Surviving cardiac arrest: 1 week in ICU
Death has always been an interesting topic for me. It’s full of mystery and something we will all have to face. But my interest has always been from a safe distance. Death is something that happens to other people, until I suffered an unexpected cardiac arrest while at Jiu Jitsu.
On Friday 4th March 2022, my heart stopped and was manually restarted. I have no direct memory of the actual event and the following account of day zero has been pieced together from my conversations with the guys who saved my life, medical staff and my own journal entries in the ICU. This blog post is part of my process of recovery.
My recovery from cardiac arrest
Day zero: Friday
I went to a lunchtime BJJ (Brazilian Jiu-Jitsu) class. It was a small class and we all got to roll with each other. After about 40 minutes of rolling I was taking a break and the guy leading the class came over to me and tapped me on the shoulder and asked me if I wanted to roll again. I didn’t respond.
He tapped me on the shoulder again and leaned in closer, repeating his question. I was on my knees with my head down and this is when he heard a strange rasping sound. He’s a retired firefighter and knew immediately that something was wrong.
He laid me out and lifted my legs and called the other guys over. They didn’t know it then but class was over. By chance on that day there were 3 guys there who had experience giving CPR: an ex-firefighter, a police officer and a medical doctor who has worked in ICU. Talk about a dream team, right?
They quickly organized themselves. The police officer grabbed his phone and called the ambulance while he got other club members to man the doors making sure the ambulance could find our exact location and the crew could get into the building smoothly.
The firefighter and doctor did CPR. My face was pale and I was lifeless, and although I may have had a weak pulse, I wasn’t breathing properly. After around 6 minutes the ambulance crew arrived on the scene. They immediately defibrillated me, rebooting my heart with a powerful electric shock. It’s possible that I received 2 shocks.
I momentarily gained consciousness as I was carried down the stairs and loaded into the ambulance. One of the paramedics gave me my phone and asked me who they should contact. I found the number and then lost consciousness again. I have no memory of the ambulance sirens or arriving at the hospital.
I regained consciousness in hospital on Friday afternoon. While I was unconscious I was hooked up to an ECG and my heart was examined using ultrasound. During the ultrasound it was observed that part of my heart was not moving as it should. I vaguely remember doctors speaking to me saying that I’d had a cardiac arrest.
When my partner arrived at the hospital I was dazed and confused and bombarded her with the following, repeatedly, for about 7 hours: What day is it? Have I had a heart attack? No-one will want to roll with me again at jiu-jitsu!
By the way, I didn’t have a heart attack. Instead, I had a cardiac arrest which just means that my heart stopped for some unspecified reason. A heart attack is when a plaque ruptures and blocks an artery, which can cause part of the heart wall to die and can lead to cardiac arrest.
Day 1: Saturday
I had a coronary angiogram. A coronary angiogram or coronary catheterization is a minimally invasive procedure to access the blood circulation of the heart using a catheter. It’s performed as a diagnostic tool and for treatment purposes. I was awake the whole time and could see my heart pumping away on the screen. The process involves injecting a radiocontrast agent into the heart and observing via x-ray to see how it functions. There were no issues reported from this examination. So it was back to ICU to wait for an MRI.
Day 2: Sunday
From my diary entry:
“I have such a deep sense of powerlessness, acceptance, surrender and gratitude. I think it’s been much harder for everyone around me. I just need to stay here and chill out and stay alive (for some reason). My short-term memory is scrambled. I’m grateful to be alive and here, but I’m also not attached to it. Not being here would also be ok. I feel happy, free and light. I’m exactly where I’m supposed to be.
I really feel for those around me. So many are suffering. Death is definitely the end of suffering, that’s for sure. The suffering is caused by holding on: attachment. The Buddha was right! Attachment is the root of suffering. Consciousness really is totally overrated and makes us quite neurotic, and here I am sitting thinking my thoughts and using language to express them.
I don’t feel indifferent. I feel grateful, blessed and unafraid.
The woman in the bed next to me has been getting a lot of attention. Medical staff burst into the room several times last night to check on her. The last person I shared a room with died. I must be bad company.”
Day 3: Monday
I was definitely feeling bored by Monday and was even walking around the ward. I guess boredom is a sign of good health! My journal entry is a lot more reflective:
“This is my reboot, my second life. I’m wondering what I need to change in my life. Are there any values/activities that I’m engaged in that I need to change or transform? What is important? What can I give up? What do I want to do more of? Life suddenly seems a lot shorter than I thought it would be. I kissed death at 46, 6 weeks before my 47th birthday. I still feel so young."
Day 4: Tuesday
Life in ICU is not relaxing. Patients and staff are coming and going at all hours and there are multiple interruptions during the night as staff rush to stabilize patients. I was feeling frustrated and bored and was working my way through the books in my Audible account, finished listening to The Dichotomy of Leadership and started a new audio book: Non-violent Communication.
My choice in listening led me to write the following in my journal:
“There is some truth in violence. It’s pure and raw and the gatekeeper to death. There is nothing more real and yet ungraspable than death. I don’t long for death but there is also a great release and freedom in it. Life is for the living, but the veil between life and death is so fine, so thin, like some silky black transparent chiffon. To slide over to the other side is so easy, so simple and, man, we’re all so, so close every day and in every moment.”
I had throbbing pain all the way up my arm from the coronary angiogram earlier in the week.
Day 5: Wednesday
The pain in my right arm meant I found it hard to sleep. I began to experience some loss and pain, and wrote:
“Without physical pain it all feels less real in a way. I realize how important pain is in the body. We are capable of so much until we aren’t. Bam! It’s all gone. The things we could do are swept away like leaves blown by a sudden gust of wind. In my case I may well be able to do the things that I did. But if I’m not then I’ll say goodbye to them and find other things to do. Pivot, adapt and grow. What a fantastic opportunity to practice patience!”
