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Mervyn

Age at interview: 76
Age at diagnosis: 73
Brief Outline: Mervyn contacted NHS Direct after persistent chest pain and spoke to a doctor who sent a paramedic team to assess him. The ambulance crew took him to hospital and he had primary angioplasty and two stents fitted. He takes the following medications' aspirin, bisoprolol, simvastatin and ramipril.
Background: Mervyn is married, has three grown up children and lives at homes with his wife. He is retired. Ethnic background' White British.

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Mervyn is married, has three grown up children and lives at homes with his wife. He is retired.
 
A few days before his heart attack, Mervyn noticed that he became breathless and developed chest pain when cycling or going up a hilly road in his village. On the day of his heart attack he experienced the same symptoms but this time the pain did not ease up. He called NHS Direct and talked to a doctor who decided to send the paramedics to check him over. On the ambulance on his way to the hospital, the paramedics put GTN spray under his tongue; did an ECG, were monitoring his blood pressure and they also took some blood. He can’t remember much afterwards as he was violently sick and feeling dopey. He thinks he was also given a sedative. Mervyn pointed out that neither NHS Direct nor the ambulance crew mentioned heart attack at that point.
 
Mervyn had primary angioplasty and two stents fitted but can’t remember anything about it. The first time he regained consciousness he was in the coronary care unit and attached to monitors. He remembers that his wife and older son were there with him.
 
The day following his angioplasty, he was visited by a nurse who explained heart attack, what had been done and talked to him about cardiac rehabilitation. A few weeks later, he started his rehabilitation programme that was in the hospital at first. Later, he joined a programme run in his local sport centre. He continues doing the weekly circuit training in the gym, designed for heart patients and walking every day. In addition, following medical advice, Melvyn lost weight and stopped using salt. He said that he was prepared to do whatever was necessary to decrease the chances of another heart attack.
 
He thinks very highly of all the care he has received from the ambulance paramedic team; the doctors and nurses at the hospital and the team at the cardiac rehabilitation programme. At present, he has an annual check-up at his GP surgery where his medications are revised and a blood test done. Until recently, he would have a telephone conference with his GP where he would be told about the results from his blood test. But this year, his GP told him that the telephone conference wasn’t necessary and that he would get the blood test results on his next annual check-up, meaning next year. Knowing the results is important to Mervyn because it gives him a chance to improve things. For instance, if he is told that there has been an increase in his cholesterol levels he would be able to change things in his diet.
 
Initially, after his return from hospital he felt anxious and vulnerable despite the support from his family, doctors and the cardiac rehab team. At the time his main worry was about the possibility of having another heart attack. Mervyn said that as he improved and felt better, the negative emotions subsided.

 

 

Mervyn describes the treatments he received in the ambulance on his way to the hospital.

Mervyn describes the treatments he received in the ambulance on his way to the hospital.

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Mervyn' So I rang NHS Direct and they said that. They asked me what was wrong and different things and then they said, ‘Well we’ll talk to the doctor and he’ll probably, he will get back to you very shortly and he will tell you then what to do.’ So I waited and the doctor rang me and I again I gave him all the symptoms and he said, ‘I think what we’ll do is
 
I’ll ring the hospital for you and they will send paramedics down to check you over.’ The paramedics arrived I would imagine 15 minutes, 15 to 20 minutes later and they checked me over and they then decided that they would take me up to my local hospital. And they, whilst I was in the ambulance I believe they put the spray under my tongue and they also…
 
Did an ECG?
 
Mervyn' Yeah I think they did an, yeah they did an ECG and they also. What did they give me?
 
Mervyn’s wife' Took some blood.
 
Mervyn' Oh yeah they took some blood. On the way in the ambulance up to the hospital I felt violently sick. And we arrived at the hospital and I can’t remember much what happened then. Everything was very vague so I’d probably been given something that probably dulled me a bit.
 

 

 

The consultant told Mervyn that he still had an artery slightly blocked but that the medication...

The consultant told Mervyn that he still had an artery slightly blocked but that the medication...

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After you were discharged from hospital did you go back to see the consultant or not?
 
Mervyn' Yes. I went once to see the consultant. And that’s when he said to me, that I didn’t know anything about, he said, ‘I’ve still got one artery marginally….
 
Mervvn’s wife' No moderately
 
Mervyn' Moderately blocked.
 
