Beyond the road to SCA

Post by Mike Munson

This is the second part of Mike’s story, you can read the first part here.

A few days later I was released from hospital and having had quite a scare (possibly more so for my family as I had no memory from that whole week), I set about trying to get back to normal, although not sure what that “new normal” might be.

Not wanting this to happen again I googled advice and found the BHF website very helpful, so no dog walking or vacuuming for 12 weeks, but also what I could do a walking started on day 1.

I found out that had I lived locally to Colchester Hospital (where I was treated) they would have arranged Cardiac Rehab, but as I was “out of area” I had to sort it out myself.

Living in Mid Suffolk I found that my local gym had classes, which I eventually attended (once the nurses accepted that I was entitled to the 8 week course). I found this very helpful and progressed really well. I enjoyed the circuit session and repeated them a couple of times a week at home to supplement.

Giving back

I was so amazed at what had happened to me I started thinking about the various things to improve the stats, about fatality rates from “out of hospital Cardiac Arrests”. So a week after leaving hospital we arranged two CPR training sessions at my running club, and I was able to say a few words to the 50 or so people who turned up about how people with just a little knowledge can really save a life by just having a go!

On Tuesday evenings after coaching at my running club a small group of us have a quick beer at the local rugby club. I had already checked out to find we only had two 24/7 defibs in town and none near our playing fields (where Rugby, Football, Cricket, Running and plenty of walking takes place every day).

I spoke to the barman and said I would like to do some find raising to get one fitted on their external wall, he agreed to speak to the rugby committee and when I went back with some ideas a couple of weeks later to meet the secretary I was shown a brand-new defib fitted already. They apparently decided in view of what happened with me (&  other incidents they had heard off) they would just allocate funds immediately.

Amazing!

I then found out we had a paramedic in our running club who ran some more CPR training both for our runners and later on in the rugby club. All of these sessions where done by off duty paramedics free of charge, wonderful people!

So I finished my rehab and was passed to what they called the Phase 4 rehab instructor in our local gym. I was given a special survivors rate at the gym which was most welcome and was looking forward to gradually improving my fitness and thinking about what I could do to raise some money (& what for).

What goes around…

I noticed that a fellow survivor (Jonathon Jenkyn ) living in neighbouring Ipswich was doing his 100th parkrun since having an SCA in mid December 2017, so I contacted him and we meet on a very cold day in Ipswich and he kindly jogged (& walked) round much of the course and afterwards we chatted to BBC Radio Suffolk about our incidents and the importance of people learning CPR.

I then found out that after his SCA he had organised some CPR training for runners in the Ipswich area and two of them had worked on me!

By this time I had started to do some very gentle walk-jogging around my home. However, on Dec 18th I found an elderly man prostrate on the frozen path near my home. One bystander commented he was probably drunk, but  I kneeled down and found he was breathing and he wasn’t happy bringing called a drunk. With another man, we tried to take him home but I was too weak so we waited for the ambulance which carried him to Hospital.

A couple of hours later I went out jogging (heavily wrapped up against the cold) and within a couple of hundred yards and with no warning I completely blacked out and crashed into a brick wall. A dog walker found me and initially I didn’t realise what had happened, then it dawned on me and obviously my ICD had done it’s job and I walked slowly home.

We weren’t really sure what had happened so called my GP. I explained on the phone and apart from a bloodied face, which would have been worse if I had not had a buff & woolly hat on I was feeling OK. The GP said she would send a note to the hospital.

Indigestion?

A couple of weeks passed and by now I had started to experience upper arm and chest pains mainly when walking uphill, but also during the night, which would be relieved by a burp after a few minutes. This was actually quite scary but the GP (again making a diagnosis on the phone) suggested it was indigestion and perhaps I could take Rennies? I did try them but it didn’t seem to help.

Then after Christmas, I contacted the local hospital to see what had happened to my GP’s message. I was told it had been passed to Papworth and I should follow up with them. As I had my 6-month review coming up on Feb 16th I asked if they wanted to bring it forward and I was told no it could wait.

Later in January, I got a call from the home monitoring team at Papworth to do a download. They called me back to confirm that it had triggered on Dec 18 but nobody needed to see me at the moment as I was due to see my local cardiologist on Feb 16th. However, my chest pains and upper arm pains continued regularly (ie most days at least once).

Devils Punchbowl

On Feb 11th some friends of mine were going for some long distance running in the Surrey Hills and asked if I wanted to do a walk in the same area. As I was going to be with plenty of other people I agreed and on a cold February day we set off. Around the 15 mile mark (by a place known as the Devils Punchbowl) I felt a thump in my chest (not like being kicked in the stomach as had been suggested by a doctor to me) and I blacked out again.

