Interview HA24

Age at interview: 58

Age at diagnosis: 57

Brief Outline: Heart attack 2002. Current medication' aspirin, ramipril, nicorandil, Tildieum Retard, GTN, atorvastatin. Diagnosed Cardiac Syndrome X 2003

Background: Retired Psychiatric Care Assistant; Married, 4 children

Describes the mixture of emotions he felt when he had a heart attack.

Disbelief was the first feeling, absolute disbelief. The classic you know, not me. Then a certain amount of frustration, but continuing disbelief. Even though people were telling me this, couldn't have been nicer and more considerate, your disbelief then begins to turn in to anger. Not at those but at the 'why me?' kind of concept and then you've got like your family on the way to see you, and I know this sounds really silly, but you begin to feel guilty that they are going to come in a distressed state. My situation will make them more distressed and so you even then begin to feel guilty about it yourself, which I know is an absurdity but you can't help it as it were.

Talks about the physical limitations he has, which was difficult at first but now he accepts it.

I think they're all predominately, they're all predominately physical things, like DIY, gardening, long walks and it's not the individual task that you can't do, it's the sum total of all of them. We've got a grandchild and you play with her and prior to it, I could run around the garden with her, I can't now.

 And it's all those things, all those other physical things because psychologically your heart attack hasn't affected your brain as it were, but they're all physical things that you can't do and at times you get really stupid and do something you really shouldn't have done but if there is a good side to it, the pain soon tells you that you shouldn't be doing that. 

And it was that, all physical related tasks that were very, very difficult, either very difficult or you couldn't do, and you knew you weren't to. But gradually with the acceptance of all things, I think, otherwise you'll keep on beating yourself up as you discover new tasks that you can't do but could of done, if I can't do it, sit down, someone else will do it for me.

On some nights he was too frightened to go to sleep if he felt discomfort in his chest.

I think literally when I came out of hospital first time, that was such a common thing. I mean, I'd go straight to bed if I was feeling alright, just a bit uncomfortable. But if there was a bit more than just uncomfortable, I shut my eyes, I'm never going to wake up, so what I'll do is I won't shut my eyes, and I know it's absurd, but it's a fear that's engendered within you and I try to put it to people in the sense, it's not the intensity or lack of the pain, it's the source of the pain that's the worry. 

Like if you broke your arm in several places and it's cripplingly painful, it's your arm but when your heart hurts, it's kind of, it's the pump that drives the engine kind of thing. You find it really quite frightening and I know it's absurd, I'm not going to go to sleep and two or three hours later you're still awake worrying and that fear was difficult to deal with. 

He felt frustrated and angry at not being able to do the things he could before his heart attack.

I think you're angry with yourself, frustrated with yourself and angry with yourself because you see something, not a major thing that you'd being doing all your life, and you can't do it and you get, initially you get so frustrated, 'Now why can't I do it you know' 'Is there another way I can do it.' 

And then the frustration turns in to anger against yourself because again you're going in to this, 'my family are having to do this, am I becoming a burden on my family' and you go down that line of thought then and I know you shouldn't and I mean you can rationally say everything to yourself what needs saying, but when it's you talking to yourself, it's not as successful as when it's somebody else.

You tend not to listen to yourself and the frustration like I say stemmed from not being able to do things that I've done all my life, suddenly I could no longer do them, which impacted on the family as well.

Suddenly we could no longer do this together or that together and the frustration turned to anger as well you know, and really it was an on-going process. I mean, even now, although I deal with it an awful lot better, I don't get frustrated very often, I very, very rarely get angry with situations. Still now and then I will do, but it passes then because I've, in a positive way, I'm in total acceptance of where we are and what's happening.

Reiki helped him to cope with his anger and frustration.

But I used to constantly have these grey episodes and I finished the rehabilitation programme and then the woman who runs it is also a Reiki Practitioner and I had probably 8-10 weeks of Reiki and the one major thing that Reiki did, and it doesn't sound a major thing, but at that moment in time I was so angry with everything, it was an enormous step for me. 

