Monthly Archives: September 2013

Not news, but I’m feeling good

I’ve realised that I have a tendency to write about days when I’m not feeling great. Sorry! I guess it’s a way of sharing my thoughts… I am still very much in the “coming to terms” phase of being a Heart Attack Survivor. There are a lot of new things that go with it; medication, dietary control, regular exercise, anxieties (my own and other people’s) etc. etc. I guess illness is one of the more worrying!

Well, I’m pleased to report that for the past few days I’ve been feeling good! I feel like I’ve fully recovered from whatever was hanging over me. All signs of malaise and tiredness have gone. All is good with the world!

I guess one of the reasons feeling under the weather is newsworthy is that I’ve been feeling good most of the time since I left hospital. I recognise that’s a good thing… just not newsworthy.

I did a couple of good rides over the weekend. Having struggled during exercise generally last week, it was great to get back in the saddle and resume my training.

On Saturday we went over 25 miles for the first time. There’s a long way to get up to the distances I’ll need to cover during my Charity Ride, but it feels more doable now, particularly as my recovery is getting much faster as well.

***

This week sees my first business trip since the Heart Attack. In fact, I’m sitting in my hotel room as I speak, having successfully negotiated the tricky drive from Manchester to Lancaster. The drive was built up as a potentially treacherous route (people have been known to go missing for days attempting it), but it turned out to be fairly straightforward.

Travel has been a feature of my work life for as long as I can remember. This trip requires a short return flight and two nights away. Absolutely run of the mill under normal circumstances, but normal circumstances went out of the window a while ago! So it’ll be good to get it out of the way. Another “first” ticked off the list!

Not today’s destination I’m afraid…
maybe next time!

I’m also pleased to report that my Stents do not set the Security Alarms off at the Airport (at least not on this occasion!). Another relief! Happy days! 🙂

Things you learn at a Cardiology Conference

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My life has had a little more variety since my Heart Attack. I’ve met some interesting people, discovered healthy eating, caught the exercise bug, been educated in control and tried to introduce balance into my life.

This week, I had the honour of attending the North of Scotland Cardiology Conference. The conference was open to all Health Professionals in the Region. There were a number of sessions on prevention and treatment of Heart Conditions throughout the day.

I had been invited along to speak about my “Heart” experiences in a session entitled “A case that has influenced my practise”. I don’t think there was anything particularly special about my case however they were keen to introduce a patient’s view into the room to provide a different perspective on things.

I’ve spoken in front of groups of people lots of times over the years. While I wouldn’t say it’s something particularly enjoy, I don’t mind it. I was happy to “volunteer” when asked if I was interested in speaking at it, although the whole experience turned out to be a bit more nerve-racking than I had anticipated.

The overall Conference Title was “The Patient journey to 2020”, so I decided to speak about my personal life journey, the impact my Heart Attack has had on it, the important role the people in the room have played in it over the past few months, and how important I think it is to keep focusing to the future. While I recognise that it’s important to operate within your limits, I think it’s all too easy for people to become overly cautious and wrap themselves in cotton wool. Having survived a Heart Attack, it’s important that you still live!

I arrived a little early for my session (the last one of the day). I wanted to make sure I didn’t get caught in traffic. I also wanted to make sure I knew the format and what was expected of me.

The Fleming Auditorium looks bigger from the front!

Upon arrival at the Aberdeen Exhibition & Conference Centre, I was slightly perturbed to discover that the Conference was taking place in the Main Auditorium, a room that seats over 400 people… what the hell had I volunteered for!!!

As it turned out, I arrived a little earlier than anticipated, so I made my way to the back of the Auditorium to listen to the penultimate session of the day entitled “A broken heart. Are women more vulnerable than men?”. (Fortunately the room was relatively sparsely populated… and I recognised a few friendly faces from the Cardiac Rehabilitation team)

There were three cases presented in my session:

One about a rather head-strong character with diabetes who gave the doctors the run-around for a couple of years before having a triple heart bypass (a happy ending);
The second about a 46 year old with two young daughters who had a malignant growth in one of his Heart Chambers and fought bravely before his body succumbed to the disease (a very sad ending); and
Me (a story about a journey that is yet to end).

So, what did I learn in my few minutes at the North of Scotland Cardiology Conference?

