Tag Archives: Heart disease

It’s never too soon

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No-one ever thinks they will get impacted by Heart Disease.  We live in blissful ignorance until one day, if they’re lucky, they get a “warning”, a “wake up call”.

Many aren’t that lucky.

In 2010, over 45,000 people under the age of 75 died of Heart Disease in the UK.

That’s certainly how it was for me.  I was bullet-proof.  Until I wasn’t.

Once a week, the Cardiac Rehabilitation sessions have an hour of education.  I consider this the “Community Service” session, where I do the time for the crimes I’ve committed in the past.  The same crimes as many people, but I got caught!

This morning we talked about the anatomy of the heart.  We covered much of the same ground when I was in hospital (see “You are what you eat“).  I’ve had 5 weeks to think about what I could or should have asked… our questions and concerns were on a completely different level back then.

What I learnt today…

atheroma_zoom1

  • The reason why atheroma builds up in some arteries and not others is not known
  • The build up can start early (in your teenage years)
  • Once it’s there, there’s nothing that can be done to reverse the build-up of atheroma
  • It can only get worse, not better (drugs can help reduce the associated risk, but don’t reverse the build-up either)
  • The only way of assessing the build-up is by performing an angiogram which itself carries a risk of 1 death in 1,000 from Heart Attack or Stroke
  • Prevention is the best strategy
  • It’s too late for me to adopt this strategy (but I knew that already!)

What’s happened to me could happen to anyone.  It’s never too soon to become aware.  Never too soon to take evasive action.

I know it doesn’t seem real, particularly if you’re young, fit and healthy.  It won’t.  Until it is.  And then it’s too late.

Try something new

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Personally, I’m still waiting for the magic!

Apparently “trying something new” is good for you… keeping you young at heart, pushing back the boundaries of boredom, interested and interesting.

I don’t think the “Live a little… have a heart attack!” T-Shirts will fly off the shelves, but there’s certainly been quite a lot new in my life over the past few weeks.  You wouldn’t expect to find many of the things I’ve been introduced to on anyone’s “101 things to do before you die” list, but they’ve certainly set things in an unexpected and different direction,

Today was somewhat of an exception as there was an element of planning involved… I collected a Turbo Trainer and introduced a bike into my exercise regime.

The humble beginnings of a beautiful relationship with a bicycle

I continue to exercise regularly.  Having returned to work, and working my way back towards full days, I have cut back to one exercise session a day.  My staple exercise is still walking, but I’m slowly expanding my repertoire.  Cardiac Rehabilitation has introduced me to a range of exercises.  As I get stronger, I can (very slowly!) expand my horizons.

The whole exercise thing is strange for me though…

I was fit in my youth.  I did a lot of sport.  I  trained 5 days a week for athletics, travelling miles to train, compete and get fixed (at the physio).  I reached quite a high standard.  We trained properly.  It was fun but serious (to us at least).

Before I left University I got lazy as far as physical exercise was concerned.  There’s been the occasional burst of activity since (a tennis season in Bahrain, 5-a-side Football, a Squash ladder), but nothing sustained… few and far between.

Coming back to it now is bizarre.  Mentally I’m still where I was when I was a fit 18 year old.  Physically I’m a complete mess… weak and unfit… and that was before the Heart Attack!

I’m going to have to very slowly build my fitness back up.  Balancing the desire to do more, with the need to look after my heart.  One step at a time.

I’m still looking for a long term challenge… cycling is a tempting option: a weekend in the Alps with the boys, part of the peloton for a couple of days.

At the moment however I wouldn’t even be able to make it home if I headed out on a bike (our house is at the top of a hill).  So today I started putting in the hours (well half an hour at least).  Stationary.  In the garage.  Plodding (if it’s possible to plod on a bike!)

Swiss-Mountain-Pass-bike--004

The road to our house is not quite as tough as this!

I would estimate I need to do a couple of thousand miles of conditioning before I’m ready to hit the open road… only 1,998 to go!!!  🙂

Standing up and Sitting down (FD + 31)

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We are encouraged not to “blur” at Cardiac Rehabilitation as it can result in over-exertion

It turns out that standing up and sitting down on a chair repeatedly over even a relatively short period of time can be tiring.

Yesterday turned out to be a an introduction and assessment day at Cardiac Rehabilitation.  A bit of an anti-climax to be honest, but not a disaster.  The “proper” sessions started this morning.

So… I discovered that walking on a treadmill is fine, cycling on an exercise bike is a breeze, cross-trainer (minus arms) is comfortable, but standing up and sitting down (poor man’s squats, I guess) hurt.  Not a scary, Cardiac Rehab, “somebody get a doctor” kind of hurt, but my legs clearly weren’t used to that kind of exertion.  They hurt then and ache now.

[Try it yourself.  Sit on a normal dining-type chair and stand upright, sit and stand, sit and stand.  Repeat continuously for 3 minutes.  If you struggle, perhaps you need to get some more exercise too!]

It was a different exercise experience for me.  I guess I’m starting from a different place.  I’m not just a little bit unfit.  I have had a Heart Attack.  I don’t really want another one.  So this needs to be about taking the exercise seriously, but not doing too much serious exercise:  Warm up.  Work out (moderate exertion).  Cool down.  And relax.