This time I remembered what happened and was annoyed with myself for thinking perhaps I wouldn’t get through this time. Anyway when I came to a group had gathered around me, I explained what had happened and said I could walk now to the next checkpoint and retire. A nurse told me (in no uncertain terms) that I should stay where I was and she called 999.

It was very cold sitting on the rim of the punchbowl and the other walkers put all their spare clothes on me and put me on a bivvy bag. However, I just couldn’t stop shaking. They wanted to move me to a more sheltered spot but the control was telling them not to move me. However, they couldn’t locate our position and eventually with some not very nice words exchanged I was moved, then a 4X4 was spotted, stopped and I was loaded into the back. It seemed the ambulance was near the main road about 10 mins away. The driver was wonderful and although he didn’t know where to go eventually found the ambulance and I was rushed to the Royal Surrey.

In A&E I did try to get them to let me go home but they insisted on keeping me in. During the questioning, I was asked if I had had an angiogram and I said I didn’t recall having one and there was nothing on my discharge sheets from either Colchester or Basildon (where my ICD was fitted) about an angiogram. The following day the consultant told me he had called Basildon to confirm that I hadn’t had an angiogram which surprised him, so I was immediately fitted in and it showed 2 arteries narrowed, requiring a double bypass. A few days later I was transferred to St Georges, Tooting and had what appears to be a very neat operation.

New man

Happy now that I was being told eventually I will be like a new man, I decided to raise money for my local Hospital who were building a new cardiac unit, which would mean not everyone would have to be sent from my area all the way to Papworth. On behalf of my running club, I have been organising a series of trail runs. We charge a nominal £2 for instructions and in 2018 I arranged 21 events in Mid Suffolk. The club where very happy to support West Suffolk Hospital cardiac unit and in addition the money was shared with CRY (who would earmark cardiac tests for young people in Mid Suffolk).

One evening nurses from the hospital came to our event and ran Afib tests. Unfortunately (or should I say, fortunately) they only found one person with Afib (I have it permanently). We managed to raise £3600 during the summer, the hospital reached its target of £500,000 and the new unit was opened in November and I was lucky to be invited.

Again I self-referred for cardiac rehab and as they remembered me I got on a bit quicker although the improvement was slower this time. During the months after the surgery, I had some issues with drugs. Initially, I was told to take codeine to relieve pain, I soon found myself constipated which obviously wasn’t very pleasant and I decided I preferred pain. Then I developed a dry cough which wouldn’t go away, and it wasn’t til one of the cardiac nurses asked me how long I had had it that she said it was probably the Ramipril. When I spoke to my GP he changed it and said 6 weeks and the cough will go, so, sure enough, it took 6 weeks.

Then the statins I was on gave me leg cramps every day. Now I am on a different statin I don’t have that problem. I developed a lung infection during the summer and the GP gave me an ECG, which he didn’t like the look of. He did compare it to one done after my original SCA but before my surgery and sent me to A&E. The regular doctors in A&E weren’t too happy either thinking I had had a Heart Attack. A blood test proved I hadn’t and they just said this was now my new normal.

A couple of things on reflection when there was an emergency…

  • The NHS (and bystanders) where all brilliant and certainly I wouldn’t be here without them
  • I don’t understand why so many do not do the rehab
  • Certainly, in my case (and I am sure in most cases) it was worse for the family as I didn’t experience any of the pain (apart from post surgery)

On the road to SCA

Post by Mike Munson

Part 1 of Mike’s story…

I had always run and in my early years at senior school started training fairly seriously for middle distance races on the track (ie 800 & 1500m) both for my school and club and over the years competed at County & National level.

When I was a teenager I had plenty of injuries but generally I was very healthy and I think until I started getting heart problems hadn’t been in Hospital since I was 4 years old.

Even though the intensity of my training eased up during my 40’s as we started a family and my career was going well I managed to keep training regularly.

When I reached 50 I entered the Dead Sea Ultra Marathon (50km in Jordan) and ran probably one of my best races nearly beating the 3hr barrier (for the 50km).

However a few months later a very strange thing happened to me in a low key 10km road race near my home in Essex. It was the last race of the year in my clubs annual Grand Prix and to win my section I needed to beat this guy who I would normally just beat.

However within the first half mile (bear in mind I am a very experienced runner and never would start too fast), I had this feeling of no energy and I had to stop and there was just nothing I could do.