I had an MRI of my heart on Wednesday.
Day 6: Thursday
The MRI revealed myocarditis or inflammation of the heart. Myocarditis is an inflammation of the heart muscle usually caused by a viral infection. This is indicated in the MRI above by the darker grey patches above the dark lines on the bottom left side of my heart. This was big news for me because up until I had this information I had no idea why I’d suffered a sudden cardiac arrest. The MRI offered a reason for this which felt reassuring.
Where did the virus come from?
At the beginning of the year my family and I had all had Covid and in late February I also had my 3rd booster shot of the vaccine. Unfortunately for the anti-vaxxers out there, there's no way to know if having Covid caused my myocarditis or whether it was the vaccine or a combination of the two.
The good news
Having myocarditis meant that I had a new treatment option due to the fact that there's a possibility my heart may heal itself with rest. I may not need an ICD or Implantable Cardioverter Defibrillator. An ICD is a battery-powered device placed under the skin that keeps track of your heart rate. Thin wires connect the ICD to your heart. If an abnormal heart rhythm is detected the device will deliver an electric shock to restore a normal heartbeat.
Instead of getting an ICD I could wear a defibrillator vest as an alternative. What a relief! The thought of having a permanent device that would need to have its battery changed every 10 years, literally made my heart sink. The plan is to do a follow-up MRI in 3 months and if the myocarditis has healed then I won’t need an ICD. If not, then the doctors will likely recommend one.
Day 7: Friday
With my defibrillator vest charged and in place we walked out of the hospital after a week in intensive care. In my journal I wrote:
“I’m ready to blow this joint. Today I’m getting out of here. I will be grateful to get home and slowly expand back into my life. I’ve not been outside or seen the sun for a week.”
Life outside the hospital was busy and noisy but I was happy to feel both the warmth of the sun and the cold wind on my face again. I was grateful to be leaving the very same hospital that my son was born in over 6 years ago.
I’ve been advised against all strenuous activities and traveling on airplanes. As this sinks in, my partner and I begin the process of canceling flights to a wedding of a dear friend and a mountain climbing expedition to climb Mount Shasta in California and Tough Viking with my son, all happening in May. I also canceled the yoga classes I teach for the next 3 months.
My partner did an amazing job keeping my family, friends and colleagues in the loop. In the aftermath of the week in ICU I began to reach out to the guys who helped keep me alive until the ambulance arrived, my mum and dad and close friends. It’s emotionally draining going over the events again and again and I need lots of rest. But each conversation I have and each connection I make brings me back into life and my relationships.
Dealing with difficulties
When things don’t go our way we often make things worse by not accepting our situation. I found the serenity prayer very helpful after my cardiac arrest. I’m also presented with plenty of opportunities to practice the following concepts: acceptance, courage, humor, humility and patience.
Acceptance
I didn’t want to have a cardiac arrest. Who does? It was also completely unexpected. It came right out of the blue. I had no symptoms of myocarditis. But it happened and accepting it helps me to engage with the healing process that I need to go through.
Courage
I had no fear or anxiety during my cardiac arrest and afterwards in hospital I was too confused to know what was going on. It’s taken time to sink in and the more it does, the more likelihood there is of fear rising. So I need to remind myself to have courage going through the recovery process. Life is so vulnerable for all of us and we’re all much closer to death than we’d like to be. My family motto is Stand Sure and it’s very much been my mantra over these last few weeks. Facing death doesn’t require courage; living a full life in the face of death does.
Humor
Having a sense of humor in the face of adversity has always helped to lighten the load. This is even more so in such an extreme experience.
Humility
I live my life as if I’m never going to die and this near-death experience is a powerful reminder that I am not death proof, and that I need to continue to practice humility in all my relationships.
Patience
Oh, bittersweet patience! How I struggle with this. On the one hand I’m grateful to be alive and on the other I feel frustrated that I can’t carry on with my life as before. The doctors have advised against all strenuous activity. I do a lot of strenuous activity! Including jiu-jitsu, running, climbing, yoga and strength training. When I remember to be patient then I can accept (temporarily) that I’m choosing to follow doctors' orders and give my heart the best chance of healing.
Meditation and journaling
There are 2 other tools that have been indispensable for me. Writing my journal and meditation. In my first week of recovery in the hospital I wrote in my journal every day. I wasn’t really in the right space to meditate but I’ve picked this up again since leaving hospital.
Reflections on impermanence
It’s so easy to say “change is the only constant in life” but we all really want everything to stay the same (and for us not to be bored!). I don’t want to be getting older, but facing my own aging is something I need to come to terms with. I’m nearly 47, not 27! I still don’t really know whether this means giving up the things that I love doing or adjusting how I do them.
Dealing with expectations
We all have them, and they are so often not good for our mental health, especially when it comes to aging and dealing with life’s uncertainties. I hope that I make a full recovery but there's some uncertainty about this because it hasn’t happened yet. The further away something is from now, the more uncertain it is, meaning the less likely that it will happen.
I guess if I can practice acceptance and humility around my aging this will allow me to adjust my expectations. Having reasonable expectations can help me avoid disappointment when things don’t go my way.
Conclusion
With my cardiac arrest and the reboot of my heart I feel like I’ve started a new life. I’m in early stage recovery and just need to keep taking it one day at a time and practicing the principles that help me live a better life with myself and relate better to others. I’m deeply grateful to be alive and for all the amazing medical care and emotional support I’ve received.
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