was ready for a break. We decided to go to Europe again to visit family and friends and had a lovely (and tiring because YOLO) six weeks away. I really need to rethink the types of trips we do...but that's another story.

Prior to the trip I had sunk so deep into work that I neglected (regular/scheduled) exercise, I had neglected our family and home, and most importantly, I had neglected myself. Amongst all my responsibilities and roles, it's been hard finding a balance, and this seems to be the constant challenge.

Upon our return to Australia, I was barely recovered from jet lag and I had a meeting for another project. I wasn't ready to start again, I really needed some weeks to myself at home to relax, get back to a new sense of normal and work out (consciously) what my next steps would be. Being a consultant and by nature of the work not knowing when the next pay day will be, I told myself I have to take the work, whatever work, when it presents itself. And so I did.

I wasn't in a good place emotionally or physically at the time but I just thought of the money I'd make to replenish our depleted savings after the six week European jaunt. Again I fell into the consumerist cycle most of us fall into. Work - make money - buy shit you don't need - repeat. Which I can deal with under normal circumstances when I actually like the work and the people that I'm working with, and the buying of the shit is holidays to see loved ones (three of the core reasons I get up with pep in the morning and go to work for). But this time around, there was no pep, there was no zest. Instead there was growing dissatisfaction, constant complaining and increased frustration. I was the furthest I had been from myself for a long time and for this I was really angry.

As the weeks progressed, I began to show my frustration at work and I let people know about it. As my scope at work increased, so did my frustration and contempt. I pushed back and managed to make myself redundant from the project about a month earlier than anticipated. I experienced a set of mixed emotions about this scenario: less cash in my pocket than I had budgeted for and sad about no longer being needed, but on the other hand, I now had a new sense of freedom and excitement for life. A renewed sense of hope.

I made room in my life for what I needed, which is the space and time to re-evaluate what's working and what's not; to structure my life accordingly and find my balance. I realise not everyone is that lucky to have the opportunity to do the same. So for this I'm really grateful.

Thanks for tuning in again.

Helping Someone with PTSD

The content for this post is from Helpguide.org

Helping a Loved One or Family Member with Post-Traumatic Stress Disorder

Image courtesy Before It's News

When someone you care about suffers from post-traumatic stress disorder (PTSD), it affects you too. The symptoms of PTSD aren’t easy to live with, and the changes in your loved one can be downright terrifying. You worry that things won’t ever go back to the way they were before. At the same time, you may feel angry about what’s happening to your family, and hurt by your loved one’s distance and moodiness. It’s a stressful situation all around—one that can leave you feeling overwhelmed, even as you try your best to stay strong. The most important thing to know is that you aren’t helpless. Your support can make a huge difference in your partner, friend, or family member’s recovery. But as you do your best to care for someone with PTSD, you also need to take care of yourself.

Understanding the impact of PTSD on family & relationships

PTSD can take a heavy toll on friends and family members, and relationship difficulties are common. It can be hard to understand your loved one’s behavior—why he or she is less affectionate and more volatile. You may feel like you’re walking on eggshells or living with a stranger. You may even be afraid of the person. The symptoms of PTSD can also result in job loss, substance abuse, and other stressful problems that affect the whole family.

It’s hard not to take the symptoms of PTSD personally. When someone you love is distant, anxious, or angry all the time, your relationship suffers. But it’s important to remember that the person may not always have control over his or her behavior. Anger, irritability, depression, apathy, mistrust, and negativity are common PTSD symptoms that your loved one can’t simply choose to turn off. With time and treatment, they will get better, but it’s a gradual process.

Tips for coping with PTSD in the family

• Be patient. Getting better takes time, even when a person is committed to treatment for PTSD. Be patient with the pace of recovery. It’s a process that takes time and often involves setbacks. The important thing is to stay positive and keep at it.
• Educate yourself about PTSD. The more you know about the symptoms, effects, and treatment options, the better equipped you'll be to help your loved one, understand what he or she is going through, and keep things in perspective.
• Don’t pressure your loved one into talking. It can be very difficult for people with PTSD to talk about their traumatic experiences. For some, it can even make things worse. Instead of trying to force it, just let them know you’re willing to listen when they’re ready.
• Take care of your emotional and physical health. As the saying goes, put on your own oxygen mask first. You won’t be any good to your loved one if you are burned out, sick, or exhausted.
• Accept (and expect) mixed feelings. As you go through the emotional wringer, be prepared for a complicated mix of feelings—some of which you’ll never want to admit. Just remember, having negative feelings toward your family member doesn’t mean you don’t love them.