After I short while I tried running again and stopped again fairly quickly. I wasn’t used to giving up so I kept trying to stop/start until I got round in some ridiculously slow time, collapsing as I crossed the line totally exhausted. 

I was taken to the hospital by a friend and given various tests. This was 18 years ago and from what I can remember I was continually asked about chest pains but I had none. They originally thought I had angina but after the treadmill test decided I had Atrial Fibrillation (AFib.).

I wasn’t given any medication or advised to do anything in particular and I had further “incidents” from time to time. At first, I thought I could perhaps warm up slower and for longer and it would help but as time went on I realised this was all random and the incidents became more frequent.

Generally then with the incidents, if I felt it coming on and I stopped, I could walk back to my car and recover but if I didn’t stop in time I would blackout. If this happened, mostly I would lay on the ground until I felt better, then walk to the finish but on occasions, if I was near the finish I could jog slowly for a few yards.

Many times fellow runners would stop to check on me, but it usually was met with me saying thanks but I was fine as I just had a little heart problem, bearing in mind I had been like this for 7 years and never advised to change anything or given any medical treatment.

In 2006  I moved to Stowmarket, Suffolk and when registering with my new doctor decided to introduce my self and explain that I thought I had Afib and he suggested I saw a cardiologist.

I was then referred to Papworth for an ablation. This was not successful but at least I was then put on medication (flecainide & low dosage aspirin ). This didn’t stop my blackouts an dizzy spells but I felt more confident that I was being looked after.

I am pretty sure one of the Doctors at the time had told me that with the medication I was on nothing serious (like death!) was likely to happen, so when I continued to collapse regularly I would continue to tell people I was OK. 

In 2012 my daughter challenged me to run a marathon with her to celebrate my 60th Birthday. I was unable to train properly and never managed more than 10 miles for my long run (even with walks & for those who have trained for a marathon will know this is not enough).

Fortunately, by running carefully (and luck I guess) I got round in under 4hrs so was happy to have achieved something. After 7 years on the same medication, I asked my GP for a review and he actually suggested I went to the local hospital for the review.

Mike with hard earned medal

They gave me a 24 hr monitor and it happened to coincide with our running clubs 5km race. Just before the last turn I blacked out and collapsed. A running friend stopped to check on me and I told him I was OK. At the final bend, he informed a marshal but she quickly told him I was OK and right behind him. The following day after returning the monitor I was admitted to hospital as they had seen my collapse on the tape. After consulting Papworth they put me on beta blockers. This stopped the blackouts but slowed my runs by about 2 mins per mile and I would get very tired even just warming up.

Subsequently, I took up trail running where we would do our own route finding. This would enable my heart rate (HR) to come down whilst stopping to find the correct path. It enabled me to enjoy my running see the lovely countryside, have lovely cakes (and other refreshments ) at checkpoints and keep fit. Socially it was (and is) a really nice laid back atmosphere.

Although I had run races for over 50 years I had never documented what I had done but when I started these trail marathons I was given a certificate each time so I started to collect them and had thoughts of joining the 100 Club. However, I had noticed around 2016 some events were getting a bit hard and at one in September I collapsed exhausted at the end and eventually the paramedic suggested my wife took me to A&E for a checkup. We didn’t go as I felt I just needed rest and I felt good the following day.

In March 2017 I collapsed again this time after the finish I had to stop on the way home to vomit. A common theme here was not feeling like eating at the checkpoints.

Mike with his saviours

On June 4th I had entered the Stour Valley Trail Marathon, an event I had completed 3 times previously. I have no memory of the day at all so this is all from my saviours and friends who went with me.

I travelled down with a couple of mates to the race and set off at a reasonable pace. One of my friends overtook me at 18 miles. Although I was slowing down I told him I was OK and if necessary I would be happy to walk the last bit. One of my friends then said she came across me down at 24 miles and phoned the race director to tell him she had come across someone who probably wouldn’t make the finish.

I actually got up and ran on for another mile including climbing a couple of stiles, then she saw what apparently looked like rubbish in the field but it was me and I was unconscious this time. She commenced CPR & kiss of life (other runners stopped, phoned 999 & helped with the CPR and elevating my legs). Apparently, 3 women kept the CPR up for about 20 mins whilst a man went to find out where we were and amazingly found an off duty paramedic having a BBQ nearby. He rushed over and took control.

The ambulance arrived after 25 mins. After three goes with the defib. and other stuff (I don’t know what else they did as I have had no response to requests to thank them) they got me round.