I really truly accepted what had happened to me. And it doesn't sound a lot that doesn't, but the dawn of realisation of, well this is what happened and this is where we are, was so important because at that time, I was so screwed up with anger and frustration, it was just untrue. And again it was unfair on the family because they've just been wonderful, and you find yourself getting very short-tempered with them and very abrasive and that. 

So the Reiki didn't cure anything, it didn't help the condition. The enormous thing it did do was, I accepted what had happened to me and the situation I was in. My anger against myself diminished considerably, which was a huge step at the time. I did figuratively, I used to beat myself up daily in a figurative sense; it stopped after that and that was a huge step forward.

Seeing a counsellor helped with his emotional recovery from his heart attack.

I think the counselling, the major benefit was you do have, I don't want to say this in a collective way 'you do have' but I'm led to believe that you do have quite morbid thoughts at times. You know not, 'I'm going to go out and throw myself under the bus' but kind of 'is it all worth it, you know.' 'what's the point?' The low self-esteem kind of road you know. 'I'm of no value to. I'm of no worth to anyone, never mind myself.' 

And I think it helps with those and gets you through that stage. And I mean my GP has said, she can't believe anybody who has had a heart attack, at some stage hasn't thought, 'it might be better if it had killed me or something like that and I think the counsellor was just very good in helping me to look at my situation with regard to myself in a different way and see a value in myself, or values in myself from a different perspective than before the heart attack.

Describes the benefits of using a pill box.

I find that brilliant because I'm on such a lot tablets, if you open that, there's like, you put Monday's 

Is it a pill box?

Yes, it's absolutely excellent because before I bought that, that was my wife's suggestion, I used to have to get that lunch box twice a day and go through every one, which it takes me about half an hour on a Sunday, put the entire weeks up, twice a day and then that's it for the week then. 

It's a very good investment that is. It's got nothing to do with the fact, oh you can't count, it's purely convenient. If I've got to take my tablets now, it's a thirty second process, instead of ten minutes getting everything out and I find it really good.

He follows a Mediterranean style diet and still enjoys his food.

Eating. Low fat is the key with eating and surprisingly enough that isn't as difficult as it sounds. It's cost me one of my weaknesses, it's cost me the cheese but they do low-fat cheeses. Low fat, eating of low fat and it isn't really that difficult once you've got over the initial change of eating. 

I enjoy eating now as much as I did before my heart attack and my intake of saturated fats is a lot less than it ever was before my heart attack and it's not a problem it really isn't. And the only tip I give to people who've got to be on it, I'm sure they all know this is always be aware of the claims on the packs of the food you buy. 

Like these reduced fat, well it could be 80% reduced to 75% as it were. You need to look and read labels but there's quite a range of food on the market, which fall within that context. 

The eating of fruit and vegetables really is not difficult because I enjoy fruit and veg and there's a lovely book they've got at the hospital, it's the 'French Connection.' How in Mediterranean countries they have far smaller incidence of heart attacks than we do and it's five reasons; garlic, olive oil, fresh fruit and veg, oily fish and red wine and I can live with that. 

Involve your partner and family in your recovery.

And throughout all this, and it's such a corny comment but it's so important that your family are there with you. In the sense, not with the counselling or the Reiki, but are there with you and understanding, helping and at times displaying quite tough love, you know. 'No, you're not going to wallow in self-pity, like. 

You're going to get up, get off your backside, we'll go for a walk, or we'll do this' which doesn't sound like enormous things but they are at times and yes, that's really important. And like the woman that did my Reiki, met both of us as a couple and explained and answered my wife's questions as well as mine, and I think it's the family that has to be treated, not just the individual. 

If the patient has got children, siblings, partner, it's important that the collective group is treated. Not by forcing information down their throats but if they want to ask something, then making time for them to give them the answer as well, because it's equally important they understand what's happened to this loved one.