Author Archives: Paul Squire

About Paul Squire

At approximately 00.30 on 16th June 2013 I awoke with a severe tightening in my chest. I was having a Heart Attack. I was 42 years old, happily married with two beautiful daughters. It was a shock! I guess you could have described me as "a heart attack waiting to happen". Isn’t the benefit of hindsight a wonderful thing! Since the Heart Attack a lot has changed!

Getting outside

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I finally managed to get outside on the bike on Sunday. I took the Mountain Bike out for a spin on an old railway line in Aberdeen. Nice, safe route without too many (any) hills, that didn’t require any real bike handling skills.

It was another beautiful morning, the final death throes of summer. A great day to get out and get some air into your lungs. Unfortunately it was a bit too nice (or more accurately, I took too long getting ready and was a bit late), as there were lots of people on the railway line. A lovely scenic place to park your car, take a walk, grab an ice-cream or a play on the swings and slides, before heading back. As a result, it was busy.

Hazard… between or around?

I was keen not to end up in a ditch, or to collide with anyone’s favourite child or youngest Chihuahua. I therefore had to stay very alert, particularly given how difficult it is to see whether a dog / child is on a lead from a distance… plenty of scope for unfortunate incidents!

I was not alone. There were plenty of other people on bikes (cyclists, I guess you’d call them) making use of the track, as well as runners, zimmer frame operators, wheelchair passengers, etc. Pretty much any moveable obstruction you can imagine. There was potential for carnage… ironically, every kind of accident other than the proverbial “train crash”.

Who is controlling who? A cyclist’s nightmare!

The casual strollers didn’t seem particularly happy with the cyclists… at least, some of them didn’t seem very happy with me: “Bloody cyclists!”, I could hear them muttering not so quietly as I whizzed past… but I was off! Gone. Somewhere else to be… until I passed them again on my return that is, when we greeted each other with pleasant smiles and a fleeting nod!

What fun!

Someone’s going to get hurt!

The ride itself was fine. I did just under 20km and rode for just over 50 minutes. A casual Sunday morning cycle. I was tempted just to keep going, enjoying the freedom, but I know I need to take it easy. “Don’t do more than you could on your worst day” (Cardiac Rehab Motto). A bit depressing really as I’ve always thought the best days were the most important. Still, I don’t want to set myself back, so moderation rules. Yeah!

A Treacherous Journey

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So, Christmas finally arrived for me this morning!

The day started with the ceremonial collection of my new bikes. This wasn’t without anxiety! The collection itself was incident free and relatively swift. However the trip home relied on the stability and strength of a new Cycle Rack (for the car), ably fitted by myself, and was therefore fraught with danger!

As it turned out, the trip was fine. No structural failures. No shed loads. Not even any audible rattles. Success! I felt particularly sporty, and a smidgen of pride, as I paraded my new bikes through town on my way home.

A very proud moment… home safely!

There then followed several hours of slightly inept mechanical “fiddling” as I made the final adjustments.

Bikes aren’t how I remember them. They don’t have the knobs and levers I’m familiar with any more. I had to refer to the internet a couple of times to work out how to work the gears (multi-purpose break levers, if you’re interested!). One of the bikes has disc breaks – heaven only knows how they work! I’m very relieved I took out some “free labour” cover for them for the 1st Year… I can see me using this extensively!

What I’ve also discovered is that it appears the more you pay for a bike, the less you get. In some ways, the “less” is good (e.g. less weight), but in other ways, the “less” is bad (e.g. the more expensive bike required me to buy pedals separately).

Fortunately I didn’t spend too much, so it was just the pedals that needed to be added. I can only dream of owning a bike that requires you to buy wheels, a seat and handlebars!

Bicycles have definitely advanced a bit!

I still haven’t managed to get outside on a bike yet, but it’s on the cards for tomorrow (weather permitting). Ominously, it felt like autumn arrived in Aberdeen today. I may have timed the bike purchase perfectly!

Still, with my bikes, the Turbo Trainer, and a Sufferfest video selection, I’m sure the winter will fly by!

Mr Grumpy

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People keep asking me:

“Are you alright?”
“Yes, I’m fine. Why?”
“You just look unhappy.”

As any amateur psychologist knows, being told you look miserable is not great for morale!

Mr Grumpy… smiling inside!

It’s got me thinking… am I less happy now than I used to be? Am I indeed miserable?

Having reflected on these important questions, I’ve concluded that no, I’m not unhappy. Neither am I less happy than I was before my Heart Attack. So what’s causing the perception of misery?

I can only conclude that the default expression on my face must have changed… Perhaps my additional chins used to force my mouth upwards into a fake smile. Maybe the unhealthy me gave off an unnaturally positive glow. Who knows!

