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Alan

Age at interview: 62
Age at diagnosis: 62
Brief Outline: Alan recently had a heart attack, was treated with primary angioplasty and a stent was put in. He is due to start a Cardiac Rehabilitation programme soon. He and his wife think that the quality of care Alan received has been excellent but would have like more information and advice for when going home. Alan walks and goes for a cycle ride every day.
Background: Married; with grown up children and grandchildren. Retired but does gardening on a part-time basis. Ethnic background' white.

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The day of his heart attack, Alan went to the Well Man examination clinic in the morning and was found to be a bit overweighed and in need of reducing his cholesterol levels but, in general, he was in good shape. Alan was given advice on what to do to improve his well-being. Alan remembers that afterwards, he and his wife talked about diet changes which basically meant to stop snacking on high fat content food such as hard cheeses and full-fat milk.
 
Later that day, when he was on his own, he started to feel unwell. He describes his symptom as ‘as if someone was trying to squeeze my chest’ and he initially thought it was indigestion. He was sweating and realised that something was wrong. He drove himself to his mother-in-law’s house, where he collapsed on arrival. His 89 year old mother-in-law – who lost her husband to a heart attack - recognised the symptoms and called 999 without delay. The paramedics did an ECG while at home and the ambulance took him to the nearest hospital where they have the resources to do primary angioplasty. On the way to the hospital, the paramedics kept reassuring him.
 
On arrival at the hospital, he was taken without delay to the Cath Lab, where to Alan’s surprise there were many people ‘running’ around him. He watched the whole procedure on the screen. He remembers that the pain stopped even before he was taken to the Acute Cardiac Unit. Later that day, he was visited by the consultant who explained to him what they had done and that the whole procedure had gone well. He had primary angioplasty and a stent put in.

 

 

Alan said that after having primary angioplasty and stent fitted he felt ‘normal’ again.

Alan said that after having primary angioplasty and stent fitted he felt ‘normal’ again.

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Well like I felt normal. I really felt normal after that. Even when I was on. I mean I’d still got the pain going to the hospital because they gave that, whatever you, in my arm and then but once I got back home I felt as though I’d had nothing happen to me. You know, I just felt normal.
 
Were you in pain after you left the
 
After I came out of hospital I had a few days in pain, yeah but whether that was anything to do with that or not I don’t know but I mean I’ve not had pain. Because I mean it’s hard to say. I mean I don’t know about heart attacks but it wasn’t. I didn’t have a pain. It was just like somebody was pushing me.Not like any real pain you’d think like but I’ve had a few pains that have been proper pains since I had it done but as I say whether it’s anything to do with that I don’t know but.
 
But after the surgery were you in pain?
 
No
 
No?
 
No, none at all. I could actually, you could actually dare I say, the only thing I didn’t feel the needle. I just felt the tingling sensation and that was all. But actually I still, I mean I knew something was wrong but then all of a sudden it was gone. So that must have been when the artery probably cleared what was going off and. Yeah no I couldn’t believe it, you know.

 

 

When back at home, Alan experienced chest pains and he and his wife were unsure if it was...

When back at home, Alan experienced chest pains and he and his wife were unsure if it was...

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Alan’s wife' Yeah there just didn’t seem to be anybody you could call on. I mean obviously, you know, the doctor is there but my first port of call when I was worried about him I rang the number at the ACU [Acute Cardiac Unit] to ask some advice. Was it normal that he was getting all the pains he was getting. And then shortly afterwards, after I had spoken to that lady, a lady rang from [name of city] because Alan had put down for the rehabilitation to be at our local hospital and they are not [name of city]. They are [County name] and a lady rang from [name of city] who was very nice and said, ‘If you’ve got any worries or concerns you could ring her any time’. And a couple, well I don’t know how many days, two maybe three days later I tried to ring her. She wasn’t there and I left a message and it went on from the Friday. I tried Friday morning and it was actually Wednesday before I got to speak to anybody. In the meantime we had been back to the GP and he said, ‘Take your medication. That’s what it is for.’ So I didn’t know whether we were worrying unnecessarily or whether. You know, there wasn’t really anybody you could talk to about it who knew about it. There didn’t seem a professional person if you like who we could chat to about it.
 
So how did you feel about it?
 
Alan’s wife' Felt a bit abandoned. As though he had been in and monitored and, you know, they’d unplugged all the monitors and put his things in his bag and we’d come home and that was it sort of thing. Would have been nice if we’d have had a contact number where you could have spoken for reassurance or whatever.
 
Have you looked for information somewhere?
 
Alan’s wife' Yeah I’ve read the booklets and the lady at the [Hospital name], she’s from the Rehabilitation Scheme, the lady that rang. I spoke to her. Well I didn’t speak to her because I couldn’t get her, I spoke to somebody else eventually on the Wednesday but I just wondered whether the symptoms Alan was getting since he’d been home were normal or whether, you know, he’d got pains and perhaps somebody ought to look at him but there wasn’t anybody sort of to give that advice really.
 
