Returning to work after a heart attack

Most people we interviewed could return to work after having a heart attack. One man, whose job was physically demanding, was pensioned off on medical grounds. Another 70-year-old man who had been working part-time decided to leave his job. Most people went back after three months; some starting part-time. One 42-year-old man returned to work part-time after six weeks and built this up to full time over the next six weeks.

He went back to work in stages and felt very vulnerable travelling to work on the London Tube.

Age at interview 46

Gender Male

Age at diagnosis 42

View profile

And that was a positive thing going back to work and you know it’s always nice with everybody telling you how good you look [laughs], whether they mean it or not. And then I went, I started to go back after six weeks on two days a week short hours, three days a week short hours, then three days a week longer hours. I think, I reckoned it must, that, we did that over about twelve weeks and then I was back at work.

What was it like going back to work physically?

The first day I travelled up on, when I, when I went up the very first time and I travelled outside the rush hour and I was, I was a bit frightened again to the point that I ended up I was working in, I was working in the East End and it’s about fourteen miles away and I ended up getting a cab back all the way home. Because I, I, once again I felt sort of vulnerable with all the, even though it wasn’t the rush hour;

I think perhaps if it had been in the rush hour I wouldn’t have felt so bad but the trains during the day can still get quite crowded and then they’re with people, the commuters I know about because I do it all the time and we don’t talk to each other, we don’t make any noise;

We just sit there, read, get on and get off. Whereas people during the day they’re moving about and there are children shouting, young kids running up and down and I felt quite vulnerable still, because physically I was still pretty weak. And I wasn’t used to going out for long periods so that was quite hard. But it was good to do that on a one off basis;;

Embed Print Transcript

One man prepared himself for going back to work as a teacher. Another had felt very vulnerable travelling to work on the tube in London. Some found being back at work exhausting at first.

Talks about going back to work as a teacher.

Age at interview 51

Gender Male

Age at diagnosis 51

View profile

I was a bit nervous about going back to work, although I wanted to go back to work. I’m getting angina very occasionally now and I’m wearing, I keep this [GTN] spray round my neck on a piece of string because it’s all right for ladies, they’ve got handbags but men haven’t you see.

Anyway I keep it round my neck and that’s very reassuring to know that’s there and going back to teaching was a bit, a bit nerve wracking to start with because I thought well what if I have an angina attack, will I be able to stop mid lesson and take a spray under the tongue and sit back and rest. But that situation has never arisen mainly because I think I have still paced myself, even though you know I’m back in a busy environment.

I’ve prepared my day before I go to do it the easiest way, to make it as simple and flow as smoothly as possible which has worked and at the moment I’m only getting angina when I’m excited not when I’m stressed. I mean, I never thought I was a stressed sort of person. People said ‘Oh [patient’s name] doesn’t seem a stressed sort of person. I don’t think stress [is] a cause of my heart attack.

I think probably being too busy, trying to do everything was one of the causes but not stress, because I could just sort of drop things and forget. But teaching could be stressful but I’ve tried to plan everything so it doesn’t cause stress and so far it’s been good.

Embed Print Transcript

She found it tiring at first being back at work on a part- time basis.

Age at interview 37

Gender Female

Age at diagnosis 36

View profile

When you did go back to work for those few days what were they like?

A bit strange. Because I still tried to do the same amount of work as what I did when I was full-time. I still tried to do the same jobs and everything as what I did before, so, but all, everything I, it’s an administration job so it’s like, sit down, it’s paperwork, it’s sorting things out and it’s just basically being tidy and efficient and organised;

And you know, that’s what I do anyway so. It was strange going back to work. The first like few weeks I got really tired really quick and just couldn’t wait to get back home and that, so, but now I’m slowly getting more into work;

Embed Print Transcript

Of those we interviewed two men were self-employed. One, who needed to begin work shortly after coming home from hospital because it was a busy time of year, said it took some time to get back his stamina. Another, a hospital consultant, described what it was like going back to work, after being off for a year while waiting for his bypass surgery and during his recovery. One man said that it wasn’t long before his colleagues at work stopped thinking of him as an invalid.

When he started work soon after his heart attack it took a while to build up concentration and…

Age at interview 52

Gender Male

Age at diagnosis 51

View profile

Being home, it was, sort of, I suppose slightly funny because I came home about a week before Christmas. So in a way you had Christmas as well to concentrate on.

