Health Update: Ventricular Tachycardia Ablation

SUP

As 2014 comes to a close I want to reflect on what the year has meant to me and give you a further health update.

I started the year on a high note, with lots of high demand research to carry out on scaling up high growth companies, corporate innovation and tracking various trends in emerging technologies. I was rearing to go and ready for a solid calendar of international travel when bam, out of the blue, I hit the ground. I hit it literally and I hit it hard.

I’d suffered a major sudden cardiac arrest, or what is more dramatically known as sudden cardiac death because only 5% of people who have such an attack survive. I was very fortunate to make it through this incident and a subsequent mini stroke. You can read the full narrative of my experience here.

After a few weeks in various intensive care units I left the hospital in March and began a regime of various medications. These medications are designed to firstly keep my blood thin enough to prevent clots and hence reduce the likelihood of another stroke and secondly to temper the excitement of my heart and reduce the number of incidences of ventricular tachycardia I was having. This second medication is called a beta blocker. I was told then that ideally the medication will be sufficient to keep my heart in check, but if not we would need to explore a further operation. At the time I remember wincing, as the thought of another bout in hospital was very hard to contemplate.

Over the ensuing months I tried to return as much as possible to a normal regime of work, exercise and spending time with family. It felt to me like there had been minimal VT activity. However, in mid May my doctors interrogated my device and at that point I’d had 62 episodes of VT that needed ICD pacing. This was a bit of a surprise to me.

My doctors wanted me close so they could monitor me and I was grounded from any air travel. I was able to write, run a few workshops and events and conduct numerous calls with clients all over the world. The distance I was walking started to increase as my strength grew and I was able to increase the frequency of time spend on the water, stand up paddling.

But as June rolled around things began to change. I kept a diary of increasingly frequent incidents at the time. The biggest impact was having to leave a school dinner/dance evening literally as we arrived. I’d begun to feel lightheaded and my ICD kicked in to pace my heart back into rhythm. I also went to hospital emergency on one occasion when I had a continuous run of VTs for a few hours.

I’d started out on a relatively low dosage of the beta blocker with the strategy of exploring the optimal range. At the end of July my medication level was raised for a second time. This was to counter the increased level of activity I was experiencing.

Mid-August I had a second device interrogation. I remember going into the session feeling really upbeat. I fully expected to have my travel restrictions lifted. The results floored me and dashed my expectations of getting on an aeroplane any time soon. Over a 3 month period I’d had a staggering 1,625 VT incidences, of which 99 had needed the ICD to intervene and provide pacing therapy. Not only was the level increasing, but this was well above the norm. The possibility of another operation was again raised at this point. While I wasn’t too keen on the thought I was starting to think this may be a good idea. The VTs were leaving me more and more exhausted.

At this point I pared back my exercise regime to mainly only doing yoga and the occasional walk. Yoga proved to be a great help though, both for stretching out my muscles and for calming the mind and giving me increased focus.

As the months passed I began to have increasing VT runs an hour or so before dinner time. I love cooking and it became almost impossible to make dinner without having to have the rest of the family take over.

My beta blocker dosage was again increased and I was now on the highest dosage. I felt completely drained. Between the VTs and the medication I was struggling to even walk from one side of the house to the other. I had to pull out of delivering a number of talks and workshops at a large company event.

With the end of the year approaching fast, my doctors kicked into action and I was referred to a specialist in VT ablations. I was fast tracked for an operation in a fortnight – the first week of December.

The operation would be performed via catheters which would firstly map out the VT circuits (the electrical activity) and then once isolated these would be ablated (zapped) at source. It’s a tricky operation complicated by the fact that I am on blood thinners and prone to having strokes.

Ideally, the doctors want to see VT activity taking place while they are mapping so they can more accurately determine where the circuits are eventuating from. This means that the patient must come off their medication and undergo VT events.

Given the number of events I was having it was prudently decided that I go off my medication in hospital rather than at home. I was totally off all medication for 36 hours and this was one of the hardest things I had to endure this year, if not ever. I was in almost constant VT that whole time and I estimate, conservatively, that during those 36 hours I had over 2,000 ICD-treatable VT episodes. Just one of them makes you feel like you have run a marathon. Many times I thought I’d pass out as attacks can reduce blood flow to the brain, but I didn’t lose consciousness once. Going to the bathroom, having a shower, things we normally take for granted, felt like massive challenges.

