Four Years On and Going In The Right Direction

As the fourth anniversary of my cardiac arrest has passed recently it gives me the opportunity to see how my life is now.

Saturday 28 February 2015 was the date of my cardiac arrest and also the beginning of my life after a cardiac arrest. I was 44. I live in a suburb on the outskirts of Dublin City, Ireland.

Suffice to say if not for certain people’s actions on that day I wouldn’t be here today; the quick actions of the security guards in the large local shopping centre near where I live, my sister-in-law, Lorraine, who came across the situation and informed the security guards of the heart issues in the family; and also Siobhan, the young cardiac doctor from the local hospital, who was in a nearby shop and got to me moments later; and of course the paramedic who then tended to me. Siobhan would later become part of the medical team who looked after me in hospital. One of those paramedics I got to meet on one of my trips to A&E by ambulance many months later.

Early Days

The first month after my cardiac arrest was somewhat eventful; initially I spent two days in the Intensive Care Unit in Tallaght University Hospital; then got transferred to the Coronary Care Unit. I had an ICD (defibrillator) fitted within days. A collapse at home and another in hospital and three stays in two different hospitals, Tallaght and Blackrock Clinic. There were numerous tests on my heart and medication changes, that is how March 2015 was for me. By the end of March, I was home properly; things had stabilised and I was able to start on my recovery.

For me, the early days, weeks and even months was a period of time where I had to come to terms with what had happened to me and begin to learn the new “me” again.

Prior to my cardiac arrest I’d never had any heart issues or chest pains in my life.

Now I was having to deal with a lot of new situations. Leaving hospital I started to realise how different I really was. I was weak with no energy, tired and also sore. The pain was on a number of fronts, the fractured ribs from the CPR, the head injury from the fall in the shopping centre and the surgery from the fitting of my ICD.  Over the first few months, these pains would almost all disappear.

However, the fact I have no recollection of the period of time around my cardiac arrest, that my last recollection was the day previous, I had no idea if there were any warning signs before my arrest. This made my “learning period” quite a worrying and anxious time; not just for me but also for my wife. This meant any feelings of dizziness, pains in my chest area or generally upper body, or unusual feelings I was making a few trips to my local A&E. Thankfully on each occasion, there were no heart issues but this was something I needed to do. It also gave me the chance to become more comfortable in the new “me” and my absolute fear of something going to happen again gradually subsided over time. As time went on these visits became less and less, and for the last year or so I have not had to make any of these trips.

As well as having fewer unscheduled trips to my local A&E my scheduled check-ups have reduced. Following my cardiac arrest, I attended check-ups with my consultant every 3 months. After about a year these check-ups were extended to every six months and in the last 2 years, I’m now on annual check-ups. I have a home monitor for my ICD so although I only need to attend hospital on a yearly basis now my hospital receives a regular transmission from my device so I have the reassurance that I am being monitored.

Rehab

During this “learning period” I started a programme of cardiac rehabilitation in my local hospital, about two months after my cardiac arrest. This was an intense programme of exercise under medical supervision and information classes on subjects including diet, exercising and medication. The programme was three times a week and lasted for two months. I have to admit looking back on it now it was the best thing I did in my recovery and was so grateful to have had the opportunity. It actually gave me the confidence I needed that I may at some stage in the future be able to resume a somewhat normal life again. Confidence is something I really lacked in the early days.

My group consisted of about 10 other heart patients although I was the only one who’d had a cardiac arrest and I was by far the youngest at it. I found the first couple of sessions a bit of a struggle but over the period of the programme, I could tell I was starting to regain my strength again.  In parallel to the cardiac rehab I had driving restrictions for 6 months so basically I was doing a lot of walking, be it to the shops, to my GP, to the hospital or just nice walks with my wife. This definitely contributed positively to my recovery. But was I glad when I finally got back behind the wheel after those 6 months…

So much did I enjoy the hospital cardiac rehab programme I almost immediately started a community-based programme. It was a weekly phase 4 Cardiac Rehabilitation class in a local leisure centre, run by a cardiac nurse specialist and physiotherapist, Tallaght Heartbeat. It’s just an exercised based programme. And I was still the youngest at it. I was getting a real buzz from this. Almost a year after the cardiac arrest I was nominated from the class for “Patient of the Year” for an award by a national organisation, the Irish Association of Cardiac Rehabilitation. I didn’t win the award but got a commendation certificate. But to me, it was recognition of how far I’d come in a year.

