I’m a believer in the principle that exercise counts twice as much if you don’t want to do it than it does when you do. As a result, I almost look forward to days when I lack motivation because you get so much more satisfaction after your work out.
Today was one of those days. Work was busy. The weather was grim; cold, wet and windy. I arrived home from work a little late, feeling a jaded.
I’ve got into a good exercise routine over the past couple of weeks:
I swim first thing on Sunday, Tuesday and Friday
I cycle Tuesday, Thursday and Saturday
Wednesday alternates between swimming lessons and a visit to the gym
On Monday’s I rest.
So far, I’ve had no trouble getting up and out in the mornings. I don’t have much time to think about it, I just grab a quick bite to eat and head out the door. I’m finding a swim a good way to start the day. It makes me feel different… good different.
I’m not the only one to enjoy an early morning swim!
Depending on the day I’ve had, the evenings are more difficult. Fortunately, once I’ve started, it only takes a few minutes for the fatigue of the day to dissipate and for me to get into my exercise. I generally feel great afterwards too – clean, healthy and relaxed.
The overall routine is definitely doing me good. I’m getting stronger and fitter all the time. I have the continual challenge of staying within the safe working range of my Heart, but it’s satisfying to see my work rate slowly increasing over time… twice as satisfying after a hard day in the office!
Today’s UK News featured a new imaging technique that could find people at highest risk of a Heart Attack:
When fatty deposits, known as plaques, build up in the arteries and rupture it can cause a Heart Attack. The new test detects the fatty plaques on the brink of rupture. There is currently no way to identify these.
In the UK, 200 people die each day from a Heart Attack.
The research that resulted in this breakthrough was funded by the British Heart Foundation.
I already know from my angiogram that one of my arteries is partially blocked. I also know that a rupture to the plaque in another of my arteries caused my Heart Attack. The good news is, the various drugs I take each day will reduce the chances of me having a repeat episode.
It’s easy for me to forget what I’ve been through and how lucky I was to be treated so quickly and efficiently. It’s also too easy for all of us to take medical advances for granted.
Today’s News served as a reminder for me: a reminder of my good fortune, and a reminder of why it’s important for me to keep training, complete my ride and raise some cash for the British Heart Foundation.
I recently presented the medical form for my Charity Bike Ride to my Doctor for his consideration. I had two main concerns: (1) that he wouldn’t think that embarking on a 300 mile cycle was a sensible thing to do less than a year after having a Heart Attack and (2) that his insurance company might have an issue with the wording of the statement I was asking him to sign.
A “No” would have left me lacking direction somewhat!
On one level I would have understood if either of these issues had arisen. I was potentially asking a lot given my recent medical history. I would even have understood if he had asked me to come back in a few months so he could see how my health and fitness have progressed.
On another level, I would have been totally gutted if he had said “No”. It would have thrown the ride into some jeopardy. Given it’s been my main focus for the past few months (at least as far as motivation for exercise is concerned), it would have felt deflated. I think I’m progressing well, and I want to stay motivated. Having something to work towards really helps.
***
Today I received the form back, signed and stamped by my Doctor. As far as he is concerned, I am “good to go”. I just need to continue to gradually build up my training and listen to my cardiologist.
For the record, I have never used these words before!
It was just some ink on a bit of paper, but I felt quite emotional as I left the Surgery. I’m not sure exactly why. It may have been the removal of doubt about whether he’d sign the form. It may have been the fact that the ball is now in my court as far as the ride is concerned – no excuses. It may also have been the small vote of confidence that he recognises the progress I’ve made and trusts that it will continue.
Whatever the reason, it reinforced the fact that the ride is important to me. 180 days to go!
“You can learn new things at any time in your life if you’re willing to be a beginner. If you actually learn to like being a beginner, the whole world opens up to you.” Barbara Sher
Difficult as it has been, since my Heart Attack I’ve had to come to terms with the fact that I am not immortal, and I’m far from super human. I have become much more aware of my limitations and more willing to admit to myself and others that there are some things I can’t do (or can’t do yet). As a result, I have started to be more open to, and take enjoyment from, trying new things.
Some might view this as me enjoying the comedy factor that being a beginner often provides. Perhaps there’s a degree of truth in this, but I think there are two other factors that are more important:
Doing new things adds variety and interest to my life. As I tend to become a little obsessive about things, why not become obsessive about doing new things, and expanding my horizons, rather than focusing on only one activity and narrowing my focus?