Women are more difficult than men
in relation to diagnosis and treatment of Heart Conditions at least, I’m sure this doesn’t apply in any other situations!
I really am very lucky
I knew this already, but it’s always good to be reminded!
I am still capable of standing and speaking to a relatively large audience without my Heart letting me down
I figured this was probably a good crowd to test this out in front of!
Listen to your doctor’s advice and follow her / his instructions
Thinking you know better is unlikely to positively influence the eventual outcomes
If you think you have a tough job and have to make difficult, important decisions, you have no idea!
I have so much respect for the Health Professionals who make life and death decisions as a matter of course, day in and day out. It must be so hard to live with the consequences when things don’t work out.

So, I did my little talk and left feeling good about myself but much smaller than I felt when I arrived. I think it did me good. Maybe next time I’ll see if I can attend for the full day!

Feeling small!

Candy Crushed

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I’d describe myself over the past few days as being “Candy Crushed”. After a hectic and highly enjoyable weekend I’ve been wiped out over the past couple of days. Not ill as such, but under the weather.

I went on the bike on Monday and really struggled. It may be partly due to the calibration of the Turbo Trainer, or a hangover from the weekend (figurative only!), but I could only manage a short session, and much lighter than I’ve been doing. (I’m sure you’ll all be glad that I listened to my body and have been taking it easy!)

It turns out that people at work have been feeling similar. Not ill but worn out. Some of their symptoms match how I tend to feel on a day to day basis – a little light headed and slightly out of it (Welcome to my world!). They’ve also experienced a sore throat and other symptoms which I won’t go into. So I’ve maybe got off lightly!

It’s the first time I’ve felt ill since I was ill, so it’s all been a bit strange. The immediate reaction is to worry that everything’s heart related… Had I made a mistake with my medication? Surely I hadn’t overdone it at the weekend! Is there something new wrong with me? etc. etc. Even if it’s not my heart, it must figure in the equation somewhere. I guess it’s all part of the rehabilitation process. Part of living.

Anyway, I’ve been taking it easy. I’ve had a few days rest from the bike and I’m starting to feel a bit stronger again.

In my downtime, Daughter No. 2 introduced me to Candy Crush for the first time. If you’ve not seen it, it’s a highly addictive electronic game (or Phone App), a little Solitaire on Steroids. The kind of game that I personally find hard to put down once I’ve picked it up. So, I’ve spent the past few evenings feeling a little sorry for myself, immersed in a fantasy land of exploding Candy (Sweets).

I’m sure I’m very late to the party, but it doesn’t look like I’m the only one… see “Candy Crush Is like Crack”.

I can’t wait until I can get back onto the bike properly and focus my energy on something a bit more constructive! Happy days!

Check Up #3 (FD +92)

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Over the years, I’ve come to realise that I’m not the best with a diary. I’ve historically had particular challenges with Birthdays (to be honest I’m hopeless), but I’m now finding it increasingly difficult to coordinate my day to day activities.

I guess it doesn’t help that I now have four different diaries to manage (technology has only taken me so far!), and that’s before I even consider my very busy social diary! I have had plenty of practice over the years and I’ve rarely forgotten things, but perhaps I’ve reached the point that I need to invest some additional time to get myself organised.

I’m not this organised!

I completely missed an appointment to catch up with an old colleague recently. It wasn’t a huge deal, but it slipped my mind until I received a slightly shirty email, too late for me to be able to do anything about it. I was extremely embarrassed. Must do better!

Anyway, this morning I sat outside the Doctor’s Surgery for 30 mins in the belief that I had an early morning appointment. When I booked it I was given a handy little card containing the details of my appointment, but heaven only knows what happened to that!

From memory, my appointment was 7.45, but the surgery doesn’t open until 8.00 (except for Fridays, so there was an outside chance that I had missed it altogether!).

Outside the Doctor’s Surgery. I predict a riot!

Eventually the Surgery started to wake up, lights spluttering to life. A slightly harassed looking Receptionist unlocked the doors to allow an unruly crowd that had gathered at the front door to gain entrance (actually it was just me and an elderly lady, but it was a bit chilly!).

