Six Today

Today marks another birthday in the Tinhouse.

There will be no cake, no candles and no presents. It’s not really that kind of birthday.

My pacemaker is six years old today.

It’s six years since they made me part android by inserting a small metal box into my chest, protecting forever me from the blackouts caused by my heart-rate dropping, and protecting forever me from the X-ray machine at airports (though this has condemned me to a lifetime of being patted down at airports instead).

It works happily away, 24/7, possibly singing “hi-ho, hi-ho” as it goes about its work. It probably does deserve a present, so perhaps I’ll stick my finger into a light-socket sometime today, just to give it a bit of a thrill.

It’s earned it. It’s keeping me alive.

Same As Usual

Today I’d to go to the hospital so my pacemaker could get its half-yearly check-up.

As usual I stood up from my desk mid-morning and announced where I was going, and as usual the management said that’s fine, take your time, hope it all goes well. When you’ve a history of blacking out and toppling over spectacularly and messily in your office, and when a device has then been found to stop that happening then most companies will be pretty keen to let you go to whatever check-ups are necessary to ensure that the device keeps devicing.

As usual I turned up, was hooked up, and a pretty young woman played with my heart, turning the pacemaker up and down, raising and lowering my heartbeat to see what will happen. You don’t even have to take your top off, you lie on the bed fully clothed, shoes and all, and to be honest it’s hard not to feel a bit like Frankenstein’s monster.

A little machine chattered out a ribbon of paper with data on it (surely it’s called “ticker tape”, if it isn’t it should be) and she informed me that all was well, that once again it’s actually very rarely that it has to turn on.

As usual she noted that I have opted to have its thrice daily battery check turned off, as usual she asked was I sure, and as usual I said yes, it used to hurt each time it turned on and used to make all the muscles around it go into spasm for about an hour afterwards.

And that was that. The whole thing took less than eight minutes.

I used to hear about pacemakers, associating them always with overweight people in their mid-70s, and how they were a sign of heart problems, and about how they meant you couldn’t go through the X-ray machine at airports, and how they could explode at altitude (that’s ok, I’m only five foot five) and I used to imagine that life with one must be a real drag.

And now I can sit on the bus wearing mine, start four paragraphs with “as usual” and reflect on how routine it has all become for me.

It’s amazing how we all adjust to stuff.

Close to My Heart

A birthday wish to part of me,

My pacemaker today is three.

I hate it still, this metal cube

That looks like I’ve a third man-boob.

(At least it means I’ll never flirt,

Because I won’t remove my shirt,

Nor will I hang round singles bars

Coz actually chicks do NOT dig scars).

My dignity I quickly lose

When I get pulled from airport queues

Because I can’t use their x-ray

(Got FIRMLY frisked at JFK).

I will not swim, or use a gym,

Lest others catch a glimpse of him

(And those of you who know me well

Will know I miss the gym – like hell).

And finally, it really smarts

When it turns on…. like nipple-farts.

And yet…

I’m free to cycle, and to drive

I’m even free to deep-sea dive

(I’d never want to, but I can

Coz I can do like any man).

I do not black-out anymore

And smack my face upon the floor.

For if I am about to fall

– Because my heart-rate’s sweet-fuck-all-

My pacemaker will fill the void

Now that I’m a part android.

So though it’s still an ugly lump,

My battery-operated pump,

Today I’ll toast it with a beer –

Without it I might not be here.

In Heart and Mind

By co-incidence I was given appointments for my latest visit to my shrink and my latest pacemaker check on successive days this week. 

Yesterday morning I’d to see my psychiatrist (or nut-doctor as I once referred to him here, before Mwa pointed out that that phrase has more than one meaning) and as my new mode of transport, the 84X, actually passes St John of Gods I opted not to get a lift from Mrs Tin this time and to catch my usual bus instead. I soon realised that I hadn’t fully thought this through.

Unlike the train, a bus is relatively small with a limited number of seats, and one quickly gets to know one’s fellow passengers by sight. For instance, the same two girls stand with me at my stop each morning, and when we get on the same people tend to be sitting in the same seats, so that already I am starting to note when people are missing and obviously on holiday. Not only that, but I have a fair idea of where each person gets off.

And I’m sure they know as much about me, as I’ve got off at the same stop every day since I started getting the bus. Yesterday morning, however, I suddenly stood up six miles short of my usual destination, at a stop just outside St John of Gods. This stop is on a dual carriageway, and St John of Gods is the only possible destination for anyone getting off there. Short of wearing a T-shirt saying “yes, I have a mental problem” it’s hard to see how I could have made it more obvious. It may be just co-incidence, but no-one sat beside me on the bus this morning.

