Thursday, July 16, 2009

Setting Goals

Some time before I reached the crisis point - where I could hardly walk 100 metres at relaxed pace without feeling as though my chest was caving in - I resolved to become fit.

With noble intentions I joined a gym - the Tepid Baths - a facility run by the YMCA just a hundred metres from my office in Auckland's Viaduct precinct. I attended several times and was able to build up to running 10 kilometres in about 45 minutes. But that is where I plateaued. I found that I took me a long time to recover from running on the treadmill. My heart rate didn't return to a modest resting pace. It felt as though I was in fight or flight mode for nearly 15 minutes, causing me alarm and anxiety which, no doubt, kept the blood pumping like a perpetual motion machine.

Even swimming, which I can manage easily thanks to a lazy-but efficient- stroke and webbed toes, began to prove more challenging than it had ever been. So I gave in. For months my bank account fed the gym's coffers without any benefit to me. I felt frustrated every time I wheezed past the building on foot. It seemed a cruel irony that I was sliding backwards and couldn't grasp a lifeline.

Two and a half weeks after my surgery I am thinking about exercises and activity again. I will return to the gym. I am keen to build some aerobic fitness and enjoy swimming again.

I have loved swimming since I was forced to learn in the early 1980's. A client of the advertising agency I worked for sponsored the first short course Triathlons held in Auckland. The general manager of the agency, an affable sadist, firmly suggested that, because I was young and fit, I should sign up for the event to show solidarity with the client's budget.

Why not? I thought to myself; and I did. Not the first 'ready, fire!, aim' moment of my life and certainly not the last.

Having agreed I asked 'What is a Triathlon?'. It was a new sport after all and my youthful braggadocio was finely balanced by my ignorance. I was informed I had to run, cycle and swim. Running wasn't an issue. I grew up in the era of John Walker, Dick Quax and Rod Dixon's inspirational successes at Olympic and Commonwealth Games. I was wiry and fit from many years of delivering milk and participating in Harriers club events. My family never owned a car so walking and running were pretty much how I got around.

Cycling? Well, how hard could that be - though I confess an aversion to bicycles born of traumatic memories - delivering the grotesquely bloated Saturday edition of the NZ Herald newspaper on freezing mornings; lashed by wind and rain; dispensing from awkward saddle bags on my trusty Raleigh 10-speed.

Swimming was another matter altogether. I could not swim a stroke to save my life. In primary school I had managed to participate at the minimum level required by thrashing across the width of the school pool with my eyes as firmly shut as my mouth; surviving the traverse on a single gasp of precious air.

I would need lessons.

I found the tuition I needed at the Takapuna Municipal Swimming Pool on Auckland's North Shore. My instructor, whom I shared with a half dozen women, two of them pregnant, was none other than the New Zealand swimming legend Lincoln Hurring. He was a patient and methodical teacher. For half an hour, over six weeks he handed me pieces of the swimming puzzle. Floating, breathing, propelling and combining each into an efficient, systematic form. By week five (and endless hours in between, fluttering, learning to empty my lungs while kicking and clinging to the side of the pool and all of the other fundamentals…however ridiculous I looked to other pool users) I was proficient. I was very proud when the master told me I was good and should get some competition.

For all the training I did in the pool, mesmerised by the black line on the bottom, waiting for it to end to begin my turn (I never learned to tumble-turn) nothing prepared me for the start of a triathlon itself. I was terrified before the event. On the tiny shelly beach, just past Devonport's boat club, a crowd of competitors was squeezed together tighter than the swim caps and speedos we all wore.

When the gun went off it was little short of a frenzy. Into the the water, leaping at first, high leg lifts like lifeguards before finding a swimmable depth - then into the fray. I found myself in the middle of the school. The water was churned to an oxygenated froth. Finding clear space to actually swim in was a mission in itself.

I had never experienced such aggression before. People in front seemed determined to kick me in the face, while people behind (men and women) tried to swim over the top. I had learned to swim with genteel hydrodynamically efficient cupped hands. My rivals were flailing with closed fists. Worse still, I couldn't find the black lines, let alone see the bottom. In the end I went wide, looking for clear ocean. I figured, at best, I could overtake at least some of the pack by being smarter and, at worst I would avoid the prospect of a fractured skull. Drowning on my first outing was a very real possibility, but it was nothing compared to the risk of being pulverised by an aquatic mob.

I finished in somewhere in the middle of the pack. Without my glasses I am a blind as a rhinoceros. Finding my bike amongst the hundreds lined up and amidst the first half of the field already making their transition from one discipline to the next proved nigh on impossible. I told my girlfriend - who photographed my misery - the event should have been renamed The Helen Keller Challenge.

