Bob

Heart attack

‘A refurbished heart and a restructured life’

After his heart attack and subsequent triple bypass in 2017, Bob experienced anxiety, anger and depression. He has since stepped out of the grief cycle to embrace a new lifestyle.

Bob, a 66-year-old Hutt Valley resident, was very aware of the possibility of a heart event before it happened. As a man in a high risk age group, a long term smoker, and with heart disease in his family, Bob described himself as “a sitting time bomb for a heart attack”.

But, when that time bomb eventually went off, Bob’s experience wasn’t what he’d expected.

“My heart attack caught me totally unware. My preconceived idea was that when the day came, there would be massive chest pains and pains down the arms, and there would be no mistaking the ‘widow-maker’s visit’.”

The day leading up to the event had been a busy one. After a 24 hour shift working as a race officer for a yachting endurance event, Bob returned home early on a Sunday morning for some much needed sleep. It was then that he was hit by a wave of nausea and struggled to breathe.

“I lay down on the floor trying not to wake my wife and I worked hard to get air into my lungs. I wasn’t that alarmed because 'this wasn’t a heart attack’. I didn’t have chest pains or pains in my arms. I assumed that it was either asthma or emphysema, from subjecting my lungs to half a million cigarettes over a life time.”

After 20 minutes, the breathlessness was gone and Bob continued on to bed. It wasn’t until that night, when the breathlessness returned, that his wife insisted she take him into Hutt Hospital.

Shocking news of a heart attack

Upon arrival at the hospital, Bob was taken straight to the Resus unit to begin tests and within an hour he was told he had suffered at least one heart attack – possibly more. Although he’d been aware of his heart attack risk factors, the news still came as a shock.

Despite the severity of his condition, Bob was by now feeling much better and assumed he would be able to go home, get a few hours kip, and return to work the next day. However, the medical staff took him to the coronary care unit (CCU) where he would stay for the next week while further tests were carried out.

Bob says he was “treated like a king”, but even with the top quality care and numerous visits from friends and family, the stay in the CCU was no holiday.

“I am not a good sleeper at the best of times and I found the long nights lying in the darkened CCU cubicle, often in tears, the worst part of my hospital stay."

Also, during this time, a newly-made friend died on the ward, making Bob all the more aware of his own mortality.

“It was becoming abundantly clear to me that I had indeed been very blessed having survived this heart attack, and if I wanted to enjoy longevity from here on, I needed to make some big changes to live a healthier lifestyle with less stress.”

Angiogram reveals bad news

Bob was sent to Wellington Hospital for an angiogram which revealed some worrying news. The blockages in the coronary arteries were too severe for stenting and the surgeons would have to carry out a triple bypass.

“I had never had an operation and to be told that I would need open heart surgery was frightening. In the darkness of the Wellington CCU cubicle I wept a heap that night. The recurring questions in my mind included: ‘They will be stopping my heart for two or three hours, what happens if they cannot start it again?’, ‘It requires a saw to cut through my sternum. Will I heal properly and regain my strength after surgery?’ and ‘The pain associated with open heart surgery must be incredible.'”

Bob then returned to Hutt Hospital where he waited for 12 days until a space for surgery became available at Wellington. He says it was a challenging time mentally, but after a few days he pulled himself out of the spiral of anxiety and self-pity and began to face reality.

“I was ready to complete the plumbing modifications required to my heart.”

Surgery awaits

The bypass surgery, when it finally arrived, took 14 hours. Bob woke up in the intensive care unit (ICU) to the smiling faces of his wife and daughter. The operation had been a great success. 

“Over the two days I was kept in Wellington ICU, I progressively had monitors wires and instruments removed in preparation to being returned to Wellington CCU ward.”

After a further four days on Wellington CCU, Bob returned to Hutt hospital for a final week of hospital care.

“Once my blood pressure returned to the desired level, I was discharged to go home – one hell of a journey. I was indebted to the medical teams at Hutt and Wellington Hospitals for exceptional care and skill, for saving my life and giving me a second chance.”

Twelve months of convalescence 

The road to recovery for Bob was a two-part process.

“I had to physically heal from the saw-cut sternum, exposure of the heart, and the cut down the full length of my right leg to take a vein for bypass. I can honestly say that at no time was I really in pain from the two sites of surgery. –Tender? Yes. Painful? No.”

For the first six months he was careful to avoid overloading his chest area. One year later he is fully healed and back out yacht racing with a new found strength.

Psychologically the recovery process was slower. 

“My early days of convalescing resulted in me bursting into tears seemingly for no reason. All of a sudden, out of the blue I would be struck with anxiety, self-pity or anger. Psychologically, I was up and down and frequently I would irrationally state that I wish the heart attack had taken me.

“I guess a lot of what I was coping with was a combination of physical stress and a journey through the classic cycle of grief – a five-stage emotional roller coaster ride through the emotional bombardment of denial, anger, bargaining, depression and acceptance.

“In writing my journey, it has become abundantly clear that all these emotions and thoughts were very much part of my heart attack, resultant care and surgery, and then healing.”

Bob says studying the Kubler-Ross Grief Cycle is hugely beneficial for psychological recovery after a cardiac event.

“It is a hollow, and quite normal to start achieving progress then backsliding into the bottom of the hollow. But each time you come up stronger, until the point of acceptance of what has happened to you and a life ahead with living with heart disease.”

