24 February 2013
n Do get your blood pressure checked and follow your doctor?s advice.
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? Do cut down on salt. Too much can raise your blood pressure, leading to an increased risk of heart disease and stroke.
? Do be a healthy weight. Carrying extra weight puts pressure on your heart and is a risk for heart attack.
? Do watch your cholesterol. High cholesterol levels can clog up the arteries and lead to heart attack or stroke.
? Do exercise for at least 30 minutes, five days a week. Physical inactivity can increase your risk of heart disease by 20 per cent.
DoN?T:
? Don?t smoke. Smoking is a major risk for heart attack and stroke.
? Don?t drink too much booze. Men should have no more than the recommended maximum of 17 standard drinks per week (one standard drink is equal to half a pint of lager or a small glass of wine).
? Don?t forget about family. The risk factors for heart disease can be inherited, so check your family history.
? Don?t stress. Stress can contribute to heart problems and poor lifestyle. Take time out to destress.
? Don?t delay. Call 999 at the first sign of heart attack.
?I had my first birthday last year. This year, I?ll be two,? says David Berber plainly. The 56-year-old former lecturer is speaking in the considered tones that would have defined his career, and the strange statement is backed with adamantine logic. ?My family changed my birthday to the date of my transplant because I?d be dead without it. It?s a great thing to celebrate, so why not??
Much of what Berber says this morning in his quiet Rathfarnham home follows this pattern; optimism and reasoning borne out of the trauma of near-death. ?Dying was easy for me,? he?ll say at one point about his nine months in the Mater Hospital?s Coronary Care Unit, his health spiralling away, his muscles disintegrating and his heart counting down as he awaited a transplant.
Since the first Irish heart transplant in 1985, hundreds have availed themselves of the procedure. We hear anecdotes about this unimaginable operation. We may even know someone whose life has been extended by what Berber calls ?six hours of plumbing and tying of laces?. It is rare, however, to encounter someone with the faculties and courage to impart the gruesome lead-up to it and the trouble-strewn recovery (?the real battle?).
In December 2009, Berber was due to go on holidays with his teenage daughter. He?d been feeling lethargic for a while, and had breathing difficulties. Two days before leaving, his wife Jackie insisted he get checked out. A cardiac efficiency test prompted a red alert and he was immediately referred to Tallaght Hospital.
If an optimist is someone who just doesn?t understand the gravity of the situation, then Berber was optimistic.
?I thought I had asthma,? he says. ?But they listened to my chest and said there?s nothing wrong with your breathing. An hour later, they diagnosed me with heart failure.?
He feels he should have known. Berber?s father died at 59. Being Jewish, no post-mortem examination was carried out, but the suspicion was heart failure or heart disease. His grandfather also died young, with breathing difficulties and heart problems. Although she had rheumatoid arthritis, it was also heart failure that ended his mother?s life.
Before all this, there weren?t enough hours in the day. He paints a picture of a ?spoiled, selfish kid? worshipped by his doting mother in a typical Jewish upbringing.
By 25, he?d snapped out of it, throwing himself into a career in academia and marrying at 36. He was a passionate sailor and bridge player. Often, he?d cycle to DIT for a satisfying day of research work, lecturing and private consultancy, then cycle out to Dun Laoghaire to sail, before cycling home.
?At 45, I was at my mental and physical peak,? he says.
Medication allowed him to return to work after the diagnosis of heart failure, but the effects of diuretics on his kidneys had him in and out of hospital. His pills were tweaked as his heart efficiency deteriorated slowly. ?As you get worse, it?s a psychological battle to live a normal life. Then it got to the stage where I could either work or play. Not both.?
Gradually, the car replaced the bicycle and Berber had to drop out of a long-held aspiration to compete in the National Sailing Championships. Soon, going upstairs was hard. Then walking itself.
He believes it was August 2010 when he reached the limit of what he could do with a heart.
?Every time your heart beats, you pump a certain amount of blood. A really fit person will pump around 75 per cent. It?s like a rag,? he explains, wringing his two fists, one on top of the other. ?The upper and lower chambers twist the blood out which pushes it around your body. Those twisting muscles went on me. I got to about 20 per cent.? At this point, a transplant wasn?t considered. Instead, Berber was brought into the Mater for assessment, two weeks ahead of a valve operation. The rate of his fall-off was now increasing and hospital afforded him too much time to think.
?I?d be up all night. I was nervous and angry. I saw myself as David the lecturer, the sailor, the bridge player; I didn?t want to see myself as David the dying person. You have an identity for yourself and suddenly this new identity is plopped on you. You get fantastic psychotherapy before the transplant and none after, which I?m a bit annoyed about.?
The morning of the operation, the doctors reassessed the likelihood of success and the valve job was scrapped. He remained in hospital ?limbo? for another month while doctors vetted him medically and psychologically for a transplant.
He went on the waiting list for a new heart, and the ?psychological warfare? really began. He accepted that diminishing blood pressure would cause his organs to fail and that he was technically dying.
What really troubled him, though, was the waiting.
?I had a very bad night one night,? he remembers, ?and a nurse said to me: ?David, you?re probably not going to live too long unless you get a transplant. But how would you like to spend your last few months? Being angry and bitter, or enjoying it? Think about that. We?re doing our best here.?
?I stayed awake the whole night thinking about that. After, I tried to treat every day like a good day.?
By October 2010, a balloon pump was fitted to assist his heart beat. The pump became infected on five occasions, leading to septicaemia and a fever that he describes as ?horrendously painful on the way up, but deliriously fine at maximum temperature?. Before Christmas, he then suffered damage to his spine and was down to about eight stone.