That was pretty much the most interesting part, really. My shrink and I have confirmed that I’m a lot happier, sleep a lot better and am really a whole lot more well than I’ve been for about two years. My only remaining problem is the derealisation, which he has warned me can be notoriously hard to shift. We are trying yet more medication in an effort to break it, so that now by the time I go to bed each evening I am basically a stomach full of pills surrounded by skin.

When the session was over I’d to get another bus the rest of the way to work. Getting on outside St John of Gods is as big a giveaway as getting off there, and things were not helped by the fact that, just as I reached the bus-stop, a fly or something flew into my eye. As a result I got on the bus just outside Ireland’s most famous mental hospital, sat wiping at my eyes the whole way into Dublin, and could almost hear the my fellow passengers thinking “poor fucker, they’ve told him he needs a lobotomy”.  

Then today I went to St Vincent’s Hospital (yes, all our Health Institutions are named after saints. I think the government believe that if the term “saints preserve us” actually works then they won’t have to spend any money on making us better) to get my pacemaker checked. I never have any trouble getting time off for medical tests of any kind, since if you black out often enough and spectacularly enough in an office your employers will practically drive you to the appointments themselves, so I left the office mid-morning, got another bus (different route, unlikely to have been any of the same passengers, thankfully) and arrived again at the scne of so many tests, scans and operations. Once again I was strapped to a bed by a young girl who then twiddled things to make my heart-rate rise and fall (I’m hoping to get a lot of hits out of that last phrase).

And guess what? Since I was last there my heart, according to this young lady, has done one hundred per cent of the beating. In other words, my pacemaker hasn’t had to turn on at any time in the last six months.

And while this means that I’m carrying around a thing inside me that’s doing nothing, like a metal appendix, it’s about the best news I could get.

You’re In My Heart

My metal implant, the inspiration for my blogname, is two years old today.

(To those of you new to this annals, I mean my pacemaker. My blogname isn’t Knobring).

In some ways it all still seems so new. I still hold my left hand up to my left collar-bone when I’m talking to anyone, covering that side of my chest as if I believe that they will be able to see the outline of the pacemaker through all my clothing (and these days, in this weather, that’s a hell of a lot of clothing). I’m still surprised when things crop up that I’m specifically excluded from doing. I’ve written before about how pissed off I was when I found out that I wasn’t allowed to go water-skiing, though in hindsight I probably should have figured that out for myself.

But more recently Mrs Tin bought me a back massager as a present for our anniversary, and I was going to plough straight ahead using it without reading the instructions because, well, I’m a bloke and that’s what we do, but by chance said instructions shot out onto the floor when I pulled the massager out of the box, and as I picked them up the word ‘pacemaker’ caught my eye. With a sinking feeling I read the sheet, and sure enough my back was to to remain unmassaged. We part-mechanoids are apparently not allowed to be subjected to vibrations or juddering, which is odd because there doesn’t seem to be any ban on us travelling on a Dublin Bus.

(As a nice end to that story, for Mrs Tin anyway, she brought it back to the shop and they were reluctant at first to refund her, because they didn’t believe someone her age would have a husband with a pacemaker. She was thrilled, so at least one of us got some good out of the present).

But in most ways I’ve just got used to it all. I can drive, swim, walk alone. I was starting to get used to not going through the X-Ray machines at airports, and am looking forward to being able to afford foreign holidays again, so I can go back to not using them again (I wonder will I be allowed to go through the new body scanners with my hand held up to my collar-bone?).

By and large I’ve forgotten the pacemaker is there. But every now and then (and very, very rarely) I feel a brief sinking feeling (though a very different type to the one above) and then recover, and realise that, had it not been for my tin lodger, I’d have had another blackout.

By chance, the most recent of these was yesterday. I was sitting at a meeting when I suddenly felt a quick jolt as it turned itself on.

Perhaps it was blowing out its candles.

Ping Go the Strings of My Heart

I took yesterday afternoon off to go to St Vincent’s to see my Cardiologist, only to be told that my appointment is the day after tomorrow.

I was quite psyched up for yesterday. I was going to ask why my muscles stay in spasm for so long after my pacemaker does its thrice-daily test-run, why it sometimes actually stings when it starts up, and why this has started a bruise which now stretches down the inside of my left arm almost as far as my elbow. (I read that sentence back a second before I published this, and realised that it said “my muscles stay in spam”. This is a fairly accurate description of my current physical condition).

