Interview HA11

Age at interview: 46

Age at diagnosis: 42

Brief Outline: Heart attack February 1999. Angioplasty and stent, February 1999. Current medication' aspirin, ramipril, simvastatin

Background: Operational Risk Manager; Married, 1 child

When he started going out again, people didn't know how to treat him.

So I think people thought that you know I should behave like an invalid perhaps or try to wrap me in cotton wool a bit. But you know with the best of intentions, but people don't, people don't know what having a heart attack is like so they don't really know how to treat you afterwards.

How did that make you feel being wrapped in cotton wool?

It's a bit frustrating, especially when the reason you're sort of out is because you're making another step, or you have made another step to get away from the sort of the twenty four hour care down to the sort of fourteen hour care from [my wife] and then [my wife] going back to work, and my mum stopped coming down to make sure I was alright and by the time I was going out you know I felt fine and I was driving and whatever. 

So you know it was a bit frustrating but it didn't happen very long and I think you know that it's done with the best of intentions.

He had bouts of severe back and shoulder pain which he did not relate to his heart.

I didn't actually suspect there was anything wrong with my heart; I thought I had a backache, a back problem. I was going to work normally, I wasn't, I didn't have any days off sick or anything but I was moaning about my back at work, and it was sporadic and it felt like once I got moving about a bit, it would go off. 

I was still playing football on a Saturday and I used to get some pain during that but it was across my shoulders and up here, and I'd always, you know you see the films and people have heart attacks, clutch their chest, or their breast and fall to the floor. So looking back I don't really know whether I really did think there might be a problem and that I've just chosen to forget it. 

Because I do remember at work running up the stairs to see if it got worse because I knew [laughs], I knew that would bring something on and then when it didn't, I thought, 'well I must be all right then, it must be my back,' and this continued, my back was getting a bit worse. 

My wife told me that I'd have to sort myself out and get my back looked at but she said, 'I didn't look too clever,' and we had something to eat, went to bed and I don't think I slept but I just felt worse and worse. So I thought, 'well I'll get up,' and I came downstairs. 

My wife came downstairs and found me bent over the ironing board. Not a pretty sight I shouldn't think, because that was the most comfortable position I could find myself in, and I still thought it was my back because being bent to ninety degrees supported, seemed to help a bit. 

But the pain was so bad and my hands were numb, my arms hurt but it felt like somebody was squeezing my top but squeezing my fingers. But I did think there was probably something wrong, but I thought, 'this is one hell of a backache,' and so we went to casualty.  

He had confidence in his consultant because of the way he spoke to him.

But he had this air about him that I was, you know it was just his actions, his voice. I mean he wasn't very old, he was probably mid, he probably wasn't much older than me, if at all and he was just, I mean it just made me feel relaxed and felt like I was in good hands and that, all the time that meant so much to me that you know my trust was in these people and as long as I felt that they knew what they were doing, I was going to be all right and that things weren't going to get any worse. 

Describes the mixture of emotions he felt during the first 24 hours after his heart attack.

I was petrified. Well, part petrified and part believing that they must have it, it must be wrong, I was in the pub yesterday. This all happened on Saturday, I was in the pub yesterday and I don't feel any worse, and then I did start feeling rotten. But I think the whole consequences of it all were dawning on me. And you know heart attack, my dad had had a heart attack but he was, he's seventy odd but I just didn't think it, it could've happened. 

Although, well half of me thought that, but then I thought, 'Well that would explain why it hurt so much,' and I mean, it really was pains I can't really describe. And I was lying there and my wife got, I managed to phone, I phoned my wife from the doctor's office and I was well a bit upset because I was just so shocked and trying to break the news to her was even worse. I'd rather somebody else had done it really [laughs]. 

But I think it was good that she could hear that it was me and that I wasn't lying flat on my back somewhere. And by the time the morning came I became a little more sort of, well the confidence was just seeping in that I can get through this, I don't know what it's going to be like when I leave hospital whenever that may be but I can see myself going out to work again. 

I don't know about playing football again but just getting back to some sort of normal life, and then half an hour later I'd think that that's never going to be the case, I'm going to be an invalid, I'm not going to be able to do anything. I'll be like the poor people that you see sometimes who live with an oxygen cylinder and a mask by them. I don't know why I thought that, but gradually as the days went on, the sort of longer I felt like I'd survived, the easier I felt.  

Initial tests did not show a heart attack but an echocardiogram two days later did.

