Steve Burcham's Blog

Last week was the best week I’ve had in a long time!  On Thursday night, I spoke to a local group of the Mended Hearts at the Dowdle Center in Huntsville.  I was surprised to find many of my former Chrysler colleagues as members of the group and Tiffany and Ashley, my nurse and pacemaker tech from The Heart Center, in the audience!  I enjoyed meeting some new friends, reconnecting with some old ones and sharing my journey with all.  Feeling strongly about the mission of the Mended Hearts, which is “Inspiring hope and improving the quality of life for heart patients and their families through ongoing peer-to-peer support,” I joined the group and look forward to being a productive member of Chapter #260.  Over the weekend, Cindy and I traveled to St. Augustine, Florida on our way to Daytona Beach.  On Saturday, she shopped at the outlet malls while I played golf at the King and Bear Golf Course.  Being a single golfer, I was paired up with two brothers, Tony and Frank, and another gentleman named Rick.  Right away, we hit it off as golf partners and enjoyed the beautiful fall-like weather and perfectly manicured course.  Since springtime, I've been working with local teaching professional, Billy Eastep to “get my game back” after transplant and the lessons are paying off.  I’m hitting the ball well off the tee box and enjoying the game again.  Afterward, Cindy and I enjoyed the afternoon in the company of her brother, Billy, sister-in-law, Heather, nieces and friends.  A pool party was already in progress when we arrived at their new bay-side home.   I had fun playing with my nieces, Arden and Marin, in backyard and in the pool.  Later, we traveled to the Daytona Beach Resort to attend the annual book award ceremony being held by the Florida Authors and Publishers Association.  I was both surprised and honored when Prayer and Grace, My Journey to a New Heart won a gold medal in the autobiography / memoir category and a silver medal in the religion category!  After meeting and conversing with a number of great national authors, Cindy and I retreated to our room to watch the Auburn play LSU in Baton Rouge.  By the time we tuned in, Auburn had gotten behind but played the second half like the champions we know and love. Thanks to all of you for making Prayer and Grace an award winning book!  What a great week indeed!