Eventually the morning of the operation arrived. I could not walk by this point and was wheeled into the operating theatre on my bed. I won’t go into the details, but it was a marathon 4.5 hour operation. The good news is that they were able to find where the VTs were originating on my right ventricle (the easier one to get to via catheter) and they well and truly ablated these misfirings. They did note that there is some activity on the left ventricle but this would have taken another 2 hours to map and the window of opportunity closed.

I’ve been home for a day now and I’m recuperating well. I haven’t had any VT activity to cause concern. If the level of activity remains low, then I hope to reduce my beta blockers to a lower level and get back into the swing of things in 2015 in a big way. Yes, there is always the possibility I’ll need to go for another procedure to tackle my left ventricle, but this may not eventuate.

In the meantime, doctors are making strides to be able to conduct such a procedure using much less invasive techniques that have extremely high accuracy. I certainly intend to keep a very close eye on these advances.

To all my friends, family, work colleagues and the doctors and hospital staff who have looked after me I thank you so so much for your support and I wish you only the best for 2015.

[The photo was shot on a paddling session with my son Tyler, on the creek at Bobbin Head, Sydney]

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Drone Defibrillators: Reducing the impact of sudden cardiac arrest

In February I suffered a sudden cardiac arrest. I was very fortunate in that I remained conscious and did not need to be defribrillated. This is very rare.

The stats for people surviving such an attack are low – 5% in most countries and usually they survive because help was nearby.

But the odds are stacked against survival. Not many places have defibrillators on hand or people who recognize the symptoms and take immediate action.

Take, for example, someone I spoke with this week. He had been riding his bike in the Bay area when he suddenly collapsed. One of the first people to come across him happened to be a cardiologist and as soon as a defib could be sourced he brought him back to consciousness.

When I hear of measures being taken to increase the odds of survival I’m excited. 350,000 people in the US suffer a sudden cardiac attack each year – any technology that increases their chances of survival has my vote.

This video shows a prototype Ambulance Drone that delivers a portable defbrillator and can be operated remotely by a trained health professional:

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Achieving Flow In The Face of Near Death: My Recent Experience

Flow

I had one of those major mind focusing events over the past three weeks.

I collapsed on the evening of Sunday, 16th February for 15 seconds and then went into an extraordinary conscious ventricular tachycardia at 200 bpm. The ambulance crew were astounded that I was conscious. The trick was flow – I’ve been a proponent since my youth when I was an elite athlete and serious surfer. I managed to pull myself into the zone and maintained this on the journey to the hospital. En route a code 3 had been called and I was greeted at Royal North Shore Emergency by a crack team of 15 doctors. I was still at 170 bpm and they were literally just about to stop my heart and try to shock me out of the tachycardia, when to their amazement I self reverted down to 70 bpm. I’d like to say it was flow again, but my humility refuses and I dare not say I purposefully did that all myself.

I was very lucky. This conscious VT event took place at home and my quick thinking family called 000 immediately. That morning I’d done a stand up paddling training session alone and in the dark, with no safety devices. And the next morning I was scheduled to fly to New Zealand on business. If this event had happened in the air or out on the water I’d very likely not be having this dialogue.

After a series of extensive tests, the specialists determined the best course of action for me would be the insertion of an implantable cardioverter defribrillator. The plumbing of my heart reflected my super fit status, but for some reason the electrics were out of whack.

I had the device installed on Thursday, and on Friday afternoon I walked out of intensive care for the first time in a week and into a private room for recuperation. I felt like a new man, but this feeling was shortlived. Unfortunately a clot had developed and within fifteen minutes my speech slurred and I lost all feeling on my right hand side. Again I was very lucky, as my wife noticed the signs of a stroke immediately and called the medical staff who jumped into action. It was a very scary feeling and not one I’d like to repeat. Within about 20 minutes I began to get feeling back, again to the amazement and relief of the medical staff and my family. I’d had a mini stroke or transient ischemic attack and the clot had moved through my brain.

I again found myself in Emergency and it was established that while I had about 85% recovered from the stroke there was still a strong possibility of further clots. I was given a thrombolysis – a very powerful procedure that reversed all effects of the stroke and broke up any other clots. This was a very intense six hours as there was the possibility of a haematoma developing on the brain.

