I tried to ask what was happening, but the words would not come out. I had woken up in a hospital bed, with my face covered by an oxygen mask, with my brother and sister, both in tears, sitting next to my bed. I began to panic. Had I had an asthma attack?
I knew the asthma I had suffered as a child was improving so I quickly discounted that. Then I assumed I must have been in a house fire and had suffered smoke inhalation, so I felt my legs for burns but they were OK. Not long afterwards, I lost consciousness again. I could never have imagined the truth: that my heart had stopped on the rugby field for 25 minutes.
I've always loved sport – so it was inevitable that I would join the rugby team when I went to Southampton University medical school. Last November, the medics team was playing in a competition called the Hampshire Plate.
I can't actually recall what happened during the match – the last thing I remember before waking up in hospital was sitting a fourth year exam on the previous Friday. I've been told I probably could remember more if I wanted to but that my brain has shut it out.
Apparently I was involved in a tackle 10 minutes into the game. I took a blow to the head (but I won the ball). Moments later I had collapsed, was having a fit and frothing at the mouth.
One guy took out my gum-shield, which stopped me choking on my own tongue and definitely saved my life. At first, the team – luckily all medical students – thought I was suffering from epilepsy or an asthma attack. But I suddenly stopped breathing. They couldn't feel a pulse. I had suffered a cardiac arrest.
I owe my life to a series of lucky events – but there's no doubt that my biggest stroke of good fortune was to collapse on a pitch-full of medics. What are the odds of that happening? Five of them – including two physiotherapists from intensive care who were spectators – began performing immediate cardio-pulmonary resuscitation (CPR) on me. A surgeon called an ambulance.
Meanwhile, a first aider had arrived, with a hug bag of kit. Inside was a portable defibrillator – my next stroke of luck. A physio called Andy shocked my heart into beating again.
Apparently I wasn't a pretty sight by this point. There was blood and vomit all around me, my face had turned blue, my lips even bluer.
The chances of anyone surviving a cardiac arrest outside hospital are very low. They decrease by 10 per cent every minute in the first 10 minutes that the heart is stopped. Moreover, I had inhaled my own vomit. I was as close to death as it is possible to be. When the paramedics arrived they put a breathing tube down my throat. By the time we got to casualty at the Royal County Hants hospital in Winchester, I'd bitten through it and they had to insert another one. I'm a bit of a fighter, apparently.
At the hospital I was investigated for brain damage, and to find out why my heart had stopped. I was moved to intensive care where I was placed under heavy sedation and fed a lot of antibiotics. Inhaling the vomit had led to a condition called chemical pneumonia. Vomit is very acidic and full of bacteria – that's why it's so damaging to your lungs.
My parents had warned that I might be unconscious for up to three weeks but by day seven I was waking up, disoriented yet desperate to know what had happened. It fell to my brother Hywel and my sister Sian to fill me in, as they were sitting by my bed when I finally came to.
"Hey Mikey, how's it going?" My brother's gentle inquiry masked a lot of anxiety. My family had been warned that even if I did survive, I would have suffered some degree of brain damage.
He calmly went on to tell me what had happened – apparently he had already told me the story over and over again as I'd dipped in and out of consciousness. Yes, I had nearly died. No, I wasn't going to die now – I was recovering.
Oddly enough I was furious – I wanted to shout at my brother. I couldn't understand why he was telling me what seemed to be a lie. I had played sport all my life. This couldn't be happening to me.
My sister later told me she had trouble recognising me. Fighting chemical pneumonia is hard work – the body uses up about 7,000 calories a day. I went into the hospital weighing 13 stone. By the time I left, I was 11 stone.
The next three days were awful for all of us. I had been on so many drugs that when the doctors took me off them, I went "cold turnkey" as their effects wore off. I began to hallucinate. I thought a cupboard was a bus which had crashed. I saw a board that carried a price list for operations, offering cheaper options including one that would be performed by second-year medics with a rusty knife. I even through the nurses – who in reality were wonderful – were trying to sell off parts of my body.
When the hallucinations ended, I was sent to the rehabilitation department. Everyone there but me was older, and had suffered strokes. So even when my parents were being told I might have to be there for between three weeks and three months, I was deciding on a quicker exit.
"Don't bother hanging up my cards," I told the nurses, "I won't be staying". I was out in five days, discharged to my parents' home in West London.
Then it was time to find out what had really happened. I was referred to a cardiologist called Dr Ed Rowland at St George's Hospital, Tooting, south London, who performed several scans on my heart and diagnosed Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC). This means that normal muscle cells in the right ventricle, or lower chamber of the heart, are progressively replaced by fibrous tissue and fat, preventing the heart from beating properly. Ironically I knew all about it because my sister had been diagnosed with ARVC five years earlier.
After my diagnosis, the whole family went for screening and my mother was also found to have it. It's a genetic condition and the gene is dominant, so if one parent has it, there is a 50 per cent risk for any children.
One week later I was back in hospital, having an implantable cardioverter defibrillator (ICD) inserted through my armpit and placed under the muscle covering my rib. If my heart ever stopped in the future, it would give me an instant shock to get it working again. It's the size of a mini-iPod and works off a battery that only needs replacing every seven years.
Everyone said I would have to give up rugby – except my consultant Dr Rowland, who told me to go for it. So I went back in February – too soon and too hard. I was playing a game of touch rugby when boom, my ICD went off. It felt like a whack in my chest. I knew straight away what had happened and sat down. It was obvious that I had to give the game up and I was gutted.
No one can explained why I survived on that rugby field in November. Maybe my heart didn't stop completely for the full 25 minutes. Maybe the cold winter air slowed down my metabolism so much that damage to my body was minimised. It must have helped that I was fit, with strong lungs thanks to my earlier passions for rowing and surfing.
Nor do they really know what caused the cardiac arrest, although there are theories that strenuous exercise or a virus can bring it on. Neither my sister or my mother have had a major problem with ARVC – although both could.
Sudden death in young adults suffering an undiagnosed heart problem is a lot more common that you might think – every week, eight apparently healthy young people will die because of one. The only real answer is a screening programme that can pick up the problem in time to have a defibrillator or pacemaker fitted, or even surgery if necessary.
I try not to think about what could have happened, about death. Very early on I made a conscious decision not to let fear of my heart condition rule my life. I owe that much to my family and all the friends who supported me through it. I fear not living a full life much more than I fear dying.
Mike is a member of the Surgery Supporters Club, run by the charity CRY (Cardiac Risk in the Young).
Read more about ARVC