Fortunately I did have an appointment, primarily to check how my drugs are working, but I also wanted to run the Euro City Cycle past the Doc too – I need to complete a Medical Form and get “Authorisation” from a Doctor.

The good news was that I continue to successfully stroll down the path of recovery. My blood pressure is fine. Everything appears to be progressing well. I’m now onto a “steady” regime of medication. I will need bloods checked to make sure my kidneys, etc. are still functioning OK, but it’s all good!

The bad news was that the Doctor, not unreasonably in retrospect, is not in a position to guarantee my fitness (Mental or Physical) to participate in the Charity Cycle. I was a bit disappointed during the initial discussion, but having thought about it it makes sense. I wouldn’t be willing to bet my Professional Reputation / Medical Practice on someone else’s actions either, particularly someone else like me!

Of course, it’s all down to insurance and lawsuits. The key is obviously the wording on the Medical Form itself. Hopefully the insurers will be sympathetic. Given the number of Heart Patients that participate in these events (it is organised by The BHF after all!), I’m hoping the Medical Form is appropriately worded so it doesn’t become a real issue. Fingers crossed!

Just another little challenge that I never thought I’d have to face!

A bit of a tit

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Before I start, I want to re-assure everyone that I’m fine, feeling good, and not hurt in any way by any of the events described herein. I have recovered from my mid-week tiredness, and I’m looking forward to a restful weekend. I know people worry about me, and I appreciate it. I will look after myself, and take things steady, but I’m not going to stop doing things, and “stuff” will happen. That’s life!

Anyway, on with the story…

Since I’ve been cycling, people have spoken of injuries picked up in bike accidents. Cuts and grazes here, fractured ribs there, a variety of debilitating and confidence draining injuries picked up in bike accidents. Yes, it’s a little bit scary, but it comes with the territory.

I was fully protected, but in little danger!

Today I had a spill myself. Actually, calling it a spill is over-egging it slightly. There was no high speed collision, no mechanical failure, no twisted pile of limbs and wheels. No, it was one of the world’s most slow, sedate cycling accidents ever. In fact, it’d probably be more accurate to call it a casual topple.

I had a bad start to the day. Embarrassingly, my topple occurred before I’d even left the car park to start my ride. It was the classic, “brain not realising your feet are connected to the pedals” accident. It was the sort of incident that would keep my father-in-law giggling for months. An absent-minded over-balance followed by slow topple and desperate but unsuccessful attempts to arrest my fall.

Apparently it happens to everyone. Today it was my turn. I felt a bit of a tit to say the least!

To be fair, Colin (my cycling companion) did very well not to fall off his bike in sympathy (prompted by hysterics). I probably would have done had I been in his position! Fortunately there weren’t too many other witnesses.

After our ride this morning. Colin still trying desperately not to laugh at the memory of my topple!

Talking of idiots, we were buzzed by a couple of boy racers on the ride this morning. I don’t understand how someone could derive pleasure from out-pacing a cyclist, but they seemed to.

Two particularly souped up cars caught our attention. Both were noisy. Very noisy. One of them also seemed to have a James Bond-style smokescreen kit fitted. Nice touch! They must be very proud!

Nice, but does it have “Automatic Smokescreen” kit?

Tired and Grumpy

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There are different sorts of tired: Exhausted, Fatigued, Weary, Drowsy, Pooped, Jaded, Sleepy, Run Down, Flagging, Broken…

As predicted by people that know better than me, I was tired this morning. Which sort of tired I don’t know exactly as it took me several hours before my brain had warmed up sufficiently to properly assess the situation. By which time the feelings had leaked away.

untitled (34) There are many days when I return from work feeling jaded. A sort of dull fog gathers around my head and upper body as the work day wears on. It’s not a positive tiredness, it’s one that grows despite you, rather than one you’ve actively gone out and earned. Since the Heart Attack, I’ve found myself slightly more aware of this sensation, perhaps because I’m more aware (“listen to your body”) or perhaps because I’m affected more.

In the old days I would have poured myself a drink and the woes of the world would have drifted away. Now, I choose exercise. An hour on the bike is sufficient to blow the cobwebs away. A post-exercise buzz, and everything is tickety-boo all over again.

