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!

Independence Day (FD + 17)

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P: “What time are you off to the gym?”
L: “About 9. Why?”
P: “Just wondering when to do my walk this morning.”
L: “Why don’t you wait for the girls and go with one of them?”
P: “What time do you think they’ll be up?”
[There is no reasonable response to this question. Teenagers. Week one of school holiday. Late nights. etc.]
Silence…

P: “I could always go on my own.”
Silence…

A few minutes later…

P: “OK. I think I’ll go for my walk.”
L: “On your own?”
P: “Yes.”
L: “OK. Have you got your phone?”
P: “Yes.”

And with that, I regained a little bit of my independence.

Little things can make a big difference… I am able to leave the house on my own; a rite of passage I thought I’d bagged when I first nipped to the local newsagent for a treat, or the corner shop for a forgotten essential, back in the day (“Mum, I’ll be back in five minutes!”). I’d guess that I was about 8 years old when I first did this, but it feels a bit young.

Things were different back then… Mars Bars were the size of bricks (certainly more than a chap could eat in one sitting) and you could pick up a couple of packets of Hamlet Cigars for the builders while you were there!

A Mars Bar and a Brick circa 1980

Anyway, the point is, some things have to be re-gained, re-learnt or re-earned. I guess a lot of growing up, a lot of learning, is about being able to take things for granted… walking, reading, writing, mental arithmetic, riding a bike, driving a car, etc. You should take these things for granted but for one reason or another some people can’t.

I’m OK walking. For the first couple of days after leaving hospital I was tentative. My chest wasn’t sore, but it was a bit tight. I definitely wasn’t 100%. I’m still not 100%, but I’m moving in the right direction.

Gentle, controlled exercise is the name of the game for me. I’m building up strength to start my Phase 3 Rehabilitation (incorporating tailored gym routines, education, etc.). The target is to get to walking 30 minutes twice a day by the time I start these sessions (just 2 more weeks).

We don’t believe in “No pain, no gain!” “Pain” is not a target state for me at the moment. I carry a magic spray that will come to my rescue if I do feel chest pain at any stage, but I really don’t want to go there!

That said, we live on the side of a hill. It’s not possible to walk more that 5 yards from our front door without encountering a slope. Doing a 20+ minute walk incorporates many slopes… as long as I don’t feel pain, get out of breath or “over do” it, I’m fine. So slopes introduce some variety and a (little) challenge.

I felt a strange sensation last night…

My legs ached slightly. Just a little. It wasn’t a scary ache. An “I’ve done a little bit of exercise today”-type ache. It’s the first time I’ve felt it since my Heart Attack. It felt good. I know I can’t push myself, but it’s the first sign that my “little” walks are doing anything more than getting the old ticker pumping.

Until recently, I’d always taken it for granted that my heart wasn’t my weakest link. I look forward to earning that back too!

How the heart works…

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OK, under exam conditions, there were some basic facts that I didn’t know about how the heart works. I’m sure everyone else knows the details, but just in case, the following link provides a brief overview of the following:

The heart and what it does
What is cardiovascular disease? and What are the symptoms?
What are the risk factors? and How can you reduce your risk?

Some of it is a bit Mickey Mouse… but one of the things I’m realising is that there are two steps to doing the right thing (1) knowing what the right thing to do is, and (2) doing it!

heart%20diagram_image1178onphotolib_article

Click on the picture to learn more about how the heart works

http://www.bhf.org.uk/heart-health/how-your-heart-works/know-your-heart.aspx

Routine, snails & another little disaster (FD +16)

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Routine

You come to rely on small things when your normal routine is interrupted, replaced by strange, temporary acts that never quite feel “routine”. I think the closest comparison is going away on holiday; we tend to jump straight into “the way we do things”, repeating them day after day (with the occasional change to accommodate “treats”). For me, these breaks are always tinged with a slight paranoia that everyone else knows something that we don’t, that we’re missing out and everyone else is having a better time / getting better value for money / etc.

I’m developing a new routine, fortunately with no built-in paranoia! My days are increasingly developing structure. Intentionally unexciting*; exercise, read, rest, eat, (watch) sport, sleep.

Snails

Geoffrey, our friendly snail

Over recent days we have looked forward to our daily visits from a snail (we’ve named him** Geoffrey… no reason). Geoffrey is huge (for a Scottish snail) and brave (foolhardy?). Boldly raising two fingers to the birds of the neighbourhood Geoffrey lives his life in the open, relying on protection from the cats or perhaps his immense size to ward off potential predators.

There is something re-assuring in seeing him going about his business each day, as we go about ours.

Another little disaster

Today we had another little disaster… “Multiple Exchange Outages” resulted in the internet being out of action*** for most of the day!

When I was a kid it seemed like power cuts were run-of-the-mill, every day occurrences. In those days, the worst thing that would happen is that you’d miss your favourite TV programmes (there were limited repeats and definitely no “+1 hour” channels), that dinner would be an improvised cold meal or that you’d have to go to bed early.

