October 13, 2015
Luke Nabi: "Steroids nearly killed me"
On September 11, 2013 I was admitted into Waikato Hospital with provisions from a general practitioner to have a check up at the hospital as he couldn’t come to a diagnosis of a continuing illness I had the past two weeks. Waiting in the emergency room, I was finally called up to update my details at the front office in there. Half way through updating my details I lost consciousness and was quickly rushed to the resuscitation room, as, the name suggests, to be resuscitated. Once I gained consciousness a couple of doctors and nurses were at my bedside, informing me, to my surprise that my heart was severely clotted, my heart had grown to twice the size it should be and all my organs were shutting down. Worried, confused, and scared were just a few of the emotions running by me at the time, I managed to keep calm and collected as I knew I was in the best place now. Shortly after being told the bad news I slipped unconscious again, my heart stopping for several minutes and was wheeled up to the intensive care unit for closer care. On arrival to the I.C.U I gained consciousness eventually, waking up to a doctor each side of me pushing and shoving a thick tube down an artery on each side of my neck, having those tubes as close to my heart to be able to get the medications given to me as close to the heart as possible for fastest delivery of the meds. Slipping unconscious and being resuscitated again I woke to the doctors putting another thick tube into my chest which would later be used for dialysis since my kidneys had shut down at this point and the dialysis machine filters the blood in your body, essentially doing the kidneys job for people who do not know. Slipping unconscious and being resuscitated for the third time I woke up finally in a stable condition in the I.C.U with a team of doctors and nurses keeping a close eye on me. After, you could say, dying several times. I realised how I could kick the bucket at any time in there, but alas, being strong was the only option I had if I wanted to live. After three days in I.C.U, the doctors stabilised me well enough to be wheeled off to the cardiac care unit, thankfully having my own room. At this point my blood pressure was critically low, my ejection fraction (EF) which represents the volumetric fraction of blood pumped out of the left and right ventricle with each heartbeat or cardiac cycle, a measurement of the heart function, was down to 9%, which a healthy heart should be between a 50-70% EF. I knew the doctors were “sugar coating” the seriousness of my condition. Wanting to know the full truth, I asked a nurse to give me the straight up truth and seriousness of what’s happening. The nurse said she’s never heard of a person with a heart function as low as mine in the 15 years she had worked in the hospital and it’s a miracle I’m alive. The struggle was real. Throughout my eight days in the C.C.U I caught infections through one of my intravenous lines, which put me into a state called rigor shakes, where my body temperature would suddenly drop from the infection and then violently shake, as a mechanism the body does to heat itself up to try kill off the infection, shaking so violently I was bending the metal frames of my bed, losing all bodily control for around half a hour until the shakes wore off. My cardiologist at Waikato Hospital said I wasn’t getting any better and said it would be best if I was transferred to Auckland Hospital where the best cardiologists, doctors and nurses in the country would take care of me and try make me well again and this was the first time the doctors suggested I might need a heart transplant. Feeling much better at this point than I did when I first came in, a wry smirk crossed my face followed by a giggle, thinking I wasn’t going to need a new heart. How sorely mistaken was I. Transferred to Auckland Catching an ambulance to Auckland Hospital, an uncomfortable ride up in a stretcher about half the width of my body. I arrived to the Auckland cardiac care unit, where they wasted no time coming to my aid. I was appointed to the care of the head cardiologist of the transplant team, taking me under his wing, being in such the serious condition I was, I got the best care available. Straight away he prescribed me all kinds of medication, in hopes of trying to better and maintain a healthier heart without the need of a transplant. Putting me on fluid restrictions and making me take every test under the sun such as an angiogram, blood tests everyday, X-rays, M.R.I scan, biopsies of the heart, electro and echocardiograms. My body had severely deteriorated, losing 22kgs in four weeks, the first week at Auckland I lost 12kgs of fluid, retaining this much fluid in my body because my heart wasn’t working, not pumping blood and fluid around my body and my kidneys were not fully back up and running yet. Given a diuretic called furosemide, which forced my kidneys to work somewhat and urinate all this fluid out into a bag, attached to a catheter that was put up my … man hood, joy stick, baby maker. I’m sure you get the idea. I would urinate at any time not having any bladder control. A few days had passed and I had a meeting with my cardiologist in my hospital room, coming up with possible causes of my heart failure. Which he concluded to be a newly-found hereditary heart condition, having a weak heart my whole life, my arteries in my heart being twice as small as they should be making any physical task more taxing on my heart needing to pump harder to circulate blood around my body and a combination of my steroid use I had done in the past, cycling testosterone and trenbolone. Which I did from bad self-image issues I’ve had, being obese most of my life, losing around 45kgs of weight and becoming obsessed with my gym training and seeing my body change, I used steroids, not so much for the strength and size gains, but the fact that I was amazed at how much I could change my body using steroids, testing my limits and never being satisfied with the results, I felt like it was never enough but all I could do now is learn from this and do what I can do to be healthy again. I couldn’t live in the past because if I had, I wouldn’t have a future. The following couple of weeks the doctors and nurses continued to give me the same medication, I honestly can’t remember most of them because there were so many, still hoping to remedy the heart to make it functional and run on its own again. During this time I was on a mission to gain my strength back in my extremely weak body, working on standing up for the first time in three weeks. I was so weak it took me 30 minutes to gain the willpower and strength to stand up with a nurse each side of me, holding me up, I only could stand for about 20 seconds before almost collapsing. Very stubborn I was, telling the nurses I don’t need assistance getting up to head to the toilet and around the ward to pump out the quads to