I continue to sleep well, but occasionally wake up feeling sleepy. Again, in the old world I would resort to chemical stimulants to liven me up. A couple of strong coffees and I’d be “good to go”.

imagesCAFA5V8Z I’ve also eliminated caffeine from my diet, so I guess I’m a slower starter than I used to be. This is, however, offset slightly by the fact that I am not impacted in any way by the after effects of alcohol and unhealthy late night snack-attacks!

As it turns out, the early morning sleepy feeling can also be accompanied by grumpiness. Severe grumpiness on some occasions.

This morning was a case in point…

I had an introduction to the gym last night. The 20:15 start time seemed fine when it was arranged, but as it happened, I got home from work feeling jaded. I snuck in a very short period of shut-eye before getting ready, but not enough to make a real difference,

The introduction session was good. It turned out that there is a lot I can still do in the gym, providing I’m sensible, and keep my feet moving.

By the time I finished, however it was 21:00, and I hadn’t actually done any exercise. Having made the effort to get there, and inspired by the introduction, I figured there is no time like the present, and launched into a gym session.

Afterwards I felt great! My exercise buzz wiped out my fatigue. I was ready to take on the world. By the time I got home, I was not however ready to sleep.

So I sat up for a while before heading upstairs…

“It was way past my bed time!”

“I would regret it in the morning!”

And I did!

So, sincere apologies to all the people who came into contact with me during the early part of today. Lesson learned (again).

Louise – I’m sure your Fruit Juices are lovely. It’s all very exciting! 🙂

Fair weather golfer

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I’ve always been a bit of a fair weather golfer. I’ve never enjoyed playing golf in inclement weather. I really don’t enjoy the hassle of waterproof clothing, umbrellas, wet grips, damp feet or the general misery of seeing a round fall apart (which is generally the way with my golf) wishing I was somewhere else. Somewhere warm and dry.

Don’t get me wrong, I enjoy playing golf. Up until recently, it’s been my primary escape outside work. A few hours in the fresh air, enjoying the best of what Mother Nature has to offer. It’s just that I prefer it in shirt sleeves rather than oilskins.

Not my favourite way of spending an afternoon!

Given there is a Scottish winter between me and the Euro City Cycle, I need to “Man Up!” on a number of fronts. One of the important ones is braving the elements to get the miles in.

I could be a wuss, and do all my winter training on the Turbo Trainer in the garage, but there’s nothing like actually being out on the bike dealing with the gradients, the road conditions and the elements. As my sessions get longer it may also get a little tedious despite the distraction of the Sufferfest videos.

So, I’ve made a pact with myself to get out despite the weather (assuming it’s safe to do so, of course!).

This morning was my first test… the weather was dreich* to say the least. I’m proud to say that I got up and out anyway and did a solid solo 13 mile ride.

A dreich Scottish day!

I headed to the Railway Line for the ride again. One of the benefits of a miserable morning was that it was quiet. It seems that only dog owners were willing to brave the elements – even the few runners that were out seemed to have dogs in tow.

I say only dog owners, but I don’t strictly have evidence to back this up as I did spot a couple of other sportsmen doing their thing… standing in the middle of the River Dee, fly fishing. Good Luck to them!

Dreich, but a beautiful morning for catching fish!

So, a new rule for me:

Don’t let the weather get in the way of doing the things you want to do!
(Except playing golf, perhaps!)

***

* Dreich: A combination of dull, overcast, drizzly, cold, misty and miserable weather. At least 4 of these adjectives must apply before the weather is truly dreich.

Scotland’s favourite word apparently, perhaps because it’s in such common use. http://www.scotland.gov.uk/News/Releases/2013/01/favourite-word23012012)

A User’s Guide to Cardiac Rehabilitation

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After 8 weeks and 16 sessions, I’ve finished my Cardiac Rehabilitation Programme. Yahoo!

The course is complete however graduation will need to wait for my final assessment – to measure my progress since I started back in mid-July – I’ll do this in a couple of weeks.

A huge thank you to all the staff!

The Rehab Dream Team: Kirstein, Maggie, Brenda and Bernard

The experience has been a wholly positive one for me. Helping me to come to terms with the whole Heart Attack experience and get back to some sort of normal routine (although it will change again now Rehab is finished!).

One of the things I’ve never understood about the Cardiac Rehab is why more (eligible) people don’t make more use of it?