A new life

Bob has made significant changes to his life in the last 12 months including stopping his 25-a-day smoking habit. He has also lost weight, retired and tried to remain stress free.

He hopes others may take some comfort from his story.

“My journey is quite unique to me, but I hope there might be some points of encouragement to others, or their families facing heart disease,” he says.

“I urge you all to read up and know about identifying, treating or coping with heart disease. It may well save your own life or the life of another.

“My journey wasn’t necessarily a long one – but wow, what a destination, with a refurbished heart and a restructured life. Despite my continued existence with heart disease, the medical profession have controlled it with surgery and I have made lifestyle changes to enhance that beautiful work and support carried out by our medical teams.”

Bob has subsequently become president of The Take Heart Club – Hutt Valley, a group that offers post-cardiac patients supervised gym exercise groups, walking groups, and cardiac care instruction as well as social events such as dinners and theatre groups.

Bob’s helpful suggestions

“I have learnt so much about heart disease in the last 12 months and would like to complete my journey with a list of suggestions that might indeed help others or their families if they have to take a similar journey in the future.”

1. Don’t give up – there is life, and many times a better and healthier life, waiting after a heart attack.
    
2. Everyone’s journey with heart disease is different.
    
3. React immediately – to any unusual pain, nausea, breathlessness or angina pains that may be indicating heart problems.
    
4. Be persistent with family or friends if you suspect heart problems – I am so concerned that a whole raft of friends were worried about my condition and grey pallor the day before my heart attack BUT no-one said anything to me! I say: BE A PAIN TO ADDRESS THE PAIN! Your family member or friend may desperately need help and your persistence may save their lives. It is even perhaps better to jeopardize a friendship in an effort to seek help and save a life.
    
5. Learn CPR (cardiopulmonary resuscitation) – recommended methods have changed in recent years so attend a First Aid course and learn the latest CPR methods.
    
6. Give up smoking – I found the nicotine patches excellent in reducing the craving for nicotine and I knew from the times I would get agitated that it was time to put on fresh nicotine patch.
   
   One unusual thing I did when I got out of hospital, having not smoked for five weeks, was to go and buy a packet of cigarettes and put them in my heart medicines and drug container. They have sat there unopened ever since and serve as being a proud reminder that I conquered 50 years of addiction to one of the most addictive substances known.
    
7. Physical fitness – there are many people out there ready to work with you in the gym, swimming pool or simply a walking group. I believe you find a new dimension in life enjoying the physical and social aspects of regular exercise.
    
8. Don’t feel embarrassed if you might be fast tracked into medical consultation – the medical profession will pull all stops for you if they suspect heart attack or other heart problems. You may need urgent and priority care.
    
9. If you are a smoker, overweight, have failed to follow medical advice or other matters relating to increasing your risk of heart disease – do not avoid seeking medical care – with my long list of ticks on my heart disease risk analysis, I had assumed that a coronary care unit would have treated me as a “reject” and put my case at the bottom priority for surgery or treatment. In fact, I did count, and there was no distinction or judgement made against me.
   
   At no stage was I ever confronted by medical staff about my smoking for 50 years – that decision to stop had to come from within and I decided that course of action on my admission to hospital. I of course was given every support and congratulatory comment by medical staff about that and any the life changing decisions made.
    
10. A newly diagnosed heart disease patient is scared – naturally a near death condition or experience, is a scary situation for anyone to face. If you are a patient or a victim of heart disease, you may need to talk about how you feel to family or friends. It is not being a ’wimp’, or just being full of self-pity, wanting to talk through your feelings and fears.
    
    Family and friends – BE EFFECTIVE LISTENERS – the last thing a heart disease patient needs is to be told the likes of, “If you had only listened to me and given up smoking 20 years ago – you wouldn’t be in this situation.” The heart disease victim knows this – he/she needs ENCOURAGEMENT, NOT GUILT.
     
11. Do not assume your treatment will follow any other – just because I had heart bypass surgery that does not mean that anyone else will necessarily follow my path. There are, of course, all sorts of options: to stent, medicate or even do nothing. We have wonderful cardiologists and medical staff who will formulate a programme especially for you.
     
12. If treatment or surgery is delayed – use that time wisely to prepare yourself physically and mentally for the road ahead. Sometimes delay and time to think is a real blessing. Also BE PATIENT – if someone has queue-jumped and been scheduled before you – ACCEPT that.
    
    On several occasions in both CCU’s I saw patients getting furious or abusive towards CCU staff because their treatment was being delayed for more urgent work. I consider that to be the lowest form of behaviour towards the beautiful caring people who work in cardiac care.
     
13. Open heart surgery – all I can say is that in my case it was not painful or anything that requires stressful worry or concern. I hear that very frequently from the many folk I meet who are respected members of the informal “Zipper Club” (from our scars of open heart surgery).
     
14. Do consider all life-changing or health-enhancing redirections in life – in most cases a big investment of time, money and resources has been made into a patient with heart disease. It becomes a responsibility for us all to continue that good work by doing all we can to reduce risk.
     
15. Be understanding with family or a friend who has undergone the trauma of heart attack, heart disease or surgery – their bodies or minds may be in a state of shock. Be a good friend and a good listener.
     
16. Take every opportunity to learn – there are some wonderful reading material, videos, and seminars provided by the Heart Foundation. Take the opportunity to read or watch as much material as you can – it could save someone’s life.

Shared July 2018