Robert
Robert suspects his heart failure was brought on by a heart attack 24 years ago and then a problem with his heart rhythm 12 years ago. He had a device implanted that will send an electric shock to his heart if it goes out of rhythm, which it did 3 years ago. He takes lots of medicines, is physically active and enjoys life.
Robert is married with adult children. He retired at age 53 from the Royal Navy after a long career, then spent 12 years as a civil servant before finally retiring. Ethnic background: White English.
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The first time Robert had a problem with his heart was in 1991 when he had a heart attack. He made a good recovery and had no further problems until 2003 when his heart went out of rhythm and he had to be given an electric shock (cardioversion) in hospital to restore it to normal. Three weeks later he was fitted with a stent and an implanted device (ICD) that would shock his heart automatically if it went out of rhythm again. At first he felt depressed about having an ICD fitted but accepted it after speaking to a psychologist and doing relaxation therapy. Later that year he was hospitalised for pneumonia and told in passing by a doctor that he had heart failure. This diagnosis was confirmed in 2008 when he was found to have a leaky heart valve.
Robert’s ICD was replaced after 6 years but the procedure introduced an infection. After antibiotic treatment the device was reinserted on the right side of his chest instead of the left. In 2012 his ICD shocked his heart when he was sitting in an armchair at home. He went to A&E by ambulance where it happened again. His medicines were adjusted and he spent a week in hospital.
Robert takes 12 pills a day at various times of day and uses a weekly dosette box to organise them. He sometimes forgets his lunchtime ones if he’s away from home but his wife carries spares in her handbag just in case. Some of his medicines have been changed after causing him problems.
Robert attends a yearly nurse-led heart failure clinic at his local surgery and sees his GP at least every six months for his heart and other conditions. He used to see a hospital heart failure nurse every three months but now only when he needs to. He can either see her at a drop-in clinic or make a specific appointment. The nurse discusses his case with a cardiologist and makes changes as necessary to his medication. He has his ICD checked annually at the hospital; meanwhile it is monitored remotely by a machine at his bedside and downloads data automatically every six months. He has fortnightly blood tests at the GP’s surgery to check his clotting time because he takes warfarin. He weighs himself at home about once a week and used to monitor his blood pressure but no longer bothers as it is always low.
Despite his heart condition, Robert lives an active life although he has lost all interest in sex. In the past he has attended cardiac rehabilitation sessions but more recently has joined the gym, which he goes to twice a week. He also does the housework and gardening and walks his daughter’s dog. He sometimes gets breathless momentarily when bending over. He eats healthily and keeps his weight down. He has a positive attitude to life and doesn’t worry about his heart condition. He belongs to a local heart support group that mainly meets socially. He believes that people should take responsibility for their lives and therefore asks for all his test results and has put his affairs in order because he knows that his heart condition will probably cause his death eventually.