After you’ve had a Heart Attack, or been treated for some sort of Heart condition, you would imagine that you’d be past the denial stage – the game is up! For many of us, we are in the fortunate position to make changes that will improve (and extend) our lives. So why doesn’t everyone?

From my perspective, it’s time to make a positive change! The Cardiac Rehabilitation Programme is what’s on offer to help… so take advantage of it!

I thought Rehab was a really important opportunity to take action, regain control, learn and reflect. I’m therefore dedicating this update to de-mystifying Cardiac Rehab for people that may need it in the future…

The Structure of the programme

There were 3 distinct sections to Cardiac Rehab which ran two sessions a week:

Exercise – 30 minutes of exercise tailored to your personal capability (using Treadmill, Cross-Trainer, Step Machine) with a facilitated warm up / cool down to get your heart working
Relaxation – 30 minutes of relaxation to help you learn how to take control and chill out
Education – 60 minutes of education on a variety of Heart & Lifestyle topics (once a week only)

In addition, your first (and last) session will be a Physical and “Happiness” Assessment. You will be asked to do a “Beep Test” and to answer some questions on your state of mind (e.g. Are you happy? Yes / No) .

Wear clothes that are suitable for exercising in – I went for full gym kit, but it really depends on what you’re comfortable in. Don’t worry, it’s definitely not a fashion parade!

Free up time

The Cardiac Rehab sessions will take a minimum of 2 hours per week. That’s if you just do the Warm-Up, Exercise and Cool-Down. You’ll need to add an extra 1 hour per week for the Post-Exercise Relaxation and another hour for the Education session. Factor in the journey to and from the hospital, and the time it takes to shower and change, and you’re looking at a fair commitment of time over the 8 weeks.

Personally, I considered this an investment in myself, in my future, for myself and my family. A long overdue investment in my health and wellbeing. Worth it?

Before you start

If you’ve followed the guidance, you will have been exercising regularly since leaving hospital. Starting very gently, maybe 5 mins twice a day, and building up slowly. You may be up to 30 mins twice daily, and feeling good, stronger and fitter. You will hopefully have gained confidence and be ready for the next stage.

As you start Cardiac Rehabilitation, you may well feel like you’re being held back, forced to go backwards even. You will likely start your exercise sessions with 1 to 1 or 2 to 1 (minutes on a Heart Exercise Station to “rest”), slowly working up the amount of time you spend working your heart.

As you demonstrate your fitness and strength, the duration of exercise will steadily increase. “Steadily” being the operative word!

Monitor your status

The Exercise sessions start and finish with Pulse and Blood Pressure measurements. Changes in medication are also recorded. I’ve found seemingly small changes in medication have had a big impact on how my heart responds to exercise – well worth monitoring so exceptions can be identified more easily.

I used my own Heart Monitor to keep an eye on my pulse throughout each exercise session. It’s not really a requirement as there are monitors on most of the machines, but personally I found it reassuring to know where I was against my upper limit.

One of the key outcomes from Rehab will be to have an increased awareness of what you can safely do and how you feel when exercising at the right level of intensity.

Our “State of the Art” Cardiac Rehab Gym

The warm up

I found the warm up quite uncomfortable the first couple of times I did it (embarrassing uncomfortable not physically uncomfortable). If you imagine the lightest, lowest impact aerobics ever, and then tone it down (right down) you’ll get a sense of the level of exertion.

I realised after a while that it is, after all, a warm up for a group of people suffering from Heart Disease. Gentle is probably the way forward!

I got used to the Warm Up after a few weeks. I guess this is a reflection on how well you’re coming to terms with toning down your behaviour to take account of the fact that you’ve had a Heart “Event”!

The cool down is similar, but even more gentle!

Pace yourself

You need to bare in mind that 8 weeks is quite a long time. Although I’m sure you’ll be keen to get back to normal, it’s an opportunity to build up at a sustainable pace. You will make progress, just don’t be in too much of a hurry.

If someone turns down the resistance on your work-out machine, reducing the intensity of your work out (and they may well do!), take a deep breath and, if you’re feeling strong, increase your speed. You can still do the same amount of work, but in different ways.