Over three and a half years since I joined I still attend it when my work schedule allows. To me now it’s almost a social occasion as much as a cardiac class and I still thoroughly enjoy it.

The format of the class has changed in recent months. The class originally was split between a small room and the use of a gym where we could use all the gym equipment. With the changes access to a full sports hall means all the activities happen in the one location. It also means the activities have been improved upon. There are still the same activities as before but now we can also play badminton, have a football kick-about or walk/jog. The chance to play Badminton really got me excited as I got to do something I had played for many years as a youngster, over twenty-five years ago.  And I’m playing now with as much vigour as I did back then. 

As an aside, something I have discovered recently is that cardiac rehabilitation doesn’t seem to be readily available for all cardiac arrest survivors both in Ireland and, more particularly, in the UK. I’m actually quite surprised by this as it was one of the first things discussed with me while I was still in hospital days after my cardiac arrest. I thought it was offered to all cardiac arrest survivors. I don’t really understand the reasons behind this decision to not offer the rehabilitation to all but I hope this situation changes. It was most definitely the major factor in my recovery and life after my cardiac arrest that for survivors to not have the opportunity of cardiac rehab does not seem right at all.

Work

Not only have I had health issues to deal with in the last few years but I was dealing with work matters. In 2011 I lost my job in a company I worked for over 20 years when it transferred to Mexico. This was around the time of a severe recession.

All my working career I worked in technical roles. With it brought responsibility and a lot of stress. Since 2011, I was in and out of work doing various jobs under fixed contracts which I suppose in itself also brought some stress. The time of cardiac arrest I was actually due to start a new job. Unfortunately, for a number of reasons this never actually materialised.

One conscious decision I made in the early days when I realised what had happened to me was that as far as work goes I was no longer going to work or look for work in any technical roles in the future. As stress was thought to be a contributory factor in the cardiac arrest my focus was to now put my health first followed by my work situation. I promised my wife that as much as she nearly lost me I was going to make sure I’d be around as long as possible from now on; and if I have to take a step back as far as work goes so be it.

It did take me almost a year to find some work and thanks to some former work colleagues, Tina and Tom, I was given an opportunity to get back with a former employer for a fixed term temporary contract.

Getting back to work I now class as another “step” in my recovery. When I did start working again I did think was I doing the right thing. As much as I was a year out from the cardiac arrest and from the rehab point of view I’d come a long way, I suddenly realised work is a different matter. After a few weeks, I’d got my “strength” and work was becoming manageable for me. That was in a big way helped by my new work colleagues; Olivia, John, Sean, Tara and Justyna. After such a difficult year I was getting my life back and having lots of laughs with this new group of friends. The company also had an on-site gym and I was able to avail of it after my work shifts. So alongside my weekly cardiac rehab class, I was getting extra exercise sessions in too.

My work situation is somewhat similar to that before my cardiac arrest, I don’t have permanent work; I just have temporary work where I can get it, but I don’t worry about it. Like pretty much everything in my life I take things one day at a time. But I have to say the work I do now is more enjoyable. There’s no stress involved and when I come home in the evenings my work is left behind.