I now have a maximum Heart Rate.  I’m not sure I’ve ever had one before.  If I have, I’ve certainly never owned a device to monitor it.  I do now. I’ve got a shiny new watch that tells me everything I need to know (unfortunately only while exercising).  My magic number is 118! [220 minus 42 (age) minus 30 (drug factor) multiplied by 80% if you’re interested.]

I tend to keep my shirt on… it reduces stress all round!

I was the only person with a (personal) heart monitoring device (no-one commented, but I did get a few looks).  Everyone else relied on the kit provided – which involved a single measure mid-way through the exercise programme.  I guess there’s a risk that I take this a bit too seriously, but I don’t think it’s over the top to want to know if you’re approaching your maximum heart rate, is it? (I maxed out at 112 bpm, incidentally).

Anyway, 1 session and 715 calories down…
15 and lots more to go!

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:

  1. The heart and what it does
  2. What is cardiovascular disease? and What are the symptoms?
  3. 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

Should I stay or should I go? (FD +2)

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I was at the point where I wanted to go home, return to some sort of normality, but slightly concerned it may be a little early. What would happen if something went wrong?  Will I be tempted to do too much?  Will we all cope without the nurses?

untitled (3)The one test I still had to have was the Heart Echo – critical as it’d provide an insight on how much permanent damage had been done to my heart.

Fortunately I didn’t have to wait too long… my number came up first, just as my toast and marmalade was being polished off.

It was strange being able to see my “broken” heart working away inside me.  I knew they were measuring different dimensions, capacities, throughput rates, pressures, etc. I could see everything on the monitor, but I had absolutely no idea what anything meant.

imagesCA3T6FW3I couldn’t stop thinking of people I’ve known at work that were “OK” at their jobs, or new to their roles, learning as they went.

It felt to me like the Sonographer had quite an important role for me at that point in time.  I hoped she was good!

I didn’t have to wait long for the results…

The diagnosis was that the permanent damage was  low to intermediate, “to be expected” apparently.   This meant that I would not be able to drive for 4 weeks (there was an outside chance it could have been only 1) and, if I wanted, I could leave hospital today… but leaving tomorrow was fine too.  My call…

Right… decisions… (I’m getting out of practice!)

  1. If I can, I will stay an extra night.  This will give us all time to get our heads around the idea of having a cardiac patient in our house
  2. Given it’s 4 weeks till I can drive, I may as well tie-in my return to work.  It had been bothering me.  Initially, the tendency was towards “the sooner the better”, but I don’t have to rush and I want to be able to do a proper job when I return.  I could start after a couple of weeks, but who knows what shape I’d be in.  Being able to commit to a date is important.  14th July it is!

Having made the decision, I’m told they need the bed.

“We need the bed.  Could you leave today?”
“Oh, OK.”
“This afternoon would be good.”
“Oh, OK.”

I texted Louise.  Much excitement (panic?!).  Arrangements to be made (school pick-up, snacks, etc.).  As soon as everything had been sorted…

“It’s alright.  I’ve spoken to the doctor.  You are staying another night.”
“Oh, OK”

Thank goodness for SMS and understanding relatives!

You are what you eat (FD +1)

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The Rehab Nurse reminded me of Gillian McKeith (“You are what you eat”).  Friendly while being knowledgeable and firm.  She had the difficult task of running (Louise & I) through what had happened, why, and helping us to start thinking about “What next?”.

We already knew I scored quite high on the heart attack risk factors:

  • Smoking  – I wasn’t smoking but had been up until about 9 months ago
  • High cholesterol – A family favourite
  • High Blood Pressure – Certainly stress has been a feature of my work life for years
  • Being overweight / obese – Certainly room for improvement
  • Lack of exercise – Check
  • Alcohol – Check
  • Male – Check

See the full list:  www.nhs.uk/conditions/heart-attack/pages/causes.aspx

Addressing any of these, together with the medication would help me prevent recurrence.

The most difficult one for me is work (which leads to Stress, which leads to High Blood Pressure).  I can see me making major changes to other areas of my life, but I need time to get my head around what changes I might be able to make at work.  Hopefully addressing some of the other factors will make me fit enough to do what I do, and help change my approach / attitude to it.  Let’s see.  (The Rehab Nurse sees “one or two like me” every week… I’m sure we’ll come back to this!).

Our vacation plans in Florida have been scuppered!

The only “Life Decision” we were ready for related to our holiday.  The ladies had unselfishly decided that two weeks in the summer heat of Florida, chasing thrills and spills at the Theme Parks and bargains at the Mall probably wasn’t the best recuperation for me.  Swimming with the dolphins would have to wait.  It would be cancelled immediately… thank goodness we took the insurance!

As far as physical activity is concerned, I could start walking gently as soon as I’m free from the monitor.  As soon as I leave hospital I should start walking 5 mins, twice a day, and then add a minute on each day, slowly building strength and stamina.  We were also informed that we could re-start “bedroom activities” after a week… this information was as useful as being told at Ante-Natal classes not to have any “intimate relations” after the water’s have broken… yeh, right!