Build confidence

You’ve probably already realised that the aftermath of a Heart Attack isn’t all about you. To a large degree, the people that you’re close to, that you interact with from time to time are more important.

Part of the recovery process is giving everyone (including yourself) time to re-build confidence in what you can safely do, to trust that you’re not going to do yourself damage or put yourself in danger again.

Well, the Cardiac Rehab Team are people too. They too will build confidence over time, but it does take time.

Do your homework

I think it’s important to continue to exercise regularly while you’re on the Programme. That means continuing to exercise at home, between Rehab sessions. That way you’ll really feel the benefit of the exercise and build your strength over the duration of the course.

Relaxation

The Relaxation sessions followed a common routine… participants either lie on a bed / floor mat, or sit in a chair, and start by focussing on deep breathing, followed by tensing and relaxing muscles from Toe to Head. The process is facilitated by an instructor reading a well-worn script.

There then followed a variety of other relaxation techniques, again following instructions.

Imagine yourself in a warm, comfortable place…

To be honest, for the last few weeks, I switched off by the time the initial relaxation was complete. Overly relaxed perhaps? I have to admit, I was guilt of being the rogue snorer on one occasion (one that I’m willing to own up to anyway!). I definitely wasn’t the only one!

The relaxation techniques are useful for winding down in everyday life, both to take a few minutes out from a stressful day, or to help respond positively to difficult situations (deep breath, drop your shoulders…).

Education Sessions

The education sessions included: Diet, Medication, Preparing for the future, Stress Management, Anatomy of the heart, Getting back to “normal”.

One of the major benefits of Cardiac Rehab is having the opportunity to talk to other people in a similar situation. As the members of the group change over the 8-weeks, you will meet and share experiences with people at different stages of their Rehabilitation. This is informal, but valuable and rewarding. I really enjoyed seeing people’s confidence growing week by week.

And then it’s over…

I’m more or less on my own now, at least for the time being. I already have a gym assessment scheduled and I’ve signed up for swimming lessons.

Swimming… yes. Butterfly… I don’t think so!

For me, Cardiac Rehab created some structure to the recovery process. I had come through my initial 4-week recuperation, and was ready to return to work. Cardiac Rehab made me focus on myself 2 mornings a week.

Memories of the initial feelings to the Heart Attack are quickly forgotten. It’s all too easy to fall back into bad habits, to proceed as if nothing has changed. The 8 week Rehabilitation process provides some extra time to fall into good habits, to seek guidance and support.

It was also really nice to be part of a little group. Although there were a diverse range of individuals participating, we all had something in common, none of us were strange (at least not because of our Heart conditions!). Most importantly, I think everyone genuinely cared about each other.

Good luck to my fellow participants current and future!!!

Artists impression of my Cardiac Rehab group!

My next (big) challenge

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As I approach the end of my Cardiac Rehab sessions, I need a challenge to help keep me focused and motivated throughout the dark cold winter nights.

This is an important decision for me. It will create the structure of my next phase of my recovery. I need to select something that is realistic and achievable, but also something reasonably challenging. Challenging enough to keep me interested, fit and focused!

I checked out the British Heart Foundation website for ideas. Given my recent fitness exploits, it made sense to look at their cycling options. They offer a large number of interesting choices… the extravagantly exotic, outrageously “foreign” and luxuriously lengthy options were ruled out fairly quickly. I also eliminated the mundane… it’d be good to do something a little bit different!

Having tested a few options with the family (where I successfully tested the boundaries of exotic, foreign and lengthy), I landed on…

…a Bike Ride from London to Amsterdam to Brussels.

280 miles over 4 days starting on 7th May 2014.

Along the way, I’m also hoping to raise a few quid for the British Heart Foundation.

This is the sort of climbing I like!

Excitedly I went to register for the trip. Unfortunately, my first attempt was a complete anti-climax. ironically my attempt failed on a web page with the title “Your challenge starts here”… it appears it does!!! Having spent some time typing in my long list of medication, I was a little frustrated to say the least!

Anyway, I eventually resorted to the manual telephone method, and I’m now all signed up!

All I need to do now is raise some cash, get properly fit and persuade a GP to sign my “fit for fun” letter in advance of the trip. All very exciting!!!

I hope you’ll join me every step of the way!