In other words, I was going to give out. It’s true that familiarity breeds contempt – I used to be just grateful that the pacemaker had cured my blackouts, now I’m starting to get annoyed about why it can’t do it a bit more surreptitiously.

Anyway, it turns out I was there on the wrong day (perhaps all the scans that said there was nothing wrong with my brain weren’t entirely accurate), so my complaints remain thus far unvoiced.

My pacemaker celebrated this by turning itself on at four o’clock this morning and continuing to ping away until I eventually got up at 5.15 in frustration.

The bloody thing is laughing at me.

The Gift of Timing – The Birth of Tinman, Part 6

We’ve all had cars, TVs and other things which stopped working, yet when a ServicePerson turned up to fix them they worked perfectly, but then they’d pack up again as soon as said ServicePerson had left (fifty quid richer). In my case I’ve also had the experience of wearing a heart monitor for 48 hours and having my heart behave perfectly for all of that time. Still, my luck was about to change.

I turned up in St Vincents Hospital on December 18th to get a loop monitor inserted in my chest. The Cardiologist had explained that this might be in place for up to 18 months, and that they would take readings from it every three months or so to see  if my heartbeat was irregular or not.

In due course I was brought into a room and three doctors and a nurse set to work, wiring me up and then spreading a local anaesthetic on my chest, all the time chatting happily away like any group of professionals performing a routine task. But just as they started to make the incision I began to feel the by now familiar sinking sensation.

It was astonishing – I was blacking out in front of four medical people who were investigating my blacking out. Has anyone ever shown a better sense of timing?

If my blackouts used to cause panic among my workmates, it was nothing compared to the effect one had in a hospital. When I came round again I had an oxygen mask strapped to my face and the doctors were pressing buttons and turning knobs, all the time yelling at me to try and wake me up. When they saw I was ok one of them gave such a big sigh of relief that his mask inflated briefly in front of him like bubblegum. I think they thought they’d killed me, and I’d imagine their paperwork would be fairly onerous in such an event. Anyway, the four of them had seen my heart rate drop so low that it stopped briefly, so instead of three months I was told to return in four weeks to have the monitor read. “We reckon you need a pacemaker,” one of them said, “we just need some readings to show to a consultant.”

Four weeks passed with no real activity apart from the night of January 11th, when I awoke knowing I’d just had a pretty bad one, so on the 15th I went to work till eleven, then said “I’m off to get this thing read, I’ll be back around two”, left my computer running and my rucksack beside my desk, and headed off to Vincents. The lovely Áinle in Cardiology hooked me up, read the printouts, frowned and then said “I just want to show this to someone”, which I didn’t like the sound of, then practically ran out of the room, which I didn’t like the look of even more. She returned with four doctors, which is probably rarely a good sign. One of them showed me the printouts and pointed to a long black line which went on for page after page. “See that?” she said, “that’s your heart stopped for eighteen seconds last Friday night.” Even I was awestruck into silence by this.

“Anyway,” she continued, “we gave you the monitor to see if you needed a pacemaker, and now we know you do. We’re going to admit you, take out the monitor, and put the pacemaker in”.

“When?” I asked. She stared at me. “Now,” she said, “eighteen seconds is a very long time.” (She didn’t add “like, hello?” but the phrase hung unspoken in the air between us).

So that was it. I rang Mrs Tin to tell her, and to ask her to bring in pyjamas and a dressing gown (well actually, to buy pyjamas and a dressing gown, because the comfy old t-shirts that you wear in your own bed seem decidedly shabby when you realise that the general public are going to see them). Then I rang GoldenEyes at work to tell her I wouldn’t be back, and to turn off my computer, then rang her again to tell her that I had a sandwich in my rucksack that she should either eat or throw away. After that I was dressed in a fetching hospital gown, complete with the kind of super-low neckline at the back that goes right down to your arse, and was brought off to meet the people in Cardiac Care who were to be my roommates for the next eight days.

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Will Tinman survive the operation? Er, well, yes, I’m the one telling the story. Oh, right, there won’t be much suspense so. Still, if you’ve stuck with it this far you might as well read the end of the saga in Part 7  – “The Tinman Cometh” .

Testing Times – The Birth of Tinman, Part 5

The heart monitor showed nothing.

This was a pity, since it sent us off in the wrong direction for a few months. With my own GP now back from holiday I had blood tests, an MRI scan, a (shudder) prostate test, all of which were negative. Meanwhile I was still blacking out every now and again (though I did have one glorious 57-day stretch without one), but had got better at recognising the onset signs, and usually managed to sit or lie somewhere before the actual collapse, so I wasn’t injuring myself anymore.

