I feel my phone buzz against my leg, and hear the familiar “bing!” of a notification. I check the screen and it’s an Instagram message.
“Hey guys I’m in town for the day and wondering if you do day passes? I really want to check this gym out. I have to deadlift tomorrow and this place seems perfect! Do you have day passes? Please say you do!”
24 hours later, a tall, muscular young man, Brendan, comes through the front door. I shake his hand and can tell immediately he’s no stranger to the gym. You might often meet someone with strong legs, or a strong chest, but their grip is weak. You never meet anyone with strong hands that isn’t all around tough as nails. I show Brendan around the gym, and his eyes light up as he takes in every serious athlete’s dream: Plenty of barbells, platforms, weights, everything competition grade. In kilos, just like the pros use. 70 feet of artificial turf for conditioning and agility work. Even our cardio equipment is no-nonsense. Full body air bikes, and rowers. A lone treadmill, because anyone serious about running is going to do it outside anyway. Even in the winter. There’s only one thing missing: The meat heads. In fact, on this particular night, it’s a pretty mixed bag. Our top Powerlifter…a woman and midwife. Certainly not what you picture when you imagine massive weights flexing on a barbell across someone’s back. On the other side of the gym, a woman in her 60s, just looking to stay active. On the other side an education administrator looking to improve his golf swing for the Sunday beer tournaments.
Not everyone gel’s with our community, and that’s okay. I can read people pretty well, and it’s usually obvious when a potential client looks around the gym incredulously: This isn’t the place for them. Brendan however, doesn’t bat an eyelash, and makes himself right at home. Despite having a physique many people might find intimidating, he doesn’t give off an arrogant vibe. In fact he’s got the kind of demeanor that makes me wish he were local. He’d be a great addition to our community. Brendan does his workout, asks for a few tips here and there, as well as a spot on his top set of squats. We chat, and while he’s wrapping up his workout, he asks if we know of any place similar to Arkitect in the Boston area. Matt, our newest coach who recently relocated from Quincy confesses there surprisingly isn’t much to choose from where Brendan’s going to be living.
“This place is perfect. I really wish there were something like this near me,” he tells me as he’s packing up to head home. My first thought is I wish the people that lived here in town realized how unique we are. My next thought is that, Brendan, like so many others who truly appreciate Arkitect have no idea how close we came to never opening in the first place, and then how close we came to shutting our doors for good.
Sometimes you just have to jump. Good advice is: Don’t quit a job until you have another lined up. I didn’t take that advice. I had been working a job for another gym in town for five years, which looking back, was about four years too long. I had unequivocally explained to my employer what I needed. They said “no”, I said “I quit.” It was scary, it was exhilarating it was…oh sh*t, I don’t have a job. Over the next few weeks, I fielded a lot of job offers, a lot of questions from former clients about what I was planning on doing, and of course, a lot of questions from my family about that very same topic. Then came an interesting question from Judy, a client at my former job. “Have you ever thought about opening your own gym?” The honest answer to that question was: a little bit. Many personal trainers and coaches get into the business with hopes of one day owning their own facility. That had never been a great ambition of mine. It’s natural for a coach to dream of having all the decision making power, to have a gym set-up exactly the way they want it, to coach exactly the way they like to coach, and so on. Truthfully though, entrepreneurship was never my main goal. A long time ago, I realized that I’m primarily motivated by the feeling of making a difference. Going back through old journals of my teenage years, there’s lots of talk about changing the world, helping people, making impact, and on doing it on a monumental level.
The truth was that even though the thought of owning a gym appealed to me, and I thought I could be decent at it, I didn’t have the means to do it the way I really would want to do it, and I hate giving anything less than 100%. I told Judy as much, and she surprised me with a proposition: She really liked me as a coach, and was interested in helping me start my own gym. From there an unlikely partnership began to grow. Judy has a big and wonderful family, has worked hard her whole life, and is nearing retirement. At the time I was one of the many lost souls of my generation, still searching for meaning, purpose, and a career. I had no wife, no kids, no property…I didn’t even have a job. While we explored our options of working together, the job offers continued to roll in. One of them was quite promising. A completely new facility in the town I was living, owned by a true entrepreneur: A guy who had no knowledge of the fitness industry, but was great at building businesses. After several meetings, they made it quite clear: They wanted me to work for them, and basically told me to name my price.