And but he assured me that the medication would sort it out. But I didn’t know that straight after I had the heart attack but I was told when. I think it was the final assessment from the [Hopsital name] that I was told. So it’s a strange thing really I still don’t know the condition of my heart really. It’s not like if you cut your finger you can say, ‘Oh it’s getting better’. But you’ve had a heart attack and you don’t really, you can’t see that it’s getting better although I did, I did a research project didn’t I? I had to go back and have MRI scans.
 
I had about 4 or 5 over a period of a year, something like that and that was for a research. And I think the person that was running it said that my, the damage to the heart muscle had more or less recovered to about 95% or something like that.

 

 

Mervyn felt anxious and emotionally low after he left hospital but the support of his wife helped...

Mervyn felt anxious and emotionally low after he left hospital but the support of his wife helped...

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I think it slowly wore off. I was encouraged by my wife to say, ‘Oh don’t worry you will be ok’. And things like that and everybody around me, family and it slowly, I say it slowly got better and I’m perfectly. I’ve got no anxiety. I feel really good now.
 
No. I didn’t try to hide it at all and every time I felt anxious or felt down in the dumps and whatever you like to call it I would tell my wife and she’d be very sympathetic towards me and say, ‘Let’s go out for a walk. I’ll come with you.’ And it seemed to work.
 
You said also that for a while you felt lonely.
 
Yes, yeah, yeah.
 
Was it because you felt that people would not be able to understand what you were going through?
 
I don’t know. I don’t know why I felt lonely. I’ve never felt lonely and I suppose it was just a reaction, you know, to what I’ve been through. That’s the only answer I can give you but it’s very, very strange, very strange.

 

 

 

 

After leaving hospital Mervyn felt vulnerable and very anxious particularly when on his own.

After leaving hospital Mervyn felt vulnerable and very anxious particularly when on his own.

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Mervyn' One thing that kept going through my mind was, ‘Am I going to have another one?’ But I did ask my GP and he said, ‘I can’t really tell you’. So I suppose I could or I probably won’t have another one. That’s a little bit of a worry. That’s still on my mind now actually.
 
So that has been your main worry?
 
Mervyn' Yeah. But when I first, when I came out of hospital I, although everybody was very good to me including my family and people at the gym and, they were all concerned and. I say they were very, very helpful indeed. I still, I felt extremely vulnerable and, and anxious all the time. I don’t think it was the fact that, you know, I felt alone as well. I can remember saying to my wife, ‘You know I feel anxious and alone’. And although I’m alright now, you know, but I can remember I felt really anxious. One evening I was very anxious. Can you remember [Wife]? I was very anxious and I had to call somebody out didn’t I?
 
Mervyn’s wife' [uh huh]
 
Mervyn' Do you remember? Yeah and a doctor came didn’t he?
 
Mervyn’s wife' Oh yeah.
 
Mervyn' Yeah. I’d. I was hyperventilating is it? Yeah but I soon got over that and he assured me I was perfectly alright when he came and…
 
Mervyn’s wife' When you were on your own you were anxious
 
Mervyn' Yeah when I was on my own I felt. Although I was very rarely on my own I felt quite vulnerable.
 
And for how long did you have these feelings?
 
Mervyn' I would say 6 months.
 
After the heart
 
Mervyn' After the actual heart attack and it, then it slowly waned.

 

 

Cardiac rehabilitation helped Mervyn understand that losing weight and regular exercise were...

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Cardiac rehabilitation helped Mervyn understand that losing weight and regular exercise were...

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Mervyn' I was definitely overweight.
 
Very overweight or was it?
 
Mervyn' Well I think I lost two stone and I don’t think I was grossly overweight but I was, I was overweight but I don’t know whether that was the cause or not. But I didn’t eat a lot of fatty foods but I did, I used to eat quite a fair bit of butter [laugh] but I don’t eat that now [laugh].
 
Mervyn’s wife' And salt.
 
Mervyn' And salt yeah. I put salt on everything.
 
And now?
 
Mervyn' I don’t, no salt at all.
 
No salt?
 
Mervyn' No salt, no, none at all.
 
And no butter?
 
Mervyn' No butter.
 
What else have you given up?
 
Mervyn' I packed up, well I packed up smoking years ago but I don’t know whether that was contributory to what I had but it was 40 years ago I quit smoking. I used to get quite a lot of exercise and I didn’t. I don’t drink at all. I don’t drink any, much alcohol, odd glass of wine that’s all and that’s about all I drink. Don’t drink much.
 
Mervyn' When I left the hospital I was given some medication and a card saying when I should take them and what times and in which order.
 
Did they provide much information before you left hospital for when you were at home?
 