I made it through that phase, but a haematoma did develop around my defib wound site. I spent another week in intensive care and returned home on Saturday 1st March. The haematoma developed some complications and a week later I was operated on to drain the site – the fear being infection. I remained in hospital on intravenous antibiotics and was discharged on Monday, 10th March.

All through this experience I was thinking about flow, performance and optimizing human development, aided in part by reading Steven Kotler’s book, The Rise of the SuperMan.

Commenting on my experience, Steve says, “It  did seem like you’ve moved through fight or flight and into flow – a very difficult thing to do, so you have some mad skills!”

This whole episode has got me really thinking hard about what I do with my life once I’ve recuperated. I know I have been given a gift, a second chance, and I also know that I’ve adopted a new mantra, GO BIG.

I’m still working this all through, processing and thinking about what I do next. I’m going to have some interesting conversations over the coming weeks.

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Intelligent Agents: Coaching For Health & Wellness

I was recently featured in the following video about the use of intelligent agents as coaches for health and wellness. It’s an area of much interest to me as I firmly believe that such technologies can assist with reversing the current obesity pandemic:

 

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Health & Wellness: Delivering Good Feeling

Yesterday I was well onto my way to clocking up 40 kilometres of barefoot running in 3 days and was really feeling buzzed.

Fortuitously Flo Rida’s Good Feeling popped up on the video screen I was tuned into. It so resonated I had to share it.

Besides featuring two of my favourite past times – running and stand up paddle boarding – it totally captures the way optimised health and wellness makes you feel

Watch. Enjoy. Get Out There!

 

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What is the secret to health and wellness? How can you lose weight and keep it off?

What is the secret to health and wellness? How can you lose weight quickly and keep it off?

These two relatively simple questions have kept many a man and woman in a state of quandary for aeons. They have been so hard to answer for so many that fortunes have been made off the back of them. Indeed, if you look around you I can guarantee that you will see a preponderance of unhappy, obese to morbidly obese people within shouting distance of you.

And shout is what I want to do. I want to shout out loud that it’s easy!

Weight loss and the subsequent exponential boost in energy and focus that comes with it is so easily attainable that no-one should be overweight.

And the overall sense of well being that flows from achieving optimal health is so incredible that it is totally beyond me that anyone would not want to get their body into trim!!!

Yet here we are. Surrounded by a pandemic of obesity. Fast food is pervasive, as is a societal bias towards overeating to celebrate good times or cope with loneliness.

How can you break out of this cycle?

You know the one I mean. You’ve out on an extra 10 kilograms, you want to exercise, but your inbox is constantly calling, you feel lethargic and frustrated. After a long day in the office the last thing you want to do is go for a run or, heaven forbid, squeeze into your lycras and front up at the local gym. It’s a microwave meal, glass of red and some ‘reality TV’ to cleanse you of the day and get you to the point where you can bear to tackle your inbox for another hour or two before heading to bed.

Once in bed, the situation doesn’t improve. Overtired, you struggle to fall asleep. No sooner do you doze off and you are woken up: by your own snoring. This cycle continues all night until your a alarm wakes you up in the morning. But you feel terrible. You feel cheated, as if you haven’t slept a wink and someone fast forwarded time to the morning.

You head off to work feeling exhausted and wondering how you will get through the day. Best you have an extra strong coffee at work. Once in the office you spend the day flitting between tasks, finding it difficult to concentrate on any one thing for too long before you concentration wavers. Focus is not your strong point.

Sound familiar?

It does to me. I lived this for the past decade. Back in 2002 I was in a similar position. I was overweight and felt like shit. The benefit was I had an opportunity to rethink: I’d been retrenched and had time on my hands.

I decided to tackle my weight problem and lost 16 kilograms in 6 weeks following a diet called the Fat Flush Plan. I felt great. Superb in fact. My energy levels rose, I achieved maximum focus.

I used this new found lease on life to orchestrate an aggressive takeover of the company that had retrenched me and took on the CEO role.

But this wasn’t sustainable. Soon I found myself in high stress situations multiple times a day. The diet I’d been on required a lot of time preparing food and I was now extremely time poor. I started returning to old habits: lots of carbs, little exercise.

