Physical Afflictions

End of June marks three months since the cardiac arrest.

Apart from the mental which I've started to delve into, there is a series of physical afflictions I've been dealing with in relation to the arrest. I have only felt comfortable sharing these now and I do so with some hesitation, but feel that I need to in order to continue on the path of healing. 

I saw my chiropractor Luke on Saturday and finally had a long overdue adjustment. Based on Luke's advice, I couldn't get my left side adjusted earlier than eight weeks after the ICD insertion, but didn't feel comfortable, mentally or physically ready to get any adjustments done until now. I've been feeling stiff and sore in different locations in my body, particularly after laying in bed and sitting around for three weeks after getting the ICD put in (which was approximately one week after the arrest). The cardiac rehabilitation program with the physiotherapist has helped, but new injuries/issues arose (e.g. hips out of whack, so kept getting a sore knee when training). I really needed an adjustment and now feel so much better for it! There were a lot of blockages, particularly (and not surprisingly!) on my left side and top half of my body.

The ICD was inserted in the left sub mammary pocket. It's usually inserted underneath the left collarbone and noticeably protrudes under the skin, but since I have a zipper scar running down the middle of my chest; and my left breast plate protrudes more than the right (both from my open heart surgery in 1988), I wanted to avoid bringing even more attention to my chest. 

For the first six weeks after the ICD insertion, I wasn't allowed to lift my left arm above shoulder height. Even if I wanted to I couldn't, because there was a lot of soreness from the operation and felt the strange sensation of the ICD leads pulling with any sudden or lifting movement. They needed time to fuse with the tissue and this takes about six weeks.

Apart from the internal stuff, I have two external scars from the surgical incisions: one close to my left collarbone where the leads were inserted; and one underneath my left breast where the ICD was inserted. Also, I have a significant scar on the left side of my neck (looks like a massive pimple) where the IV was inserted while I was in intensive care.

The whole underneath of my left breast was severely bruised from the operation and because of this and the incision underneath it, I couldn't wear a bra for four weeks.

My chest was constantly sore from the CPR, which had caused me to have fractured ribs. These can take at least six weeks to heal. Every time I breathed in I would experience sharp pains. So I got used to a shallow, half breathing type of constant state to minimise the pain.

I couldn't sleep on my front (it's my preferred go-to-sleep position) or left side, so it was impossible to get comfortable and often to fall asleep.

I had bruising and track marks like a junkie, running up and down my arms from the IVs in hospital and daily blood tests I had for two weeks while I was admitted.

I had (and still have, but somewhat slightly calmer now) pimples on mainly my neck, but also my face, back and backside from the stress from the whole event. I feel like I'm going through puberty...again. It wasn't fun the first time and it's not fun a subsequent one.

Most importantly, from being bed-ridden for a month, apart from the stiffness, I became totally unfit and struggled to even go down the twelve stairs in our building to get to the ground level. Not to mention the constant tiredness and low energy levels.

On Friday I graduated from the Cardiac Rehabilitation/Heart Failure Program at St George Hospital. I got quite emotional and upon reflection, realised what a massive milestone it is for me, particularly taking all the physical afflictions listed above into consideration. It feels like a massive achievement because I've come so far from being a fragile post operative and cardiac arrest patient, to being well on my way to feeling strong, fit and energetic again.

The visit to Luke and a couple of things he said got me thinking a lot about all these physical afflictions and how I feel about the ICD. I was hugging Chris the other night and could feel it there  between us. I feel it every night I lie in bed on my left side to go to sleep. It still feels so foreign and strange, a part that doesn't belong to me but yet is connected and vital. It's such a strange duality to experience and with time, one that I need to accept as being part of me.

I've come a long way but now realise that it's just the beginning. There's still a lot of work to do and these things can't be rushed, particularly the mental aspects. I'm just taking it one day and one milestone at a time; and practicing my deep breathing.

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.