Image courtesy of Patricio Ducaud. Yeah, yeah - good one Patto!
Image courtesy of Patricio
Ducaud. Yeah, yeah - good one Patto!
This is an official account, as it were, of the tale behind the Pacemaker that was implanted into your erratic scrivener, Lindsay Fleay. I'm basically writing all this down as the story is sort of getting a bit frayed with endless retelling and starting to sound ominously well rehearsed.
First off - for all concerned relatives and friends, I'm feeling fine. Very well in fact - better than I've felt in my entire life. Fit as a fiddle and a lot more able.
What I have is a heart condition: third degree atrio-ventricular heart block, or more simply, complete heart block. The block is electrical in nature, not a physical obstruction, and the condition deals with the way electrical impulses pass through the heart, keeping it coordinated.
As I understand it, there are two little electrical nodes in your heart: in the top right there's one that initiates the heartbeat; and a second, the AV (atrio-ventricular) node, that sits in the middle and regulates the beating signal so that the bottom half of the heart knows when to fire after the top one has struck a beat. The AV node is a set of specially conductive cells and not part of the nervous system.
My AV node is for all purposes, dead. The electrical pulse from the top right can't get through the middle and has to take the long way around the outside of the heart to reach the other side. By the time it gets there, the top half has beaten again and both halves basically beat at different rates. This wonky heartbeat is known as arrhythmia (there's quite a few types of this sort of thing, caused by all kinds of different things). The valves at the top of the heart, the atria (plural for atrium) run normally at around 60-70 beats per minute (bpm). But the ventricles, the two big chambers in the lower half, beat on their own time, which is abnormally slowly - at a sluggish 30 bpm. A heart monitor shows two different frequencies beating away, only occasionally matching up as both slide in and out of phase.
In effect, when the block is active (which is, I fear, all the time), my heart basically trips over its own feet the moment it has to deliver blood. The moment I try to get out of neutral, blood supply becomes a problem. My blood pressure drops sharply. This translates into cramps stitches, nasty dizzy spells, and at its worse - a complete blackout. Usually it was the act of face planting that woke me up.
So, big surprises all around. At the ripe old age of thirty-four, Lindsay Fleay needs a pacemaker. Also, just as perplexing, was just how on earth I kept going for those last few months. I don't own a car: I walk everywhere and commute, or take a taxi when I have to. While working at Animal Logic can be grueling at the best of times, it seems the stress had upped my blood pressure to ward off the worst of the blackouts. I'd just feel intolerably tired instead; propped up on a desk, feeling sleepy in the middle of the day; finding even small problems and issues magnified out of all proportion.
As for the Pacemaker, its a subtle and sophisticated little piece of German electronics. For you gadget hounds, its a Biotronik Actros DR Pacemaker with two electrical leads. The A Lead is a PX 53-JBP a that threads down a vein to wire up my heart's atria, and the V lead is a MEX 60/15-BP v squirreling down another to connect up the ventricles. Its surgically implanted under the skin just below my right collar bone, and you can see a sort of flat, roundish lump the size of an Australian fifty cent piece sitting there next to a keyhole scar that seems to be rapidly disappearing. That's it in the picture, second from the left.
But it all goes back further than this. The big kick in the teeth for me (and everyone else) - apart from all the fun of confronting your own mortality and knowing you're now permanently (and utterly) dependent on Western technology and all that that implies - is that I've most likely had this all my life.Of course, in hindsight, it seems so bleedingly obvious I'm left wondering how on earth I could have possibly missed it. Ever since I can remember, there's always been an invisible barrier whenever I've tried anything physical. Swimming more than four laps always produced a cramp and cycling up a hill always caused a stitch. It didn't matter whether I was fit or a complete slob; whether I stretched and warmed up vigorously or just jumped into it, ate well or badly - there was a point where the cut out would kick in and I'd have to stop and either gasp for breath or wait for the invisible piranhas having a go at my instep and my calves to ease off. A quick rest, and suddenly, its like starting completely fresh again. I used to chalk this up to bad habits and poor exercise.
