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Neil

Age at interview: 65
Age at diagnosis: 62
Brief Outline: In 2008, and following a heart attack Neil underwent quadruple bypass surgery. Later, he experienced a stroke that he interpreted as a 'wakeup call' and began to make lifestyle changes. He retired from a highly stressful job, gave up smoking and reduced his alcohol intake. He takes medication and uses complementary therapies.
Background: Neil is married with three adult children and grandchildren. He lives with his wife and he is a retired company director. Ethnic background' white.

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Neil is married with three adult children and grandchildren. He lives with his wife and he is a retired company director. In 2008, following a heart attack, Neil underwent quadruple bypass surgery. The period following his heart attack is a bit hazy and he doesn’t have detailed memories of it, only that he was in a lot of pain following surgery. The heart surgery went well and Neil was allowed to go home after a few days. Neil was determined to be positive and wanted to get fit again. He got a letter from his local Cardiac Rehabilitation Unit and tried to enroll in a programme two weeks after his surgery. The nurse told him it was too soon and that he ought to wait. He was disappointed but had to wait for about six weeks before being allowed to join in.
 
Neil attributes his heart disease to work related stress, heavy smoking (up to sixty a day), too much alcohol and genetics. His father had strokes and died of a heart attack.
 
Three weeks after his surgery, Neil went back to work and life went back to ‘normal’, smoking and experiencing stress at work. But after he experienced a stroke, he decided to change his lifestyle for good' he stopped working and gave up smoking. He interpreted the stroke as ‘someone trying to tell me something’.
 
The cardiac specialist nurse offered hypnosis sessions to help him try and give up smoking. At first he refused but later accepted the invitation. Neil said that he had about three sessions as well as attending the smoking clinic at his GP surgery. The hypnosis programme worked and he has never felt tempted to smoke again.
 
Overall, his health experiences have made Neil more aware of his and his family’s wellbeing. In addition to taking his medication, he has read and researched at length about ways of keeping healthy and about complementary therapy. He takes several multivitamins and has had (privately) Chelation Therapy. Neil explained that this therapy clears toxins from the blood and unblocks arteries. Neil said that his diet has always been good and he does not have a weight problem.
 

Neil has had difficulties related to his medications. He developed acid reflux for which he was given omeprazole. Research on the Internet told Neil that it was thought that omeprazole reduces the effectiveness of the blood thinner medication; clopidogrel. Neil now takes lansoprazole which does not clash with the heart medication. The high pressure tablets felodipine, caused his face, lips and tongue to swell. Again, the problem was resolved by simply changing the medication to lercanidipine hydrochloride. Neil takes around six tables everyday plus 9 vitamin supplements.

 

 

Neil described his lifestyle before his heart attack as ‘burning the candle on both ends’.

Neil described his lifestyle before his heart attack as ‘burning the candle on both ends’.

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How was your lifestyle before you had the heart attack?
 
Oh I burnt the candle at both ends for years.
 
What do you mean? [laugh]
 
Did too much, late nights. I was a heavy smoker at this stage as well.
 
How heavy?
 
Oh up to 60 a day. I was in a pressured job. I was a company director which carries a lot of responsibility and there were problems every single day of one form or another. But that’s what I was paid to do but it was stressful.
 
Were you overweight also or?
 
No I wasn’t overweight, no.
 
How about your diet?
 
Well as far, I believe my diet was ok.
 
So it was the stress and the smoking that you
 
The stress, the smoking yeah. I probably drank too much as well. I think it all caught up on me and of course it is hereditary. My father died of a heart attack and he had strokes as well. So yeah I was, I think I was doing all the wrong things. I’m a bit better now.
 

 

 

Omeprazole appears to have an effect on clopidogrel. So Neil’s anti-acid medication has been...

Omeprazole appears to have an effect on clopidogrel. So Neil’s anti-acid medication has been...

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Did any of the drugs clash because?
 
They did clash but I only found out recently they were clashing. Because I’ve got high blood pressure as well which of course was another risk factor for me. The [mutter]. Oh no and I’ve got gastric reflux. That’s probably from smoking all those years. They put me on a tablet which reduces the effectiveness of the blood thinner by up to 25%.
 
And that is lansoprazole?
 