And how were you feeling at that time? I mean were you apprehensive, scared?
 
Alan' Oh no, no not scared sort of I was just getting, perhaps I perhaps thinking that’s what happens, you know what I mean, it wasn’t, because it wasn’t the same sort of pain. It wasn’t.
 
One of them, I must admit one of them was. It felt as though it was going to be but then I had a spray and it went but the others were sort of really ping pains like a more of a stabbing pain in my chest where the others were like I said, as though somebody was trying to just crush me together.
 
Squeezing yeah. And did any doctor or a member of the team in the hospital explain to you the possibility that you were going to feel like this or?
 
Alan’s wife' No.
 
Alan' No, no.
 
Alan’s wife' That’s why we didn’t know quite what to do with it and also the nitroglycerine spray that he was given which they said to take if he did get any pain we weren’t really sure whether he should take it every time he got a pain. I mean Alan is quite good with pain. He’s not mardy with pain and he was kind of not using it waiting to have a bigger pain to use it for. And I am saying, ‘Well perhaps you ought to take it when you
 

Alan remembers one of the paramedics reassuring him and telling him that he was going to be ‘in...

Alan remembers one of the paramedics reassuring him and telling him that he was going to be ‘in...

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And how long did it take the ambulance to arrive to your mother-in-law’s house?

 
Well I mean, you know, to be honest I don’t really know, probably 5, 10 minutes I would have thought but I mean I don’t know. It could have been less. It could have been a little bit more like, you know, because I was, well leaning back in the chair and the paramedic man was trying to calm me down a bit like because I was worrying what was going off. And I was no sooner there and they put me in the ambulance, sorted me out and we had the alarm going and [laugh] away we went. They chucked me off.
 
In the ambulance what happened? How did they manage you?
 
They stood up, they watched it on me, checking me but I mean apart from that I was normal really. I mean they just sat beside of me because I was trying to talk to ask, you know, what was going on. You know, ‘What’s going to happen to me?’ And she was trying to calm me down like because I was withering about it and the next thing we were there.
 
She was explaining to you?
 
Yeah she was explaining what was going to happen. She said, ‘Like I’ve seen it hundreds of time, don’t worry about it. It’s, you know, you will be in good hands’. Which I was obviously, you know, I was very impressed.

 

 

Alan and his wife were ‘very impressed’ by the service provided by the cardiac care unit and the...

Alan and his wife were ‘very impressed’ by the service provided by the cardiac care unit and the...

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Alan’s wife' We were very impressed with the service.
 
Alan' It’s when they said what they were going to do in the ambulance and I thought, well tomorrow or the day after. And she said, ‘Oh no as soon as you get there like’. You know because I thought I would be in my bed then they’d come up and fetch me like, you know, but it was straight in and in then.
 
Alan’s wife' And when I got there it was all over.
 
Alan' Over and done with yeah that’s the amazing part to me especially not feeling anything either. I mean I’m not a one for…
 
Exactly
 
Alan' …having operations. I mean it’s not the best thing I like you know, I mean but…
 
Alan’s wife' It didn’t help because my mum, bless her heart she is 89, jumped in the ambulance with him and when it came and she left a note on the back door that said, ‘Gone to [Hopsital name]’ which is obviously the other hospital. So my daughter came here and we sped off in the car and we went to [Hopsital name] and we parked and then we went to see if we could find him and he was at [Hopsital name]. So then [laugh] we had to obviously go and reclaim the car and go to [Hopsital name] and by the time we got there it was all over. He had been done but he wasn’t up in the ward. But the lady on the reception just said, ‘Don’t worry he’s had his op. You know everything is fine. He’ll be coming back here soon.’ And we just sat there and waited but we couldn’t believe that it had been done when we got there after taking a slight diversion into the other hospital.

 

 

Both the nurse and consultant drew pictures to explained to Alan his heart attack and treatment.

Both the nurse and consultant drew pictures to explained to Alan his heart attack and treatment.

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How was the care while you were there [hospital]?
 
Alan' Oh it was very good. I mean there was always somebody there and about, you know, they were always looking after you and. Yeah very good, yeah I mean the nurse came to me and obviously I asked her what had gone wrong. And she drew me a picture and everything of what they had been doing and the, like consultant lady came and she did the same thing as well really pictures for me showing me what they had done like, you know.
 
Alan’s wife' And it was the same team which was nice. You saw the same faces every day.
 
Alan' Yeah, yeah, well it was very good yeah.

 

 

When discharged from hospital, Alan was disappointed to hear that his cardiology follow-up...

When discharged from hospital, Alan was disappointed to hear that his cardiology follow-up...

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So when is your next appointment in hospital?
 
Alan' July
 
Alan’s wife' Not until July
 
July so that will be?
 
