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6/ Body blow...


I arrived at the hospital mentally prepared and full of optimism. I felt empowered and proud knowing my experiences and challenges of the past six years hadn't broken me. I'd been denied of any physical control of what was happening inside my body but I was still the boss when it came to my mental state. I sat in the driving seat and was sanguine.

As the procedure was planned, the insurance had secured me my own side room in addition to the equipment downstairs that was to finally relinquish the grip the SVT had over me.

After a shower with the surgical wash, I adorned the now familiar hospital gown and was taken down to the theatre, a now familiar well trodden route. I felt like a true veteran, the once surprising low temperature of the theatre now expected. The firmness of the theatre operating table, the arm supports all now bearing no novelty at all. The gown was moved up to expose my groin. All the surgical sheets were set in place and the warmth of the iodine came as a welcome contrast to the coldness of the room. The doctor arrived at his usual spot and was all prepared to make the small incision, adding to the existing scars of the previous failed attempts.

"Doctor, may I have a quick word?" enquired the lab technician, hidden from view behind all the monitors and screens. The Doc stepped away and disappeared towards the direction of the voice. A few minutes passed before the doctor reemerged, this time on an alternative trajectory. He approached me to speak to the lesser familiar end.

"I'm very sorry Nick, it appears a piece of the equipment from America is broken. We'll have to see if we can get a replacement flown over urgently and it is my intention to the defer until tomorrow"

Despite my obvious disappointment, I chuckled to myself. I really had earned the tag "Lucky". Friends and I had often joked if something was going to go wrong, it would go wrong for me. If something was 98% a sure thing, I would be the 2%. I applied my newly honed sense of optimism. "So what, what difference does one more day make? It's no big deal". I was returned to my room but I did think it was highly unlikely that they would be able to get an expensive piece of medical equipment over from Baltimore in time for the next morning.

The following morning arrived and to my genuine surprise, it brought with it the replacement equipment. Yesterday's procedures were reenacted, but this time to fruition.

The operation went very smoothly with no surprises this time. The super strength adhesive tourniquet had to go without its meal of hair. It wasn't catching me out, I shaved my thigh to make sure! The sign of a seasoned veteran.

My rhythm seemed good but the usual bit of popping and banging was present again. Hopefully this time, after a few weeks they will fade away for good as my heart healed. The medication remained as a safety net hopefully keep the worst arrhythmias from occurring. The weeks passed and the rhythm improved to tolerable levels. I started to cautiously gain satisfaction that thankfully 1998 was the point I could finally draw a line under a very challenging six years. I was convinced the remaining "chatter", as I refer to it, would just dissipate over time.

Life started to move in the right direction finally. I scoured the paper for jobs, eager to get earning properly and start catching up from the time lost. I got a job after my first application, to run the bar in the local leisure centre, The Heights. Not exactly what I wanted to do but it was a job, I gratefully accepted their offer. It was perfect to set me up whilst I looked for something else I could make a career from.

On my first day I was greeted by a duty manager named Nolan who was to take me through a very informal induction. He instantly made me feel welcome, he was gregarious with a wicked sense of humour. We were both the same age and just got on straight away. The rest of the staff were lovely too and I slotted straight in instantly, loving being around people partaking in exercise and of a similar mindset to myself. The job role was simple and mundane but the people made up for it tenfold, it was akin to a very large family having a good time rather than a regimented place of work.

My mountain biking became more regular and I was loving the freedom of riding without the associated fear of an attack. My new regular salary enabled me to buy my first car that was totally mine. Nothing flash, just a good condition, low mileage Vauxhall Nova in burgundy. This whole experience really had made me old beyond my years! Nolan by contrast had the most flamboyant, bright yellow, Ford Fiesta. It matched his personality perfectly. It was 1999 and thoughts were starting to turn towards the millennium, I was going to ensure it was a party to remember.

I was still having regular check ups at the hospital and the Consultant was monitoring the remaining rhythm disturbances. He wasn't totally satisfied that things were fully dealt with. He scrutinised over reams and reams of ECG printouts and lab results. My notes now came in huge volumes, I think we were onto volume 3 by this stage.

"I'm beginning to doubt your initial diagnosis of SVT. I'm thinking you may well have Arrhythmogenic Right Ventricular Dysplasia."

"Arrhythmo.........., what?! What's that?"