After that, I suppose I had this in the back of my mind there was this concern because working for myself and there was a, the particular work that I do, January I knew was going to be a busy month, but I found that I, when looking at it initially trying to sort of get back to work, I found that the concentration and the effort was very much, I had to take it very gingerly you know, maybe just sort of half an hour for one day, then it built up maybe an hour another day.

Luckily, as I said, I had some relatives and friends to help. But it did take quite a long time to sort of build up sort of the mental stamina and sort of physical sort of stamina so as to get back into that.

Embed Print Transcript

Explains what it was like going back to work as a hospital consultant after being off for a year.

Age at interview 62

Gender Male

Age at diagnosis 59

View profile

Well I was, I was a little bit concerned that when you know I have a gap of one year when I haven’t practised. And I felt that if I’d start practising again then things have been, might not be as quick or as responsive as it used to be;

And that is why I started, when I started going back to work, I went back to the, to the hospital where I used to work before and I know the people there and then I had a word with them and I said yes I have been ill, gave them a good idea what happens and some, actually I went back where I did the surgery because [laughs] and I started back in this hospital again because I used to work there before;

So I know all the people around and that’s important. That’s important that if you can get the first step after being off work for any illness, if you can start in a place where you feel you have a good ground there that will be a really good step, because the people there do know you, they trust you;

They know that you are coming back and they will be able to help. Particularly if you ask them then, if you don’t ask them it’s your fault [laughs], but if you ask them you will find quite a lot of people would be willing to offer their help.

Embed Print Transcript

It was strange at first going back to work but wasn’t long before his working life returned to…

Age at interview 55

Gender Male

Age at diagnosis 47

View profile

Right from my own experience and from other peoples experiences that I’ve met since, going back to work after a heart attack is strange at first. But within, I would say within two to three weeks, basically you’re back to where you were before. Hopefully you’ve learnt that you’ve got to switch off now and again and you can’t go writhing and tearing at things the way that you used to;

But yeah, it all comes back and you become, it doesn’t take you very long to get back in to your work and it doesn’t take very long for the people you’re working with to realise that you’re not going down, you’re going to be alright and then they start shouting at you, as they would have done. Yes, so going back to work after you’ve had a heart attack, [laughs] if you’ve got to do it, do it, it’s okay. Yeah, it works.

Embed Print Transcript

Although many of the people who were working at the time of their heart attack did return to work, some had to take early retirement at a later stage, either because they had another heart attack several years later and their GP advised them to retire, or they found they weren’t coping and the company suggested they took medical retirement.

One man whose GP advised him to give up his work as a head of department in a school, after his second heart attack when he was 55, described how he came to terms with this. Another man was forced to retire on medical grounds at the age of 50 after his second heart attack; he talked about how for a long time he found it difficult to accept and to find a purpose to his life. Since early retirement was not planned, a few men had the additional worry about how they would provide for their families.

Describes how he felt when he had to take medical retirement at the age of 55.

Age at interview 61

Gender Male

Age at diagnosis 49

View profile

I was quite angry at first that I’d had to give up. It was a decision that was made for me and I really was quite upset that I had to stop before what I thought was the time I should. I really felt I’d got more to give and I could do more. As time has gone on, I have sort of come to terms with that and no longer does that form a, a massive thing in my mind now.

I’m a lot more satisfied with what I’m doing, because by doing these courses, I feel that I’m putting something back in and getting some, well a lot of fulfilment from doing that. So that feeling of anger has gone now. I’ve accepted it; it did happen so I just have to get on with it.

Embed Print Transcript

He found it hard to accept early medical retirement for a long time and to find a purpose to his…

Age at interview 63

Gender Male

Age at diagnosis 40

View profile

Yes I suppose having been the breadwinner. I’m from a generation that I never wanted my wife to go out to work. Maybe we were fortunate that we were in such a position that she didn’t have to.

And following my initial heart attack, and certainly following my enforced medical retirement some thirteen years ago, I found it difficult, very difficult to come to terms with that and were my wife present, she would tell you that I made life quite difficult for her at that period. Partly related to the job that I had, I was used to being in a position of authority and I found it quite difficult to find a reason for being.

