Irfan Essa’s Personal Weblog

Here is a brief personal update on some of my recent health related issues. If interested, please read on. (updated) It is not intended to be an inspirational story or anything like that. Just a story.

For the last many years, I have felt heart palpitations and usually felt shortness of breath. I had been diagnosed with a Mitral Valve Prolapse (about 15 years ago) so I did know that I had to be careful. As most know well, I am an avid squash/racquetball player, so I just used to stop play for a bit and continue when I felt better. Recently I was also starting to feel a bit dizzy. Shanila was trying to get me to schedule a visit with the Doctor for a while, which as most men do, I was procrastinating on. Then a friend visited from Boston, who had recently suffered a heart attach. This made me seriously consider a Doctor’s visit (relinquishing to Shanila’s insistence) and all I feared was a Doctor telling me I need to keep in better shape. A Cardiologist friend supporting her in wanting me to get tested added to the pressure.

Images from WebMD

A Doctor’s visit resulted in an EKG, which was abnormal, so I was referred for a Cardiology Consult. A Cardiologist decided to do an Echo Cardiogram, a Nuclear Stress Test and then a Cardiac MRI. After all these tests, it was I was diagnosed with a Hypertrophic Cardiomyopathy or HOCM or HCM, (webmd, Wikipedia, OR Cleveland Clinic have good descriptions). Which in essence implies a thicker heart wall than usual (normal is around 8mm., mine was 28+ mm.). It is an inherited illness, which means I get to blame my family and not my lack of exercise or unhealthy eating (whew!). Though, so far no one in my family has been diagnosed yet (My family members reading this, go to a Cardiologist soon!).

The MRI and the stress test also showed Cardiac Arrhythmia, specifically Ventricular Tachycardia. The reason was that the the thickened heart walls had internal scars which were causing these life threatening issues (could result in a cardiac arrest, which is different then a heart attack, primarily just very sudden!). I was then scheduled for a Cardiac catheterization (heart cath) aimed at seeing if any arteries were in trouble. The Doctor (an Interventional Cardiologist) doing this procedure said that all was clear and there were no blockages. For further testing, a Holter Monitor was then prescribed to measure heart EKG over 24 hours. The holter monitor did confirm the presence of Ventricular tachycardia. My cardiologist, who is very thorough was concerned with this and wanted for me to deal with this aggressively, including considering a Implantable Cardioverter-Defibrillator (ICD). He also prescribed medication generally called Beta Blockers to reduce the risks with HOCM. A Cardiologist specializing in Electrphysiology (EP) was brought into the discussion for a second opinion. An Event Monitor was added to tests, to measure my heart function over a period of 3 weeks. This is kind of an interesting device that allows you to note on a (touch display) handheld device when you feel an irregular heartbeat and it stores and then wireless transmits the data to a service, which then sends the data to the Doctors.

Medtronic Secura ICD (The one I have). Click to see more from Medtronic's site.

In the 2nd day of being on this monitor, the Doctors called saying they have seen all they wanted to see (in this case instances of  Ventricular Tachycardia) and they seriously recommended a implantable cardioverter-defibrillator (ICD) for me, which was scheduled for July 9. The installation was done by the EP Cardiologist in a procedure that lasted about 2 hours. I was back home after the procedure, being at the hospital from 7am – 5pm.

The date for the first cardiac test was June 1 and the ICD installation was on July 9. So quite a fast ride, especially as there were (luckily) no real life-threatening emergency events before or during this period. I was fearful that my Doctors would not let me travel to an attend CVPR 2009 in Miami (a conference I was one of the organizers, a co-chair of), but it was good that I was able to go there with my family as that allowed me time to think about all of this.

So as of today (Saturday, July 11, 2009), I have the implant and slowly recovering. It is quite impressive piece of computing (and you know me and my interest in gadgets!, unfortunately it is not networked (no email), and unfortunately for Shani, it does not have a remote for her). I need to continue to be on Beta Blockers and need to limit a lot of extensive physical stuff. And this device needs to be checked (interrogated)  on regular basis (and data acquired) and adjusted as needed.

Support of family/friends in this period has been amazing and now I have learned a lot about heart and healthcare (so beware!). Shanila has been rock solid through all of this and it was through her strength and support that I have been able to get to this stage. My boys have been amazing throughout this too.  They know everything about it. I have shown them videos and pictures of procedures from the Internet.  They kinda are curious, if I am bionic or a cyborg.

I am not mentioning any other names here (but will be happy to in person), but my Cardiologist was absolutely amazing. He was aggressive in how he wanted us to deal with this situation and was a great guide. It is also important to mention that he is also a close and personal friend and he was very good at identifying and working with other experts as needed. In addition to him, all other Doctors and the rest of the medical staff was amazing. I will admit, being in hospitals is NO fun, but the people there are truly dedicated. So my hats off to them. Thanks also to folks who I work for (ie. those who are responsible for paying me) and I work with (my colleagues/collaborators), for their understanding and flexibility during these days. Amazingly (so far) my insurance company was pretty efficient through all of this too.

ICD Implant (from ClevelandClinic.org)

Finally, with this recent (firmware) upgrade, I am irfan v1.1 Will keep everyone posted as to how things progress. I would he happy to discuss this all with anyone in more detail as needed. If you want the picture of the device on me, I can send you that too (here is one, be warned!). I am also learning there is a lot of information (and opinions) about devices like this on the Internet.  I understand that now I have a ZAPPER and belong to a very special club.

So, why I am writing this story?  As it is not intended to be inspirational, etc. Well, there is a moral, besides the usual of “listen to your partners,” etc., (which one should).  And that is don’t be MACHO and claim to be impervious, as none of is made of steel. If you feel some health issues coming about, talk to someone, preferably a Doctor and be clear what the issues are.  I think I did and now at-least I have taken all the precautions to deter from a worse case scenario.