That is omeprazole with clopidogrel. So they’ve switched me now to lansoprazole. Which I’m told doesn’t have the same effect on the blood thinner.
 
And which blood thinner are you taking?
 
Clopidogrel. But I spoke to the pharmacist before I spoke to the doctor and the pharmacist said, ‘Well it’s not proven yet.’ He said, ‘Perhaps you ought to see your doctor’. So I went to see the doctor and she changed the tablets anyway but she wasn’t aware of it. And the next time I saw her she said, ‘You were absolutely right about the lansoprazole and the clopidogrel’. She said, ‘Thank you very much’. Which I thought was nice. So yeah it was all changed around.

 

 

Neil’s rehabilitation programme included exercise, relaxation techniques and hypnosis to help him...

Neil’s rehabilitation programme included exercise, relaxation techniques and hypnosis to help him...

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Did they give you any advice or?
 
Oh loads of advice and diet plans like your 5-a-day and stuff like that. Yeah and the specialist cardiac nurse up there [Nurse’s name], offered to, said she was learning hypnosis and offered to give me hypnosis for the smoking. And I refused and then after a few weeks she offered it again and I accepted. And it was from that point on that I stopped smoking.
 
How many sessions did you have?
 
It was two or three but at the same time I was doing the smoking clinic at the doctors.
 
At your GP’s?
 
Yeah at the GP and they were giving me, [oh what’s that drug?] antismoking pill?
 
Yeah and they were doing relaxation techniques,
 
Where?
 
At [Hospital name].
 
At the hospital
 
After we’d had our exercise sessions we went in to another room and like we had the pharmacist come in and tell us all about drugs. We had relaxation tapes and general talks on your well being which I thought was good.
 
It was a very complete programme?
 
Excellent
 
They give you a programme of exercises to do. They’ve got, I think it was four or five stages. The sheets are all up on the wall. You start this way depends on how you look to them as to what stage you start on. They started me on the second level and you do, you go through oh 8 to 10 exercises. When they think that you are ready you move on to the next level until you reach the top level. And it was very good, very good. I loved it, yeah.
 
And how often, how many days a week?
 
Twice a week, yeah
 
For how long?
 
I think it was about 8 weeks. It was 16 or 17 sessions I went to.
 
And after, the exercise it was followed by relaxation?
 
Yeah there was something different at each class. You had a programme. You didn’t have to go if you didn’t want to but I think I went to most of them.
 
And this takes place in the local hospital?
 
Yeah.

 

 

 

 

Neil is not supervised during his exercise routine at his local gym but was asked by the gym...

Neil is not supervised during his exercise routine at his local gym but was asked by the gym...

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It’s purely physical stuff. I mean I do all the weights at the gym and all the cardio [ah] but I can only do like 45 to 50 minutes, you know. And that’s me then, whacked. And it probably takes me 20 minutes to get my breath back, yeah, but I keep at it.
 
Who is supervising you when you do this cardio?
 
Nobody. I had an instructor to start with and he realised that I knew my limitations and showed me how to work the machines and all the rest of it. Told me what my heart rate should not go above and stuff like that, you know.
 
And how do you check your heart rate?
 
Well I have a heart, called a heart-right monitor. It’s strapped to your chest, transmits it to the watch and if you go over what you’ve set it starts beeping so.
 
Is this something that you have discussed with the cardiologist or the nurse?
 
No, no I discussed it with the trainer at the gym and he said, ‘It would be a good idea for you to get a heart monitor’ ‘so that you don’t overdo it’. Because he was a bit worried.
 
But don’t you think that this is an issue that maybe you should discuss with your cardiologist or GP or not?
 
I think I did mention it to my GP but [phew] I don’t know as that they are interested in stuff like that, you know, GPs. I’m really not. I think she told me my maximum heart rate should be about 135, 140 which she didn’t tell me not to do anything.
 
And can you go back to your cardiology rehabilitation team or?
 
Oh I can phone her up.
 
Ok so if you have any concerns or any questions you can ask her?
 
Yeah, yes she’s very good, well they are both really good. There’s two there, [Name] and [Name].
 
So did you talk to them about that you were going to continue exercising after you finished there?
 
Yes or I told, I told her that I’d joined a gym while I was still doing my 8 weeks on the rehab and yes she said, ‘ That’s fine.’
 

 

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