Oddly enough I enjoyed the experience and completed several more Triathlons before someone stole my bicycle from the stairwell of my apartment building in the city (the charming Art Deco Brooklyn apartments in Emily Place - recently gentrified and cleared of hookers and addicts, but not petty thieves). I took the removal of the bike as a sign, it coincided with having a terrible inflammation of my arm sockets from spending too much time swimming up and down the wonderful Parnell Baths. I had developed an obsessive compulsion with swimming and took advantage of the liberal terms of my employment, spending hours each day there (and sometimes the Newmarket Olympic Pool when it was an outdoor amphitheatre, before it was shut in by developers and incorporated into Auckland's dreariest multiplex cinema).

I like running less and less and the sight of middle aged men in Lycra on vastly overpriced bicycles makes me determined never to adopt cycling as a pastime. I still like swimming and I am dead-set on getting into shape to complete at least one of the Auckland Harbour Swims which are usually held in November. That gives me 3 months and a goal.

Tomorrow I'll have a chat to my Doctor and a personal trainer at the gym to figure out a plan.

Activity and fitness are obviously components of Pimp My Pump™. I am very object oriented. I find it hard to do things for the sake of doing them. Years ago my first wife suggested I learn to ride horses (she was an outstanding equestrian), 'What for?' I asked. So she bought me some riding boots and gave me a voucher for polo lessons for my birthday. It all made sense after that.
I still have the boots, but I haven't ridden since.

So. I have a goal. The by-product should be to tone up, be fitter, lower my blood pressure (hopefully so I can reduce the doses of meds I take) and give me something to look forward to.
Though, if the start is anything like a triathlon mêlée, excuse me if I enter the water a genteel last.

Sunday, July 12, 2009

Pimp My Pump™ logo

Plans progressing to get the word out about heart health for men with Pimp My Pump™. This morning I got an email from the designer who is helping me (who wants to be anonymous) with this attachment :

I am really pleased with the result. Feels like progress. What do you think?

I went at it a bit hard last week, going to the office, a recording session, the movies. My inclination is to get on with things, but I wasn't prepared for the tiredness that set in. I don't think I've slept as often or as long. I wondered if I might have contracted Tapenui Flu in the hospital? But no, tiredness is pretty usual after coronary surgery.

The best thing is to listen to the old body. I have time off from work, so I'll use it to sleep if I have to.

Listening to advice is one of the mistakes I made that resulted in my quad bypass. Or, rather, not listening. I was diagnosed with very high blood pressure some time ago. When I visited my doctor she sent me to the hospital - I got cranky about being left to wait on an acute ward for several hours and left. I began taking the blood pressure medicine I was given and monitoring my BP with a meter the doc loaned me. I didn't really see any significant change and so pretty much gave up on the pills. Ultimately . I didn't feel any different with or without the medicine. So, despite being told not to stop - that is exactly the opposite of what I did.

I'm guessing that's not uncommon. Hypertension is a disease. It may have no obvious symptoms (I didn't go to the doc in the first place to have a heart check, I was getting persistent headaches), but once you've been diagnosed it is important you follow the advice you are given.

It may seem pointless, but believe me, what is pointless is having avoidable surgery.

Friday, July 10, 2009

Welcome to The Zipper Club

Well - here it is, …membership qualification for the 'Zipper Club'. One long scar and an array of holes where the surgical drains stayed after I was closed up.

It isn't really all that painful. I'm on mild off-the-shelf painkillers and my sprained ankle is more annoyingly sore. I confess that holding my shoulders back to disguise my man-boobs was kind of uncomfortable, but vanity must be served even in the most trying of circumstances.

Thursday, July 9, 2009

Operation Pimp My Pump™

Well, the deed is done. Stage one of Pimp My Pump™. A quadruple bypass at Auckland Hospital last Monday. I had intended to update the blog a little sooner, but the truth is the procedure kind of knocked the stuffing out of me for the best part of the week and the effect of hours of anesthetic was to turned me into a zombie (but at least I was alive).

I won't dwell on the procedure*. As far as I am concerned they shaved me, wheeled me in, squirted happy juice into my system…and that was all she wrote. It's funny, years ago (2003?) I mocked up a print magazine as a companion for eMale, a website I owned - It's purpose was to package health information for men by sugar coating it with male oriented general interest, (ironic?). The cover story was The Wake Up Call and feature a picture of the comedian Rodney Dangerfield that had been published in Esquire magazine. Dangerfield looks pensively at his bypass scar and in the Esquire article he says:
I recently had double-bypass surgery. As they wheel you in, the doctor always gives you a last look. You know that look. That look of confidence to make you feel good. I always say to every doctor, "If I don't make it, I'll never know it."

I woke after 12 hours and, so I am told insisted that:

a) the nurses on the ward had better be cute and
b)I be immediately taken to the movies.

So I was as delusional as ever.