But I was seen very quickly so I knew that they, what they suspected. And I was put in a side ward, got a, what are those called, the rooms off casualty, and I had oxygen. Something went under my tongue, I think it was for angina and I was put on a drip that was a clot busting or blood thinning. But it was all sort of precautionary because you know a bit like back ache, you can't see sort of immediately. 

I sort of felt a bit better, I think some of it was because I was in hospital and you sort of feel well nothing can happen now. So we were there all night. I had an x-ray, I had blood tests and I now know that they were looking for enzymes or something in the blood, which is another indication. 

I had cardiograms and about six o clock in the morning the sort of, someone in charge came in and said, "Well I didn't like the look of you when you came in but you do look a lot better now. There's nothing really shown up to say what's happened so we want you to come in on Monday to have a stress test.' 

And I had an [echo] cardiogram before they did the stress test and it wasn't very long. It seemed very, very short and I was sitting out in the waiting room in the hospital with loads of other people and the sort of the girl on the desk came over, looking absolutely shocked and said that I was going to have to see the doctor straight away, and so I went to get up and she said, "No, no we'll get you a wheelchair," and I said, "Well I've just driven here and walked in, I don't need a wheelchair," and promptly got up and walked in. 

And she was saying, "Do you want to phone anyone?" and I said, "Why would I want to do that?" and I walked, I sat down and the doctor said, "Well there's no easy way of taking this, but you've had a heart attack, probably on Saturday, early hours of Saturday morning".

Thinks that fear and anger at what had happened to him led him to take it out on his wife.

But everybody else was saying how marvellous I was doing and you know patting me on the back for handling this terrible thing so well and I mean [my wife] was getting recognition for the support she'd given me as well but it was, I think it was, it wasn't fair that everybody was saying how fantastic I was handling it when [my wife] was getting the dark side.  

And I really was horrible, I was finding fault in things that weren't there. I was sort of picking on little things and making a lot out of them. I was so argumentative you know, I'd argue that black was white and, sometimes I sort of knew I was doing it and stopped an apologise but I'd then do it again two minutes later. And it really did get bad to the point that we had an absolute screaming row in the kitchen and it really was sort of hands on hips shouting. 

And it just all came out about how frightened I still was and that I was frightened that I might die. Well I still, I didn't actually, it sort of came out but then I, I didn't actually consciously sit there thinking you know I might die tonight or tomorrow or whatever, but it was just the fact that I think I've never even given, the fact that it was ever a possibility at forty two as I was. You don't feel quite immortal but you don't consider going quite so soon [laughs]. And now I had to face it and I didn't handle it very well at all. 

He went back to work in stages and felt very vulnerable travelling to work on the London Tube.

And that was a positive thing going back to work and you know it's always nice with everybody telling you how good you look [laughs], whether they mean it or not. And then I went, I started to go back after six weeks on two days a week short hours, three days a week short hours, then three days a week longer hours. I think, I reckoned it must, that, we did that over about twelve weeks and then I was back at work.

What was it like going back to work physically?

The first day I travelled up on, when I, when I went up the very first time and I travelled outside the rush hour and I was, I was a bit frightened again to the point that I ended up I was working in, I was working in the East End and it's about fourteen miles away and I ended up getting a cab back all the way home. Because I, I, once again I felt sort of vulnerable with all the, even though it wasn't the rush hour. 

I think perhaps if it had been in the rush hour I wouldn't have felt so bad but the trains during the day can still get quite crowded and then they're with people, the commuters I know about because I do it all the time and we don't talk to each other, we don't make any noise. 

We just sit there, read, get on and get off. Whereas people during the day they're moving about and there are children shouting, young kids running up and down and I felt quite vulnerable still, because physically I was still pretty weak. And I wasn't used to going out for long periods so that was quite hard. But it was good to do that on a one off basis.   
 

Information from his consultant helped him to take control during his recovery.

So he sat down and he sat down with us for nearly an hour talking about diet and lifestyle, exercise, sort of doing things gradually, but mainly the fact that there's no reason why I couldn't get back to as normal life as possible. And we talked a lot about diet and these were obviously his opinions but he was talking about, we were talking about vitamins and he gave me a long list of vitamins that he recommended. 

And he said, "To be honest, scientifically nobody really knows whether it does any good but they seem to," and he said, "and they won't do you any harm." And so I've been taking those ever since. 

He explained that I'd be on medication, on aspirin for blood thinning and he said, "Everybody should take a low dose of aspirin every day," he said, "it just seems to do so much good for so many things." And some statins to keep cholesterol low, even though mine wasn't high at all, but he just said, the lower the better. 

