Healthy Body, Healthy Mind

St George Hospital have a Healthy Heart Program run by physiotherapists at the hospital's onsite gym. I'm currently half way through my fourth week of physical rehabilitation. The program runs for six weeks total.

On the day of my cardiac arrest, the ambulance officers had taken me straight to St George Hospital and I stayed there in ICU until being transferred a few days later to RPAH, where I would be monitored by my cardiologist and getting the defibrillator inserted. I only vaguely remember someone slipping me a pamphlet and explaining the program while I was getting packed into the ambulance to head to RPAH.

It was weeks later before I came across that same pamphlet, on top of my washing machine of all places. I knew then I had to follow up but didn't do anything about it. The truth is I didn't feel ready to even think about the program, let alone sign up for it. A few days after this, the coordinator rang me to see how I was going and give me more information. It was really kind of her, I really needed her to organise it all for me and she did, it was the gentlest ever nudge to get me on the road to recovery. I'm so glad she persisted.

I didn't know what to expect and it all seemed overwhelming. Some previous gym sessions have not proved very fruitful or enjoyable. Once I gave a personal trainer a try. She totally ignored my heart condition and any information I gave her about myself (so much for the survey!) and got me (trying) to do chin-ups on a bar. WTF? Anyone who knows me personally will know that that type of exercise is not for me. Needless to say I never went back to that personal trainer. So much for personal...

Anywho I digress. I went to the Healthy Heart Program with an open mind and with time, have found my heart has totally opened to it too. I love it. I don't want to miss a session. It's on twice a week. My session group is on Tuesdays and Fridays in the afternoon. It's an hour of me, the machines and my music. I get the opportunity to clear my head and in a comfortable, caring and encouraging environment, to heal. Although I'm the youngest person in the group, I feel right at home. Everyone is so lovely and there to do the same thing as me: heal, learn, escape, exercise, be healthy.

The gym session is essentially run as a circuit. The circuit includes bike, treadmill, leg presses, leg weights, stepper, and free weights, amongst other things. Prior to starting the exercise program, I had gone in for an assessment where we discussed my case and requirements. Therefore every exercise is then specific to each person in resistance, weight and freedom of movement. The exercises are usually limited to six minutes each or three repetitions of eight, 10 or 12. Or in the case of the stepper (which I progressed to this week from the ordinary steps) for me, three repetitions of 30 seconds each. We all have a personalised exercise plan, which has been created by one of the physiotherapists. After each exercise one of the nurses/physios will check our stats (BMP, oxygen levels, blood pressure) and record them, so we are constantly being monitored. The fitter that everyone gets as time progresses, the more the exercises are increased in intensity, offering a slow and gradual build up.

On Tuesdays after the gym session, they also offer an hour education session with a different topic every week including: physiotherapy and general recovery information, occupational therapy and nutrition.

The Healthy Heart Program has done wonders for my confidence. I feel more strong, energetic, alert, connected, focused and fit. I feel safe and have around me people who are going through a similar experience. I also have goals again such as continuing exercise to be fit, healthy and to strengthen my heart. Currently I've committed to two gym sessions and two (long) walks a week (due to our increasing sedentary lifestyles we should all ideally exercise seven days a week, even if it's for half an hour). I've increased awareness around my nutrition and am once again focusing on losing the left-over post-pregnancy weight (something playing on my mind constantly and reinforced by my cardiologist on my last check-up). Excess weight has been directly linked to heart disease and problems.

The group varies and includes people who have recently had a quadruple bypass, double bypass, stent insertion and mechanical valve transplant. I'm the only one in the class who had a cardiac arrest and defibrillator inserted. Coupled with my age, I'm a unique case and sense that the "oldies" are more interested in what got me there than other classmates. This means I have made a lot of new friends!

Interestingly enough a few of my classmates are quite fit and regularly exercised before their operation/procedure which got them doing this program. One of the many common feelings expressed is that of disappointment. The disappointment arising from "having done the right thing" and then still ending up having heart issues. I can relate to this intensely but the more that I focus on my exercise and continuing to look after myself, the more that this disappointment fades. The more I accept that I will still try hard to do the right thing and be the best I can be, and that sometimes, shit just happens. The more that I also start to release the fear associated with shit just happening.