The land of the living
I had returned to my senses a little by the next day. nurses were keen to get me out of bed and seated in a chair. Sounds easy enough. My first attempt was pretty tricky. Getting vertical for a moment caused me to pass out. But these days laying around in bed isn't the way to recover. The following day that was exactly what I wanted to do. I still had a 'central line' running into my jugular and hadn't slept more than an hour at a time or been able to eat more than a mouthful of baked beans. The prospect of eating anything made me feel nauseous.

The next day the door opened a little and I was able to walk (albeit slowly) to the toilet and to shower - seated - by myself. I had to consciously decide to eat, regardless of how I felt about it. I figured that my body needed some resources to heal the wounds.

One of the things that shocked me were the surgical wounds on my inner thighs - running on my left leg from groin to just above the knee and slightly shorter on my right thigh. I look as though a large shark has tried to bite by tackle off. I'm told the wounds are actually a nice clean job. I realise my legs weren't insured for millions like Rihanna's but, while I was prepared for the chest wound, these caught me by surprise.

By Day 4 I was feeling stronger and more confident. Sleeping pills helped me get some rest at night and food gave me strength. By Day 5 I was ready to go home (Don't tell anyone but I was able to dress and sneak out to have lunch with my ex-wife and daughter in Newmarket - a spicy Thai Tom Yum soup - my first meal with any flavour for three weeks).

All a blur
I developed a problem with my vision following the surgery - blind spots and after images. The surgeon thought it would best to stay in the hospital, rather than going home, then attending an appointment with the eye clinic at Greenlane. It was probably good thing to take a couple more days.

The interesting thing about the visual disturbance is that it turns out to probably be the result of tiny blood vessels in my eyes relaxing as the result of lowering of my blood pressure. This is another reason to have your blood pressure checked. Uncontrolled blood pressure not only affects your heart, but also eyes, renal system (kidneys), can cause headaches, sleep apnea and impotence (I'm guessing I have your attention now, right?).

So - I am coming right. It is amazing how quickly changes have taken place.

I came home on Monday. Chilled for the rest of the day and got used to the idea of attending to my own needs. It felt good. My son, the comic, brought me brass bell to ring if I felt a seizure coming on. Tempting to use it when I feel a cup of green tea coming on…(seem to have lost my taste for tea and coffee-not sure if that is common or whether it is simply to by-product of being served disgusting tea and coffee in the hospital).

Weighty Issues
When I went into the hospital I was a heavyweight at 91 kilograms, after two weeks in bed I weighted 88kgs. Following the surgery I was back to 91, which was mostly made up with retained fluid - not uncommon. Diuretic tablets solved the water retention and I have dropped down to 86kgs. In truth I have a few more pounds to loose. That's another sign that you might have a problem gentlemen - carrying a little extra pounds around your gut.

I'm back on my feet. Been home four days, been in the office (briefly) the past two, had lunch with friends, and spent a little time at a recording studio where my friend the musician Monique Rhodes is recording top kiwi artists for a charity Christmas album. I'm getting around with just a little discomfort. The sprained ankle I gave myself in North Shore hospital gives me more grief than any thing else.

I've arranged a publisher for Pimp My Pump - the book and I'm setting up a charitable trust for men's heart health education. I'll fill you in with more details later.

The message is simple…

If you are:

a) Male
b) 35 - 50

Make an appointment to see your doc. Get a heart check - blood pressure, cholesterol, family history. In most cases there won't be a problem. But if you you get it early you won't have to go through the rigmarole I have - and believe me, I would rather not have.

If you have any interest in how by-pass surgery is done then there here is a blow by blow video.
If that doesn't convince you to get a heart check. Nothing will.

Thursday, June 25, 2009

Impatience is a Virtue

Waiting is part of the public health patient experience. Patience isn’t just a virtue but an inevitability. My parents instilled in me the notion that there will always be someone worse off than you. It bears remembering here. They are welcome to my place in the queue because the truth is, today, I am anxious about the surgery.

Friends have told me that, when they heard I need a quadruple bypass, they did what we do now and Googled the term. I haven’t. I prefer to rely on the bloodless schematic of my heart prepared from the data collected during the angiogram I had a week ago today. The diagram bears as much resemblance to the viscera of my actual heart as the famous London Underground map does to the Victorian twists and turns of the tracks themselves. Looking at my heart map, with its legend of blockages; 80% here, 100% there, 50, 50, 50, 40, 40, it is easy to be as dispassionate about the truth as I would be if I was poring over the electrical wiring diagram of my old Sunbeam motorcycle.

So, you see…I have neatly avoided the videos on YouTube, my theory being that it can only frighten the living bejezuzz out of me. In any case, observing the process will have no lasting benefit to me. It’s not as though I will be called on in the future to assist in an impromptu roadside open-heart surgery ‘because I have experienced it.’ I am counting on being blithely unconscious during the process in any case, so my recollection will be unreliable.