Mervyn' I think that all the information I got was written. They gave me books, very small books on diet and things like that. They were very good, very good indeed and we did attend a few weeks after that we did attend a meeting at the [Hospital name].
 
A few weeks after we did go back to the hospital to attend a meeting and they explained that I needed to lose weight and they explained the diet and things like that.
 
When you were in hospital were you advised to make changes to your lifestyle?
 
Mervyn' Yes, yes.
 
What did they say about it?
 
Mervyn' Well I was told that I’d need to lose some weight. I wasn’t told in a schoolmaster type way but I was encouraged to lose some weight. They said it very nicely. Encouraged to lose some weight and they said, ‘You must try to keep your salt intake low and things like that which I have done.
 
Ok.
 
Mervyn' And I’m frightened not to now.
 
Is there any advice you would give to others who are having difficulties making lifestyle changes after a heart attack?
 
Mervyn' I didn’t, I personally didn’t have any trouble at all because when I was told that I’d need to lose weight, cut down on salt, things like that I was frightened not to if you see what I mean. They, you know, I was a little bit scared. I thought, ‘I’m going to do this’, and I have done it haven’t I?
 
Mervyn’s wife' It’s not been difficult.
 
Mervyn' No salt now and no butter and I watch weight.
 

 

 

Mervyn attended cardiac rehabilitation and then went to join a community-based programme. He says...

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Mervyn attended cardiac rehabilitation and then went to join a community-based programme. He says...

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Did you feel well supported by the staff there [cardiac rehab programme], by the physiotherapist?
 
Absolutely brilliant they were. Every exercise we did we’d be told to do five minutes on a cross-trainer or a bicycle or rowing machines and then after each exercise they’d, took your pulse and wrote it all down and I’ve got it all there. And then there was also there was, they advised us to walk during the day on other days and it started at, I think it was 10 minutes and then quarter of an hour, then 20 minutes and slowly build up your exercises. But they were very good, very good over there.
 
How often did you attend, weekly?
 
It was a period. It was over a period of. It was once a week for six weeks was it? It’s in the book in there, something like that. And then at the end of it the nurse said, ‘If you want to you can join another course but I’m afraid you’ll have to pay.’ But I didn’t mind that. And I go over there every Monday and it costs £2.65.
 
Ok [laugh].
 
[laugh] But it is well worth it, well worth it, yeah. Well worth it.
 
So for how long is the course?
 
We go for, it’s indefinite, just rolls on indefinitely.
 
Ok
 
And we go for one hour.
 
And it’s the same kind of?
 
Very, very similar
 
Very similar ok.
 
Very similar and the girl that runs it is extremely qualified and she is a no-nonsense person and we all have a good time.

 

 

 

Mervyn wonders if his GP’s attitude regarding communication of personal data is a widespread...

Mervyn wonders if his GP’s attitude regarding communication of personal data is a widespread...

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And if you have any kind of concern who do you talk to about it? Do you go to your GP and discuss it or?
 
Mervyn' Well I get, I have a yearly review with my GP.
 
And what does that consist of?
 
Mervyn' Well he, he weighs me and he reviews my medication and I have a blood test and that’s about it.
 
Ok.
 
Mervyn' The only thing I, I have a blood test but I don’t get the results and I usually have to wait until the next year to find out the results of the blood test.
 
So can you not phone the surgery before and ask?
 
Mervyn’s wife' You asked if you could didn’t you?
 
Mervyn' Yeah I asked
 
Mervyn’s wife' And he said, ‘It’s not necessary’.
 
Ok would you like to have those results?
 
Mervyn' I would yeah. I think that they when I’ve had a blood test as soon as I, well as soon as I’ve had the blood test I think I ought to get the results either through the post or whatever. Just to reassure me. I don’t know if that’s general practice or not but I’d certainly like to know.
 
So you think it’s something that could be improved.
 
Mervyn' Yeah that’s about the only thing I can think of just for peace of mind.
 
I know I got one lot of results because I’ve got them written down but that’s the only time isn’t it, once? But I’d just like to know.
 
Have you talked to your GP about it?
 
Mervyn' Well not really, no.
 
You haven’t mentioned it to him that it would be good for you. I mean for your piece of mind to have these results and have them explained to you.
 
Mervyn' Yeah I think I’ve got a right to know really but I don’t know. I said, ‘Could I have a telephone appointment this time to get the results’. And he said, ‘Oh that won’t be necessary’. But I say that’s the only thing. I’d like to know.
 
But it might be different with other people. They might get their results in another area, I don’t know. I don’t know what their procedure is.
 

 

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