Although the physical rehabilitation is doing wonders, I have also come to acknowledge that for me, it's not enough. I also need to nurture my mind and psyche. I started about a month ago with seeing my holistic therapist and with her help, started dealing with my emotions as they were coming up, as well as getting my acupuncture and herbs to assist in my recovery. These treatments alone are generally enough under normal circumstances, but going through such a traumatic experience with the cardiac arrest, I knew I needed more.

My cardiologist referred me to one of his colleagues who is a psychiatrist with a focus on helping people deal with post traumatic stress. My psychiatrist is a really lovely, personable man with a good sense of humour, who made me feel instantly comfortable. As my friend Kate said yesterday (totally out of context but still very applicable): "sometimes you have to kiss a lot of frogs". I've seen a psychiatrist many years ago who was a total fuddy-duddy and well, just plain scary. Same goes with cardiologists. Again, I'm lucky to now have a solid and suitable network of healthcare professionals. But I am highly aware this is not always the case for everyone. So I urge you, if you're not feeling right or getting adequate care from any of your healthcare providers, you will have to kiss a few frogs and try others, until one sticks.

Last week I had my first session with him and even though we only had the psychiatrist's hour (50 minutes) to start discussing my history, I already feel better because I feel empowered. Rather than continue to wallow in self pity and uncertainty, I've taken responsibility for my emotions and taken steps to get help where I need it.

The healthy mind and healthy body concept is like the chicken and the egg argument. Which comes first? I don't think it matters. The point is that you pick one and the rest follows, it's inevitable. The most important thing is that you make a decision and take action.

One Month Check

On Thursday I had a check-up with my cardiologist and the defibrillator clinic at RPAH, which is about a month after being discharged from hospital.

I got good news, really good news. There were no changes to my heart post the cardiac arrest and no incidents recorded on the defibrillator.

I've mentioned this news to a few close friends and my automatic declaration after sharing the news, is to let them know how relieved I am.

I was lying. I'm not relieved. I'm even more confused because "I'm (almost) back to normal" with nothing really wrong; with no solid reason as to why this incident happened; and still, with no certain answers. The reality is that I will never have any (certain) answers. It's the uncertainty that I have to come to terms and live with.

I'm scared that any moment I could have another cardiac arrest.

What if I'm walking and crossing the road with Zoe, when it happens?
What if I fall and hit my head?
What if....who knows?

In the waiting room at RPAH to see the defibrillator doctors, my husband got chatting to a gentleman who was also there for his check-up. He's in his early 60's and up to his third model of defibrillator. He's had 38 zaps.

I asked what happens when he gets zapped. He said he sees a white flash before his eyes then blacks out for some time, before coming to. He advised me if this happens, to sit down and remain seated in case there is an additional zap after several minutes. He told me that one time he was on the escalators at a shopping center when he got zapped and he collapsed. People walked past him without helping, without checking if he's OK. Until a bit later, when two tradies figured out what happened and called an ambulance. My heart broke when he told me the story. I was surprised I didn't cry when he was talking to me. He's really sick. He can no longer work, he can hardly do anything and he should have a constant carer, but he can't afford one. He could have died 38 times but the defibrillator saved him.

Chris asked me if I felt better speaking to him, if I was convinced the defibrillator works? Sure, technically yes, I felt a little more convinced that it does work. But I felt more sad that that man has had such a tough time, that he's so sick. That, in no way makes me feel better that in comparison, I'm not as sick. Everyone experiences their own level of suffering. I'm just sad that for whatever reason, there's so many people out there that are unwell.

Over six weeks after the cardiac arrest, I am still finding out slivers of new information about the event. The day of the arrest I was touch and go. A hospital counselor spoke to Chris when I was admitted into hospital in the ICU. My condition was uncertain. She advised him to ring our immediate family/friends to let them know what happened. They didn't know whether I would make it or not.