"ARVD for short. It is a condition where the proteins that hold the cardiac cells together don't form properly. The cells become detached and your body attempts to repair the damage leading to the accumulation of fatty deposits in the heart tissue. It is a progressive disease that can lead to arrhythmic complications and possible sudden cardiac death"

Sudden death?! I'd often wondered how much my heart could take and now he confirmed it. It could just stop, like that, no notice period served on my end of days. It was one thing listening to the voice of my conscious pondering, it was quite something else sitting across a desk hearing the words come from the Consultant.

"The arrhythmia you are still experiencing are likely to get worse and I suggest we take an alternative approach to correct them. I'd like to perform a surgical right ventricular disarticulation. Imagine a skin graft, it's similar. We will cut around the outside of the right ventricle then remove the outer layer. It will in effect sever the nerve connections, making the arrhythmia impossible, it will then be stitched back on"

"Is this feasible via catheter, like the ablations?" I enquired

"Unfortunately not. It will require a full sternotomy" he indicated, drawing a line with his finger down the front of his chest.

"The operation will reduce the efficiency of your right ventricle so your left ventricle will have work harder to make up for the shortfall. It will however potentially eliminate your arrhythmia and you can resume a full normal life"

Shit! The seriousness of my condition had just stepped up significantly. I didn't know what to make of it all. Total shock. Have my chest cut in half and wound right open? That's grim. How long would it take me to recover? Would I recover? We are basically introducing heart failure to correct the arrhythmia. Placing faith in my consultant, I reluctantly agreed for the operation to be scheduled in.

The 19th May 1999 came around quickly. I was admitted to the hospital for my operation to be performed the following day. I settled into my side room quickly and got myself organised. When bed time arrived, I went to the bathroom to clean my teeth. I glanced at my reflection staring back at me and it called me to stop, to just observe for a moment. My chest, free from any scars would never look like this again. After tomorrow I will wear the scar of that day for the rest of my life, a constant reminder. These are the last few hours I will ever look like this. I visualised where they would make the incision, it was going to be huge. I could sense the anxiety and fear starting to build. I studied my reflection intensely for a while. I realised the image staring back didn't look like me, I barely recognised this kid at all. I'd spent so many years living deep within my conscious, rationalising, building resources, strength and robustness. This kid looked fragile, his image didn't match the image I had of myself at all. My mind told me I was strong and resilient, the reflection told me the opposite. I realised I had to make a choice, who do I need to be? The image from my mind or the image from the mirror. The anxiety and the fear was coming from the scared reflection, he was the one having doubts. I decided I couldn't have doubts, not now. "You CAN do this!". The reflection nodded in compliance.

The morning of the 20th May arrived along with a doctor and the consent form. He went through the exhaustive list of risks of the operation. I enquired if the operation was a common operation. "It's been performed once before at this hospital".

Oh right, so not common at all then.

"How did it go for the previous patient?" I enquired.

"If you could just sign here please" he replied, pointing to the dotted line.

Marvellous, very encouraging! I signed, thinking it's probably best not knowing.

I prepared for surgery. Body shaved, Hibiscrub showered and once again rocking the NHS gown. Totally prepared, all ready for the pre-med and to make my way to theatre. Mum and Paul will be here soon too. Everything is in place. Wait! No! I'd neglected to let James know I was having the operation. I'd already made contact with all my Island based friends in the lead up to the operation, but in the whirlwind I'd neglected to let James know. Should anything go wrong, I'd hate him to think I didn't value our friendship enough to even call him to let him know. I grabbed for the phone and hastily dialled his number.

"You what?! Right now?" came James' response after I'd elaborated on my opening "Hi mate, guess what I'm doing today!" . We chatted for a couple of minutes and agreed to catch up properly during my recuperation. He and Mary were likely to be visiting home fairly soon so we agreed we should meet up at a pub somewhere.

"I can't believe you are about to go to theatre and you are phoning me!".

James wished me luck.

Mum, Paul and the pre-med all arrived on time. The pre-med provided some last minute entertainment as I kept sticking my shaved leg out of the bed, enquiring if people wanted to stroke it. I mused at how I might keep it that way, much to Paul's amusement.

The trolley duly arrived at the door to my room with the two porters. I was unceremoniously dragged across from my bed onto the trolley. I was convinced my super hair free legs could propel me across the room onto it, but I guess the porters weren't as sure. We headed off towards the theatre, Mum and Paul in close pursuit. We arrived at the point of no further access for relatives. Mum gave me a kiss and was naturally visibly upset. "I'll be OK, don't worry". Paul leaned in "Good luck Bro, I'll see you soon". I turned to Paul and made him a request;

"Please look after Mum".

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