Tuesday 23 April 2019

Still young at heart

Mallow man Mick O'Shea is a prime example of the importance of organ donation. He talks to Maria Herlihy about his transplant journey

Mick and his wife Jennifer did the Quest Adventure Race in Killarney in October 2018. With a smile, Mick said Jennifer beat him on the day but he completed the 27 km course in 2hr 36 min
Mick and his wife Jennifer did the Quest Adventure Race in Killarney in October 2018. With a smile, Mick said Jennifer beat him on the day but he completed the 27 km course in 2hr 36 min
A picture of Mick taken in the Mater Hospital in Dublin, pre transplant stage

When 38 year-old Mick O'Shea felt he had the flu over the May bank holiday weekend back in 2017, in an attempt to offset it he took off running but didn't get too far. Little did he know that by August, he would begin to put one foot in front of the other again with another person's heart pumping in his body.

And by September 11, a day etched in the minds of so many, Mick was back home in Mallow.

Mick, along with others from throughout the country, stresses the importance of organ donation and its awareness. The annual campaign was held recently and was organised by the Irish Kidney Association and supported by Organ Donation Transplant Ireland. The focus of the campaign is to remind individuals to talk to their families about their organ donation wishes and keep the reminders of their decision available by carrying the organ donor card, permitting Code 115 to be included on their driver's licence and having the 'digital organ donor card' APP on their smartphone.

But, like all stories, it is best to return to the beginning to that May bank holiday weekend. With a smile, Mick told The Corkman that when he didn't get too far on the Friday night when out running, he reverted to option B - that involved "dosing myself with paracetamol". He repeated this the next day but when he was lying down he felt that his lungs were filling up.

However, on the Sunday he felt mildly better - that was because he out of bed and standing up. By 9pm he was back lying down, he simply couldn't sleep and was feeling worse by the minute.

He did like most do, reverted to Dr Google which, Mick admits, is always a mistake.

"I tapped in my symptoms and I got back that it was either heart failure or I was pregnant and I thought to myself, well it isn't that anyway," Mick recalls with a dollop of good humour.

As he sat on his sofa at home, reminiscing about that weekend 18 months ago, Mick said he battled on and, like "a typical man", he threw in the towel and went to his doctor on the Wednesday - six days after symptoms first appeared.

He shakes his head and laughs at the memory but now readily admits when he got to Dr Aidan Kelleher, he felt like he was at "death's door". What ever about the giggle about the pregnancy, what about heart failure?

During the examination, Mick was ticking a lot of boxes for pneumonia and Dr Kelleher sent him to Mallow General Hospital (MGH) for further tests to err on the side of caution.

At MGH after some further tests, he was told he had a heart infection and not pneumonia. They had seen it many times before but would admit him to keep an eye on him, removing the fluid too which was building up on his lungs.

To be on the safe side he was sent to CUH where there is a 24 hour cardiac care unit along with specialist teams. Mick went by ambulance to CUH where he was met by whom he describes as an "absolute gentleman", Dr Peter Kelly.

Again more tests were done while consultants sought to get to the root of the infection. At this stage, Mick was stable and by Friday evening he was on the phone letting people know how he was. However, fast forward a few hours and he went into heart failure. The stakes were now upped greatly.

"Staff were running from everywhere and while I was aware of the panic going on around me, it was still a very strange environment to be in," he says.

And so began the first phase of the mountain Mick would climb. An intra-aortic balloon pump (IABP), which is a long skinny balloon that controls the flow of blood through the largest blood vessel - the aorta - was put in place. The device gets smaller when the heart pumps so that blood can flow out to the rest of the body. It then gets bigger when the heart relaxes to keep more blood in the heart.

However, a balloon pump is also quite big and bulky and when it is plugged out it runs on batteries. As explained by Mick, the balloon pump didn't work as planned so the next step was to transfer him to the Mater Hospital in Dublin.

When Mick was being taken in the ambulance to the Mater, he had an anaesthetic nurse along with a Garda escort. He spent the next eight days in Dublin with the balloon pump with a 12 per cent heart efficiency rate.

"The balloon pump was the machine which was keeping me alive," he says.

And so after the health upheaval Mick had finally got a diagnosis - myocarditis. This is an inflammation of the heart muscle and reduces the heart's ability to pump, causing rapid or abnormal heart rhythms. A viral infection usually causes myocarditis, but it can result from a reaction to a drug or be part of a more general inflammatory condition. Signs and symptoms include chest pain, fatigue, shortness of breath, and arrhythmias. However, severe myocarditis weakens the heart so that the rest of the body doesn't get enough blood and clots can form in the heart - leading to heart attack or stroke.

On May 24, 2017, Mick said the balloon pump was taken off and it was deemed that his viral infection had gone. "The heart was coming back up to normal and, with the medicine I was taking, it could all come good," he says.

Again to make sure all was good - a biopsy was done. But it wasn't good news - Mick was going back into heart failure.

He was then put straight on an ECMO machine (Extracorporeal membrane oxygenation) which is used during life-threatening conditions such as severe lung damage from infection or shock after a massive heart attack.

But first he had to undergo surgery to have the tubes fitted. Afterwards he couldn't move and nurses had to help him with absolutely everything. From living life to the full, he found himself lying still in a bed with no movement.

"It was a tough, tough time," Mick says, as he went from being very active to lying earthly still. There was naturally a huge feeling of helplessness.

"This really was a mental game. It was hugely tough. I suffered from hallucinations and I found it so hard going. It was a surreal environment."

With sheer honesty, he says: "Of course there were days and nights when I wasn't positive. The ECMO really wore me down, it was a very, very tough time."

On July 1, he was told he was on the heart transplant list. With a slice of humour, Mick pointed out that getting a new heart was not a run of the mill thing - they had to be donated and such vital organs were in precious short supply.