And ramipril which if I remember rightly does something to do with making the blood, making the blood easier to pump, I'm not quite sure what. I used to know but as the years have gone by, I'm not so well up on the clinical side of it.  

But he was very realistic because he was talking about, try and steer clear of red meat. Eat as much vegetarian as you can and he was, he said, 'These aren't the only, this isn't the only advice, this is just my advice.' 

But he very much talked about taking control, that you can do this, you can do that. You can stop eating red meat, you can stop smoking. You can start walking as soon as we tell you to, to build up, you can join the gym, you can look at what other foods are healthy. It was all very positive about taking control and sort of getting your life back.  

I think especially in the first year because you really are doing absolutely everything you're told to, everything the consultant said to do and more. Everything you've read because it's your way of fighting back. 

And you pick up every leaflet about heart attacks and look up things on the Internet about angiogram's and stents and, but that's like empowerment, it means that you know this heart attack struck you down but now you're going to do something about stopping having another one.  

He was able to adopt his daughter from China three years after his heart attack.

But we'd had a trip to China planned and paid for in, well we paid for the flights in April and that was just too much for me, we cancelled it. My doctor and consultant both said that there was no reason why we shouldn't go. It was a seven day trip but it was just too far away in too short a time so it was disappointing. But it was just, that was just one thing, it was sort of a hurdle too soon I think.   

We've adopted a little girl, which I'm not sure but it does make it a lot more difficult if you have health issues before you get approved and my consultant was very helpful in writing to social services. We adopted our daughter from China so we did make the trip, that was one of the reasons why we were going originally. 

[My wife] to this day I think, still thinks I engineered all this so I didn't have to get on a plane to go so far because I'm not, I'm not a great flier. But that was another big leap, even though it was sort of three years after the event once again that was, you know that really was going into the unknown and going to Beijing and then flying down into southern China. 

But I think by then I was more comfortable that there was and there's no reason to think that there is another heart attack on its way.

Taking a holiday abroad during his recovery felt like another stepping stone towards normal.

But when we went we went to Neurka in Spain and it's somewhere that we've been before and so we knew, I mean it sounds funny now but we knew there was a big hospital in [town], that there was another one within half an hour away. 

We knew that there were a number of ex-pats out there and my view was there's a lot of old people, old ex-pats who live out there and they must all be getting ill [laughs] so they must have good medical facilities out there. And so, but it was just looking back odd that we had to consider, that we considered all that before deciding on where we'd go. 

But it was nice to go back to somewhere where we'd been before and it seems to be a reoccurring theme of having sort of different comfort zones. But I needed it and but once you're there you forget that was one of the reasons why we went. And I think that flying, going abroad, you know it was all another step to normality. 

How long after was this?

That would've been for about, about three and a half, four months after. And if somebody had said to me, 'you know, right you're going to have a heart attack but don't worry, three and a half, four months later you'll be on the beach in Spain.' I wouldn't have thought that was possible. But we did take it easy,

Changes to his diet were easier than he imagined and as his taste changed, he found it enjoyable.

Well we didn't eat tons of red meat, we didn't eat particularly badly but we didn't really watch what we ate. But suddenly looking at sort of vegetarian dishes. I mean I'd never eaten a lentil in my life, I couldn't stand the sight of them. It was one of those things that I assumed I didn't like, even though I'd never had it.  

But it was amazing that once I'd started fiddling around with different spices and we bought a wok for stir frying. And I'd always liked Indian and Chinese food and I've always enjoyed cooking and suddenly I was cooking all this new stuff and having to follow recipes and for a while I was following the recipe, you know well I bought some new scales and I was following and measuring everything to the absolute microgram and millilitre. 

But the stuff that was coming out wasn't too bad apart from the fact that we had no salt in anything. And that was probably harder to get used to than a nice fatty steak [laughs]. But it did say in some of the things that we'd read that would become easier as your taste adjusted, which it did. 

But it seemed quite hard at the start because it was such a great big sea change but it was pretty enjoyable. That was a real positive out of it.

His heart attack put things into perspective and he no longer takes things for granted.

And I found that things that used to really worry me, like doing presentations at work was a particular horror of mine. I can use my experience of having a heart attack to sort of overcome that sort of fear because I just think well it's not really much to worry about because it's not going to be anywhere near as bad an experience as some of the things you've been through. 

So it just puts things into perspective and I'm a lot more, well I was always fairly laid back but in real terms now, although I might get wound up about the same things just as quickly and just as animated it's all superficial, I don't really worry about things like that any more because there are, you know it really does stop you taking everything for granted.