Nowadays similar disruptions have much wider implications. If I was trying to work I’d have been completely stuffed. As it is, we are unable to communicate with the outside world (except by mobile, of course), and our entertainment options are severely constrained… we might even have to resort to another jigsaw puzzle!

* For the record, I should point out that others in our household are experiencing a rather more hectic and exhausting lifestyle at present.

** I realise this is sexist. I’m also slightly conscious of the fact that it is potentially more correct to refer to Geoffrey as “it” rather than he or she.

*** At time of sending this situation has been resolved.

When I find myself in times of trouble… (FD +14)

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It’s two weeks since the traumatic events of Father’s Day. It seems like a lifetime ago! A sense of calm* has descended on our household:

The girls have finished school for the year and are chillaxing into their summer holiday.

Louise has resumed her gym regime, more comfortable leaving me unattended. Able to get some time back for herself.

I have settled into my recuperation, combining gentle exercise with rest and a healthy diet. As time has gone by, I have become oblivious to what’s happening at work. My diary is clear for the next couple of weeks (well almost!), and I’ve got a few more days before I officially start pottering at home. I am doing what I’m told!

This weekend we hit trouble: The summer TV schedule has destroyed our Saturday night routine. What were we to do? Relying on our instincts, we did what civilised people have been doing since the dawn of time… we dug out a jigsaw puzzle.

A recently completed jigsaw puzzle

Gone are the days of finding the pieces to let the girls contribute, it turns out that jigsawing has become a highly competitive pursuit, requiring trash-talk and show-boating to get the full experience (I have no idea where they get it from!). It has also become extremely addictive – the crack cocaine of family past-times.

It was all too much for me… I had to retire to bed, exhausted, leaving the ladies to finish the job.

I’m supposed to be taking it easy. It’s nice to do something together as a family, but I’m sorry, if I’m going to fully recover, we need to find something a little more relaxing to do!

* I initially wrote this as a typo, “A sense of clam…”, which may have been a Freudian slip given the amount of fish consumed in the past two weeks!

An athlete’s pulse and “little” walks (FD +13)

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The drugs are working.

The combination of medication has reduced my blood pressure (to a “perfect” level) and also reduced my pulse to under 60 while resting… “an athlete’s pulse” according to the community nurse… unfortunately an athlete on performance enhancing drugs.

The medication is laying the foundation for my recovery, and for my future health. Some of it reduces the work my heart needs to do. Other pills reduce the “stickiness” of my blood and the arteries, reducing the chances of plaque build-up and / or blockage in the future.

While a major component of my recovery, medication alone is not enough. I also need to get myself fit and healthy. The first goal has to be to get back to some sort of physical normality (whatever that means now?!).

Physical recovery initially meant small, slightly humiliating steps. “Little” walks, twice a day. Five minutes to start with. Under supervision. Wrapped in lots of rest. The bruise on my wrist, a constant reminder not to push too hard too soon.

So far, supervisors have been willing… well mostly! Our little walks have given us a chance to catch up on the events of the day, to get some air into our lungs, or to plan the day ahead, while monitoring my condition – breathing, heart rate, signs of fatigue or distress (none to report to date!).

silly-walk-monty-python-13514283-1280-8002

We do not typically dress or walk like this

We do a minute extra each day to build strength and stamina. This challenges us to find new, longer routes… how many times a day can you walk past someone’s house before it starts to become impolite?

I’m pleased to report that I should graduate from “little” walks to walks on Monday (we have decided 20 minutes is the official threshold). Hopefully the supervision will continue to be keen despite the exercise “upgrade”. I won’t need it forever… in time I’m hoping to be able to leave the house on my own… in time!

Medication

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In the past, filling in forms has been quick straightforward for me:

Q: Any medical conditions? A: No
A: Are you on any prescription medication? A: No

Not any more!

I’ve generally been lucky and flown below the healthcare radar, not worrying medical professionals too much. Age has crept up on me recently though… reading glasses were the first external sign of wear and tear. A sign I perhaps should have paid more attention to!

Now things are different. I have an array of medication that I need to take twice a day, most of them for the rest of my life.

I’ve even invested in one of those handy pill dispensers that you only have to remember to fill up once a week, and it tells you whether you remembered to take your medication. How times have changed!

The doctors have made it clear that taking the medication is very important. Not only will it help my recovery, but, in combination with a healthy lifestyle, it will help prevent recurrences.

I really would not have chosen to be in the position I’m in now, but in many ways I’m better off, safer at least, than I was before.

It all smells a bit fishy

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So, although the pies were only a minor factor in my heart attack, they will be (or, in fact, the lack of them will be) a major feature in my recovery / future quest for health.

My Body Mass Index is high. At 29 “point something”, I am at the top end of “Overweight” (25-30), borderline Obese (>30). To get into the “Normal” range I would need to lose about 40lbs (2.5st). This seems like a huge amount of weight to me.

“Big bones” have always featured in our family… it appears that it’s generally accepted that inability to account for differing frame sizes is one of the flaws in the BMI (incidentally, muscularity for athletes is another one, but I’m not going to go there!).
http://www.nhs.uk/tools/pages/healthyweightcalculator.aspx

Having said that, losing weight really won’t do me any harm. As with everything, it needs to be one step at a time – no need to set a firm “final” target just yet.