I am told I tried to get off the stretcher to finish the race when told I was a mile from the finish. I had 2 further arrests (in the ambulance and in A&E at Colchester). After 3 days in an induced coma, I came round, had a defib fitted at Basildon and was released.

No real explanation for what had caused it. Just out of interest I believe it may have been the hottest day of the year (at that point).

A nice touch the race director sent me a medal as he felt I had probably run a marathon distance along with a new vest from his club, noting humorously that the paramedic was probably from a rival club as he had torn and thrown away my vest!

To be continued…

CPR Counts!

As a survivor you know

Post by Malcolm Robinson

On the morning of 15th April 2017 my wife, Ann, and I set off by bus from near our home, heading for Birmingham city centre. I was going because of two reasons. There was a vegan food festival taking place and I also wanted to explore a guided walk I was planning to lead for our rambling group, associated with Tamworth Folk Club. This walk was to look at, among other sites of historical interest, the multitude of graffiti left on various appropriate walls in the Digbeth area of Birmingham, just to the east of the city centre. These were put there by invited artists, from far and wide, for the ‘The City of Colours Street Art Festivals’ which took place in 2014 and 2016.

Ann got off the bus in Sutton Coldfield town centre to have her hair cut and I carried on to look at the food festival before she would join me on a later bus. Leaving her in Sutton is the last thing I remember for about the next week. There is a text message on my phone which I sent to her at 11.27am which reads ‘Don’t get bus to town. I am coming home. Will tell why when I see you.’ But Ann was already on the bus and phoned me to tell me so. If I had already got on a bus I may well not be alive today.

I told her that I had an ache in my chest and was feeling very cold and thought I should abandon the walk. By the time Ann reached me in the city centre I was feeling much better and decided to carry on as planned. It seems, from notes I took as we were exploring, that we had almost completed our three-mile perambulation and were heading for our favourite vegetarian restaurant, The Warehouse Cafe, for lunch.

Nearly there, I suddenly keeled over on to my right side on the pavement. Ann thought I had tripped but soon realised I wasn’t responding. The fact that my tongue was lolling out to one side caused further alarm. By now a group of onlookers had gathered to witness the scene, one had phoned for an ambulance but no-one was offering further assistance. Then suddenly a stranger, Judy, was there (you’ll be hearing more about her later). Ann was trying to rouse me by shaking my shoulders and Judy said, ‘Don’t do that, he’s had a cardiac arrest’.

Judy immediately took control of the situation, got me on to my back and started cardio pulmonary resuscitation (CPR) and also closed my fixed-open eyes to prevent burst blood vessels in them. Another bystander (unknown and untraced) offered to help and between them they kept my circulation and breathing going for the 20 or so minutes it took for an ambulance to appear. The first call hadn’t resulted in a response, so a second 999 call was made and then two ambulances and two police cars turned up at the same time! With all their fancy gear they defibrillated me twice on the pavement and once more in the ambulance on the way to City Hospital, Dudley Road, Birmingham.

I have made some investigations since coming home and discovered that the chances of surviving what is medically known as a VF Cardiac Arrest occurring in the street is no more than 4-10% and then only if a competent person is on hand at that very moment. A lot of people might think they could do it but not many would be confident enough to apply enough pressure to fracture several ribs in the process (a necessary and painful side effect that I am not moaning about).

The ambulance crew wasted no time in stripping me nearly bare by using scissors to completely destroy my jacket, jumper, shirt and trousers. Punched a hole into my left shin to insert some sort of line for injecting an unknown brand of fluid into me and kept me alive until I got to hospital. Judy had left her coat over me before departing, leaving the paramedics to carry on with my resuscitation. Eventually the ambulance took off with Ann in the front with the driver; an exciting experience if it hadn’t been so stressful. The Police had asked if I had any other relatives that they could inform and she had given them my children’s phone numbers. They called Hannah who, at first thought it was a hoax call, having experience of some idiot making a similar call about their house being burgled a couple of years ago. She tried to call me (I didn’t answer!) and then called Ann who was in the ambulance and got the dreadful confirmation of the truth. Hannah, in turn, informed her brother, Mark. Ann informed her daughters, Laura and Eleanor. It didn’t take too long before there was a big family gathering in A&E. I, of course, missed all the fun, being blissfully unaware of any of the foregoing hullabaloo.

At the hospital I was quickly transferred to the catheter lab where three stents were put in my right coronary artery by Dr Derek Connolly. By the time I came out of this procedure all of our kids had arrived, and then I was transferred to Critical Care where I was kept for three days before being transferred to the cardiac ward.