Late in 2011, when I was being qualified for a heart transplant, a friend gave me a book that was written by a heart surgeon who himself had gone through a quad-triple heart bypass.  One of the takeaways from reading his story is this: if you have experienced a health setback, part of the recovery plan, if at all possible, should include physical fitness training and participating in a big event.  He suggested entering a 1-mile walk or a 1K “fun” run.  After I received my new heart in February of last year, I put his advice into action and began training for the 2012 Cotton Row Run 5K footrace.  Even though I had been walking about two miles per day post transplant, the doctor’s approval to begin running came less than four weeks before race day!  With training time cut short, I immediately started running on the treadmill at the Hogan YMCA in Madison, Alabama and managed to muddle through the Cotton Row 5K finishing at 40:09.  Here’s what I wish I had known back then.
Running with a Transplanted HeartTheoretically, heart transplant patients receive younger, healthier hearts.   While improvements in the recipient’s quality of life are dramatic, a full return to a normal state of full physical stamina is not assured.  Here’s why:  The transplanted heart is denervated.  Simply stated, it is no longer connected to the recipient’s brain.  In a normal, healthy human being, the heart receives signals from the brain through the Vagus nerve.  The vagus nerve is a “wandering” nerve from the brain that runs through and controls bodily functions in the neck, thorax, and abdomen including the heart.   When a normal healthy human being is working, the healthy heart has two responses to that work:  a chronotropic response and an inotropic response.  Dictated by the brain through the vagus nerve, the heart can speed up (chronotropic response) and also beat more forcibly (inotropic response) as the environment and work activity demand.  Having spent most of my career in the automotive industry, it’s easier for me to think about these properties of our hearts analogous to a truck and it’s engine.  Metaphorically, think of our bodies as the truck and our hearts as the engine of the truck.  Image also, that our trucks not only have a V-8 engine, but one of those new technology engines that allow some of its cylinders to be activated or deactivated on demand.  So, when our “truck” is running or lifting weights our “engine” can respond accordingly to accomplish the tasks at hand.  A healthy human’s heart can go from being a 6-cylinder engine at idle to an 8-cylinder engine under heavy load in our bodies at a moments notice.  And it can go from idling at a stoplight to a full-throttle take-away very quickly.  However, the transplant recipient’s denervated hearts, are more like a 4-cylinder engine that can maybe perform the work of a 6-cylinder engine if given enough time to speed-up and get ready for the task.  Without the vagus connection, the transplanted heart responds to chemicals (like adrenalin) in the bloodstream rather than signals from the brain, which takes much more time.  Gunning our engines is not possible.  With no other contributing health factors, even with a newer healthier heart, a transplant recipient may likely only achieve about 40-60% of their original physical work abilities and stamina before heart trouble.  So, how do heart transplant recipients prepare for and conduct physical activity?  Here’s what I have learned.
Steve’s Keys to Exercise Post TransplantIn summary, if you have a transplanted heart and decide to start exercising vigorously:·      Understand your new physical limitations and set your expectations accordingly. ·      Buy a RoadID wristband and wear it.  Mine has my name, date of birth, wife’s name and cell phone number, doctor’s names and phone numbers and the banner “Heart Transplant 2012.”  ·      Get your doctor’s approval, then set goals and work towards achieving those goals.  Initially, I improved my stamina in a highly monitored physical therapy laboratory at the Spain Rehabilitation Center in Birmingham, Alabama.·      Add 10 minutes (minimum) of warm-up time to your routine.  Warming up your new heart before exercise is a critical success factor!  Heart transplant recipients cannot skip or skimp on the warm-up because it takes much longer for the denervated heart to reach the target heart rate. My new heart takes 5 minutes of vigorous walking to get up to 150 bpm and 19 minutes get to my target heart rate of 165 bpm!  Usually I start running above 150 bpm.·      Know your target heart rate & range.  Generally, your target rate is calculated by subtracting your age from 220.  Using a runner’s wristwatch actively monitor your heart rate during exercise and heed the alarms.  For example: my target is 165 bpm.  My range is 160-170 bpm and my runner’s wristwatch set to alarm at 170+ bpm.·      During exercise, stay hydrated and watch your heart’s performance.  If your heart rate exceeds your upper limit, slow down or stop until it drops well below the range and then proceed.  I notice that it’s easier to run again after I have walked a bit.·      Schedule exercise for 2 or 3 times per week. ·      If you don’t feel up to exercising one day or for a week or even two, don’t do it!  The old rules of “playing hurt” and “pushing yourself through” setbacks don’t apply.  I’ve noticed that I get tired after several days of work, exercise and playing golf and need a “down” day or two to allow my body to rejuvenate itself.Now, when running 5K races, I walk a bit at the beginning of every mile to let my heart rate drop back about 10-15 bpm.  Even though I didn’t consider myself a serious runner before transplant, nor do I now after transplant, I still love to get out and run!   It’s tough at first, but the great feeling of accomplishment after you finish a race or your daily run is worth it.  Oh, and one last point – don’t expect to win your age group – just run and have fun!           
References: “Point:Counterpoint: Cardiac denervation does/does not play a major role in exercise limitation after heart Transplantation,” Arne K. Andreassen. J Appl Physiol 104:559-560, 2008. First published 5 July 2007; doi: 10.1152/japplphysiol.00694.2007

Wow, what a wonderful day for a footrace!  This morning was unusually crisp and cool for a Memorial Day in the south.   This year, “Team Burcham” consisted of my brother, Mark and his wife Mary and son, Wesley.  Plus my “sis” Nancy, niece Julia, Stephen Davis, a friend and colleague from Digium, and my dad, Terry, whose 81stbirthday is today.  After the start of the race, Julia and Wesley decided to run up in the front of the pack and left the rest of us in the dust. We were so happy and honored to be running along side our dad, who served the US army as an MP (military policeman) during the Korean War back in 1952-1954.  I’m so blessed to have a wonderful family and another yet unknown family, that during their time of loss, carried out their loved one’s wishes and donated “gifts of life” to recipients like me allowing me to enjoy more quality time with the ones I love.  As a matter of fact, we are all blessed to enjoy our freedoms and our great nation, one that has been built and protected over the years by so many men and women in service – some that have been lost along the way.  It is my hope we all take a moment in prayer today in memory of those who have gone before us in service and for their families who, like my donor family, who will be missing their loved one today.  Then celebrate these United States in the good company of your friends and family! 