Avoidance is in my nature. I avoided the realization that the pain in my chest would not magically go away. I avoided confronting the truth that taking the blood pressure medicine I had already been prescribed would protect my heart and other organs from damage. Avoidance based on denial was the last thing I needed. The gruesome reality is, had I confronted the issue of my high blood pressure earlier I might not find myself in a hospital bed, being woken at all hours of the night to have blood taken (I have named Lestat the technician who has come several times undercover of dark. He takes great pleasure not only in his work but also announcing, “Ok, Pain coming…now” before sinking his needle into my vein – or somewhere near it.

If you are approaching 40 years of age or have passed that auspicious mark I recommend you visit your doctor to have your heart health checked. It will be a simple procedure. Your blood pressure will be checked. A blood sample will be taken and checked for the state of your cholesterol.

My recommendation is: don’t wait till it is too late.
Impatience might be the virtue you most need now.

Tuesday, June 23, 2009

An Off-Beat Idea

A couple of weeks a go I had a heart attack, though I didn't know it at the time. I simply thought it was a more exaggerated version of the chest discomfort I had been experiencing for weeks. When I went to the doctor he diagnosed angina, gave me some medicine and sent me home. That night he called. I was surprised, I thought house calls were a thing of the past past. He was concerned because the results of the blood test he had taken that afternoon had returned and showed I had experienced a heart attack, probably on the weekend - enzymes released into my blood stream told the story (I could imagine one of those CSI animations of the artery wall rupturing and releasing plaque and enzymes into my bloodstream). I should go to the hospital, he said. I felt fine and said I would come see him in the morning. I can't really remember why I chose not to, but lets just say that by Friday that week I had another 'event', this time I didn't take myself to the hospital. I was taken - in the back of an ambulance.

In hospital I waited my turn for an angiogram, a relatively minor procedure involving making a cut in an artery in my wrist, inserting a catheter into into it and feeding the tube up to my chest cavity where a dye is injected that reveals by x-ray where arteries are blocked.

There are usually three outcomes:
1.No heart disease is revealed,

2.Some blocked arteries are shown and can be opened then and there by inserting little balloons with stainless steel mesh 'stents' which expand when the balloon is inflated then stay in place when the tube and balloon are removed, allowing blood to flow through the heart Unrestricted,

3.My case was the final, worst case scenario. Too many serious blockages in all of the wrong places, like intersections. The map they drew me showed blocks of 100% and 80% down to 'minor blockages. of 40%…all of which adds up to a quadruple bypass.

The news shocked me. I am still quite young - mid forties. My reaction was muted, but I couldn't stop a tear rolling from the corner of my eye as I lay there. I worried most of all about frightening my children. My daughter is just nine. My son is 17 and I worried he would be anxious- his mum died of cancer when he was just 4.

The past few days have been quiet and reflective. Waiting in the hospital for news of whether I will be accepted for the quadruple bypass surgery I need (I will find out today - and where I will be placed on the waiting list). My age means I will probably have a lower priority than an older person, but the extent and ongoing pain, even at rest, may indicate a more urgent need. I am philosophical. A part of me is happy to delay - the frightened part, the residual male bullet-proof 'I will be fine' bravado part. Another part of me just wants it over with so I can begin Life 2.0, bypassing the ill effects and getting on with an improved diet and lifestyle. Genetics are a factor too. But there is little I can do about that.

I woke early this morning with a start. I had an idea. For many years I have been, ironically, interested in Men's Health. In 1997 I started an ad agency with a couple of partners and our first major brief was to launch a major cholesterol lowering medicine and to promote a blood pressure tablet for a large multinational drug company. I went on to invent the Family Health Diary advertising programme. So, ignorance is no excuse. I have long known the risk factors for heart disease: 40+…Male…family history. Hitting the jackpot comes as little surprise. A poor diet and not enough activity probably didn't help.

But, back to my idea.

Rather than feeling sorry for myself I'm going to do what I can to help others prevent the need for radical remedies when the alternative is simple and easy to integrate into everyday life.

Pimp My Pump™

My heart will be re-engineered by grafting arteries 'harvested' from my chest wall, arms and legs around my blocked arteries. I had an image in my head of an engine, with tubes and pipes, glistening in the sun. Like the MTV show Pimp My Ride my clapped out heart will have a new lease on life…surgeons are going to Pimp My Pump™

The thing is that radical surgery isn't the only way to achieve a positive result. I want to get the message out to men in their late thirties and forties (and their partners) in a way they can accept and that being aware of heart health and actively taking steps to promote it is far less traumatic than what the next few weeks holds in store for me.

So, stand-by for updates about my plan.

Today I will make some calls to enlist support and help to get the word out. I registered the domain this morning - still waiting for the DNS record to populate.