There are other reasons to think more carefully about what I eat… the heart attack has increased my awareness of “good” (HDL – High-Density Lipoprotein) cholesterol and “bad” (LDL – Low-Density Lipoprotein) cholesterol, of my “five a day”, fibre, Omega-3, etc. etc. As a result, my diet has already changed dramatically… Sustainably? Only time will tell.

Fortunately I (we) like many of the “good” foods… salads, fruit and veg will feature more heavily going forwards… crudités have already become the snack of “choice” and oily fish is the new cold meat.

Equally as important are the foods to be avoided… Fish Supper, Onion Bahji, Butter, Roasted Nuts, Bombay Mix, Pâté, Cheesy Nachos, etc. etc. (“MMmmm!” – Homer Simpson)

Diet for diet’s sake won’t work for me. Creating a healthy heart is a good, noble incentive, but I may well need to set myself a different target, something more tangible, something that ties in both exercise and diet.

I’m starting from a fairly low level of base fitness so I’ll give it a few weeks, until I’m into Rehab Phase 3, before I decide what that target might be.

Welcome to the club!

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I had always thought that everyone was well, that we were still too young to need to deal with any of the “age” issues that impact older generations, or “other” people. From time to time, I have been aware of people being ill, but these have been exceptions. Exceptions that have fortunately resulted in happy endings (touch wood!).

Have I not been paying attention? Not been listening? Been living in denial? Or perhaps people have been keeping secrets, sharing bad news on a need to know basis. Anyway, now I’ve had a heart attack, it seems that I’ve been welcomed into a new club. A club of frailty and mortality, of horror stories and near misses, and there are a lot more members than you’d think!

In a way, it’s nice to be accepted. The shared experiences are positive and reassuring. Many have walked similar paths before us. It seems that life has caught up with us while we slept (literally in my case).

I suspect that entry into the club comes with responsibilities. Responsibilities that I will only understand in time.

Prevention is obviously the way forward. There are plenty of clubs for that out there already… Health Clubs, Sports Clubs, etc. Hopefully by actively participating in those, and looking after yourself, you will be able to postpone joining our new club for a long time… fingers crossed!

Check Up #1 (FD +11)

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I have never been great with doctor’s surgeries. I’ve always felt that being “under the doctor” was something to be avoided, an acknowledgement of weakness. In fact, I think this was my first visit to the doctors in over 12 years.

Looking around the waiting room I felt I was healthy, certainly in the top quartile (and that’s including the carers, drivers, etc.). There really seem to be a lot of sick people around these days!

Fortunately the doctor seemed to agree. Given it’s the first time I’ve seen him since the heart attack, he seemed remarkably relaxed about the whole situation. You’d think it was run-of-the-mill. Something he sees every day!

A quick review of my hospital discharge information “letter” confirmed:

I am 42
I have had a heart attack
Stents were fitted to my left anterior descending (LAD) branch
The procedure was a “complete success”
The ECHO revealed mild-moderate damage
I was well following the procedure

So that’s all good!

If they had got my address right it would have been a full house! I don’t know how many times we corrected the address when I was in hospital – they have a hybrid between the flat I lived in when I first came to Aberdeen and my current address. It’s incorrect. Wrong. Useless. The letter helpfully states “An appointment will be sent to the address above”… but don’t hold your breath!

A further review of my medical history revealed:

“The pies may well have been a factor, but the fags are the main culprit.”

It appears that smoking is, far and away, the biggest factor in (my) heart health. I don’t quite understand why I should have had my heart attack after having given up smoking (over 9 months ago), but I did.

Having given up, there have been no guilt-trips or nagging, just confirmation that I’ve “done the most important thing”.

I really would not like to be in my situation and still addicted to nicotine. Smoking is bad for you!

The doctor confirmed that, as the stents are ensuring blood flow to my heart, I should be in better shape now than before the heart attack. My blood pressure is also “perfect”… the pills are working.

So it’s full speed ahead to the next stage of my recuperation… rehab here I come (after a wee nap of course, it’s been a busy day)!

Trust me, I’m a doctor

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I’m used to being in control, knowing what’s going on. From time to time I might even consider myself an “expert”. Since my heart attack things have been different.

Since the moment the paramedics stepped into my life, I’ve had to sit back, keep quiet and let the professionals do their jobs.

In today’s connected world, it’s very easy to go online to try to be one step ahead, or to second guess every decision that’s made: What does that mean? Why are you doing that? Why aren’t you doing this? Why that medication? In tests, this one scored better. etc. etc.

There is a school of thought that you should understand absolutely everything that is happening, it is your body after all. From my perspective, even if I wanted to I couldn’t understand absolutely everything – you can’t short-cut the years of training (theoretical and practical) that go into qualifying as a medical professional (unless you’re Doogie Howser, M.D. of course!). That means it comes down to degrees of understanding.

I understand the basics of my situation and my role in the recovery, recuperation and rehabilitation, but I’ve chosen to trust the professionals to make the difficult decisions and do their jobs well. With trust comes responsibility… so far, so good!