"There are only about 15 heart transplants per year. I was listed as number three priority and, of course, that means there are two people before you also waiting for a donor. There is a huge amount of waiting involved, a huge amount of medical testing involved, a huge amount of stress involved and not forgetting the person who is actually donating a heart," says Mick.

During all of this, his weight plummeted from 85kg to 65kg in eight weeks. However, to be viable for a heart transplant, adequate weight is paramount.

"I had zero strength and I couldn't help but think of how I was - out running, out on the bike, out enjoying myself with my wife, Jennifer. Your mind floods with thoughts and it is part and parcel of it all," Mick continues.

"It was also hugely tough for Jennifer and my mother Nora and they would make the journey up to Dublin not knowing what would happen."

While he desperately wanted a heart, he was also realistic about the time frame as he got to know other patients also waiting on heart donation who were there longer than him.

"A person can wait a long, long time for a heart donation or any organ donation. That is why it is so important that people have the conversation with their family on organ donation."

Then came notice that a transplant would go ahead but Mick wasn't in line for it. Then four weeks later, for a third time, he was "worked up for surgery" but yet again he wasn't the number one priority.

In the middle of August he finally got the call - the real call - he was a priority.

His wife, Jennifer, had left the hospital to get a pizza for him when the hospital transplant co-ordinator walked into this room with the news. Mick got on the phone to Jennifer where she thought he was joking.

"I didn't get to have that pizza," says Mick with a smile as he had to be fasting.

He went for the transplant on a Thursday and woke up on Saturday morning. It must have been a surreal feeling to wake up with another person's heart beating inside your body?

"I didn't have time to think about anything as, unfortunately, I was told I had got a clot."

As Mick explains, with a clot the options are to blow it into the lungs or cut it out by surgery - if the clot had gone into his heart it would have meant that the transplant had failed.

It was a lot for Mick to take in and it also meant another operation. Thankfully, the clot was outside his heart and all was rectified. It was a massive relief.

And as each day passed in the Mater, Mick watched as the countless machines with lots of wires were slowly reduced, one by one. He watched his progress as he began to put one foot in front of the other. He watched and noticed the movement return to his body. He watched and waited for when he could go home. That Friday night run that he went on back in May seemed a world away from where he was now at.

So how does Mick look at life now?

"Every day now is a good day. I went from walking 20 to 30 metres to 500 metres by simply putting one foot in front of the other. I smiled when I reached a milestone but it has been tough. I am incredibly lucky as I have got a second chance - that doesn't happen for everyone, so instead of looking at what happened to me, I think of how lucky I am."

But has it been smooth sailing since?

"Well, I won't forget September 1 as I was at home and I had forgotten to take one tablet, so I rang the Mater where I was told I was in rejection as they had just re-read my biopsy results. I had to return to the Mater for a high dose of steroids over three days and, thankfully, this rectified the rejection," he said.

Finally, on September 11, he put the key in the door and was back home in Mallow.

"That date of September 11 is etched in the minds of so many people as being a horrific day in history. It was my own bit of history but it was a good bit of history for me," says Mick.

While he will have to take the anti-rejection medication for the rest of his life, it isn't something that fazes him, considering all that he has been through.

"My outlook in life now is completely different to what it was. I was born healthy but, at 38-years-old, I never thought I would end up not being healthy and need a heart transplant. I did have a heart transplant and went through my own recovery. I now have such a hugely different outlook in life," he reveals.

Mick, an electrical engineer was a self employed contractor working at the EPS Group in Mallow when he fell so ill. Despite all Mick has been through, he heaped a huge amount of praise on Patrick Buckley, MD of the EPS Group.

"Patrick at EPS backed me all the way and he really has been fantastic. If I was to personally thank everyone who has helped me I would end up having hundreds of pages.

"People that I hadn't seen in years reached out to me and the amount of calls and texts and what not from people was over-whelming. People really stood by me and showed so much support and I am so grateful to them all," he says.

Despite all that Mick's body has gone through - along with his mind - he has knuckled down and recently completed a 17 week personal training course.

"I absolutely loved doing the course as I met like minded people and the people who were attending the course were inspirational to me."

When asked why he opted to do this, he said that his goal now in life is simple - it's to help people who now find themselves in the situation that he had been in.

"I have got a second chance at life and I am grabbing it with both hands. We are all on this planet really for a short time and you should enjoy your life but, and this is the but, you must make an impact."

Since Mick's recovery, he has travelled to Dublin to speak to others who are waiting on a transplant list. "I feel the person resonates better with you as they know what you have been through and what you are talking about is what you have been through.

The doctors and consultants can speak to a person from a medical viewpoint, but it's really the person who has been mentally and physically on the journey who can have the greatest impact and the greatest calming manner on a person who is waiting on a transplant."

With the theme of giving back now central to Mick's life, he will do exactly that when he joins Transplant Team Ireland at the World Games in August where he will take part in the cycling and running events.

Mick, who quickly dishes out the humour, tells this reporter when he meets fellow transplant patients who now have become a second family to him, it is quite the scene when phones start beeping at different times as a reminder to take their tablets.

"My phone alarm goes off at 10am and at 10pm and I take various tablets at that time. When I'm with friends who have received transplants, you would be in the middle of a conversation when all you can hear is beep, beep, beep all around you and friends check their phone and then take their tablets," he says with a laugh.

Mick never thought he would find himself walking around with another person's heart. He has a completely different outlook on life and has re-trained as a personal trainer (PT).

He graduated on Saturday from his PT course and his fellow classmates nominated him student of the year.

"It is very fair to say that I have a very different quality of life now but what I do have in spades is a far better perspective on life and, for that, I am very grateful," he adds.