Saturday, July 21, 2007

How I got here

I was at the end of my second year at UCT studying a four year mechatronics engineering degree, I had spent the passed two years working hard and playing hard. Enough time was spent at the normal student activities of getting as drunk as possible, as often as possible and doing stupid things. I was living on the third floor of yellow block at Kopano Residence (awesome place). Anyway, I was experiencing what doctors would probably call "exercise intolerance". As a 19/20 year old I would struggle to walk the 1 or so kilometers up hill to campus. Two years of doing it everyday hadn't helped my fitness, I didn't even notice, I just assumed I was unfit and that was that.

Then I got bronchitus... well I thought it was bronchitus and so did my GP... at first. I was really ill, coughing and sputtering all the time, it felt like there was continually fluid in my lungs to cough up... and there was. I would need to stop and rest after 1,5 of the the 3 flights of stairs to my res room. After taking 2 courses of antibiotics and returning to the doctor, he was convinced there was something wrong with my lungs, pneumonia or something. He sent me for a chest xray. What he said to me was "Well Mark, theres nothing wrong with your lungs! But see this thing that looks about the size of a white soccer ball? Thats your heart." I was in cardiac failure, my lungs were filling up with fluid because my heart could not pump blood fast enough, it was massively enlarged and not working well at all. I got an appointment with a cardiologist the very next day and was immediately put on some serious diuretics, which I called "Niagra pills" I have never pee'd like a race horse before or after that. I also went on a cocktail of cardiac drugs, I can't remember what they were now, but they made me feel much better, and stronger very quickly. I went to stay with my aunt, Jeannette, so that I didn't have to climb to the third floor and it was much easier to eat a low sodium diet. Many thanks again Jeannette if you ever read this.

There were some changes I had to make to how I lived life, I was terrified of exercise for one. Almost any exertion would make me light headed. I had to change my diet, I was told to eat as little salt as possible, and to drink a limited amount of fluids every day. Due to the expense of seeing a private cardiologist, my parents soon decided that I would have to get public healthcare... we didn't have medical aid. My initial cardiologist refered me to a Dr A. Okreglicki (now Prof), known just as Dr A.O. or A.O. at the Groote Schuur cardiac clinic. The care I got from him was wonderful, even if I had to sit in the waiting room for hours on end, I would always be seen and he was always had the patience to listen to my never ending question... damn engineers :P . He said that I had a Dialated Cardiomyopathy (CMO) and explained to me that my heart was very enlarged and that my atria had stopped working properly. As I understand it, the heart has four chamber, two atria, and two ventricles. In a normal heart the atria beat first and pump blood into the ventricles, the ventricles then pump the blood to the rest of the body. The atria and the ventricles pump in a one to one ratio, beat to beat. Whether my atria started beating out of time before my heart was enlarged or the other way around is uncertain and irrelevant. Mine don't beat in time, my atria beat much faster than my ventricles and hence they are "tired" they aren't making a useful contribution to how my heart works. They are actually just quivering, this means that there is a possibility that blood could stagnate in them and clot. This is obviously a very dangerous situation as a clot could form and be pumped to anywhere, causing an embolism and possibly a stroke.

I was put on warfarin, an anticoagulant to reduce the risk of this happening, but being on warfarin is no fun. It means regular bloodtests to check that your INR is within the correct "therapeutic" limits. I was now terrified of cutting myself and bleeding to death. Not soon after starting on warfarin I had a terrific nosebleed... I phoned everyone I could think of to come take me to hospital, but nobody answered their phone... So I put my head back and let the blood run down the back of my throat and drove myself to the GSH emergency room. The casualty people were very unsympathetic... hehehe... they sat me in a corner and told me to wait, gunshot wounds and stabbing take preference to nose bleeds, why I can't the time someone had a chance to see to me, the nose bleed had stopped! They insisted I wait for the results of an INR test. So I needed cautery, if I remember correctly they cauterised both my nostrils, with silver nitrate... the effect of which was that I walked around varsity with very itchy black nostrils for the next week. I remember taking all this a sense of humour that I think sometimes took my friends by surprise, everynow and then I still crack a joke about heart attacks etc. Perhaps they'll post some replies to this effect.

Due to the warfarin and the strain alcohol can put on the heart I was also told not to drink... I think this was the hardest thing... not because I was dependent or because drunken jokes aren't as funny when you are sober. I think normal teetotallers have it easier than me, they can drink as much coke, water or whatever they like all night long. I have a limit on the amount of fluids I can drink so endless non-alcoholic drinks are out of the question... so the inevitable "where's your drink?" is always awkward as I'd prefer not to tell people I have just met "Oh I have a dialated CMO" and then field questions about my health all night long! But "No thank you" also doesn't work too well either, so it's always difficult. More recently I do drink moderately and try to be disciplined enough to nurse a drink for as long as possible.

While I was still at varsity I went to speak to the people at the Sports Science Institute just to ask them what they suggested I do, as it turns out they have a program for people like me... but usually much older than me... the Chronic Disease Risk Reduction and Reversal Programme... as a student, and a unique student, Prof Noakes allowed me to attend for some time, free of charge. I'm not sure how it happened but one of the bean counters got to know about it and I was asked to pay a reduced rate which was still prohinitive and so I stopped. After that I avoided exercise for some time... what happens when you faint from low blood pressure while exercising alone? I did subscribe to Virgin Active for some time, but did not find the environment appealing or motivating, seeing people who were so much more able than you doing things with such obvious ease is very frustrating. Then I read about Run Walk For Life, their program has been designed for people who have been sedentary for some years they start you off very slowly and increase your effort as your body gets used to it. It took me some time to gather up the courage to actually go join... and then they asked me to take a stress ECG, which was very expensive and the medical aid wouldn't pay, but I did it anyway and joined. I was at Bergvliet Run Walk For Life for about 18 months on and off. I had goals, I wanted to run the 2005 Gun Run 10km in under 1 hr... alas that didn't happen, I think I did it in 1hr11mins. But I finished.

After that circumstances changed and I decided I wanted to do the 2006 Argus Cycle Tour. So I concentrated more on cycling which I find much less intense than running. I trained with Romy a good friend, I finished in just over 5hrs, I was really pleased! After that circumstances prevented or discouraged me from concentrating on my exercise goals. I recently moved to Gauteng, to start a dream job. I joined the Brooklyn branch of Run Walk For Life, and am now writing this blog to make a commitment to my exercise goals.


Anonymous said...

I remember you finishing the gun run...and I'm really cross that you think 1hr11 wasn't as good as 1hr. The point is you were out there finishing 10km. And as far as i'm concerned those extra 11min were spent admiring the view!! Dee

Mark said...

Hehehe, thats a good one, I was ummm looking at the wonderful sea views :P

Janet said...

Hey Mark

First time I've had time to read some of this. Good for you for doing it, makes really interesting reading. Hope you are well.


Mark said...

Thanks for reading it Janet. I know there's a lot to read. I don't really expect people to read all of it, but it's nice to have a comment once in a while.