This piece of information came out when we were having lunch with some friends on Saturday. I was shocked to say the least. I knew the situation was severe, but I had somehow managed to downplay it in my mind so I could process it. I buried the severity deep down inside me so I wouldn't be terrified, but instead could function. And now, that terror is surfacing. I really don't want to have another cardiac arrest.

Chris' view has been interesting. He said I experienced the worse possible thing I could, and survived it. That may be the case but at this stage, it still doesn't mean that I'm not terrified it could happen again.

The Only Way is Up

Before the cardiac arrest we had booked three trips: two interstate and one abroad. We like to travel and having family and friends spread all over the world makes it more of a priority. One of the first things I did after coming out of hospital was start organising our upcoming trips.

At the time I had an overwhelming urge to go ahead and lock in the trip details as soon as possible. On the surface I thought the reason was to make the most out of getting a second chance in life. I didn't want to miss the opportunities to see our family and friends. Underneath all that was the overwhelming desire to resume life as normal. You see, I'm the trip organiser in our family, so the trip logistics and destination selections are my domain. So I took the reigns and went full pelt into organisational mode.

In my chat with Dr Jaime O (my holistic therapist) this week we discussed fear and not letting it be the motivating factor behind my actions. Instantly I felt guilty (there is that pesky guilt creeping in again) that fear was my motivation behind continuing with the trips. On one hand I had my existential crisis around mortality and on the other, a bunch of emotions that were only just starting to surface. Evidently, guilt was the initial and predominant emotion, with fear a close second.

I thought maybe I was afraid not having done some things I wanted to do in this life? Afraid that I would leave this existence having missed out on something: a moment, an experience, an interaction. That's what my mind was telling me, that they should be the things I should be afraid of.

I caught up with my dear friend Krystal for a coffee recently. She asked me if what happened made me think about my bucket list. I thought about that question for a moment, lingered over it whilst holding my cup of hot chocolate. "No, not really. I think I do a pretty good job of living my life exactly how I want to live it, and doing all the things I want to", was my response. Perhaps the only things I haven't done from my list are learning Italian or to play the guitar.

Considering I live my life how I want, then logically, I shouldn't be afraid of missing out on anything. I realise now what I was really afraid of, is losing myself. I realise that sometimes we have to lose ourselves before we can find ourselves again.

I've been feeling that I need to redefine who I am. That these events (the cardiac arrest and the insertion of a defibrillator) somehow made me into someone else, that they define me, that once again I'm that sick person I spent the first 25 years of my life believing I was. I've worked really hard to shed that limiting belief. Similarly to life and death, my life and my condition are two very separate entities. So the challenge is to integrate and manage them. I'm like everyone else, with the same hopes and desires, just a little bit special, so I have to ensure to look after myself accordingly.

I no longer think I need to redefine myself. I'm simply Angie 2.0. The same as before but new and improved with the addition of some technological advancements, an insurance policy if you will, in the form of my defibrillator.

I'm writing this 37,000 feet in the air, cruising above the clouds. We're on our way to Perth to visit my long-time friend Jenny and her family. In my state of fear weeks ago I was thinking about all the things that could go wrong. I'd be stuck in a plane for five hours. What if I have an arrest during the flight? What if the defibrillator doesn't work? What if I die on the plane (and all the horrific logistics around that)? What if my defibrillator sets off the security machines at the airport? What if these fears become so overwhelming that I don't want to fly?

Traveling is up there on my value system, along with family, friends and new experiences. These values are closely intertwined. Once I realised that my true fear is losing who I am, and that travel is a big part of me, giving into the fear and not traveling became impossible. Who I am is not negotiable. I refuse to give in to a shitty, intangible emotion like fear. What a waste of time!

For the first time in a long time I finally feel like myself again. I put my headphones on and listened to my music full blast. I starred out the window and looked beyond the clouds into the misty horizon. I dreamt of faraway places. Then I cried. I cried for the fear and guilt I needlessly have been feeling. I cried for the people in my life whom I love. I cried for all the people in our world that feel pain and suffering. I cried for the gratitude I feel for my life and existence. I cried for the moment. I cried for finding myself again. I cried for the surrender that I finally felt.