In effect, when I worked out or did anything strenuous and passed a certain point, my heart would abruptly slam on the brakes, dropping to its "default" state. The baseline for that cut out period had been hovering at a distance of a few laps for most of my life. In the last twelve to eighteen months before the surgery, it seemed to start moving. At the beginning of 2001 I was starting to notice that long walks involving hills were a bit of an effort and thinking that I was coming down with the flu again. Early 2001 I had my first evil dizzy spell and nearly passed out walking up someone's steep driveway in the middle of a Saturday night.
You know something's seriously out of whack when you catch yourself thinking in good days and bad days. A good day is one where only one stop to gasp for breath and ease the tightness in your chest is needed on the first flight of stairs. A bad day is one where you're walking back from the station in the middle of the night, and suddenly, halfway there, it in all honesty feels like you're never going to make it home - alive. The dizzy spells were the worse: these aren't the normal light headed ones you experience when you jump to your feet off the couch all of a sudden, leaving all your blood in your feet. These fucking bastards were of a different order entirely: scary and silent.
That was near the end, before the implant. All this had been slowly creeping up, stealing closer by degrees until I found myself creeping around like some decrepit old man, stopping for breath all the time while everything just became more and more difficult. I become extraordinarily sensitive to even slightest of inclines, and anything else other than a slow walk or a lie down would just wear me out. But staying still for too long seemed to invite horrific dizzy spells. Enjoying several months off between between film projects at Animal Logic did not help. Usually its the stress, long hours and deadlines that wear you down. This time, it was relaxing, walking everywhere, doing (ironically) cardio workouts three times a week and eating well (or at least better than on the fly at work) that was making me strangely less fit and increasingly fatigued. Being an idiot I just assumed it was lack of fitness, a recurring flu, or plain old fashioned laziness.
Towards the last couple of months, all kinds of dreadful fears were starting to surface. I thought it was neurological at one point, a fear made quite solid and real by the recent death of my good friend Clive, who was taken from us by a battalion of brain tumours. I feel like the vet peering over the lip of the trench, contemplating the smoldering crater of a near miss...
Since the pacemaker all that has completely gone. Physically, its like re-entering my late teens again (extra weight notwithstanding!) The moment I surfaced through the anaesthetic everything felt completely different. A perfectly calm chest. For the first time in my life it was actually a pleasure to listen to my own pulse. What a surprise - and a startling revelation. By comparison, the old ticker had been flopping about like a stranded fish! I'd never felt comfortable under my ribs, ever - even when sleeping. I thought that was normal! But when there's nothing to compare it with since your first breath - well, that's a real kick in the teeth. In hindsight, all that fidgetiness, endless pacing around, throwing myself about whenever I did anything - it was probably kick starting my heart every time it started winding down. Everything now seems calmer and more efficient.
At the time, you're too busy struggling through with it to really come to grips with the situation. Its only afterwards that the full implications come along and beat you around the head. Plus all the subtle by significant changes that come with being fully aerated for a change. For example, updating my RTS game site, RTSC, could take anything up to a week of dithering. Now it takes a night. All those old and unfinished projects I used to do have suddenly returned to occupy my mind again. I'd never realized they'd left - this decline seems to have been taking place over the last few years. I've even had to relearn what its like being genuinely worn out after physical exercise, without my heart opting out after the round. Oddly enough, while I'm puffing and panting and feeling sore and hot and sweaty, my chest is as cool as a cucumber and as placid as a calm lake.
So there you go. That's pretty much it in a nutshell, although I could rant on for ages about the fun stay in hospital, being the only under sixty in the cardio ward. I managed to score an upper body thrombosis (blood clot) as a result of the surgery, but apart from the action packed adventures with medical bureaucracies, drug therapies and other mind numbingly tedious encounters with forms, pills, attendances and other edge-of-your-seat stuff, there's nothing much more to tell.
I'll just mention at this point that all the bits with the burning helicopter, escaping a crashed car at the bottom of Sydney Harbour and being kidnapped by midgets was all made up. Sorry. :)
Cheers!
Finally written up and posted on Fri, Apr 26 2002 by Lindsay Fleay