In my local I used to prop myself in a corner of the bar, with my back to the wall, the counter on my right side, and the back of my stool on my left, and actually blacked out briefly there one night without falling, and with only one person of the three I was sitting with noticing what had happened. It’s a sign of how adaptive I was becoming to living with this permanently that I stayed on in the pub after the blackout, instead of rushing home as I did the first time.

Though I was slowly becoming resigned to a life without driving, without swimming, without walking anywhere alone, my wonderful GP certainly wasn’t, and her next step was to send me to a Neurologist – the brother of a well-known TV personality. It was he who started the whole cycle that led to me getting better.

Dr Niall Tubridy – feck it, let’s name him, he was great – looks like, is as thin as, and has the same voice as his brother (really spookily, when I arrived into his Reception his brother’s show was on the radio). He listened to my story from the beginning and then said “so, what have you got?”

I stared at him. “Come on,” he said, “we all know the Internet’s out there, what have you looked up?”

I named a few things. “And what do you think you have?” he asked again.

“Er, all of them,” I muttered.

“Look, I’m going to give you all the brain tests now,” he said, “but I’m telling you before I start that this is a heart problem.”

“I’ve had a heart monitor, ” I said. “I don’t care,” he replied, “From what you’ve told me there’s something wrong with your heart. I’m going to write to your GP and tell her to organise an appointment with a cardiologist here.”

I was impressed by the fact that he said this before he gave me the neurological tests, as he wouldn’t have looked too clever if he’d then given me the tests and said “shit, no, I was wrong, there is something wrong with your brain”.

He was as good as his word, and a couple of weeks later I found myself in front of Dr Colm Keane, a cardiologist who decided that I should have a loop monitor fitted inside my chest which would record every time my heartbeat went above or below a certain level. An appointment was made, and on December 15th I turned up to have this fitted.

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But the first monitor showed nothing. Will this be any different? Read on in Part 6 – “The Gift of Timing”.

Bedless in Bedlam – The Birth of Tinman, Part 4

So, I was put into an ambulance in front of the entire staff of the entire five floors of our building. Just to really rub it in, the one way system around Abbey Street meant that the ambulance had to drive round the building and then, nee-naring happily away, drive past them all again.

I was fairly groggy, having hit my head pretty hard, but when I looked over at GoldenEyes I was shocked.  I’ve never seen anyone so pale in all my life, and I realised that she (and probably the rest of the office) thought I was dying.The ambulance girl was testing me all this time, and it was she who was the first person ever to mention that my heart rate was very low, though she did say it might be because of shock. By then we had arrived at the Mater, and got the chance to experience A&E, Irish style.

I hadn’t rung Mrs Tin yet, since I decided that I’d wait till I had more info on what was wrong with me. I knew she’d have to give a reason why she was leaving to the Tinkids, and reckoned having her say “I’m going to see your Dad in the Hospital, I don’t know how bad he is” before driving off  would not go well. I also wanted to be able to tell her what ward I was staying in. It was only many hours later that I began to suspect that in fact they weren’t going to keep me in at all.

By then I’d had heart tests, chest and head x-rays, and numerous other tests, all of which seemed to involve having yet another needle stuck into my arm and yet more blood drawn out. I’d been to the loo, but just as I got there I was asked to wait outside while four Gardai, with a fifth one who was handcuffed to a guy in a wheelchair, who was also handcuffed to the chair, went in instead (A&E in the Mater is directly across the road from Mountjoy Prison). At one stage GE and I were just sitting, saying nothing, when an orderly came over with an empty glass jar. “Urine sample”, was all he said. “Is it? It’s very clear,” I answered (I was starting to feel better). “No, I want one,” he said. I looked at GE and sighed. “You can’t say I don’t know how to give a girl a good day out,” I said, standing to head off to the loo again.

When I returned GE had been joined by the HR Fireball, a mad Nordy woman who has since left to work nearer to home and her four young kids (and who I really miss). When I said that it looked as if I might in fact not be admitted HRF was horrified, and kept pointing out my head wound to anyone passing by, and suggesting in a loud Ballymena voice that I might have concussion.

Around this time a  young doctor brought me into a room, while the two girls sat outside, one either side of the door. The doctor gave me a 48-hour heart monitor, which had wires taped to my chest that led down to a box that I had to carry around for, well, 48 hours. He then told me I could go home. “What about going back to work?” I asked. And although I had two black eyes, a big bloody (no, literally) bump on my forehead and – by his own admission in giving me the monitor – a possible heart problem, he said “I don’t see why you can’t go back tomorrow”.