regain my vitality. I had them worried much of the time but my strong will allowed me to push through my barriers, surprising everyone and myself to of how fast I was getting back onto my legs again. Following this I had an angiogram, a procedure where my cardiologist would jab me in the groin with a syringe full of local anesthetic, numbing the area for him to put a catheter up a thick artery from the groin leading up to the heart to check the pressures of my heart chambers and take a micro sample (biopsy) of the heart, checking to see if there was any autoimmune diseases at play, which there was not. A small improvement About a month and a half into my time in hospital I had regained much of my strength and my heart function had improved to a 23% ejection fraction, confident my cardiologist was, he took me off my main medication assisting my heart function, dobutamine, and being stable enough to stay at a small hostel called Hearty Towers where pre and post op heart and lung transplant patients would stay until further notice from their doctors. So glad I was out of hospital, so relieved to be at Hearty Towers, I was told a week later after having another, one of many, echocardiograms of my heart that my ejection fraction had dropped down to 10%, quickly being rushed back to hospital and put back on the dobutamine. Consulting with several cardiologists and cardiac specialised nurses, we came to a mutual understanding that medication wasn’t going to fix my heart and that I needed to have a transplant, and to have one quick as my heart could stop for good at any given time. I was now on the active waiting list for a heart. I was reluctant at first in agreeing to a heart transplant, being told I would only have an average of 10-15 years of life left until the new heart would eventually fail. I eventually realised this was the best option or I would be bedridden for a long time and possibly die an earlier death. I complied. About a week later the transplant nurses ordered in a portable intravenous drip machine they would attach a bag of the dobutamine to, through a line from the inside of my arm leading straight to the heart, allowing me to get up and about and stay at Hearty Towers while the medication kept my heart pumping. So happy I had this machine that it allowed me to head out for a couple of my mate’s 21st birthday and head to the local malls in Auckland. This definitely helped my depressed and anxious mental state I was in, relieving some of that. Very lucky I was, only waiting two weeks on the waiting list. One of the nurses on the transplant team knocked on my door in Hearty Towers and entered, bringing the best yet most nerve-racking news of my life, that the hospital has a possible donor heart for me on its way now to the hospital. Being the laid back, “go with the flow” guy I am I kept my composure, though mum burst into tears and my brother did too on the phone to mum when she told him the news. I had a quick, last minute check up from another cardiologist on the transplant team, getting the thumbs up being stable enough for the surgery, mum and I immediately made our way to the surgical ward. A new heart Getting all prepped up and waiting for final confirmation if the possible donor heart was a match, which they test for that as soon as they get the heart for compatibility of blood types and size and also to make sure there was no coronary heart disease in the donor heart. I got the confirmation I wanted to hear, everything was a go, adrenaline pumping for the high risk, life-saving operation. I waited about three hours until I was wheeled off to the final prep room where I said my final goodbyes to mum before heading in, comforted by a huge team of doctors nurses and surgeons, assuring me I would be fine. An anesthetist administered the general anaesthetic, putting me to sleep within seconds. The next time I would wake, if all went well, would be with my new heart. The 18th of November, eight hours of surgery I had undergone. It was a great success. Only two hours after coming out of surgery they woke me up. Waking up incredibly high and zoning out, feeling very good at this point from the high doses of dopamine and ketamine they had given me, I quickly coughed out the ventilator I had down my throat with ease which kept my lungs working while I was under. I was so relieved when I woke, being told the surgery went perfectly well. I was in the I.C.U post op for three days. The best and worst time of my stay in hospital I would say from all the drugs and painkillers they had given me. One time thinking a young guy, not much younger than me, who had a valve transplant and was being kept on a bed next to me was a rubber doll and thinking some sort of game show was happening in the room where cameras were placed secretly in the walls taping my reactions on all the drugs. Dark times in my head it was. Upon entering an increased stable condition I was transferred to the high priority unit, a step down from intensive care unit for a couple days then the post op heart ward where to my disappointment, I just missed out on the record for the quickest recovery and sign out of hospital by two days, that being seven days and I was in there for nine, then to be transferred again to Hearty Towers where I made a very quick recovery, only staying there for one month, training with the heart transplant physiotherapist “breaking in the new ticker” before making my way home in time for Christmas. Finally going home The time I had looked forward to from the first day I went into hospital had come. I arrived home, still weak and the road to recovery would be a long one. The first thing I did when I got home was sit on a seat outside in the backyard in the warm sun, breaking down I’m tears knowing that this life changing experience would be the highlight of my life, to go through this with the strong mind I had and to come back from the dead almost making a 100% recovery now. I have gained 19kgs back with five months and two weeks of gym work back under my belt. Now for the rest of my life I have to take immunosuppressant pills and other medication every morning and night so my body does not reject the new heart. The human body is a smart tool, knowing that a foreign organ is in the body, it tries to fight it off. But most of all I would like to say, thank you to all the doctors, nurses, surgeons and especially my friends who were with me every step of the way, supporting me in every way possible and keeping me in good spirits. I am forever in your debt. Today I take every day as it comes, just now I have the most positive mentality, coming back with depressed thoughts on what life has install for me with the new heart. But the situation is just how I perceive it so if I want to be happy with my life now I just have to think positive, be happy with how far I’ve come and grateful for the ongoing support of my friends, family, doctors and nurses. Here’s to another fruitful 500 years of life.