Over the course of the next decade I put on the weight I’d lost and even gained a few more kilos. I was frustrated. I remembered how I’d felt when I was slimmer.

It’s not like a lay around like a sloth. I was mountain biking on weekends. Two years ago after a stopoff in Hawaii during my Australia-US commute I discovered stand up paddle surfing and dived into this. But the killers remained : stress, a sedentary workstyle and a diet full of carbs (I loved making pasta and pizza) and minimal exercise during the working week.

Mid 2011 I decided to try and turn things around. I joined the gym at The University of Sydney and so began my journey back to wellness. I would be in the gym three days a week for an hour or so. My usual routine involved a 4 or 5 km run on the treadmill: run 800m, walk 200m, followed by 10km on an exercise bike and 1 km on a rowing machine and a few light weights.

The thing is this did nothing for my weight. Sure I felt a little better and it probably helped a bit keeping me in tone for my weekend stand up paddle sessions, but my running was real tough going. It felt like I had a dead buffalo tied around my waist that I was trying to drag around. In reality that is exactly what I did have. Have you ever picked up a 15 kilo weight and really felt how heavy it is. That’s what I was packing.

After a visit to a naturopath I decided to give up caffeine. I found that when I stopped it for even 24 hours I’d have bad withdrawal symptoms. This was a pointer that my body didn’t process caffeine too well. Stopping was really tough. I felt nauseous and had a splitting headache for four days. However, I did feel much better after the withdrawal symptoms subsided. I didn’t want to go through that again!

In late November I took a few days off and went to Singapore. I had a great time staying at the Marina Bay Sands, which has a range of awesome restaurants in walking distance. Not to mention all the other delights of this fine city.

It was only on my last day that I made a tour of the hotel’s gym facilities – for like five minutes. I began to feel really bad. Essentially I’d squandered a real opportunity to exercise flat out for five days.

By the time I returned to Sydney I felt awful. I was bloated and I hadn’t done any exercise of note for a week. Stupidly I pushed myself hard in the gym for two days. Something was going to break and by the third day I could feel an ache developing in my right shoulder that arched up into my neck. At first I thought this was simply stiffness from the exercise and that it would ease. It did the opposite. The intensity of the pain grew to such a point where I had to seek help.

I first thought a massage would help, but if anything it simply intensified the pain further. Feeling like I had a knife in my shoulderblade I turned to physio. This helped to ease the pain, but it soon returned. I’d never tried acupuncture, but my wife had a painful ligament fixed by it a few years ago. I was ready to try anything and thought I’d give it a go.

The hard part was finding a reputable needle sticker. The first lady I saw relieved the pain for a day or two, but it soon came back. I also wasn’t comfortable with her set up – she seemed to operate from a range of venues and her operation felt tacky.

December arrived and I’d arranged a session with the naturopath ages ago. By now I’d made up my mind. I wanted to go on the diet. The fact that Xmas madness was only a few weeks ago did not deter me. Instead it spurred me on. I did not want to think about how I’d feel after a few Xmas parties, dinners and lunches.

My naturopath Sheena was surprised at my decision. She had not seen it coming, but credit to her she was ready to let me dive in.

I started the very next day. The first two days are about eating as much fatty food as possible so as to line your organs and protect them from the shock that soon follows. It turned out that on the second day I had a lunch planned with some patent attorneys. We had a great meal in an Italian restaurant – loads of carbs washed down with plenty of red wine and even a shot of grappa. By now though I was already starting to lose my appetite and left the restaurant feeling elated, knowing that it was the last time I’d be eating like that for while.

Besides the strict regimen of the diet I was also taking some special drops three times a day. There were some logistics to deal with given that mobile phones and computers could deactivate the drops, but I worked out a routine pretty quickly. I stored the drops in a cupboard in our common room in the office, with a note saying they were mine, in case someone else came across them and wondered what they were. I had a second bottle stored in the downstairs bathroom at home.

Even though I’d started the diet and was soon into the restricted calorie part, the pain in my neck and shoulder had not gone away. In fact it had intensified over the course of a fortnight and I was in agony.

It was Saturday morning and I had to be driven around. Going over speed bumps was total agony. I was supposed to be hosting a dinner that evening and boy did I need help! I was adamant that I wasn’t going to take pain killers. I knew how important an optimized liver was to weight loss and felt they would set me back and counteract the diet. Not to mention that I hated the woozy feeling they brought on.

