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Stanley

Age at interview: 59
Age at diagnosis: 59
Brief Outline: Stanley had a heart attack and four cardiac arrests. He underwent primary angioplasty and had a stent fitted. He feels breathless so his hospital appointment to see the consultant has been brought forward by several months. He gave up smoking four weeks before his heart attack.
Background: Stanley is separated and has three grown up children. He works full-time as a plumber and since his heart attack he has been staying with his girlfriend. Ethnic background' White British.

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Stanley is separated and has three grown up children. He works full-time as a plumber and since his heart attack he has been staying with his girlfriend.
 
Stanley was alone in his girlfriend’s house when he felt unwell. He had no pain, just a fluttering feeling in his chest and he began to sweat. He called 999 and decided to wait for the ambulance on the street. He suffered three cardiac arrests on his way to the hospital so he can’t remember much except that his girlfriend arrived home from work and accompanied him in the ambulance.
 
In hospital, he had a fourth cardiac arrest. He received primary angioplasty and was fitted with a stent. An ultrasound scan revealed that the heart attack had done little damage to his heart.
 
Stanley smoked around thirty cigarettes a day for about twenty years. However, four weeks before his heart attack he had given up smoking because of the expense. Stanley is a plumber and says that his work keeps him physically active and his weight under control. As such, he thinks that smoking was the main contributor for his heart attack. His father had a heart attack but he was also a heavy smoker.
 
After his heart attack he has never smoked again and watches his diet; eating more fruit and vegetables. He is also slowly building up his exercise routine. He knows what to do if he starts experiencing chest pain but he hasn’t had any.
 
Stanley is taking the following medications' aspiring, ramipril 2.5 mg, simvastatin 40 mg and Effient 10 mg (for one year). He is having sleeping problems and wonders whether this is a side-effect of one of the medications.
 
Stanley is suffering from breathlessness and some activities like climbing stairs make it worse. He mentioned this symptom to the rehabilitation nurse who in turn, passed it on to the hospital. As a result his hospital appointment to see the specialist consultant has been put forward by several months. Stanley thinks that his breathlessness may be linked to him giving up smoking.
 
Stanley lives on his own so after he was discharged from hospital he has been staying in his girlfriend’s house as it is closer to the hospital than his. She is also looking after and caring for him; seeing that his diet is what it should be and that he exercises.
 
His main concern is his breathlessness and he is glad he is seeing the consultant much earlier than originally planned. He said that he couldn’t have had any better care than that he has received.

 

 

Stanley gave up smoking one month before his heart attack because of the expense. He had no...

Stanley gave up smoking one month before his heart attack because of the expense. He had no...

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How was your lifestyle before you had your heart attack?
 
Well I thought it was alright you know I kept fairly fit. I'm not like, you know, I'm not overweight. I do a manual job and I'm, you know, on my feet all day and I thought I was reasonably fit for my age.
 
OK so you did quite a lot of physical activities?
 
Yeah
 
What about, I don't know drinking or smoking?
 
I don't drink at all but I did smoke a lot.
 
A lot?
 
Yeah, yeah thirty, probably thirty a day but I had stopped smoking four weeks before I had the heart attack.
 
Any particular reason. Are you, were feeling bad? Your chest…?
 
No it was when, when they went up in the budget [laughs].
 
Ah because of price?
 
Yeah they got too expensive so I just stopped.
 
And did you have any problems stopping?
 
No, no not at all.
 
And you smoked for how long?
 
Twenty years.
 
Twenty years around thirty a day?
 
Yeah
 
And then you gave up with not much problem?
 
No, no problem at all, just stopped.
 
OK [laughs]. How much do you think smoking contributed to…?
 
A lot I think. Yeah I think a lot of it was to do with smoking.
 
Anyone in your family with a heart problem, your father or…?
 
Yeah my dad had a heart attack at fifty two but he was a heavy smoker as well.

 

 

Stanley was alone at home when he started to feel unwell and called 999 and went to wait for the...

Stanley was alone at home when he started to feel unwell and called 999 and went to wait for the...

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Well I’d had no symptoms in the past until, you know, the 15th till the day it happened. I’ve never had any pain or anything.
 
And what happened on the 15th?
 
I’d taken my partner to work… and which is only like five minutes away and it was when I drove back and it was you know when I entered the flat. I just started, you know, I got like a fluttering feeling in my chest, no pain but it made me feel a bit drained, you know, like blood had drained from my head and I started to sweat a bit but other than that no real pain just a fluttering and it didn’t get any better and I was starting to get light headed so I phoned for a 999.
 