Under normal circumstances, I’d prescribe happy pills to cheer me up (or a stiff gin perhaps!), but I’ll have to focus on happy thoughts and make an extra special effort to be Mr Happy!

Check Up #2 (FD +61)

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Another beautiful morning in sunny Aberdeen… the summer just keeps on coming!

This morning saw my first visit to the Doctor since 27^th June. It seems slightly strange to be so conscious of all aspects of my health but to have limited direct, regular medical oversight.

I’m not sure what I would have expected, but somehow taking the “let us know if anything changes” approach somehow seems a little “light”.

Is it this type of thinking that creates an unnecessarily high demand on the NHS, I wonder?

On arrival at the surgery, I was slightly surprised to discover that the entertainment was BBC London News. I can understand the News aspect, catching up on the breakfast news seems like a reasonable thing to do.

What I couldn’t fathom was why we should be interested in the traffic around the M25 (London Orbital), or how smoothly the various London Underground lines were running (the Northern was experiencing minor delays, incidentally). I can only assume that someone in the Surgery has a cheeky weekend in London planned and is trying to get into the mood a little early. If that’s you, the game’s up! (But have a great weekend anyway!)

London Underground Map… particularly useful if you’re planning on spending the day in Aberdeen!

The Doctor’s consultation itself was an uneventfully positive affair:

My BP (medical speak for “Blood Pressure”) is fine – artificially kept low to reduce the workload on my heart.
My liver and kidney function is “normal” – good news, as a potential side effect of the drugs is that they “break” something else that was working fine before, in particular my liver or kidneys.
My cholesterol is “abnormal”… abnormally low I guess. My total cholesterol reading was 2.9 mmol/L (Good if less than 5 mmol/L) and my “bad” cholesterol is 1.6 mmol/L (Good if less than 3 mmol/L).

Follow the link for more information on High Cholesterol: http://www.nhs.uk/conditions/Cholesterol/Pages/Introduction.aspx

So, it’s all good! The drugs continue to work!

I was just left with a not so subtle reminder not to rush things or push too hard!

OK… I hear you!

My heart is not allowed to do this… yet!

A Lifetime First

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1989… a classic!

1989 was a year that changed the world… the end of the Berlin Wall, Tiananmen Square, The Dalai Lama won the Nobel Peace Prize, the Hillsborough disaster, “The Simpsons” started, the Madchester music scene… I finished school, went on my first lads holiday and started at University, while my family emigrated to Wales… temporarily, as it turns out.

I think 1989 also marks the year in which I last owned a bicycle. I can remember borrowing other people’s bikes at University, but I have no recollection of transporting my own back and forth each term. I definitely haven’t owned one since, so I conclude that 1989 was the year!

I was always a little bit jealous… until now!

As children. all my bikes were second hand, sourced from the ads in local paper, the Maidenhead Advertiser… eagerly awaited each Friday evening.

On one occasion, I remember my brother getting a new bike… a Raleigh Grifter XL. Why the situation warranted a brand new bike, I can’t remember, but I do remember it being a big deal!

I have never owned a brand new bike… until now!

The cycling has been going well. I still haven’t moved out of the garage, but my sessions are getting longer, and I’m getting stronger. I realised yesterday, that I’m now working as hard during my rest periods as I did at the peak of my early bike sessions.

Up to now, I’ve been using a borrowed bike which is slightly too small for me. To exacerbate the problem, and having tried “everything” (including WD-40, heat treatment, and a large hammer), I’ve been unable to raise the seat. As a result, I’m restricted when I ride. Given I’m getting ready to venture outside on a bike, we decided it was time to invest in a bike I can call my own.

I decided to go for something a little more conventional than this!

I say a bike, but it turns out buying a bike isn’t quite as simple as that! It turns out that there are too many choices; Where will you ride it? How long will you ride it for? How often? Do you want a Road Bike, a Mountain Bike or a Hybrid? What brand? How big? Too confusing!

In the end, I made my decision…

I decided to buy two bikes. One for the road. One for the dirt.

All I need to do now is wait until Saturday for them to be built!

It’ll be like Christmas!

Developments

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Stress, noun
1. Pressure or tension exerted on a material object:
2. A state of mental or emotional strain or tension resulting from adverse or demanding circumstances:
3. particular emphasis or importance

A typical Cardiac Rehabilitation Relaxation session

At the end of each Cardiac Rehabilitation session, we have 30 minutes of “relaxation”; gentle music, overlaid with softly spoken instructions to focus on eliminating tension from different parts of the body (“now we’ll focus on our thighs…”), breathing deeply and generally chilling out.

It feels good, indulgent. It rounds off the Rehab session before heading out into the big wide world.

According to Wikipedia; “the body’s way to respond to stress is by sympathetic nervous system activation which results in the fight-or-flight response”.