Over spring break this year, Cindy, Anna and I joined Buddy and Carole for a week of snow skiing in Park City, Utah.  Wanting to be “in shape” and ready to spend an enjoyable time on the slopes, I prepared myself by jogging 2-3 miles, 2-3 times per week.  Weather permitting, I would run outdoors in the neighborhood and other times on the treadmill at the Hogan YMCA in Madison. So, when we decided to ski everyday for the entire length of our weeklong stay, I enthusiastically said, “yes,” and ordered the lift tickets.  I was in for a bit of a surprise as jogging doesn’t closely simulate the actions and moves required for snow skiing.  Like a beach bum that hits the beach without sunscreen on the first day of his vacation, I hit the slopes ready to shred powder all day.  I was ready to conquer the slopes like I hadn’t done in years before transplant.  And that’s what I did, new heart and all.  After gearing up slope side, Buddy, Carole, Anna and I spent the entire day skiing greens, blues and double-blue runs at Park City.  Big mistake!  My heart did just fine but I woke up the next day with the most painful thigh muscles ever.  It felt like I had done a thousand squats the day before!  I may have been a little whiney on day 4 and day 5, and I may have “called it a day” at lunchtime on a few days, but I did manage to ski everyday for 5 days and travel back to Huntsville in time to join my family, friends and Digium colleagues for the Heart Walk, a 5k walk around Bridge Street Town Centre in Huntsville to raise funds in support of the American Heart Association.  I’m proud that the "Digium Pacers" fundraising efforts were recognized at the event and we had a nice turn out of walkers on a beautifully sunny and crisp springtime Saturday morning.  Thanks to all of you that donated to and attended the event.  You helped us raise thousands in support of the AHA.  

“Why do you run?” Cindy asks me when I return from a workout at the Hogan YMCA or a 5K footrace.  “You weren’t a serious runner before heart transplant -- why now?”  And she is right.  Running is something fairly new to me.  I think what motivated me to run in my first footrace, the 2006 Cotton Row 5K, was that I wanted to join my dad, 74 years old at the time, my step-sister Nancy, my brother Mark and his wife Mary in a fun family activity.  Now, I believe I run, not only to enjoy the company of friends/family and the rejuvenating aspects of exercise, but for three reasons.  The first is to gage my health performance post heart transplant.  Back when I was living with a full-blown case of dilated cardiomyopathy, walking to the mailbox required a waypoint to stop & catch my breath.  So, if I can run a 5K without huffing and puffing my way through, then, I feel well overall.  Second, I hope my presence and story may provide strong motivation for others, even those with physical challenges.  And, finally, to support the cause at hand: this Saturday’s race benefited the Wounded Warriors.  Running alongside a platoon of marines was inspirational.  Adding to the experience, State Senator Bill Holtzclaw – a retired marine himself -- called cadence for about a ¼ of a mile of the race.  Being performance & numbers minded, afterward I went back and checked my 2006 race time, the very first time I entered a race.  I finished the 2006 Cotton Row 5K race at 35:18.  Post transplant, I finished the Wounded Warrior 5K with Bill at 36:12, only about a minute off my very first race!  Running alongside the marines surely helped.  My goal for the 2013 Cotton Row Run will be to come in less than 35:18.  Friends and family, let's run it together!

Valentine’s day now holds additional meaning for me.  It marks the anniversary of receiving my new heart.  It was around Valentine’s Day in 2009 that I experienced my first cardiac symptoms.  It was last year on Valentine’s Day that I woke up with a new heart beating in my chest.  Now, on this Valentine’s Day, my book, Prayer and Grace: My Journey to a New Heart, chronicling my journey from tachycardia-to-transplant, became available for sale on Amazon and Barnes & Noble!  I remember the encouraging posts all of you wrote which started the wheels spinning in my head: “you should write a book,” “you should start blog!”  I’m so thankful for all of those strong encouragements because writing the book became an enjoyable project.  Less than a month ago, when I pressed the “publish” button, I felt a sense of accomplishment and closure that I haven’t felt in a long time.  Now that it is available, I thought I would share with you “what P & G is.”  As you all know, about a week after my heart transplant, I was released from UAB Hospital with a requirement that I had to live in Birmingham, Alabama and go to doctors’ appointments twice per week for five weeks.  Reminiscent of our newlywed days, Cindy and I shared a one-bedroom apartment adjacent to the Summit Mall.  I think she encouraged me to write to keep me out of her hair!  It was then that I sat down to begin writing P & G.  It started off as a diary of my health journey and over time, with much prayer and input, it became my “modern day parable.”  Remembering our Lord’s days here on earth, Jesus transformed the multitudes through use of parables to illustrate his Father’s truths to and captivate the masses.  So, P & G is my true story, the parable of “the man who asked God for help during life’s most difficult times and received His help.”  I wish it to fall into the hand of those who are lost or struggling physically or spiritually and through its reading transforms that individual into one eager to know Him and be counted among his flock.  If just one person finds the Lord because of my journey, it will make my four year struggle with heart failure worth the trip.