I got quite depressed following medical retirement. I think like most men and women who work for a living there are days when you wish that you didn’t have to. There are days when you wake up and think ‘oh I don’t want to go to work today, I want some time off. But when you’ve got to retire and you don’t want, it’s very difficult.

With the help of my wife and taking up various other options, such as, learning to play a card game, going back to college, my computer studies, we managed quite well.

Embed Print Transcript

At the time of his heart attack James was coping with medical retirement with the help of…

Age at interview 63

Gender Male

Age at diagnosis 62

View profile

Yeah as I explained earlier about my stroke I was one day working very hard and long hours and the next day I’m basically retired. So when the heart attack came it was like a double whammy you know, I’d already given up my job now there was no chance of me getting another job; my age and my health. I could do something manual but I don’t think anybody of sixty three or sixty two as I was then would want me. So it was one of the hardest thing to accept that you’re not going back to work and I think that’s the probably the one thing that got me down the most, you know, because I miss the tomfoolery and the rivalry, everything about the job which you, you miss so much. I probably hit my worst part then when I realised this and this is why I’m still on citalopram (antidepressant) because obviously they help me through the worst of the winter which is the worst months because of course there’s not much to do for an agile mind I suppose, that’s one way to put it. But I try to, I fill my week with my children, my grandchildren, they’re a blessing. I’ve got my partner and I’ve also got my golf when I can play. In between that I’ve learnt to cook [laughs] which amazes me at times and my partner says I do the best roast potatoes she’s had so that can’t be bad. I don’t know, getting over that, it’s difficult, it’s not something you could say, ‘Well I’m going to do that within a week or two weeks or a month or a year,’ it’s however quickly you can do it. It’s, I personally probably got over it the day I decided that I wasn’t going to smoke anymore. That I think has been probably the big saving of me. I think that not smoking has made me feel that I’ve got control of my life again. While I was still smoking I hadn’t got control of my life, I was basically stressed out at being doing nothing which is [laughs] a strange way to be. It’s very difficult to explain, it’s, and it’s not something that you can put into words. I think it’s a feeling that you know that you’re, you’re in the right place and that is where you’ve got to aim to be I think, yeah.

Embed Print Transcript

Describes his financial worries when he had to retire early at the age of 50.

Age at interview 63

Gender Male

Age at diagnosis 40

View profile

We are both well aware that it was a time that we wouldn’t wish to revisit at all and it was through her guidance if you like that we took up alternative things to keep us busy. That was a great problem finally, having your life taken away from you.

Is that what it felt like at the time?

And it still does, even looking back, even though we have a reasonable standard of living, I’m not for one minute crying the ‘poor tale, compared to what could have been it still causes you to think. Immediately I had to take medical retirement, my income dropped by 60 some percent.

Now at that early age, still in early age at 50, which is when I had to retire, as with most people your financial plans are all built around your retirement date when everything comes to fruition.

Up until then you may be carrying mortgages, you may be carrying car loans, all sorts of financial commitments. Obviously at that stage, our kids have not quite flown the coop. I couldn’t persuade them to leave, I couldn’t understand it [laughs] and so it is of great worry, great concern that ‘how the hell am I going to keep my family, because like I’ve said, through choice I was the breadwinner.

I didn’t want my wife working, I wanted her at home. She did get a part time job, which she quite enjoyed and shed actually to give that up if you like, to look after me. So roles were very much reversed for a while and I found it difficult to cope with. So yes, it felt very much like someone had taken your reason for being away from you and it did take some while to find other reasons to keep, to keep going.

I didn’t reach what you would term I suppose as clinical depression, or it didn’t get that serious that I was considering ending it all, not by any means. I had still had a lot to live for, as my wife kept pointing out and weve still got a lot going for us and yes, but we lost a lot and I felt we lost a lot. We are both well aware that it was a time that we wouldn’t wish to revisit at all and it.

Embed Print Transcript

One man, who over the course of thirteen years had two heart attacks and two bypass operations, returned to work each time, but finally took early medical retirement when he was 63. Another found it difficult to cope in his job, which involved unnatural hours and quite a bit of stress, and he worked in another field for a few years before he returned to his job. A third man, in his late thirties, had returned to work after his heart attack, but after he had a second attack and developed heart failure, he had to give up his job.