I’m not entirely sure where lying down with your eyes closed, chillaxing fits in to this evolutionary response – I’m sure it will become clear in time, but we haven’t done our “Stress Management” education session yet! (It was actually supposed to be last week, but it got switched with “Medication” at the last minute!)

I guess that we are made to deal with our challenges face on, or to turn tail and run away! Biologically, we’re not made to dwell some things too much. Relaxation is a good way of re-establishing a sense of calm and stability after doing what you need to do.

The bottom line is, we all face stressful situations of differing degrees every day. They cannot be avoided. Even locking yourself away can be stressful for most of us (“What’s going on outside?”)…

Which brings me to my stress of the week…

We recently received a Planning Permission notice for a house to be built at the top of our garden. Seven houses in total, in two plots, but it’s the one that will overlook our house, replacing a nice wooded area that I’m concerned about.

Fortunately, there’s a simple solution that will allow the development to proceed without giving us too much cause for concern.

Unfortunately, the people that have applied for the Planning permission seem to think it’s OK to ignore us, and have been doing so for several years!

It’s very frustrating!

I find I need to think relaxed, warm, calming thoughts each time the potential development enters my mind… slow, deep breaths… “You are feeling relaxed”.

We will fight. There is a course of action we can follow.

I will practice my relaxation, and hope they have a section on “responding to unwanted planning applications” as part of the “Stress Management” session when it’s eventually held!

Not enough hours in the day

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It’s 20:50, and I’ve just eaten, sat down and put my feet up for the first time today. I appreciate lots of people don’t get a chance to relax at all… caring for others, working late, second job, studying, etc. I’m lucky to get a few minutes to myself, watch the golf, and chill out before I turn in for the day.

Apparently he’s often mistaken for me!

On “normal” days, I’ve got into a routine where exercise is the number one priority for me when I get home from work. A good routine to get into given my recent medical history, but one that is increasingly eating into my day. As I get stronger, I am able to do more exercise.

Today I did a cycle session that took just over an hour. I wasn’t cycling constantly, and I never went over my maximum Heart Rate, but it took time.

I think that during my recuperation I got used to having almost endless amounts of time. A little exercise, a little TV, a little read, a little snooze… and all before lunch. Fantastic!

My gradual return to work similarly gave me a feeling of extra time… strict 8 hour days, working from home after Cardiac Rehab, regular rest… long relaxed evenings incorporating moderate exercise. Just what I needed to help get back on track.

Over the past week or so, things have felt like they’re returning to “normal” at work. I’m working with a couple of clients, not being asked to do too much or pushed too hard (in fact, they’re being incredibly understanding), but I’m working on some interesting stuff. The kind of work I want. The kind that I find difficult to “put down”.

As a result, my work days have extended a little. Not by a huge amount, but back towards a “normal” work day. In combination with an extended work-out, my days are feeling shorter.

(I suspect this is mentally exacerbated by the ever shortening days).

From where I’m sitting, I can’t see a huge number of options to create more time:

Sleep less – Not a particularly viable option for me. I need at least 8 hours sleep a day, ideally more.
Work less – The only thing I can commit to is to be aware of time, and what I’m spending it on. I need to earn money. I also enjoy what I do. There are plenty of people watching out for me to help ensure I don’t go mad!
Do less – Having just rediscovered it, and needing it to help prevent future health issues, I’m not about to start cutting back on exercise. What I do need to do is build up a selection of options that provide a mix of intensities / duration. In time I’ll finish Cardiac Rehab too which will give me some extra time, but I do need to make sure this doesn’t result in every day feeling the same… I’m enjoying the variety the morning sessions gives to my days.
Suck it up and get used to it!

Any other ideas? Suggestions appreciated!

Ch… Ch… Ch… Changes (FD +50)

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Doesn’t time fly!

It’s the big Five-Zero! Fifty days since I had my Heart Attack. Seven weeks and a day. Forever, and no time at all.

Doesn’t time fly when you’re having fun! 🙂

To say a lot has changed would be an understatement. Some changes have been forced on me. Some have been voluntary*. Others have been a consequence of circumstances.

Scary?

“It must have been scary!”… No, not really. At no point over the past 51 days have I felt like my life was in imminent danger. However, it doesn’t take much imagination to see that things could have gone that way. In the UK, one in three people who have a Heart Attack don’t make it to hospital.

The next time you’re in a lift with two other people, imagine one of you not making it to your floor. I was in that lift. I was lucky. I didn’t realise how much danger I was potentially in until afterwards. By that stage, the immediate danger was over and the ball was in my court (more or less).

A new Dad (in reverse)

In some ways, it feels like part of me died when I had the Heart Attack. Not in a bad way. In a way that created space for new parts of me to grow in their place. In fact, its probably more correct to say “dormant” rather than “new”, many aspects of the “new” me have been there before. A very long time ago! So long ago that only close family members and very old friends might recognise them. As far as the girls are concerned, I am a new, thinner, slightly bizarre, “active” Dad.