Often in films a man will be cut or have blood poured on him before being dropped into a tank of pirhana or sharks, who will then devour him. I achieved much the same effect on the poor doctor (well, I was pissed off by then) by walking out the door and saying to the two girls “he says I can go back to work tomorrow”. I often wonder did he have to get therapy afterwards, after the verbal devouring they gave him.

I finally rang Mrs Tin and she set off to come & drive us all home, & we went back to the waiting room to (obviously) wait for her. By now it was after six, and A&E was full of drunks. One guy was lying across three seats and, when no-one came near him, rolled off onto the floor. One of the attendants walked over. “Come on, Peter,” he said, poking him with a biro, “you know you can’t stay here”. Unfortunately he said this in a Polish accent, and straight away one of the Real Dubs sitting waiting was up in arms, defending a fellow Irishman against this blow-in (who was taking all our jobs – after all, if he wasn’t here Real Dub could have been the one dealing with drunks & mopping up vomit). “You can’t try & move him like that. For all you know he has a serious injury”, said Real Dub, suddenly a health expert. I personally reckoned that the fact that the Polish guy knew Peter’s name probably meant that Peter tried to get a bed this way most evenings (which I later had confirmed to me, they either get admitted or the cops take them & put them in a cell – either way they get to sleep in a warm room), but Real Dub continued to harangue the attendant, demanding immediate treatment for poor afflicted Peter.

Peter somewhat spoiled his argument then by getting up, going out for a cigarette, then coming back in and lying down again.

It was almost worth the whole traumatic day just to see the look on Real Dub’s face.

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Will the heart monitor reveal anything? Will Tinman realise that there are only 2 days left till  his Pacemaker Birthday and that he has 3 parts left in this series? Find out in Part 5 – “Testing Times”.

Being Outed: The Birth of Tinman, Part 3

At six a.m on August 15th, 2007, it was raining.

I had quite an important meeting organised for that afternoon, so was dressed slightly better than usual for work. I looked out the window during breakfast, decided I didn’t fancy getting these clothes wet, and opted to drive the whole way into the office.

The only way in which driving right into the very heart of Dublin is ever an option is to be there before seven a.m., so I rocketed along the M50 at astonishing speeds (in the aforementioned rain) and duly arrived at 6.55. Now I know that I could, of course, have blacked out at 120kph on the Motorway, but at the time they were still happening infrequently enough to not loom large in my mind.

That was the last time I drove for seven months.

At about 10.30 I was walking back from the kitchen in the office with a mug of tea and a glass of water. About ten feet from my desk I felt the now familiar draining begin. Desperate that no-one see me fall, I put the water on a printer and then knelt down, hoping I could fight it off. I then, rather amazingly, placed my tea on the carpet a few feet away from me, so that when I did black out and topple over, as of course had always been inevitable, I did as little damage as possible.

I was comprehensively outed, though, especially as MyAgeGirl saw me fall and apparently ran round yelling “CPR! CPR!”. When I came round I opened my eyes, saw about twenty people around me, and closed them tight. “Crap, I’m at work, aren’t I?” I muttered.

“You are,” I heard The Overlord say. I opened my eyes again, sat up at looked at everyone. “Well, this is embarrassing,” I said.

“Do you need CPR?” asked The Overlord. “Dunno,” I said, “can I pick who I get it from?”

He just stared at me for a second. “You’re feeling better, I take it,” he said drily.

And I was. So I got up, went back to my desk, assured everyone that I was fine, didn’t need to go home, was seeking treatment, etc. People came and suggested possible causes, everything from Epilepsy (my own vote at the time), to Multiple Sclerosis(?).

And the morning drifted on. People still suggested I should go home, but I couldn’t, because GoldenEyes and I still had this meeting with a guy over from the UK later that afternoon.

Neither of us ever got there. At 12.15 the fire alarm sounded in the building. A restaurant was being fitted-out on the ground floor at the time, and the oxy-actylene torches would set the alarm off about three times a week. We all grumbled, got-up, and all five floors – about 400 people – trooped down the stairs and gathered outside in the Millennium Walkway.

And that was when I felt it again. I leaned back against the wall, said to GoldenEyes “I feel terrible,” and before she could do anything, I fell face forward onto the concrete. My forehead and right eye swelled straight up like a balloon, and though I came round almost immediately, someone from one of the other companies on another floor had already rung for an ambulance.

It was agreed that GE would come with me, and off we headed for the Mater Hospital.

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Will they find out what’s wrong? What’s A&E in the Mater like on a Wednesday afternoon? Find out in Part 4 – “Bedless in Bedlam”.