Therapy

At some stage in the first year after my cardiac arrest, probably about 9 months after, I had an appointment with a psychologist in my local hospital. It was a routine appointment. It was an appointment attended by my wife too. On the day a student psychologist also sat in on the meeting. I don’t recall all the details of the meeting but it involved a lot of speaking on my part and a significant part from my wife. The topics did include the story around my cardiac arrest and my recovery to that point, and how I’d been dealing with a traumatic event in my life. The parts of the story around the events of my cardiac arrest were told by my wife.  It was probably the first time real details of the day had been shared with someone outside of close family. We spoke about events prior to my cardiac arrest at times in the meeting. It had been quite a difficult few years beforehand. We had both to deal with job losses and deaths of close family members, plus a few other private matters, in that time. There were some brief moments of upset during the meeting but for most of the time, it was very upbeat and positive. Both the psychologist and the student commented on how strong and positive we both were throughout the meeting. They could tell that after my cardiac arrest we both were dealing very well with what had happened. At the end of the meeting, the psychologist said she didn’t feel there was any need to schedule any further appointments but that the “door was always open” if one was needed in the future. And, thankfully, that still remains the one and only appointment.

Although my life after cardiac arrest in the main has been one of a continual upward trend it has not all been plain sailing. It has had ups and downs. I’ve had periods of anxiety and fear, thankfully relatively short-lived, due to the fear of something going to happen again. I’ve had issues of a potential faulty ICD which was discovered in late 2016. This potential issue actually came to fruition in October 2018 where I had to have a replacement ICD at very short notice and have just about recovered from that surgery.

Rose

I’m not the only one who’s had to deal with life after cardiac arrest. My wife, Rose, has had a lot to deal with. While my challenges have been of a physical and psychological nature my wife’s have been different.

She has the images I’ll never see of my cardiac arrest on that Saturday morning in a shopping centre and the chaos and situation unfolding in front of her eyes. She has the images of me being taken away in an ambulance and not knowing what my outcome was going to be. She has the images of me critically ill in ICU. I was told that I did not recognise anyone in the beginning. And she will always have these images…

Rose’s recollection of the experiences of the day gives an insight into what she would also have to deal with in the future. In her own words,

“I had left my husband while he put the shopping in the car, I blew him a kiss and waved, something I normally wouldn’t do. So off I went to the shops for my things. I had met one of my friends and was crying because I had lost my mother 5 months earlier. My phone then rang and I thought it was Brendan to see where I was. It was my sister Lorraine who had told me Brendan had had a fall. I said, “What do you mean a fall”. I ran out of the shop with the makeup in my hand and turned to go back in with it. I heard my sister calling me, I could see Brendan lying there. My dad grabbed me and told me not to look. But I had to look, he was my husband. I could see them shocking him. He was purple. The security sat me down, I was in a right state. I heard the girls who gave me water say they had a pulse. An old lady came to me and gave me a holy medal. Maybe she was my guardian angel”

Every step of my recovery is also a step for my wife. As she has seen me improve over the time it has helped her too. My recovery is her recovery. As I have recovered I have done so with no recollection of the event that has changed my life, but that has helped me. I don’t have flashbacks and thankfully haven’t had any nightmares.

For the best part of 8 months, my wife never left my side at all. She was my absolute rock right throughout my recovery and beyond.  She attended all my cardiac rehab classes in the hospital in the early days so she was able to see first-hand how I was coming on. She even made friends with some of those in my class and that went in some way to helping her.

“I was afraid for a long time after my husband’s cardiac arrest. I lived on my nerves. I couldn’t leave his side and then when I did, and even now, if he is late, even by a few minutes coming home, or texting me back I’d panic.”

“In the early days after he came home every night when he was sleeping and I couldn’t hear him I used to call him to see if he was breathing. He would answer “Yeah’ and I’d just say “It’s ok’. I didn’t want to make him paranoid so I’d feel him to see if he’s warm.  I very seldom do that now, only the odd time if I’m unsure”

She was my support and in a way I was hers. I helped her realise that I was going to be alright as I continued to improve.

Attitude

One thing I have definitely noticed in myself is my attitude to life. I have changed. I totally appreciate the fact I’ve been given a second chance, and make the most of it. All too often in recent times I’ve heard and read of many people who haven’t survived a cardiac arrest. I know I’ve been one of the lucky ones. I’ve lost friends and acquaintances through illness and accidents since my cardiac arrest and sometimes question myself how is it I’m still here when the odds would have been stacked against me in the situation I was in.