Keeping mind and spirit occupied was the major hurdle, he recalls. ?The worst loneliness is at night when everyone?s gone and there?s nothing to distract you. My attention span was useless; I couldn?t concentrate on reading or bridge. I could only sit up at 15 degrees, so focusing became difficult. I had to eat like that, too. I wasn?t allowed to exercise. You think it?s a chance to read every novel you ever wanted or do a PhD, but it?s not. It?s just a chance to sit there and wait.?
Incredibly, Berber still found ways to challenge himself. He insisted that one Chinese nurse teach him basic Mandarin. Another friend who sings professionally taught him how to hold a note. When general and presidential elections came along, he exercised his right to vote despite being in intensive care, changing his legal address to the Mater Hospital and mouthing his decision to the visiting garda.
Other rays of light trickled through. The nurses became like family members, helping him laugh and ?stay sane?. A visiting rabbi, meanwhile, entered his ward and noticed a crucifixion effigy on the wall, only to quip: ?One suffering Jew in a room is enough, but two.? It was Jackie, however, who was the only person he was able to express his real fears to. ?I think it?s really brought us together. She supported me so well; she gave me the comfort of knowing that, if I died, my daughter would be looked after.?
The day finally came. When Berber?s daughter asked if he was afraid, he answered with steely resolve: ?No. This is my chance to live.? He asks me not to reveal the exact date, for fear the donor?s family recognise it. Each year, donor families and transplant patients share a non-denominational mass in memory of the souls who died. No one knows who is who because donors and recipients are never encouraged to know the other party.
?Someone has to lose a life in order for you to gain one; that part?s very difficult. You feel ?survivor guilt?. You go to sleep and this thing?s beating and you know it?s not yours. I do cherish and look after it as a gift. When I?m alone and hear it beat, I always think someone kindly donated this to me and it lives in my chest. I hope that gives comfort to any family that donates.?
He flashes back: ?I woke up and everything was white. It was like waking up with a really bad hangover. I said to the nurse: ?Am I dead?? She pinched me and said: ?Did you feel that?? I nodded. She said: ?Well, if you?re dead you don?t feel pain?.?
What followed was a grisly recovery that involved time in the cardio-thoracic higher dependency unit. The new heart had problems settling in, including a blockage, emergency surgery for an internal bleed, another spell in intensive care, and a terrifying ordeal where a stoppage required adrenaline and defibrillation.
With so much muscle wastage, he needed 22 weeks of rehabilitation, including intensive physiotherapy. New restrictions took getting used to. Medication to stop his body rejecting the new heart has weakened his immune system, meaning exposure in public areas is a risk. He must watch what he eats (?Ironically, it?s almost a Jewish diet: no bacon, pork products or prawns?). The damage to his spine and left leg still curtails certain movements and his energy levels are nowhere near what they were. But as someone who thrived on setting goals for himself, David was restless.
Learning table tennis invigorated him, even if progress was slow and frustrating. A six-week window of health also allowed him to swim as a means to get a full body workout that also brought meditative tranquillity. He then set his sights on the Transplant Games, an international sporting event that promotes organ donation, winning silver in the 50m swim.
?There were only two of us in the race,? he laughs. ?But I sat in the chair, catching my breath, and said: ?I did it!? I stood on the podium with my crutches in the air, cheering. From being dead in a bed to being able to swim 50m ? it was huge for me.?
Forced into early retirement, his active mind is now kept busy by seats on Tallaght Hospital?s Patient Advisory Committee and the board of the Irish Heart and Lung Transplant Association. He pays visits to others awaiting transplants, something that provided him with much hope during his own long wait.
His advice to them is simple: ?Face the fact of what you?re going through. Consult with professionals. There?s always treatments, but you have to change your lifestyle.
?Accept your limitations and make the best of it.?
That Transplant Games medal now hangs on the wall of Tallaght Hospital Rehab Clinic, his way of thanking them and to encourage other transplant patients to set goals, too.
?It wasn?t the competition; it was the fact I actually did it. I was given this gift of life, and I?m trying to pay it back in whatever way I can. Having a transplant doesn?t make you the most perfect human being in the world, but to be able to get back to semi-normality is perfection.?
As men, are we bad with health matters? Berber rolls his eyes and groans. ?Men. Ignore. Ill. Health. I ignored it. I had tasks to achieve, bills to pay, a role to play and an image to keep. A man doesn?t want to talk about failure. We just go out and get drunk and laugh at the football.
?It took my wife to say, ?Go to a doctor?. Women get together and say, ?How do we deal with this?? Men hide the broken wing, and we?ll do anything not to show it, including killing ourselves.?
This second life has its complications, but it?s a ?wonderful frustration? for him. ?If I can learn to lie in bed and accept dying, I can learn to sit on a couch and accept living, and do it with grace and dignity. That?s my journey. I haven?t got there yet, but I will.?
A Man?s Guide to Heart Health is available free on irishheart.ie or by calling (01) 668 5001
More Optimist Sailing News on: http://www.independent.ie/lifestyle/i-was-dead-in-a-bed-now-i-have-a-life-29090574.html
Source: http://www.optimist.co.za/i-was-dead-in-a-bed-now-i-have-a-life/
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Sony Corp. admits that it does not have a mass-production PlayStation 4 box that it can bring out to the public. Nonetheless, the company seems to be pretty open about its plans regarding the new system and its current state. While the price of the PS4 is something that has yet to be determined, some reports point to the company?s alleged plans to start mass production of the device in Q3 2013.