I’m really looking forward to developing my capabilities, progressing to an “intermediate” level, and exploring the opportunities this might bring.
So, as the days shorten and the winter weather starts to kick in, I’ve looked to try different types of exercise that are suitable the dark, cold days. This has required me to dig deep, to admit I’m a beginner to a bunch of strangers, and to begin…
I have already added swimming to my fitness regime, and I’ve been practicing my Free-style breathing for a few weeks, but I am still very much a beginner. The combination of my “agricultural” technique, my general fitness level and coming to terms with not being able to breathe when I want to, means I need to briefly rest after each 25 metre length.
Friday saw me setting my alarm extra-early and heading to the local swimming pool for a pre-work swim. This meant swimming in a lane for the first time… with other people. Four other people, in fact.
I was comfortable with the principle of swimming in a lane, but uncomfortable with the finer details; Was there some etiquette that cannot be communicated via the arrows on a small, white board? Was it OK to rest? (I’d be in real trouble if it wasn’t). I guess the nightmare scenario would have been if I had come into contact with another swimmer!!! Surely “touching” is not acceptable, particularly given the general lack of clothing.
As it turned out, I needn’t have been worried. Everything was very civilised. We all pretended each other didn’t exist, of course, but the swim went off without incident. In all, I managed 800m in total, 32 times 25m lengths. Of course, I’ll try to build my stamina over time. I might even try for my 50m badge in my next visit to the pool!
***
My regular cycling companion has been under the weather this week, so rather than setting out for our weekly Saturday Cycle, I headed to our local gym for an RPM Class. Louise (my Wife) has been encouraging me to go to an RPM class pretty much since I started cycling. Today was my first.
I have to admit, I spent most of the class wondering whether Louise is aware of what I have been through, and what rehabilitation from a Heart Attack entails! I found the session “intense”.
I hit my maximum Heart Rate after about 5 minutes, and struggled to bring it down throughout… and I sweated… profusely!!! And that was without standing up to cycle. By the end of the session, the pool of sweat beneath my station was substantial. There was little evidence of similar levels of effort from other participants despite the fact that they all worked a lot harder than I could!
There were a number of contributory factors to me finding the session tough. Not least that, although I’m getting fitter, I still have a way to go. The fact that I didn’t know the routine meant that I wasn’t able to effectively moderate my effort to increase / decrease on demand (I hit “Maximum” about three notches on the dial too early!). Apparently this will all come with practice.
My big take-away for the next session is that I should take a towel with me!!!
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!
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!
There have been a number of stories in the UK Press recently about the value (or lack thereof) in “Over 40 Health Checks” (example http://www.bbc.co.uk/news/health-23765083). Given my recent experiences, I feel that I should have an opinion on this.
Cheeky! It tends to be too cold in Aberdeen for this sort of nonsense!
The argument for the tests is that the programme could prevent 1,600 heart attacks and strokes, avoid at least 650 premature deaths, prevent over 4,000 new cases of diabetes and detect 20,000 cases of diabetes or kidney disease earlier.
The argument against is based on the fact that most people who need the test the most are the least likely to volunteer. As a result, people that are perhaps lower risk go through the stress of the tests and may get offered medication they don’t necessarily need. The money could perhaps be spent targeting higher risk groups for more direct interventions.
I’ve had a few days to think about this, and I’ve struggled to reach a conclusion.
From a personal perspective, I have never had a test, and wasn’t planning on getting one in the near future. If I had undergone the test a few days before my Heart Attack, what would it have told me?
I suspect my Cholesterol would have been high, and I would have been told I would benefit from losing some weight. Maybe it could have told me more, but we would have been dealing with degrees of risk (as far as the Heart Attack was concerned anyway) rather than absolute certainties. The tests may have been more conclusive.
Who knows?! I didn’t give it a try.
Having survived my Heart Attack it’s easy to forget the fact that 1 in 3 people in the same situation don’t even make it to hospital. Avoiding Heart Attacks is a very good thing!
I’m not sure what would have prompted me to take the test in the first place. I guess that’s the bigger issue. Perhaps I’m missing the fact that I was one of the difficult to reach, high risk individuals!
Given the tests are available, if you’re over 40, I would suggest you take a deep breath and get yourself checked out. You don’t have an excuse for not doing it… I’ve told you to! We can leave it to the policy makers to worry about whether it’s good value for money or not.
Another beautiful morning in sunny Aberdeen… the summer just keeps on coming!
This morning saw my first visit to the Doctor since 27th 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).
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!
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*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.
Heart attack waiting to happen 