I began to weigh my options. On the one hand I had the chance to be my own boss, to do things the way I thought they should be done. Although being a small business owner is challenging, its essentially a well spring of potential both financially and intellectually. You are in complete control of your destiny, and that is very appealing. On the other hand, I could slide into a position with less responsibility, more upfront pay, benefits, and obviously far less risk.
As days pressed on, I knew the time to make a decision was looming. There were meetings, phone calls, e-mails, things were getting done. Steps were being taken in both directions, and soon there wasn’t much of anything left to discuss. Dotted lines needed to be signed. I gave myself the weekend to think about it, and would make my decision on Monday. After weighing out the pros and cons, I decided that I was going to take the job instead of being a business owner. I rationalized the decision a thousand different ways. I’d be making money immediately. I’d have less stress and less responsibility. There was room to grow, and I’d be appreciated for my role in the company.
I got in my car and began to drive over to the gym to tell the owners I was accepting the position. With each turn I made, I began to drive a bit slower, and slower as I neared the building, eventually pulling over to the side of the road just before the gym was in view. I panicked. My knuckles white against the steering wheel, sitting in a parked car. I thought about all of the people who were messaging me, asking where I was going, what I would be doing. I felt like people were counting on me. I felt like I didn’t truly believe in this job because it was another gym just selling a gimmick instead of selling real results. I was tired of gimmicks. I thought as long as I was getting paid, it wouldn’t matter if this wasn’t a gym I would want to be a member of myself. But I couldn’t do it. I couldn’t sell out. A mere hundred feet from the building, I turned my car around, drove home, called the owner of the gym and said “thank you for the opportunity, but it’s not right for me.”
I had never owned a business before, done a business deal, or had a business partner. Neither had Judy. The next few weeks went fast as we got all of the formalities taken care of, and then it was off to the races. I’m forever grateful for her and her family and the role they played in making Arkitect a reality. Since then our relationship has been simple. She invested in me, and from there let me do my thing. I truly believe I have a lifelong friend in her as well. Like most small businesses, the road has not been without it’s bumps. There was one major bump however, that no one could have anticipated, and that was my heart, and I do not mean that in a metaphoric way.
In 2012, three years prior to opening Arkitect, I had strolled into my primary care doctor’s office with a long list of symptoms. I felt anxious, I was worrying about everything. I couldn’t sleep, I had bad muscle cramps, I was getting headaches. These symptoms are most likely every practitioners dread, as they are the outcome of hundreds if not thousands of maladies. My doctor did what any good doctor would do, and ran a host of tests, including an EKG, which looks at the rhythm of the heart, it was there he found an anomaly. Looking back it’s obvious that the combination of a bad break-up with a serious girlfriend, coupled with working a job that was becoming evidently dead-ended resulted in some serious depression and anxiety. I had little time to consider those elements though, because now I had a new word to focus my attention on: WPW, also known as Wolf-Parkinson-White.
To understand WPW we need a brief cardiac anatomy lesson. Your heart is split into four chambers. Two top chambers, two bottom chambers. The top chambers are known as the atria, the bottom chambers the ventricles. There’s a piece of your heart connected to your brain, this is called the sinus node. Your brain tells your sinus node when to create a heart beat, which is basically just an electrical impulse. The top chambers (atria) beat, and then there is a little bridge called the A/V node, and that bridge carries the heart beat to the ventricles. When you have WPW, you have an extra bridge, that bypasses the A/V node. The concern is that a heartbeat can get “stuck in a loop” and make your heart beat too fast. Although I was asymptomatic for WPW, and my doctor thought it was unrelated to my other symptoms, he sent me to a specialist called an electrophysiologist (EP), which is a doctor that specializes in the rhythm and electricity of the heart. I tell people that cardiologists are heart plumbers, and electrophysiolgists are heart electricians.
The EP told me all I needed was a simple procedure called an ablation where they enter your heart via your arteries, and use tools to cauterize the tissue causing the problem. I was assured it was a low risk procedure, and therefore elected to have it done. After the procedure the doctor came to talk to me, and told me that things went pretty well, that he had chosen to do a cryoablation where they freeze tissue instead of burning it, but because it was so close to my A/V node, it slowed my heart down too much and they had to undo it. The doctor told me not to worry about the WPW, because he tested the strength of the extra “bridge” and it wasn’t strong enough to carry an impulse that could kill me. The recovery was quick, and I was back on my merry way.
