Interview HA12

Age at interview: 66

Age at diagnosis: 65

Brief Outline: Heart attack, March 2003. Coronary artery bypass surgery July 2001. Current medication' aspirin, cozaar, pravastatin (lipostat)

Background: Retired BT Manager; Married, 2 children

Diet in his childhood and during his twenties may have been a factor in causing his heart attack.

So I said to the doctor, the surgeon, 'why did I have a heart attack?  All my friends say you are the last person to have a heart attack. I'm relaxed, I don't work, I've been retired now, fully retired for six years and semi-retired for ten. I have no great stresses or needs, no family worries. Two kids are happily married with children. Happily married with the wife. Financially, reasonably financially secure. So I don't have any worries, so I don't have that sort of worry, I keep, I thought I keep myself fit, I don't eat to excess.'  

And the surgeon said a very telling thing, he said, 'you're a child of the war.' I was born in 1937. He said, 'you'll be a member of the dripping brigade.' He said, 'when you were a kid, your mum, on a Monday, after the Sunday roast on a Sunday, would have given you a dripping sandwich and you'd have loved it, dripping toast.' He said, 'you all did at that age and your mum thought it did you good, get some grease on your chest. Also because it was the war years you'd be eating the fattier things, leg of lamb, rack of lamb.'

And these were all the things I loved as a kid and funny enough I still love, [er] cottage pie, sausages. He said, 'you were a member of that and that's when you lay down this trouble, when you were a child.' And he said, 'then how did you live afterwards?' And I said, 'well okay, I got married when I was in my, end of my twenties but I was an engineer.' And I said to him, 'when you think of what you did to yourself.'

I was an engineer and we had a staff canteen and the only thing they could cook properly was chips so I would have chips every lunchtime with something. And I was going to college, so I'd go to college most nights so I'd have chips for my tea. So in my formative years, until I was probably thirty, I wasn't eating the right things and I was laying down this that's happened.          

A video he watched on the cardiac care ward helped him during his recovery.

There was a video shown to us in the heart unit. It's actually done by John Cleese and it had a very poignant part in it. The very first lines of it said by John Cleese is, it said, 'you are the lucky ones, you are alive. You've had a heart attack and you've survived it. 

Now we can do something about it, medication, surgery. We can now control it and we can control your life and give you your life back. You are the lucky ones, you have survived.' And I had that message in my mind all the time, 'I've survived the heart attack.'  

He feels his heart attack affected his wife more than it did him.

But the biggest person it was affected was my wife. She took a long time to sort of release the apron strings, to let me go and walk on my own, let me go and get the paper, do the mile or two mile walk round the lake. 

I'd have to carry a phone, I still have to carry a phone and she likes me to still ring when I'm at the farthest point and she is concerned and it, it's had more of an effect on my family I think than it has on me. 

They're the ones that really bear the brunt of these and they're the ones that you have to thank really because it's them that worry about it more than yourself. Yourself, at least in my case, I think I can do anything now, I can, I can be anywhere and do anything. Your family still worry.

My wife I think now is getting, I mean if she lets me go, she lets me go and play golf with my brother. But it's the effect on them, especially my wife, is the big effect of heart attack.

Is there anything you think that helped her to be sort of be happy about you doing more things.

Yes the things that, that encouraged her was (a) that she spoke to the people in the rehab, the physiotherapist and the, sister who's there and they said, 'okay this is what can happen to you know, you're doing fine, don't worry about it.' She's spoken to the local practice nurse, because I still go and see her now and again. And again she's said the same thing. 

She's spoken to the surgeon who said, 'I've fixed him now, he's okay, I've had my hands all over him, I've sewn him up. He's now got three bypasses, he's got three arteries, or they were veins of course, now that are pumping through and he's good for a bit longer.'

So it's positive information to her. She's read all the books the same as I have, all the information of things you can do, time scales of when you can do it. So those are the things that have really given her, is the support network around as I say the rehab, the local doctor and the surgeon that did the job. So those are the things that have reassured her, and I think now she thinks I'm okay.

Staff were unsure when his heart attack occurred so he had warfarin to thin the blood instead of thrombolysis.

Was it a chest pain?

Not really, it was as if there was a mouse running up my chest, it was a most peculiar feeling, as if there was something just going like that, up my chest. And it was just a little pain that ran up, most peculiar feeling, and that was really all I was getting and I didn't feel right, I didn't feel right at all. 

So I was taken, my wife took me in the car this time to the hospital, went again to the Accident Unit and they were very good. As soon as I mentioned heart problems in the reception I was straight through to the doctors area. They did, they put the tests on me, they said 'yes, you're in trouble', and they took me through to the local CCU which is at that hospital. And they said, 'yes, you've had a heart attack'. 

They weren't sure whether it was the first time or whether it was Wednesday or whether Wednesday was a prelim to it or whether it was three o'clock in the morning. 

They said, 'unfortunately, because if it was three o'clock in the morning which they were beginning to think it was, I couldn't have this clot busting drug which everybody gets and you should have within the first hour or so. So I just stayed in the CCU, they put me on warfarin and all the usual sort of drugs and looked after me really.
 

His bypass operation was delayed for a week because he was still taking clopidogrel.

I went in on the Thursday for the operation, I think it was the Friday, I may get it wrong on the days but it doesn't actually matter. And the surgery was just shutting for the evening and I said to him, 'oh by the way, I've still been taking the aspirin should I have stopped'. He said, 'oh no we can get over aspirin these days. We're so used to people taking aspirin when we operate, aspirin doesn't actually matter.'