PTSD & the family: Social support is vital to recovery

It’s common for people with PTSD to withdraw from their friends and family. While it’s important to respect your loved one’s boundaries, too much isolation is unhealthy. Your comfort and support can help a person with PTSD overcome feelings of helplessness, grief, and despair. In fact, trauma experts claim that receiving love from others is the most important factor in PTSD recovery.
Knowing how to best demonstrate your love and support, however, isn’t always easy. You can’t be your family member’s therapist, and you can’t force him or her to get better. But you can play a major role in the healing process by spending time together and listening carefully.

Why someone with PTSD might be reluctant to seek support

• Being afraid of losing control
• Feeling weak or ashamed
• Not wanting to burden others
• Believing that others won’t understand
• Wanting to avoid thinking about what happened
• Fear that others will judge or pity them

How to be a good listener

While you shouldn’t push a person with PTSD to talk, you can let them know you’re available for them. If they do choose to share, try to listen without expectations or judgments. Make it clear that you’re interested and that you care, but don’t worry about giving advice. Leave that to the professionals. Instead, do your best to simply take in what they’re saying. Never underestimate how much the act of empathetic listening can help.

A person with PTSD may need to talk about the traumatic event over and over again. This is part of the healing process, so avoid the temptation to tell your loved one to stop rehashing the past and move on. Instead, offer to talk as many times as needed. And remember, it’s okay to dislike what you hear. Some of the things your loved one tells you might be very hard to listen to. But it’s important to respect their feelings and reactions. If you come across as disapproving, horrified, or judgmental, they are unlikely to open up to you again.

Communication Pitfalls to Avoid

• Giving easy answers or blithely telling the person everything is going to be okay
• Stopping the person from talking about their feelings or fears
• Offering unsolicited advice or telling the person what he or she “should” do
• Blaming all of your relationship or family problems on the person’s PTSD
• Invalidating, minimizing, or denying the person’s experience
• Telling the person to “get over it” or “snap out of it”
• Giving ultimatums or making threats or demands
• Making the person feel weak because they aren’t coping as well as others
• Telling the person they were lucky it wasn’t worse
• Taking over with your own personal experiences or feelings

PTSD & the family: Tips for rebuilding trust and safety

Trauma alters the way a person sees the world, making it seem like a perpetually dangerous and frightening place. It also damages people’s ability to trust others and themselves. Anything you can do to rebuild your loved one’s sense of security will contribute to recovery. This means cultivating a safe environment, acting in a dependable and reassuring way, and stepping in to help when needed. But it also means finding ways to empower the person. Smothering someone with PTSD or doing things for them that they’re capable of doing for themselves is counterproductive. Better to build their confidence and self-trust by giving them more choices and control.

Making a Cardiac Comeback

How will you write your comeback story?

A question that has plagued me since I survived a sudden out of hospital cardiac arrest in March 2014. Mine, now anyway, is more an of existential question, of finding a way to make the shock and struggle mean something, a way to help other people, a way to have an impact on the world. But for a lot of people in the same boat, including people dealing with heart disease, it's more practical than that. It's about achieving a certain level and quality of life on a daily basis that someone without health issues most likely takes for granted.

Last Tuesday (11 August) I attended the ICD Support Group at Royal North Shore Hospital. I'd been to a couple before, but this one focused on the guest speaker Dr Samuel Sears from East Carolina University. Dr Sears is a Clinical Psychologist who specialises on the psychological care of people living with an ICD. You can access his bio here.

Apart from being a really warm, funny, approachable and knowledgeable guy, what became abundantly clear is his passion for the area of mental health for patients with ICDs. This is the area I struggled with the most post my cardiac arrest so I too am very passionate about it. It also seems to be an area lacking in Australia. As far as my knowledge extends, there doesn't seem to be someone like Dr Sears who specialises in a combination of cardiology and psychology. Specialised care has to be sought independently for either a psychologist or psychiatrist through a referral from your GP or Cardiologist. It was therefore refreshing to meet and listen to Dr Sears speak about this topic because he understands both sides of the coin: the mental and physical.

His focus is on providing his patients confidence in facing their fears and struggles in the face of threat. Some challenges that ICD patients have to tackle include:

1. Coping with their cardiac condition
2. Coping with an ICD
3. Resuming activity and quality of life

In the face of the above challenges, the aim of his talk was to: increase our understanding in what it means to be confident; as well as activate one strategy that each audience member believes will help them lead a more confident life.