Three years later, it’s Christmas Eve, and my business is slated to open in less than two weeks. I start my day the same way I had been for the last few months of unemployment: A light breakfast, and straight into a workout. I’m excited to try out my new heart rate monitor that I received as an early Christmas gift. I throw it on as I eat my cereal, and notice something strange: My heart rate is only about 40 beats per minute (normal is 60-90). I assume the batteries likely need replacing in the monitor and head off to my workout. During my training I check my pulse manually, it’s well over 100. Everything is as it should be.
After the workout, I try the monitor again. It reads the same: high 30s, low 40s. I check my pulse manually, and when I do, all the blood drains from my face. My heart rate is only about 38. Although I feel okay, I know this isn’t right, so I decide to go the hospital. When I arrive, the staff has a meltdown over the fact that I drove myself. I assure them I feel fine, but I wind up in a hospital bed. Doctors and nurses are throwing around terms like “first degree heart block” and “long QR interval.” As a coach I understand the basic workings of the heart, but all of this stuff is Greek to me. They tell me that they can’t let me go home until an EP comes to evaluate me, and being that it’s Friday, and Christmas eve, that won’t be until Monday. You’re going to spend the weekend, and Christmas in a hospital bed.
Naturally disastrous thoughts start to creep into my mind. “Holy sh*t,” I think to myself, “I’m about to open a business and I’m in the hospital because something is wrong with my heart. My heart!” I wonder how Judy is going to take the news. Is she going to freak out? Is she going to regret her decision to work with me? Am I going to be able to open the gym in time? Will clients understand? The weekend was a tough one, but some family stopped by and brought me food and presents to cheer me up. On Monday, the EP who I had seen years prior for my ablation told me I had developed a second degree electrical block, meaning not all of the heart beats created by my sinus node are making it to my ventricles, but as long as I don’t feel like I’m going to pass out, I will be fine, and no treatment is needed. When I inquire about why this is happening, he tells me that it’s common in athletes, that because an athlete’s heart is so strong, it doesn’t need to beat as frequently. I ask him if this could be related to the procedure he had done a few years ago, and he says “no.” That, as it turns out, was a lie…
I’m discharged from the hospital, and the next year is a blur. I’m working crazy hours, doing everything I can to grow the business, continue my own education, coach, maintain my personal relationships as well as my sanity. The business is doing well, but I’m not. I’m gaining weight, I’m exhausted all of the time. I’m stressed the hell out. If there are any small business owners reading this, none of it will sound surprising. I realize that I haven’t been taking great care of myself, so I shift my focus away from the business slightly, and back to me. I buy a bicycle and start riding it a few times a week. I’m riding, I’m lifting, I’m paying closer attention to what I eat. I’m gaining weight, I’m exhausted. This can’t just be stress, can it? Then it happens. I remember it like it was yesterday. I’m sitting in the gym on a quiet afternoon. Only one client training. I’m sitting down because like usual, I’m just so damn tired. I go to stand up, and just before I do I feel the lights flicker. Not in the gym, but in my brain. It was as if a thunder storm was rolling through, and although power didn’t totally go out, there was a split second interruption. A chill runs up my spine, and I think “did I just almost pass out?”
I brush the thought off, as more clients are walking through the door into the gym. Over the next few weeks, the sensation happens again, and more frequently. To the point where I can almost feel it before it happens. I know the warning signs and signals. That’s when the thought crosses my mind: What happens if I pass out while I’m driving? I call my doctor. My primary care doctor sends me to a cardiologist. He gives me a holter monitor to wear that will track everything my heart does. It also has a button on it when that I am to press any time I feel symptomatic. I wear the monitor for a few days, push the button a few times, and get a call at the end of the week from the cardiologist.