 I enjoy life as best I can now and have a greater appreciation of the simple things of life. I try to keep upbeat as much as I can. One peculiar change I’ve noticed in myself since my cardiac arrest is my dress sense. Gone are nearly all my dark clothes and replaced with brighter and more colourful clothing. I don’t want to be dressed in dark and miserable clothes. Maybe this is just an outward expression of my positive attitude.

Seven months after my cardiac arrest I took a foreign holiday. It was the first time I would leave the security of having my local hospital only a ten minute journey away. It was something I was concerned about at the time but the timing of a six-month check-up the day before I went and being told by my consultant to go enjoy myself put me more at ease. The holiday was made more reassuring for me as it was to a place I know very well as it’s my regular holiday destination – Benidorm; so I was going to a place I’d treat as a second home. In the end, the holiday passed off without incident at all. I’ve been on several holidays since and go on them now without a second thought.

Maybe a bit of my stubborn streak has come to the fore to make sure what happened to me wouldn’t hold me back. I have got back to a level in my life that I would call “normal”. It’s not without an awful lot of effort. To some, it seems that this level of “normal” is just an automatic and natural progression as time has gone on since my cardiac arrest. I can understand how they can come to that conclusion, but it’s so far from the truth!!! 

Yes, I do have my heart issues and some limitations. Where in the past I could have spent hours, or a full day, doing a task, such as the gardening I’d now do the tasks for shorter periods of time and in stages.

This is probably down to fatigue and definitely one thing that always remains a constant for me following my cardiac arrest; even to the present day. Although it doesn’t affect my ability to work it does affect me to varying degrees but thankfully never to the extent of complete exhaustion. It’s something I know I have to live with as it’s an effect of my medication and my heart condition.  After researching it I’m aware it’s a very common issue for most cardiac arrest survivors so I don’t worry about it and just get on with it. Anyway I know when I need to I just rest.

A Long Way

So why have I come a long way in my recovery? I can put that down to a few reasons.

  • I don’t look up much on my heart issues. I’ve read my hospital notes, just get on with life and know as long as I look after myself and do the right things I’ll be alright. I could google all the stuff and worry myself more so purposely don’t do it. Maybe it’s a bit of “head in the sand” syndrome but for now, that suits me.
  • I’ve had great support from family and friends, and most especially my wife. Apart from the medical people, she is the only one who really knows all about my condition; and the efforts I make to live as normal a life as possible.
  • I’ve never hidden away from the fact of what happened to me, in fact, most people are fascinated with my story.  I can tell my story without upset and I’m happy with that. I think sharing my life-changing experience with others and talking about my cardiac arrest has helped me relieve any pressures or stresses I may have had. I also think it’s a similar situation with my wife. Almost everyone that she meets she tells them my story, too, no matter what situation she’s in she can turn the conversation onto me.   
  • I’ve joined a number of groups on Facebook over the last couple of years which are heart / cardiac arrest or ICD related groups. To me, in the beginning, it was reassuring to know I wasn’t alone in my “new” life after my cardiac arrest. I was seeing posts from people going through the same issues I was dealing with. My only regret was I hadn’t come across them earlier as I only joined the first one nearly eighteen months after my cardiac arrest; it would, I’m sure, have helped me greatly in the early days but I think I did well anyway. The groups also help me connect with other cardiac arrest survivors as I have yet to meet another survivor in person, but maybe that will happen someday.

I feel I have got to the stage that I may be in a position to help others in the groups, even just reassuring them, especially those that are in the early days after their event. I know I don’t have all the answers and I’m sure I’ll still have questions and concerns that others will be able to help me, when I need it. That’s why I like these groups.

All in all, I think I’ve come a long way in a short four years. My life has settled down to a large extent; and my condition has stabilised. I take my medication, I watch my diet closely (although I’m not absolutely strict on it), I exercise and generally look after myself better now; while trying to keep my life as stress-free as possible. As long I can continue that way I’ll be more than happy, and I’m sure my wife will, too.

Brendan and Rose Keegan, Dublin, Ireland.

June 2019.

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