 

Pharell Williams puts it well: "Clap along if you feel like happiness is the truth. Clap along if you know what happiness is for you. Clap along if you feel like that's what you want to do". I'm happy to feel like myself again and live my life how I want to live it. Beyond that there's nothing much I can do, just go along for the ride.

In my mind, I'm clapping all the way to Perth.

The Burden of Guilt

We were at a family function on the weekend and I was asked about my health and events leading up to the cardiac arrest. In fact it felt more like I was being grilled. Spit roasted and turned in my own juices to over cook.

"We're you stressed?"
"Work must be really stressful."
"We're you working long hours, did you have a lot of work on?"
"It's not good being stressed."

Mother fucker I haven't worked for over a year. Instead I have been at home chillaxing, playing with my daughter, organising my social calendar and going on coffee dates with friends. During that time the most stress I've experienced is deciding what to cook for dinner that night; and if I never got around to it, what take-away food to order.

I'm sorry if my language is offensive; but that's the answer I should have given. They know nothing about my life but they are full of assumptions. I haven't seen these people since Christmas. Instead I was a lot more diplomatic even after the bombardment of guilt. I was subliminally processing the conversation, feeling uneasy but not quite sure why. Until later.

They were trying to find a reason. The uncertainty of life, and death, are too much to bear. Stress was their scapegoat. I can empathise, I've tried to clutch on to various reasons.

The reality is that not even my doctors are completely sure what the reason for the cardiac arrest was. They found fluid around my heart so the most likely explanation is I had a virus. The virus weakened my heart and attacked it, messed with the electrics.

There was nothing I could have done or changed, no influence I could have had over the matter of my cardiac arrest. All it's workings were invisible.

I saw my holistic therapist on Monday, she's back in session after her maternity leave (YAY!). We had a very good and long chat. We pried open the lid to a very deep can of worms, which I'm dealing with.

One of the prominent emotions I am feeling is guilt. In my view I did all the right things, yet my body still let me down; I ultimately let myself down. Was there something else I could have done? The guilt suddenly takes a turn and joins forces with severe disappointment.

Guilt is a heavy cross to bear.

Not only had I been feeling guilty myself (without realising mind you!), I now had "family" making me feel even fucking worse. Like there was something I should have done that I didn't. Like I haven't been managing my own health or haven't had awareness about it my whole life already. I'm not ready to deal with their shit and their emotions, and I shouldn't have to either. I'm struggling enough dealing with my own.

Fuck that. Now I'm just pissed off. For me, this comes before understanding and finally acceptance.

Heart Week 4-10 May 2014

We're right in the middle of Heart Week, which serves to raise awareness about heart disease. This year the Heart Foundation is urging everyone to learn the signs of a heart attack in order to avoid having one. Learn the warning signs here.

If you get the chance to host a morning tea in your home or workplace, take the opportunity to discuss these heart attack warning signs and further spread awareness.

Should you feel compelled to help further, the Heart Foundation and the Heart Research Institute will happily accept donations anytime of the year to progress vital heart research.

Do you suffer from heart disease or have a history of it in your family? Then it's worthwhile completing a "Heart Attack Action Plan". The Heart Foundation shows you how to do this and offers free downloadable collateral to help you complete it. It's worthwhile being prepared.

Happy Heart Week!

33 Minutes

After my cardiac arrest I was unconscious for 33 minutes before being revived.

In that time you could watch a TV show, with minutes to spare. You could cook a quick meal. You could have a lengthy phone conversation with a dear friend. You could go for a jog, bike ride or swim. Or you could save someone's life.

I just lay there on the floor, occasionally gasping for air and then stopping, lifeless, while my husband Chris performed CPR. He dialed "000" and had the phone operator on speaker. Although he had done a first aid course a few months back, the operator guided him and offered extra support. In the meantime, our 10-month old daughter played on her play mat with her toys quietly, thinking that mum and dad were playing next to her too.