Even knowing what I know now, I’m not sure if there is anything that would have convinced me to make some of the changes I have done in advance of something “happening”. It still all seems slightly surreal. Perhaps if someone I knew well, who I could easily relate to, had been through the same thing as I have, it might have been enough for me to take action. Perhaps.

The bottom line is, if you want to, it’s not that difficult to convince yourself that it won’t happen to you. That you’re low risk. Different from people like me.

Awareness isn’t enough!

You need to take action to make a difference.

It doesn’t surprise me that prevention of Heart Disease is such a challenge. For many (me included) it requires big changes to make a difference. I guess the key is to keep any changes small, to recognise when you’re veering of course and make minor corrections to keep you on track. So many people are so far off course that small changes just aren’t enough.

For me, my broken heart has been fixed, the course has been corrected and I’m looking to the future.

Catching up

I have some catching up to do – a holiday with the family (although Florida must wait!), recognising the patience of my colleagues, repaying the goodwill of our clients, and sustaining the lifestyle I’ve adopted since leaving hospital so none of us have to go through this again!

Here’s to the next 50 days… and making it count!

***

*Voluntary is probably a bit strong. I’m not sure I had a huge amount of choice in any of the changes, but I guess even the perception of choice makes them more palatable.

Another minor milestone (FD +47)

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I feel like I’m making real progress on the exercise front. Some of it is down to exercising. Some of it is down to understanding the kit and exercising better.

Although I’m still a complete novice, I feel like I’m in a position to provide some advice on cycling (at least cycling in my garage):

Cycling Lesson 1: It hurts less if you have the right kit!

The shorts, gloves and shoes all made a substantial difference to last nights “ride”. Why didn’t I think of it earlier!

Yesterday saw the introduction of another training aid too…

I got a tip from a guy at work to try out a Sufferfest video. Specialising in Cycling Training Videos, they have the motto:

“I will beat my ass today to kick yours tomorrow” (IWBMATTKYT for short)

They have a range of “entertaining” videos targeted at the stationary cyclist market. They create training sessions where you follow / copy / compete with professional cyclists performing in competitions (World Championships, Tour De France, etc., listening to fast music, and following instructions “shouted” out via text on the computer screen.

http://vimeo.com/46131597

It might sound strange, but the videos provide some useful pointers for the novice cyclist and also create a major distraction from the clock. In my limited experience, the biggest challenge with inside cycling is clock watching. Every minute seems to last forever!

For me the intention is clearly not to have a Sufferfest, in fact not to suffer at all! That’s not really what my exercise is about right now. For me I’m treating it more as a Recoverfest (Trade Mark pending!).

Irrespective of what the on-screen cyclist does, or the instructions I’m given, the Heart Monitor is the most critical piece of equipment for me. Keeping below my 118 bpm threshold is essential.

In time, I’m looking forward to testing / pushing the boundaries, but I have to keep reminding myself that I’m still only in week 3 of Cardiac Rehabilitation. Much as it would be nice to kick Bradley Wiggins’ ass in a Time Trial (albeit virtual), my goal has to be to put in the miles, to get myself fit and strong, to lay the foundation for the future.

Anyway, the video worked for me. I would highly recommend checking out The Sufferfest if you’ve not discovered them already.

Breaking news…

All the exercise and hard work has resulted in another minor milestone for me at Cardiac Rehabilitation today…

drum roll…

wait for it…

I was allowed to jog on the treadmill!!!

I’ve got another 5 weeks of Rehab to go. I’m hoping I might be able to fly by the end of it!

Someone’s going to get hurt!

Honesty is the best policy (FD +46)

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Honesty is the best policy!

Over the past couple of weeks, I’ve noticed people looking at me with a little sympathy in their expressions. I had assumed it was because they knew I had been away recuperating after the Heart Attack, and they felt sorry for me.

I could understand it… if I was in their position, I’d find it difficult to know what to say. I’d probably have mixed emotions. I’d be glad they were “OK” and back at work but relieved it didn’t happen to me, and a little concerned that it could happen in the future. That made sense.

Today, someone was honest with me…

“I thought you look like you’ve lost weight because you’re really sick!”

I didn’t realise trying to get fit would result in such a harrowing experience for others! Sorry!

I feel good. Better than I have in a long time.

As I’ve said previously, I tend to lose weight in my face first, so a little weight loss may look a bit more extreme than it is in reality. I can assure you, there’s still plenty of scope for slimming down before I get anywhere near my fighting weight.

I guess it’ll just take a little time for people to get used to the new, evolving shape of me… and get comfortable with the fact I’m not just fading away!