The Cath Lab (FD ~02:30)

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It turns out that Aberdeen’s road network is very efficient at 02:00 on a Sunday morning (shame about the rest of the time!).  We arrived at the Aberdeen Royal Infirmary in next to no time.

Daughter No. 1 was at a sleepover.  Fortunately, Daughter No. 2 had slept through the excitement.  The in-laws were en-route, thank goodness!  Louise was to follow later so Daughter No. 2 could sleep through.

It was clear that the initial tests performed at the house indicated that I was having a heart attack… when we arrived at the hospital the Catheterisation Laboratory (Cath Lab) was already fully prepped and buzzing.  I was wheeled in, transferred onto the bed and the team went to work…

There were approx. 8 people in the room… electrodes were applied to my chest together with defibrillator pads (in case of more emergencies!) and my right wrist was prepared for the procedure.  (I’m sure there was a lot of other stuff going on too!).

Coronary AngioplastyI was awake throughout… a small incision was made in my wrist to gain access to an artery into which guide wires, balloons and stents were eventually inserted.  Having had a look around, the cardiologist identified a severe restriction in my Left Anterior Descending (LAD) artery – it wasn’t completely blocked, but was getting there.  The balloons were inflated to expand the artery and two stents were inserted to keep it open.  While they were there, they checked out my other arteries too… no cause for concern.

The whole thing was quite surreal.  It’s obviously not something you can prepare for.  I just had to try to relax.  I was in the hands of professionals, they knew what they were doing, and I had to let them work.  The fact that it was my heart they were working on was almost incidental.

I had the occasional sense of something happening inside me, but I’m not sure how much of that was in my head… it certainly didn’t hurt.  The only real sign of action from where I was lying was the camera moving around my chest, a robot whizzing around to look at my heart from different angles.

Within about 40 minutes it was all done.  Fixed (at least as much as I could be).

I had had a heart attack and an invasive cardiac procedure (“we don’t call it surgery”).  Things were going to be different.

Transferred back to a standard bed, I was taken to the recovery room ready to be moved to the Cardiac Care Unit (CCU).  I rolled past Louise and John (Thanks John!) who had recently arrived having successfully navigated the abandoned shell that is ARI at 3 am on a Sunday…

“I told you I was having a heart attack!”

Not the best brag ever.  I was right, but nothing to be proud of.  What do you say to your loved ones when you’ve just been saved from a heart attack?  Hopefully you’ll never need to answer that one!

Father’s Day (Approx. 00.30)

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“Louise…”
“Louise!”
Deep breath… as loud as I could manage…
“LOUISE!!!”
“What?”
“I think I’m having a heart attack.”
“Don’t be so stupid, you’re not having a heart attack!”

I’ve done some research subsequently and it turns out that many, if not most, female nurses in Aberdeen would have responded to their partners in exactly the same way. Similar conversations:

(While cooking) Male: “I think I’m having a heart attack”
Female: “Are you hungry?”
M: “Yes”
F: “You’re not having a heart attack!”

M: “I think I’m having a heart attack”
F: “Do you have shooting pains down both arms?”
M: “No”
F: “You’re not having a heart attack!”

M: “I think I’m having a heart attack”
F: “Did you put the bins out?”
…

You get the idea!

The bottom line is, it’s difficult to get your head around the fact that your partner might be having a heart attack.

We had gone to bed together at about 11pm. Tired. We were looking forward to Father’s Day Lunch and a bag of balls on the driving range at Donald Trump’s new course near Aberdeen.

I guess it must have been around midnight when I awoke feeling a little strange – some tightness in my chest that seemed to come and go (lessen at least) as I raised my left arm above my head. I had cooked my “Killer Chilli” (poor name in hindsight!) for dinner, so indigestion was the obvious initial diagnosis.

After a few minutes I got up and went to the bathroom. I started to feel worse fast. More tight. More discomfort. An unfamiliar feeling. I laid on the floor and called for help.

“I really think I am having a heart attack. Please, call an ambulance.”
“You’re not having a heart attack… let me check…”
There then followed a serious of questions to compare my symptoms with those of a “typical” heart attack.
“Please, just call an ambulance.”
“I’ll call NHS 24, they’ll know what to do…”
Within 5 minutes, an ambulance was dispatched.

I couldn’t get comfortable. I would even go so far as to say I was in “extreme discomfort” (although I’m still struggling to translate this onto a “marks of out 10 pain scale”).

If I was having a heart attack, we knew “time means muscle” (“minutes mean myocardium”). We knew aspirin was a good idea… we didn’t have any aspirin. (Doh!)

Thankfully, the ambulance arrived quickly.

The Paramedics were calm, methodical and professional. They were everything you’d want in my position. They performed a variety of tests (including the 1st of many ECGs), and administered some basic medicines (to slow this, reduce that, etc.) before packing me off.

Finally I was dispatched into the balmy heat of an Aberdeenshire night (I shivered like I’ve shivered before) and on into the ambulance for some oxygen and morphine (“to take the edge off”).