The two ambulance officers arrived, Chris ran to open the door. They continued CPR. Chris described it as a never ending passage of time. For as quickly as everything was happening, everything was simultaneously moving in slow motion.

The CPR wasn't working. It took 2 x 200J shocks and one dose of adrenaline to revive me. Then I was taken to the closest hospital.

What followed was a night of sedation, memory tests, MRI scan, chest x-rays, medication and treatment for aspiration pneumonia. The icing on the cake was the insertion of a single lead, MRI compatible Automatic Internal Cardiac Defibrillator (AICD) in my left submammary pocket.

I was in hospital for nearly two weeks. Plus six weeks recovery and R&R after the insertion of the defibrillator, so I don't unwillingly pull the leads out. Put that in your pipe and smoke it.

That's the technical stuff over and done with. Now I'm at home about 3.5 weeks into that recovery period and dealing with a barrage of (sometimes random) emotions and thoughts.

The latest of which have been irrelevant, trivial details about the event. What do the ambulance officers look like? Where did they park the ambulance? Which of our neighbours in our apartment block were watching as I was carried out on a stretcher and into the ambulance? Was there a lot of traffic on the road? What route did they take to the hospital? What route would have I taken? Did Chris and Zoe ride in the ambulance with us?

Random and trivial and yet all so seemingly important in my mind. I'm not quite sure what picture I'm attempting to paint in my head. One of survival, or the adverse? If things had gone badly, what would the aftermath of my death look like?

So here we are, at the root issue: mortality.

Prior to the cardiac arrest I was terrified of death. When I came to, post the arrest, I felt somewhat comforted because I hadn't experienced any pain. I had simply slipped into an all encompassing velvety, thick, warm darkness. I figured should I be so lucky that I eventually meet my end in the same manner, I couldn't have it any better.

Even so, I now have a whole new set of questions presenting themselves. This is an area and a process I will be exploring in time to come. I did start though by watching this video on TED by Stephen Cave: The 4 stories we tell ourselves about death.

“Death, therefore, the most awful of evils, is nothing to us, seeing that, when we are, death is not come, and, when death is come, we are not.” - Epicurus

In other words:

"Death is not an event in life: we do not live to experience death. In this sense, life has no end." - Ludwig Wittgenstein

What resonated with me is the distinction and complete separation between life and death. For some reason I could never see this previously. Once we're dead, we're dead. We don't know the difference. We ourselves do not experience the loss of our lives and ourselves, it's the people left behind that have to deal with that.

For now I will continue exploring, processing and living my life, and as Mr Cave says in his presentation, ensure to make it a "good story".

Why?

I no longer ask myself "why me?" like I used to when I was younger. I'm not a victim, I'm just another ant in the anthill that stuff just randomly happens to. No matter how much we try to effect change, we ultimately do not have that much influence. We are not the ones in control, for the most part anyway. Control is an illusion, at the most we can try to influence, guide or steer some variables.

I don't know if I believe in fate or destiny. The idea that I'm not the one guiding my life - making everyday deliberate choices - does not resonate with me. I like the idea that I consciously make decisions and then live with the consequences. The tricky part are all the other variables we don't choose or can't control amongst all that. It all becomes so blurred: choices, fate, destiny, universal randomness.

I didn't choose to have a heart problem. And for the most part I'm healthy, I'm doing my part to combat it, or at least delay the degeneration. But I do have to live with the consequences.

I had my routine, my checkups, my team of healthcare professionals and everything was in order, or at least I thought it was. Until I had the cardiac arrest.

Now, in this moment, there is a lot of uncertainty and a massive question mark looming over my future. Perhaps there always was, I just never realised it. I guess it's the same question mark that hangs over everyone, but I've been made to pay immediate attention to it. 

I'm thrust into a new reality. I'm not quite sure what my life is supposed to look like or be yet. All I know is that I can't go on this journey on my own. I can't waste this opportunity to share my story and hopefully help people along the way. This is part of my healing and redefinition process. Thank you for coming along on this journey.