In Critical Care I had numerous tubes inserted into pretty well every available orifice, was cooled down by a large freezer block on my chest and kept sedated for two days, before being warmed up on day three and allowed to regain consciousness.

Now for a few words about Judy. Without her presence on day one, and knowing that no-one else at the scene was making any efforts, or had the knowledge, to resuscitate me, I would not be alive. It’s as simple as that. What is more remarkable and bordering on miraculous is what I have learned since about her.

Judy’s Story

Judy hadn’t been feeling very well during the preceding week and was due to go to St Albans to visit her mother on the day we are relating to. Instead, her daughter offered to go to see her grandmother by coach. The coach station is in Digbeth. Judy had taken her into Birmingham by car. She does this fairly frequently and always chooses to use the same car park. On this day she parked in a car park which she never uses. On leaving to drive home, on a route which, again, she never uses, she approached a crossroads and noticed a gathering of people near one corner. Through a small gap in the crowd she saw two lower legs sticking out from behind a low wall. This was me flat out on the ground.

She pulled up realising that someone could be in trouble and, seeing me lying there, asked if anyone was qualified to help me. No-one moved but she learned that an ambulance had been requested. This was when Judy took control of the situation. At that moment I had no pulse and wasn’t breathing and had very little survival time left. I am at a loss, here, to know why the person who called for the ambulance wasn’t receiving CPR guidance over the phone.

(20 months later I eventually found out that the person calling the ambulance had told the operator that I was breathing – perhaps it was agonal respiration, that would have down-graded the urgency of the response and that might be why it took so long for the paramedics to arrive. When Judy arrived she took the phone and put them in the picture)

We have now learned that the chances of Judy being there at all were very slim, but how come she was the right person at the right time, considering that a moment earlier she would have passed by and not seen me in trouble. This is where it gets even more incredible.

Judy is a nurse who used to work at The National Heart Hospital in London and now is a practice nurse in a GPs. She had trained to use CPR, correctly, and had used it in the hospital. Like me she has had hormonal cancer and follows the same dietary practices as me, eating only plant-based whole foods, cooking everything from scratch. She often visits the same restaurant where we were headed for. We have both suffered the deaths of our first spouses and have remarried. We both have medical backgrounds. She was a British champion ballroom dancer in her younger days, but I can’t be sure if I was. Remember, I have suffered some memory loss!

After the ambulance crew took over the process of resuscitation Judy put her coat over me and left the scene to drive home. At this point no-one knew who she was, except that she had told Ann her name. While she was driving she suddenly thought that she might have left her house key in her coat, so she turned round and drove back to the scene. By this time the ambulance had departed, with Ann in the front seat alongside the driver, but some police were still there clearing up the remains of tubes, fluid dispensers and dressings that I hadn’t been able to tell them to tidy up. I hate litter! She learned which hospital I had gone to and drove there. At the A&E department she caught sight of one of the policemen who had been at the scene and asked if he wouldn’t mind seeing if her coat was there. He invited her in but she declined, saying she didn’t want to intrude on the family’s privacy. The coat couldn’t be found but it later turned up in the bag with my shredded garments. Judy later found that her key wasn’t in her coat anyway.

At this point none of my family knew any more about Judy than her first name, nor the identity of the young man who had volunteered to assist with the CPR. Hannah tried using social media, to no avail. Judy, however, could not get me out of her mind over the next few days, which I find quite flattering. She eventually telephoned the hospital A&E to see if she could find out if I had survived. All she knew was my first name and the date of my admission. The nurse she spoke to said that she too would not be able to rest without knowing what had transpired. She told Judy that I was now in the Critical Care ward and was put through to there. When she identified herself the person who answered knew that my family had been trying to trace her and so the connection was eventually made.

Judy came to visit me on my fifth day in hospital, but I have no memory of this and certainly would not have been able to pick her out in an identity parade. This is why it was so good to meet her when she came to our house for lunch on 18th May when we had a good three-hour chin-wag. This is when I learned the full story of that first day and when I came to the realisation of how incredibly lucky I had been and how almost spooky it was. Judy has had many psychic experiences, some of which she related to me, and is convinced that we were destined to meet. It’s difficult to argue against that.

There’s much more to the story but this will give you a good idea why I started feeling the need to ‘give something back’ by improving other victims chances of survival. Don’t imagine, like me, that it couldn’t happen to you, either. I had had no previous symptoms whatsoever, was very fit and on a very ‘heart-friendly’ diet. Cardiac arrests can hit anyone of any age at any time – hence the need for bystanders who know the life saving drill.

You can read more about Malcolm and his excellent way of giving back at his website CPR Counts