He said, 'what else are you taking,' and I showed him and there was an aspirin replacement [clopidogrel], which I can't think of the name but I can find it if you wish. And he said, 'I can't operate on you if you take these, I can't stop you bleeding'. He said, 'I can if you're desperate,' but he said, 'but if you were my family I can't operate.' 

So it was a lesson to be learned really, I should have informed him or he should have asked me what things I was taking.

So he sent me home and said, 'come back in a week's time.' And in some ways it was a good thing because when I went in the first time I was very, very apprehensive, I knew he had a 98% success rate and I kept saying to myself I've got to be one of the 98 not the 2.  

I'm a quite positive person really and you know I felt I'm going to be a 98 not a 2 but I was very apprehensive when I went in on that Thursday and the build up a day or two days beforehand I was very apprehensive about the whole thing. Then he sent me home and I thought he knew what he was doing. 

Okay we made a mess of the fact of this tablets and I shouldn't really been taking them but I went through the following week quite happy and went in on the following Thursday night, I thought very relaxed, at least I felt relaxed and wasn't apprehensive. 

Describes his 'black' day in hospital after his bypass operation.

And things were doing nicely and the surgeon said, 'today will be a day that you will be dopey, you'll be alright' he said, 'but you will have a black day,' he said, 'you'll definitely have a black day during the period you are in here. I hope to get you out in six days,' but he said, 'everybody has a black day'. And the following day my black day appeared. 

Not much to me particularly but my heart rate I'm told went up to 180 pulses which I mean I could feel, feel I was racing away and on this monitor it was on 180 and going up and down slightly. 

And obviously they called, called the doctors in and the surgeon in and I said, 'what had happened?' and he said, 'well the person to blame is me', he said. 'I've had my hands on your heart and your heart didn't like it', he said. 'I've upset your heart', he said, 'and it's now showing up and it's doing this', he said. 'But we'll, we'll put in a drug.'  

So fortunately I'd still got this drip in so they put this drug in and it was, as I say a black day to me, partially I suppose but it was more of a black day to my wife really and she knew this black day was coming but she could see this figure of 180 not coming down and she spent several hours with me watching this figure until it eventually it did come down and that was the end of my black day really. And from then onwards, I had certain pains, but I never had a great deal of pain from the operation.

His goal was to get back to playing golf after his heart attack and bypass surgery.

But my goal was to play golf again and they told me in the little book, the heart booklet, which I've read, that at six weeks I shall be able to not play golf but I should be able to walk on the course. 

So at six weeks I started walking on the course again. With my wife mainly and we'd play nine holes, or she'd play nine holes and when we got to a green and I'd putt and then slowly but surely I'd sneak another golf club in and play with a [inaudible]. 

And after, just after six weeks I started to hit the golf ball again, although people have said, you know 'careful of your chest.' But the people in the rehab said, 'it's a swinging movement rather than a stretching.' Don't lift, people kept telling me, 'don't lift bags of cement and don't pick up slabs.'  

I have no intention of picking up slabs in fact I told the surgeon that if anyone's going to pick up a bag of cement, I'll let the wife do it. [laughs]

So I had this goal to play golf again and at six weeks also the rehab people called me and said, 'start the rehab again.' So I'm back into the rehab now, which is I'm only going once a week now for twelve weeks and I think again that's absolutely essential to do all this. 

But it was that goal and they said, 'at three months you should be able to play golf.' And at three months I started playing golf and I'm round to playing fourteen holes now, out of the eighteen, including going up the hill that used to worry me.

Talks about playing with his grandchildren three months after bypass surgery.

It was initially, now I play with them now and will lift them, although my wife looks down at, because they are the 'bag of cement effect'. And I was a bit protective of me chest, especially this dead, dead patch.

My one little granddaughter, she's a wriggly bum, she sits on lap and there's arms and legs going all over the place and you get a poke in the eye and she'll, she'll sort of put her head back and would bang on this. So there was a bit of wariness about that. But we spoke to the surgeon and he said, 'well after three months, all where he's, he's cut down and separated the breast bone, and I'm actually put together with titanium loops'.  

He said, 'at three months', he said, 'that's absolutely solid now'. He said, 'you know you can't get through that, you can't damage it. And at two months even it's pretty well knitted'. That was when I was really starting to sort of move about and play more golf or at least started to swing. And he said, 'you know you can't get through that.'

He checked that the hotel was not near a steep hill when he went on his first holiday after his heart attack.

And we've already been away to a hotel in England. We picked it with very great care, the one we went to. We went to [town] and it sounded like the old crocks outing because we went with our friends. I've had a heart attack, [my friend] whose had knee surgery, another friend whose had knee surgery, so could we walk up from the beach. 

So we chose this. We rang round the hotels in [town} and said, 'are you fairly close to the beach or is there a walk down', and they said, 'oh we're just a 100 yards up the high street'. So we went. And it was quite a steep slope and we were all, you're always a bit apprehensive until you've done these things and then we went, one day while we were at [town] we went to [town].

Now to go down to [town], people who know [town] it's a side of a house jump. And we went down because there's a nice little caf', we had a cup of tea down there and whatever, and I sailed back up there, and after I'd done that I thought I can do anything, I can go up the side of a house and I passed our two friends who were coming up with their knees because they climbed as well.

So yes, holidays we look forward to and it was another stepping stone. I went up the slope from [town] and those are the things that you can see as stepping stones. You do something a bit more and you succeed and you think I can do it once, I can do it again. In fact I did do it twice at [town].