Alan’s wife' Six months after.That’s what I thought was. I realise they are busy don’t get me wrong or anything like that but it seems like a long time to me when you think what you’ve had. I know there are probably thousands of heart attacks, I realise that like, but when they were actually talking to me I am sure they said to me, ‘It would be 5 to 6 weeks they’d be getting in touch with you to come back just to make sure that you are getting along alright’. But obviously, you know, it was 6 months.
 
Have you phoned them and asked why July?
 
Alan' No I mean when I spoke to the lady about going for my rehabilitation thing as well they seemed to think it was quite normal.
 
Alan’s wife' I mentioned it to the lady who I spoke to when I rang [Hospital name] and she said, ‘Oh yeah that’s probably quite normal’. Then I said we were expecting a check up in 6 weeks, that’s what they told us and she said, ‘Oh well I don’t think that happens very often’. That was that.

 

 

 

 

Alan and his wife explain how he has gradually increased his daily physical activities following...

Alan and his wife explain how he has gradually increased his daily physical activities following...

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Alan’s wife' Well we started with little walks. They suggested that didn’t they that you go out for a little walk every day and build it up. And we walk anyway obviously with the dog so we started little walks and then sort of extended them as the time went on and then when we were walking sort of quite comfortably he decided to go out on his bike. Didn’t know if it was a good idea or not but he came back and said he was fine. So [ha] he has continued but he does it every other day.
 
So that is flat?
 
Alan' Yeah I just go along the canal at the back here yeah.
 
How long ago you started going on your bike?
 
Alan' I’ve been doing it just over, I think this is the second week, yeah every other day.
 
Every other day and for how long?
 
Alan' I, it’s about. I’ve been going a mile along the canal and back so it’s two miles. I’ve just started, I go I don’t know probably half a mile further now or perhaps a mile further now but I mean it’s all flat there are no hills at all. It’s just straight pedalling like, you know, nice and easy.
 
And how do you feel after that?
 
Alan' Ok, yeah out of breath but ok yeah and enjoying it. Well I do it early in the morning anyway when it, especially now they’ve put the clocks forward I can be out at 6 in the morning and.
 
But do you feel out of breath when you are pedalling or?
 
Alan' No I must admit no. This morning I put a little bit more. I went that way this morning. I went up the hill there was a bit, well not hills but, you know, and I felt it up there a little bit more than I would do normally but I just had a rest when I got to the top before I went off again and pedalled downhill.
 
Ok.
 
Alan' But really out of breath, no not really. I mean more than I used to be probably but
 
But the doctor hasn’t given you any sort of advice' take it easy to start with walking and things like that?
 
Alan’s wife' They [doctors] did say to do a little walk when he was in the hospital. They said it was a good idea to have a little walk every day and nothing too strenuous and build it up which is what we did isn’t it.
 
Alan' Yeah
 
Alan’s wife' Really from the beginning just a little walk up to my mum’s. She lives just up the road, to start with and then sort of increased it and went out with Alf [dog] didn’t we when it was nice.
 
And for how long do you walk now?
 
Alan' [phew] Probably half an hour or so with the dog, just along the canal again that’s all, to the garden centre. There is a garden centre over the back there. We go around there and back around again. It’s a nice casual walk. You know it’s not strenuous.
 
Alan’s wife' We started with 10 minutes or so didn’t we?
 
Alan' Yeah
 
Alan’s wife' And then built it up after that but when it has been nice in an afternoon we have perhaps gone a bit further haven’t we? We have a little sit on the seat half way and then come back.

 

 

Alan’s wife felt ‘abandoned’ after Alan was discharged from hospital and started feeling unwell....

Alan’s wife felt ‘abandoned’ after Alan was discharged from hospital and started feeling unwell....

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Alan’s wife' There just didn’t seem to be anybody you could call on. I mean obviously, you know, the doctor is there but my first port of call when I was worried about him I rang the number at the ACU [Acute Cardiac Unit] to ask some advice. Was it normal that he was getting all the pains he was getting. And then shortly afterwards, after I had spoken to that lady, a lady rang from [City name] because Alan had put down for the rehabilitation to be at our local hospital and they are not [City name]. They are [County name] and a lady rang from [City name] who was very nice and said, ‘If you’ve got any worries or concerns you could ring her any time’. And a couple, well I don’t know how many days, two maybe three days later I tried to ring her. She wasn’t there and I left a message and it went on from the Friday. I tried Friday morning and it was actually Wednesday before I got to speak to anybody. In the meantime we had been back to the GP and he said, ‘Take your medication. That’s what it is for.’ So I didn’t know whether we were worrying unnecessarily or whether. You know, there wasn’t really anybody you could talk to about it who knew about it. There didn’t seem a professional person if you like who we could chat to about it.
 
So how did you feel about it?
 
Alan’s wife' Felt a bit abandoned. As though he had been in and monitored and, you know, they’d unplugged all the monitors and put his things in his bag and we’d come home and that was it sort of thing. Would have been nice if we’d have had a contact number where you could have spoken for reassurance or whatever.

 

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