I found an acupuncturist in Gordon and he could fit me in at 2pm that afternoon. I arrived skeptically, but desperate for some relief from the pain. I was in luck – this guy really knew his stuff.

A few hours later I was hosting the party pain free. In fact, the next morning I even felt strong enough to go for an hour long stand up paddle session on Pittwater. Admittedly I did take it easy on the paddle, but together with the added energy I was getting from the diet I was soon on a high. I felt so good.

I’d initially planned to return to the acupuncturist a few days later. However the pain had totally dissipated and I cancelled the appointment.

I could now concentrate totally on the diet and optimizing my health. The first week or so of restricting my calorie intake to 500 a day was a bit of a shock to the system. It was analogous to being in a foreign city with really bad jetlag – my body was still getting used to it. That said I could feel the kilograms of excess weight falling off, my energy levels rising and my focus sharpening.

I had no qualms about doing the diet. Xmas party season arrived and I successfully navigated through by drinking lots of water and staying away from the inevitable snacks that circulated.

By Xmas day I had already lost 10 kilograms. We were hosting a big family lunch and I was determined to stay the course with the diet. One trick I’d picked up was that humor was a great food/drink deflector.

For example at one cocktail party I was attending someone asked me what was in my glass, water?

I replied, “Of course not, it’s pure vodka!”

We both knew this wasn’t true, but it allowed the conversation to move on and not get stuck with me being seen as a party pooper.

So on Xmas day I found a set of 10kg barbells I had lying around and handed one to my sister. She had recently also lost 10 kilograms. I quipped that to remind us of our recent weight loss and ensure we didn’t stray, we would have to each carry one of the barbells around all day.

This was met with much laughter.

Of course we didn’t do anything as ludicrous as carry the barbells around, but the humor deflected any further conversation about what I did or did not eat or drink all Xmas day.

Before I knew it the first three weeks were drawing to an end. To celebrate I decided to buy myself a pair of Vibram 5fingers running shoes and get back into running.

Many years back, when we lived in Cape Town, I’d run a few half marathons and really enjoyed the feeling of a solid run. I had run in a pair of Nike Free shoes a few years back, so I was not a total stranger to barefoot running. However, this was in an era before barefoot running started getting a cult-like following and back then I didn’t think of heel striking or shifting my style of running.

And so, when the Vibram info sheet said to take it real slow the first month…I did the exact opposite. As the new year started I shifted to the high protein phase of my diet. This totally increased my energy levels exponentially. I translated this new found energy into my running and by the end of the first week I had run about 42 kilometers. This is the length of a full marathon and it felt like a good weekly target.

Things were going swimmingly as I reached the end of the diet. I’d lost 15 kilograms in 6 weeks, reduced my blood pressure and increased my energy and focus massively.

However, as I transitioned from the diet onto a balanced nutritional plan I was floored with an injury. My left foot began hurting one morning on a run and the pain would not go away. Tendonitis had struck.

The only cure is rest. I found it extremely frustrating not being able to run and every time I thought it was better enough to get back out there it would seize up again and I was back at square one. I did some lap swimming and slow walking on the tread mill and within a few weeks it receded.

The good thing about this phase and of the injury  is that it forced me to really be ultra conscious of what I ate as I moved off the diet. I found that my nutritional plan mapped very closely to what I had been eating on the high protein phase. I avoided carbohydrates like potatoes, white rice and stayed away from sugars as much as possible.

In fact, the really good news is that my weight continued to drop a few bars and I was able to reach my target weight comfortably.

Fast forward to early April and today – Easter Monday. My weight has stabilized at its optimal setting, I am still following a strict nutritional plan and loving it. I managed my longest run this morning of just over 2 hours and feel fantastic.

I’m keep to help others achieve this level of health and wellness and I’m thinking through how best to do that. For example I did notice how clunky it was recording my food intake, exercise and weight in different apps, getting inspiration from a range of disparate sources and not being connected to others in a similar situation. Yes, there are some great tools around like SuperBetter, Fitocracy, Pinterest et al, but I kinda think something’s missing.

I hope this post, even though it is a bit long, inspires others to consider optimising their health!

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