“I’ve reviewed your monitor results, and talked them over with an EP. The times you recorded with the button correlate with episodes of very low heart rates. You need a pacemaker.” I ask why I’m having this issue, he says the cause is unclear. I ask if this could be a result of the ablation I had a few years ago. He says “possibly.” I tell him I want a second opinion, and he tells me “This isn’t an emergency, but you want to get this handled sooner than later.” There’s a seriousness in his voice, and I know what he means. If you pass out in an inopportune time…behind the steering wheel, in the shower, on a ladder…
Unfortunately my second opinion came in the form of a trip to the ER. One day the episodes became so bad, I knew I was running out of time to make a decision. Once again I walk into an ER (albeit a different one from last time), and get admitted. The doctors at this new hospital give me a few definites: I definitely need a pacemaker, and it’s definitely because of the ablation procedure I had. I also definitely didn’t need the ablation in the first place because I was asymptomatic, and I could have had a stress test to determine the severity of the WPW, instead of an invasive procedure. I protest the pacemaker, knowing it will require some lifestyle changes for me and my passion (Weightlifting). They tell me there is no other option, and schedule the procedure for the next day.
It’s Monday and I am awake early because my roommate in the hospital snores loudly, and nurses come in every hour or so to check our blood pressure. I’m told I’m not allowed to eat anything because I need to be fasted for the procedure. A few hours later, another nurse comes in to shave my chest and prep me for the implant. I get shaved, and I’m just about to be wheeled to the OR when another nurse bursts in the room and says “you have Lyme disease!” My first thought: Thank god.
The ER doctor had ordered blood work when I had arrived at the hospital, and the results had just come back positive for Lyme. Normally having Lyme disease isn’t a good thing, but it can cause a slow heart rate, and it’s treatable with medication, rather than getting an implanted device. Now I’m being visited by a new doctor, an infectious disease specialist he’s explaining to me spirochetes, and antibodies, and confirmatory tests. I learn that Lyme is typically a diagnoses of exclusion and the presence of specific antibodies in the blood. The initial test came back equivocal, meaning up for interpretation. Another test at a special lab must be done, so they draw more blood and send it off.
Each day I fast, in the event that the test comes back negative and I need a pacemaker. 10 a.m., noon, 2 o’clock, 3 o’clock, 4 o’clock…the nurse gives me the okay to eat. Even if the test comes back this evening and it’s negative, there won’t be time to do the surgery anyway. Repeat this process, Monday, Tuesday, Wednesday, only one meal a day around 5:30 p.m. Each day a different room mate. This guy had a stroke. This guy had a heart attack. This guy is coding. And then, Thursday afternoon, a nurse comes in to my room, a sullen look on her face: The Lyme test came back negative. You’re getting a pacemaker tomorrow. She tells me I can eat dinner. I don’t want to eat dinner. I’m going to have a machine put inside of me. I’m going to be dependent on a machine. The thought of it makes my skin crawl.
The next day I’m up early, they prep me for surgery, and a doctor comes to talk to me about the procedure. He goes over the risk of infection, the risk of puncturing a lung. I ask if there will be any surprises on the other side. He says no, and hands me a piece of paper to sign on the dotted line. It’s a waiver. Everything goes well. I’ll have to stay one more night, and I’ll be discharged in the morning. That night I can’t sleep. Despite heavy medication, the pain is intense, and since I normally sleep on my side, which at the moment is not an option, I lay staring at the ceiling, watching the minutes tick by. The next morning a Physicians Assistant (PA) comes in to begin my discharge and mentions that on my monitor last night there was a brief episode of what looked like atrial fibrillation (afib), which is when the upper chambers of your heart don’t beat but flutter instead. She tells me it’s not a big deal, and that sometimes getting a pacemaker can cause that and a low dose of a beta-blocker should do the trick. I tell her “no meds” and she frowns and gets a doctor. The cardiologist tells me that the episode on the monitor was brief, and may have been an “artifact.” I tell him the EP said there would be no surprises. He tells me the pacemaker tracks my rhythm, so if I go into afib again, it will alert my doctors office. I get discharged and I head home.