Dr Sears presented findings from some recent medical studies.The gist of some of these was the discovery of distress, depression and anxiety experienced by patients with ICDs and their families; and the constant fear they live with which inhibits them from living their life. Furthermore this fear leads to a lack of engagement in activities. The most profound study presented was that of exercise and ICDs conducted over 2.2 years and on 98,000 patients. The discovery was that on average, these patients moved less than 2 hours per day, which means they spent at least 22 hours per day not moving. When the survival rate was looked at in terms of most active versus least active, the study concluded that the most active patients were most likely to be alive four years later. When talking about activity we're not talking anything complicated or extreme either - just some form of basic movement, as opposed to being sedentary. Conclusion: some, any movement is better than none.

In fact, data now suggests that doctors have been too safe with the prescription of types of activities that heart/ICD patients can partake in. What they do know is that muscles, joints, the human body and mind have been designed to function better as a whole with movement. Of course it is important to note that competitive athleticism remains very much a grey area and clinical judgement should be made by a cardiologist.

Dr Sears eloquently went on to discuss confidence in cardiac patients, how to achieve quality of life, and perceived safety and confidence in the context of threat. Some standout points:

• Quality of life (QOL) is personal and point in time dependant
• Your definition of QOL is under your control
• Confident living is the fuel for the achievement of QOL
• Arrhythmia is random, don't know for certain what causes it
• Doesn't matter what causes arrhythmia, but you have strategies to keep you safe (medicines, ICDs and monitoring)
• Can't control arrhythmia but don't allow it to control you!
• When it comes to confident thinking and living, work out what activities are your goal, and work towards these
• These activities should make you feel alive and well. Think about what activities you liked to do in the past, before getting an ICD or having an ICD shock?
• Be proactive, test the limits safely
• ICD gives safety to make a cardiac comeback, essentially helping you deal with a condition that is spontaneous, unpredictable and potentially life threatening
• QOL is an achievement, not an entitlement
• A shift from victim to survivor reduces stress
• Mental health is what we believe about the future; it's earned and deliberate
• Have an ICD shock plan
• Foster confident relationships by creating intimacy and finding ways to feel closer to the people who love you

People with heart disease are faced with their own mortality in a very real and immediate manner. Heart disease which some may think makes you weaker, actually makes you stronger. Regardless of the adversity in your life it's up to you to decide whether you face it as a victim or a survivor.

That's a lesson I learned early on in life and I guess what drives and motivates me to take action rather than sit back and be a passenger in my life.

So what was my one strategy I took out of this presentation that will help me lead a confident life? It was the reassurance that I'm doing everything I can possibly be doing to prolong my life: medication, ICD, regular monitoring by my cardiologist and GP, regular exercise, balanced eating, minimising stress, and most importantly taking time out to have fun and create and enjoy wonderful moments with the people I love.

How will I write my cardiac comeback? I think the above is a damn good start. Only time will tell what happens and evolves beyond that.
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Some interesting facts and statistics:

• The first human ICD implant occurred in 1980.
• There's 4-6% chance of and ICD shock in an average year.
• Activity avoidance in kids is 84.5% and 39-55% in adults.
• A weaker heart (e.g. 35% ejection fraction) has a tendency to act irregular.
• Risk of driving in ICD patients is the same as other people - it's equally as dangerous.

You can view a similar presentation that Dr Sears has done before, The Medical Trapeze: Living Confidently With a Safety Net.

Greetings from Byron Bay

When my shrink suggested I take regular time out to myself I thought "good luck" and "that will be nice". But months later I went ahead and made it a reality by committing and booking some flights. I didn't give it much thought, just took the action. Days leading up to my weekend away I was getting cold feet and contemplating cancelling. I guess I was fearful of getting out of my comfort zone and to some extend felt guilty leaving my family behind. Now that I'm here, I wish I could go back to those few moments and bitch slap myself! 

Anzac Day got me thinking: we celebrate the sacrifice that people made, essentially we are celebrating their death. So why not celebrate life as well?

To take two days/nights out of normal life, in the scheme of things, is not a big deal, but it can make a massive world of difference. So much so that I've decided to make this an annual weekend away, to coincide with my anniversary of the cardiac arrest and to celebrate living. 

Rest, relaxation, rejuvenation, reflection and taking stock. Whatever form it takes, be it an hour or two taking a long walk, having a coffee, seeing a movie, sleeping in or having some time away; we all need it.