ICD Operation & Mental Health Recovery

Hogmanay is normally a time of celebration for families and friends across Scotland, however the bells that welcomed in 2017 rang with a little more trepidation for me.    Earlier that day I had endured/enjoyed a day out at the football with my 2 children watching Celtic come from behind to secure a 2-1 victory against city rival Rangers.   From my seat high in the Broomloan Road stand I had watched my team Celtic secure our first win at Ibrox for a few years.   The pulsating ninety minutes had left many in the 50000 strong crowd checking their heartbeat, but for me, the day brought me a new sensation & worry.


As I made my way to my seat at the very top of the away end at Ibrox, my heart was racing.    Was it the expectation of another Glasgow derby – or was my heart trying to tell me something? 


Shortly after I was born in 1978 I was diagnosed with a congenital heart defect called Tetralogy of Fallot (a combination of four abnormalities of the heart).    The condition meant that I needed 2 operations to help restore my oxygenated blood circulation when I was just 3 and 6 months old.  These procedures were followed up with 4 open heart surgeries (including 3 pulmonary valve replacements) when I was 3, 9, 19 & 31.    It’s fair to say that I am aware of just about every heartbeat.   However, the frenetic sensation in my chest was all very new to me & was very different to the increased heart rate when celebrating a winning goal.


As part of my aftercare with the Scottish adult  congenital service at the golden jubilee hospital I was able to discuss my symptoms with the nurse practitioners who arranged for a 24 hour tracing of my heart.   Unfortunately, no irregularities were identified during the review.    This was simply because my heart never raced out of control when it was being monitored.     Over the next 2 years I continued to feel the strong palpitations in my heart intermittently, until in late December 2018 I visited Glasgow Royal Infirmary after I had experienced a series of palpitations lasting well over 20 minutes.


On admission to the hospital I was diagnosed with non-sustained ventricular tachycardia symptoms.   These were no ordinary palpitations, this was serious and the condition had to be treated immediately.     I was given beta-blockers to treat my extra prominent heartbeat, however my specialist would not allow me to leave hospital until I had been fitted with an Implantable Cardioverter Defibrillator.    An ICD is a small device which can treat people with dangerously abnormal heart rhythms.    It sends electrical pulses to regulate abnormal heart rhythms, specifically those that can be dangerous and cause a cardiac arrest.   So, I had to spend Christmas in the hospital and was scheduled for surgery on Friday 28th December 2018, almost 2 years to the day since I first experienced the dangerous heart rhythms.


I was taken to the operating theatre for surgery early in the morning.   The device would be implanted under local anaesthetic and I would be awake during the entire procedure.   This was a particularly unsettling experience, however the surgeon and his team ensured I was comfortable throughout and kept me informed of the progress being made.   I was taken back to my ward to recover and have a bite to eat.    The device was tested to ensure the wires were in position correctly  and could regulate my heart if required.    This was a rather strange sensation feeling  a machine change my heartbeat.


With the operation a success I was discharged from hospital the following day, oddly enough just as Celtic were playing Rangers at Ibrox again for the traditional New Year fixture.   This time I was happy to be in my own home instead of the stadium.


Over the next 4 weeks I had to learn how to adjust physically to my new device, this included sleeping, stretching and getting dressed.    I also watched as the bruising & swelling dwindled during my recovery.     A little over 5 weeks after my operation I returned to work with the support of my employers, colleagues and family. 


I managed to overlook the warning signs that should have directed me to my GP to get my racing heartbeat checked for almost 2 years.    I made a similar mistake later in 2019 as I struggled to deal with the mental impact of the change in my heart condition.


As with all my previous heart operations my focus was on physical recovery, some simple exercises to help loosen the tightness around the reforming muscle and tissue surrounding my newly implanted cardioverter defibrillator.    I was fragile both physically and mentally.   This new stage in my desire to overcome the challenges I faced growing up with a serious heart defect left me questioning everything about myself.    However, I thought the best way to deal with it was to get back to being “me"; family life, work, Celtic  and squeezing in as much of everything else as I possibly could, including socialising, gigs and sporting events.

In reality my response to the operation had overlooked the importance of mending the mental wounds caused by the emergency surgery and the severity of the palpitations I had experienced for the previous couple of years.    I had not sensed denial, empathy or justification for the changes in my condition.    I just accepted it, but never really changed.    I kept going, and did not give adequate attention to healing the unspoken trauma.

During the 11 months after my ICD operation I increased my workload and activities in the office and at home.    The impact was crushing.   I completely lost interest in everything I enjoyed and live for.     Family time, football, Celtic, writing and even work - they all suffered.    I woke up on the morning  of the 10th December and broke down in tears, I had no idea why – I felt numb and I couldn't leave the house.   I took some time off from work hoping it would help, but my indifference only grew.

I tried to focus on healthy eating and some light exercise even some mindfulness techniques, but noticed my focus easily strayed.     I found it hard to speak and even harder to sleep.  I started to experience long spells of anxiety and began counselling sessions, arranged through my employer.   My GP prescribed antidepressants, but I drifted into a dark lonely depression.

I made an appointment with my nurse practitioner at the golden jubilee hospital.   Our discussion covered the last 12 months and more, but the focus was on my actions in the last fortnight.   I broke down as I shared details of my growing anxiety and depression, the images and thoughts that had left me paralysed with fear. 

The importance of speaking to someone became very clear to me.   I have follow up appointments with a clinical psychologist to discuss the next steps with me.   I know that there are no quick fixes and it will not be easy.     However, I also appreciate that mental well being is as crucial as physical health and I will be working hard to repair both.

The strength and patience shown by family and friends during this time has helped me open up and to say “I am not ok”.    I am still frightened, but I have taken the first steps in helping overcome my fears.