Over the next few months I came to grips with the fact that I’m partially dependent on a piece of machinery. The fact that I have more energy, and weight is flying off of me helps me to accept it. I’m back to training, and my physical limitations aren’t nearly as severe as I thought they were. The business is growing, I’m feeling better and stronger every day. Until I’m not. Nearly a year after the implant, and almost suddenly I start to feel easily winded. My heart rate is now resting at about 95 beats per minute, which is too high. I’m getting dizzy when I stand up. I call the EP, and he tells me to come in. The EP sends me for an echocardiogram, and schedules me for a follow up appointment to go over the results. During the test, the echo tech is chatting with me about what I do for work, what I have planned for the weekend. The usual small talk. As the test goes on, I notice a shift in his body language. Something is not right. He asks if the test is just routine or if there was a specific reason why the echo was ordered. I explain the situation, and he excuses himself. The follow up appointment next week won’t be necessary, I’m getting sent back down to the EP’s office right now.
The Doc doesn’t waste any time breaking the bad news: My heart’s pumping function has decreased by about 25%. It’s beating at a normal rate, but the amount of blood it’s pumping out with each beat is too low because the heart itself is weakened. I ask if the pacemaker could be causing this and he says “unlikely.” He orders a whole slew of tests including blood work, urinalysis, EKG, cardiac MRI and a cardiac catheter EP study, where they go into my heart and look at my arteries. He wants to rule out coronary artery disease. I ask him what the risk factors are, he tells me high blood pressure, family history, smoking, drinking and a sedentary lifestyle. I check none of those boxes. The following week, when I’m being prepped for the test, the nurse tells me it will take about an hour, unless I need a stent, then it will take two. I’m on the table for fifteen minutes when the surgeon pulls the camera out and says “we’re wasting our time. This guy can go get a pizza in the cafeteria if he wants.” My arteries were pristine.
After fighting with my insurance company, and finding a facility that can do a cardiac MRI on a patient with a pacemaker, my EP tells me he’s never seen results like this and I have several abnormalities. Words like sarcoidosis, amyloidosis, ACRV, are getting thrown around. Rare diseases that all have one thing in common: given enough time they all end in me getting a heart transplant, or worse…
The EP sends me to a hospital in Boston. This is over his head.
After several more sparring matches with my insurance company, I end up in Boston and I meet with a top cardiologist that specializes in these strange diseases of the heart. He goes through the list and tells me my case is peculiar because for every potential disease there are factors pointing to and away from each diagnosis. There is one thing he adds to the list that the EP back home did not: The pacemaker itself. He tells me there is a chance that the pacemaker is weakening my heart, and he’s going to send my case over to the head of the EP department to get his opinion.
Next comes more tests, more hour long phone calls on hold with the insurance company, the hospital’s billing department, and lots of coaching since my only employee gave her notice at work via facebook on New Year’s eve, which is the night before every gym’s busy season. All while I have the heart function of someone 40 years my senior. I decide to focus only on what matters most: the clients I currently have, but working the morning and night shift is getting the best of me. I can’t make it through a whole day without needing to sit for a bit while I’m at work because I’m so tired. Any thoughts of trying to grow the business have gone completely out the window. Right now is all about maintaining, and I’m not doing a great job of that. Things start to fall through the cracks, and I begin to crack apart.
At this point, I have completely lost faith in modern medicine. Modern medicine had taken my strong, healthy 27 year old body, and completely ruined it, and was very nearly ruining my mind as well. All I could think about was the end, and how close to it I felt. I walked into my EP’s office in October of 2017 complaining of not feeling great, and here it was the spring, and I still didn’t even have a diagnosis, never mind a prognosis. The uncertainty was killing me. The thought of getting a heart transplant was killing me. Even if I were able to get one, the organ rejection rate in the first year is massive, and even if you make it out of the first year, you will live the rest of your life on immunosuppressants; harsh drugs that weaken your immune system, but keep your body from rejecting the donor’s organ.
Finally, I was able to see the EP in Boston. He took one look at my case and said “The is the pacemaker doing this to you.” Finally, a diagnosis. He explained that a traditional pacemaker paces the right ventricle only, and this can cause a delay between the left and right ventricle which doesn’t happen when your heart beats on its own. This fraction of a second delay can weaken the heart and that was exactly what was happening to me. There is a treatment: Another type of pacemaker, one with an extra lead (wire) that paces the left ventricle simultaneously. There was a slight caveat to this good news…the treatment isn’t always successful. Sometimes it works, sometimes it doesn’t, and no one really knows why, or who will see success and who won’t. The only thing they can do is try and hope for the best. And if it doesn’t work? “We’ll manage your condition with drugs as long as we can, and then…” and then I would need a new heart.
