A LOT OF PEOPLE KEEP THINGS MEDICAL IN CONFIDENCE and I totally understand that. However this is ME and I figure that I have nothing to lose and everything to gain by sharing information and experiences. Mine is a path that many have trodden but many more are yet to take the journey. If I can help in any way by revealing my own personal details and experiences then I have done some good...
What is an ICD?
Smaller than the size of a palm, an ICD packs a lot of power into a little space. It sends electrical pulses to the heart when rhythms get dangerously out of control, effectively halting racing beats and protecting against Sudden Cardiac Death. Almost everyone has seen a physician on television, paddles in hand, yelling "Clear!", then applying those paddles to the chest of a patient to shock him "back to life". As dramatic as the scene may be, defibrillation, or shock, can be the only way to stop certain deadly heart arrhythmias before they kill.
For those who are at high risk of the deadliest forms of arrhythmias - ventricular tachycardia and ventricular fibrillation - an internal "shocking" device may provide the best defense against sudden cardiac arrest. Such a device, known as an implantable cardioverter defibrillator (ICD), is considered effective in fighting cardiac arrest over 90 percent of the time, an astounding success for a condition that few survived as recently as 15 years ago.
More about ICDs
Implantable cardioverter defibrillators (ICDs) are small devices, about the size of a pager, that are placed below the collarbone. Via wires, or leads, these devices continuously monitor the heart's rhythm. If the heart beats too quickly, the ventricles will not have enough time to fill with blood and will not effectively pump blood to the rest of the body. Left unchecked, the rapid heartbeat could cause death. To intervene, the ICD issues a lifesaving jolt of electricity to restore the heart's normal rhythm and prevent sudden cardiac death.
ICDs also can act as pacemakers when a heart beat that is too slow (bradycardia) is detected.Most ICDs keep a record of the heart's activity when an abnormal heart rhythm occurs. With this information, the electrophysiologist, a specialist in arrhythmias, can study the heart's activity and ask about other symptoms that may have occurred. Sometimes the ICD can be programmed to "pace" the heart to restore its natural rhythm and avoid the need for a shock from the ICD. Pacing signals from the ICD are not felt by the patient; shock signals are, and have been described as a kick in the chest. I can personally vouch for that.
Here's an interesting x-ray.It shows the ICD on the right of the picture as you see it. It shows also the wiring into the heart and the RV lead curves right round and down. I bet that's not where most people think the heart is! The white 'l' shape at the top right hand side and the spherical shape on the rib are just part of the external medical apparatus - at least I hope they are - it's MY body you are looking at here as at January 2011.
What was my first shock like? I will quote direct from my journal - the one I wrote when I was in Norway in Feb'March 2010.
'When we returned I went into my cabin to get half an hour sleep.I was to wake to one of the worst experiences of my life...
I set my alarm for half an hour and awoke at its call. I turned it off and went to the bathroom. I washed my face then went to get a shirt. Suddenly and completely out of the blue my heart blasted into a full blown and aggressive Tachycardia attack (mega fast palpitations). This was the first time that I had experienced such an attack since the ICD had been implanted.
It is terrifying and life threatening. My heart was pounding, my head was muggy from just waking up then within a few seconds...BOOM. The unit administered an 'appropriate' shock to my heart - all 830 volts of it. It knocked me back and I staggered onto the bed. Had I just taken that sledge-hammer to the chest? My heart began to beat normally again - the shock had worked and had possibly saved my life. I looked at my watch - it was 16:10hrs UK time. I had to keep a note, and keep my head.
After a few seconds I began to fully comprehend what had just occurred. I was devastated, not least because the pacemaker element of my device had failed to work meaning the shock had to be effected and also the knowledge that this meant another automatic 6 month driving ban under UK law.Suddenly I felt terribly alone in the small cabin. Here I was in the Arctic Circle, on a ship with no doctor and no hospital nearby. It couldn't have happened in a worse place. I felt frightened and wondered what would happen if the device malfunctioned and just kept shocking me. There were lots of 'what ifs'.
Suddenly there was a rap at the door. It was my trusty old mate. He had phoned my cabin but had received no reply and seemed to know that something was up. I challenge anyone to hold a rational telephone conversation whilst being hit with 36 joules! I explained what had happened and Jeremy instantly flicked a mental switch into 'protective mode'.I did not want to worry him unduly but he had all my medical details so he had a perfect right to know. I wanted him to attend the photography lecture and have his supper (which was lovely seafood this evening) so we did a deal - much to his chagrin. He could have my room key and make checks on me when he needed to. I wanted to be alone as it's the best way for me to get myself together again.
He has only gone a few minutes when an announcement from Marco was made on the cabin intercom."Ladies and gentlemen, I know the dining room staff will be very unhappy with this but we have the Northern Lights outside. Ladies and gentlemen...THE NORTHERN LIGHTS". What the hell was I supposed to do? I was just trying to recover from my shock, but I was here to see the heavenly dancer and it was the last night. I wanted to photograph it as this is the sort of thing that dreams are made of. I simply had to go for it! I put on some (but not much, in my hurry) warm clothing and made my way steadily to the freezing platform that is deck five. I had left a note on the floor of my cabin so that when Jeremy walked in he would know where I was.
As I looked to the heavens I could see that aurora borealis was indeed beginning to appear in the starry and slightly cloudy sky. The dusty particles spanned a great expanse and then as if the heavenly dancer wanted to give me something joyful after my dark moments earlier she began to shine brightly, illuminating the sky, resplendent in that emerald appearance. The green aspect kept on changing. I suddenly remembered the wise words given to us earlier on the trip; 'Never mind the camera, first enjoy aurora borealis with your eyes and your heart'.
Truthfully, if my ticker was to have given up, there could have been no better place to go than in such a natural paradise.'
This is the photograph I took that evening. It was one of the most emotional evenings of my life.
Here's the very neat scar from my operation in september 2009. It looks painful but surprisingly it wasn't too bad at all. All this, and it was a sub-pectoral implant, under the muscle. I am a very slim man and I thought it would be much more painful but not so. The ICD moved about a bit for some months after and now sits virtually under my armpit - see x-ray above- but I don't have too many problems. Yes I can feel it and sleeping on my left side is now not really an option but a poor nights' sleep now and then is a price worth paying as far as I am concerned.
Here's another aspect.Interesting how the right side of my chest was shaved but the ICD went in the left hand side. Probably precautionary to save time depending upon the decision made when on the slab!
I was honoured to be invited to speak in Rome early in 2013. St. Jude Medical asked me to be the 'surprise' speaker at a conference that included cardiologists, sales reps and many other personnel from the company. I talked about life as an ICD patient and how the work that they all did - everyone of them - was of crucial importance to people like me. I emphasised the human factor, and that the dollars and cents were not everything. I was especially delighted to receive a standing ovation. It was a very emotional day as I have not shared some of the content of my talk with family or friends but here I simply had to make an exception. I then gave a talk in England where I was fortunate enough to receive another standing ovation and I am hopefully giving another presentation in Prague in December 2013. I want to thank the St. Jude team for believing in me. Also my cardiologist, Dr Tim Betts for opening the door for this opportunity for me.
This one is for the St. Jude staff and everyone who does their bit for heart patients everywhere at all levels, in all countries. THANK YOU. St. Jude know that I am one of their starfish.