You called 999 yourself?
 
Yeah
 
OK. So you were alone?
 
Yeah I was on my own yeah.
 
OK and how long it took for an ambulance to arrive and what happened when the paramedics arrived.
 
It took about ten minutes for the ambulance to arrive although it seemed longer. But by this time I had made my way out of the flat and I was waiting out on the road for the ambulance and you know I was getting a lot dizzier.
 
Where you standing up, sitting on the pavement?
 
No I was standing up but I was starting to get a lot more light headed. Then the ambulance arrived and they got me in the ambulance and shaved my chest and cut my t-shirt off and put their…
 
Electrodes?
 
…their electrodes on and by this time I’d phoned my partner. She was on her way back from work and they let her in the ambulance and I don’t really remember much after that.

 

 

Stanley suffered three cardiac arrests in the ambulance on his way to the hospital and another...

Stanley suffered three cardiac arrests in the ambulance on his way to the hospital and another...

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Yeah I had three cardiac arrests in the ambulance. And then I had another one when I was in theatre but I don’t remember any of them. I must have had one as soon as my partner got into the ambulance, I think I had one then. I can remember speaking to her and I had one then and then I don’t remember anything then. Although when I first got in the ambulance the paramedics sprayed under my tongue and made me chew half an aspirin but I don’t remember anything after that.
 

 

 

The cardiac rehabilitation nurse arranged for Stanley to see the consultant sooner than...

The cardiac rehabilitation nurse arranged for Stanley to see the consultant sooner than...

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I should have been seeing him [consultant] in October but it's been brought forward to tomorrow because I still get quite out of breath.
 
You're breathless?
 
Yeah
 
OK.
 
And the cardiac, the rehab nurse, cardiac rehab nurse at [Hospital name] I think she's had the appointment brought forward, you know, because I don't think I should still be out of breath like I am.
 
What makes you feel breathless?
 
Just talking can. You know if I've, you know, I can feel myself getting a bit breathless now.
 
I feel like I've been talking longer than I should without taking a breath, do you know what I mean? I have to [intake of breath] but you know, it does it after a short sentence. I do, I do get a bit breathless but I don't know whether that is because I've stopped smoking because I did get a bit breathless before the heart attack. I was a bit wheezy after I stopped smoking.
 
Yeah
 
So I don't know whether it's that or whether it's, you know, effects of the heart attack I don't know.

 

 

Stanley had a heart attack three weeks ago and says he is able to do light daily activities.

Stanley had a heart attack three weeks ago and says he is able to do light daily activities.

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Well I, you know, I do what I can around the house. I do the washing up, tidying up, make the beds, take the dog for a walk.
 
OK
 
You know do what I, what I can do.
 
Do you get tired easily or…?
 
Not really no. I did, I met my daughter and my grandson at a local park and I was probably there for about three hours that made me feel a bit tired when I got back but that was all walking round and…
 
And that, you know, I was a bit tired after doing that but…just doing chores round the house now, doesn't bother me a lot.
 
I feel like I want to do more but can't. It's, you know, it's a bit frustrating.
 
So the nurse told you to, to do things but within measure… not to overdo it?
 
Yeah
 
OK and you find it difficult to pace yourself?
 
Yeah I feel like I want to do more but you know I can't.
 

 

 

Stanley talks about the support and information he and his partner received when in hospital and...

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Stanley talks about the support and information he and his partner received when in hospital and...

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How was the care like when you were in the cardiac unit?
 
It was very good yeah.
 
In which sense, in which way?
 
Well they, you know, they never left you very long, they were always coming back to check to see if you were alright. They were all pleasant, you know, did as much as they could for me I think. They were very good with my partner explaining everything to her and they let her stop the night.
 
So she stayed in hospital?
 
Yeah, yeah she stayed the night with me yeah.
 
Anything that you would like to know but you haven't been given it?
 
No I don't think so.
 
No? OK.
 
No, no I think it's been fine. Everything, you know, I had an hour’s meeting with the cardiac rehab nurse and she was very thorough. You know any questions that I wanted to ask I could and she explained everything that had happened to me and you know, yeah it was very good.
 
That was when you were in hospital?
 
No that was when I came out and I had an appointment at [Hospital name] with the rehab nurse yeah. Yeah that was very good.
 
What is in that manual?
 
Well it [the Manual] explains, it explains what a heart attack is, what causes it, what, you know, what's happened to you, what you can expect. It explains all about the stent, how it was done and everything like that. What to expect afterwards, how to feel and how other people feel.

 

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