Despite this relatively good news, it wasn’t as simple as getting a new pacemaker the next day. There was insurance to contend with, and my doctor needed a few more tests. Having a diagnosis did only little to calm my nerves, and my string of bad luck with doctors gave me little faith the treatment would actually work. I felt like I was on the home stretch, of both this medical journey, but also of my life. I started regretting decisions I had made. Had I just sacrificed the last good years of my life slaving away in this gym only to never truly see my hard work come to life? Why hadn’t I traveled more? Why hadn’t I taken more vacations, or been more open with the people I cared about? Why hadn’t I taken more risks, or pursued my passions more vigorously?
My good friend and fellow gym owner, Ben Dearman and I would chat about life, business, and health. Not only is he a gym owner, he’s also a cancer survivor. If anyone understood what I was going through it would be him. I confessed that I seriously questioned my ability to run the business if things continued the way they’ve been going, or if they got worse. I told him the thought of closing the gym down had crossed my mind. Admittedly, I would rather walk away while we were on top, then watch is slowly disintegrate. The thought of closing Arkitect killed me. I had worked so hard, so many people had put their faith in me, and I knew that all of my amazing clients would effectively be homeless. There simply isn’t any other gym that offers what we do. We are a maverick in our community. Ben asked me if I had ever thought about selling the gym, and even though I hadn’t, the idea did appeal to me. I’ve always said that Arkitect was bigger than any one person, and that included me. We have something special at Arkitect, and to see it go on further than I could take it really appealed to me. Ben mentioned he might know someone that was interested, and next thing I knew, I had four different parties all vying for my time and interested with serious offers. Suddenly the pressure of making a decision to close up shop, sell, or keep moving forward and hoping for the best started to overwhelm me, and I was transported back to that day in the car, sitting on the side of the road, torn with what to do.
I was constantly choking on regret because I felt like I was out of time. I was drowning in guilt because I knew my clients weren’t getting the service they deserved. My consciousness was cloaked in shame because I was letting this mentally beat me, and I thought I was stronger. The procedure was scheduled, and I counted down the days. Then, again, another delay came. Again insurance. It was pushed out another three weeks. Three agonizing weeks. I thought for sure that in a sick twist of fate and irony, my heart would give up in the interim between the two dates. Any drop of optimism in me had evaporated.
When the day finally came, I knew what to expect. I had just been through this two years prior. Most pacemakers last anywhere between 5-15 years. I was getting a new device after only 24 months. It seemed the scars had only just settled from the first time, and now I was getting cut open all over again. The doctors came in, explained the procedure. Sign the papers. Nurses buzzing about. This person putting monitors on me. My skin cold against the table, the oxygen mask, the medication. The bright light, the sleepiness. I’m tired. I’m drifting away now. I’m dreaming. I’m having nightmares. My shoulder hurts. I want to wake up but I can’t. I feel a hard pressure in my chest, and what sounds like a staple gun. I realize the staples are going in to me. I’m waking up now. Everything is numb except where I can feel the staples going into my flesh. I hear voices say everything went well.
Now I’m back in the hospital room. My roommate is snoring. Different hospital, different year, still lying on my back, staring at the ceiling. The next morning the attending doctor comes in to discharge me. He tells me that the leads from the original pacemaker were heavily damaged from whatever is I’ve been doing. If you break them, there isn’t any room to put in anymore. They have to last you a lifetime. In that one breath, my Weightlifting career officially comes to an end. Despite how much the barbell has meant to me throughout my entire adult life it’s a small concession if this treatment actually works. I’m discharged, and I’m going home.
The ride from Boston back to Concord seems to go on forever. Everything hurts, I’m exhausted, and I know my bed won’t bring sleep because of the pain. I walk up the stairs to my second floor apartment, and I’m brought to my knees with pain. It feels as if someone is driving a dagger through my spine and into my heart. Panic sets in, but is quickly eased as I realize the pain is subsiding as my heart rate comes back down. I pull out my phone and do a quick search for the symptoms in conjunction with a pacemaker implant. It sounds like I have pericarditis, an inflammation of the pericardium, which is the sack that surrounds the heart. I phone the hospital, and the doctor on call disagrees. He tells me that if the left ventricle lead was irritating the pericardium that would mean it was outside the vein, which case it would be a medical emergency, and since I’m not having trouble breathing or feeling nauseated, there is nothing immediately wrong. He tells me if i’m still in discomfort on Monday to come in. Monday, I take a trip back to Boston. The doctor in the clinic listens to my description of symptoms, and tells me, “I think you have pericarditis.”
After a week of high dose anti-inflammatory medications, I’m feeling better. I’m sleeping through the night for the first time in over a year. Waking up to use the bathroom is a common sign of a weakened heart, as is waking up gasping for breath. Both of which happened in various frequencies over the last 18 months. I think I feel like I have more energy too, but at this point it’s hard to tell. The last few years have been such a roller coaster, I don’t even remember what “normal” feels like anymore. I head in for my 6 week follow-up, and a nurse interrogates my device and tells me “you’ve been having episodes of afib.” I shrug it off, and think back to the morning after my first pacemaker implant. “It’s probably just an artifact” I tell her. She shakes her head no, and shows me a number of dates where the pacemaker has recorded episodes of atrial fibrillation, with one bout lasting over three hours.
I slumped down in my chair. It seems now, long term medication was unavoidable. It had been a source of pride over the last few years, not being on medication. I always loved the look of surprise at the beginning of a doctor’s visit when a nurse would ask me what medications I was taking and I would boastfully say “none.” I was always an anomaly in the heart wing of hospitals anyway. A healthy, muscular young guy with a heart problem? The week I had spent in the hospital waiting for the Lyme test I had felt like a circus attraction. All the staff from other units wanted to come see the young guy and his bizarre heart rhythm. Less than 5% of all people with pacemakers are under the age of 50. To be 33, have a pacemaker, weakened heart function, and not be on any meds? I was practically a unicorn in the medical sense. But just as I was beginning to come to terms with the idea that medication was inevitable, the nurse told me I hadn’t had an episode in a few weeks, and it was possible the afib was a result of the pericarditis, so for right now they would just “keep an eye on it.”
I left the hospital that day with mixed emotions. I’d have to wait another few weeks before I could get an echocardiogram to see if the new pacemaker was actually strengthening my heart, and now I could have afib to deal with. As I drove home I felt numb to it all. I had been through so much over the last few years, and it seemed like there was always a surprise waiting for me around each corner. Although I hadn’t fully recovered my optimism, I was starting regain my fight, and I felt motivated to move forward. I realized that selling the gym wasn’t the right move, neither was closing it. If I go out, at least it will be on my feet swinging. The EP I saw in Boston had left the hospital to take a job across the country. I had seen so many specialists, my primary care doctor was completely out of the loop. It also made sense that I should get a cardiologist just to generally monitor my heart health, afterall, it had been through a lot.
I made an appointment with my PCP, filled him in on everything and explained that I wanted to see him, a cardiologist, and an EP all at the same hospital. I wanted everything under one roof, so I could eliminate the fragmented care I had received from being such a medical nomad over the last six years. He agreed, and I saw a cardiologist that week, who ordered some follow up tests: an echo to look at my heart function, and another pacemaker interrogation to see if there had been anymore bouts of afib. The first bit of good news came when my echo came back completely normal. My heart pumping function right at the top range. A device interrogation showed no signs of afib. The treatment had worked.
I was standing in the gym when I read the echo report, I felt like the weight of a thousand chains had been lifted off of me, and I couldn’t stop smiling. Immediately all of the regret I had been feeling washed away. I looked around the gym , and for the first time in a long time I saw what I used to see every day: Opportunity. Those around me could see the change in my face, and when I broke the good news, they were genuinely happy for me, and that’s when my purpose was reaffirmed. I used to dream of changing the world when I was a child, but in that moment, I saw all those wonderful people who had stood by me through my absolute worst, and I realized I don’t need to change the world. I don’t need to change anything actually, all I need to do is be a positive impact in my community. And right there in front of me was the opportunity to make a positive impact in other people’s lives. People that mattered. People who are part of this little bubble that is Arkitect, that is Concord, that is New Hampshire. And maybe, just maybe that bubble will grow to something even bigger, but if it doesn’t, I will still feel pride and gratitude for those who have been part of what we do and who we are. In the end, Brendan was right: This place is perfect.