He returned to work part-time, then worked in another field for a few of years before returning…

Age at interview 66

Gender Male

Age at diagnosis 47

View profile

I must say I was worried. I had a letter from my employers pointing out that I was only entitled at that time to two months sick pay. If I’d been working at that particular association a couple of months longer, I’d have been entitled to a year but I guess that was something they had to do but it was very upsetting. I went back to work part time after the two months, but I was finding it difficult.

It’s an exacting job to do involving unnatural hours and a fair amount of stress. So a friend of mine who worked for himself in the Finance and Insurance Industry offered me a job running his office and from the following September, I did that. Until some years later I realised that I was working as hard at that.

By then had my own contract with Allied Dunbar, so I went back in to the Conservative Party as an agent again.

Embed Print Transcript

Sab assessed the shortcomings of his work as a driving instructor and decided to retire. He works…

Age at interview 65

Gender Male

Age at diagnosis 64

View profile

No, no just a, I’m not doing driving school anymore, I’ve given that up. It wasn’t stressful just I thought it was time to give up because other people on the road, I was worried about in case somebody bumped you while you’re teaching someone to drive and I was petrified of getting hurt again so that was a main reason and so I thought there’s no need to and I retired and I’ve got a very good pension so that was a blessing in a way that I become ill at the end of my working life if you like so that made it easier but the; being examiner is much easier because the people can drive so you sit next to them and conduct a test and it’s wonderful to go and meet people and stay with the people. That gives you a bit more confidence as well. I didn’t want to sit home and do bits and pieces outside you know and I wanted to go out.

So I’m still worried about anybody, like having a head on collision or hitting you anyway in the car and impacts of that accident might hurt you, you know, your chest or in general health so that scared me a bit because what they done to me. And before that I didn’t have that feeling. It seems to be fading away as I go along but that was the main reason to start off with and I’m thinking it is a hard work to get someone ready for the test and stressful as well. So I thought I’m going to take that out and make it easy for myself but, you know, this is another lovely thing about being retired that you have a choice that you give yourself; you take some of the element out that you’re worried about and make a life easier which I have done. So that makes life much easier.

Embed Print Transcript

One 55-year-old man did not return to work until 12 months after his heart attack because he was badly depressed. He found it difficult to cope back at work, and after pressure from his employers, took early medical retirement. The effect on him was devastating.

Describes how early medical retirement affected him.

Age at interview 63

Gender Male

Age at diagnosis 53

View profile

I was still on Prozac which stopped sheer depression. But my confidence you know I’d, I’d built up enough confidence to go back to work, but then that again started to drain away and I felt inadequate, I couldn’t cope. Then my immediate bosses started to be difficult. I think they must have realised that perhaps I wasn’t going to last and they needed somebody younger and somebody fitter. So they quite deliberately put pressure on me.

Eventually the company had enough of it, and their insurers also had enough of it. And so I went onto ill-health early retirement, and that was it finished. But again that was another knock; everything seemed to be a knock. If I failed in anything at all, it was huge, it was tremendous. No matter how trivial in real life it, it might be, if I failed something then I just felt, ‘Well what’s the point in me living, I just don’t need to be around and all this stems back to having had a heart attack.

I cannot get rid of this idea I’m a failure, because I’m 63, I’ve been out of work several years now and nobody will employ me in, in a sort of a job that I should have, the challenge and salary and all that sort of thing that I should command because I don’t have the confidence and with angina, nobody wants to see you having angina every day in an office or whatever. So no, I can understand employers not, not wanting to touch me.

But, although in one respect I’m not bothered about being unemployed because I’ve always got something to do. It still makes me feel a failure because I think I should still be out at work, not for financial reasons, I’ve got a lousy pension, which is a struggle, and I’m not yet entitled to the State Pension. I just have to change my life to suit the very low income I have coming in.

Embed Print Transcript

After being forced to retire from their jobs, some of those interviewed were at a loss to know what to do with all their free time. One man described how his life had changed. Another was demoralised trying to find a job, but then became involved in running exercise programmes in his local area for the ‘GP exercise by referral’ cardiac rehabilitation scheme. Another man studied computer courses at college, learnt to play bridge and became involved with a heart support group.

Talks about what he did after his early medical retirement.

Age at interview 55

Gender Male

Age at diagnosis 47

View profile

I relax, this is easier for me now because about a year after I’d had a heart attack, after spending a whole year telling everyone within the company I worked for that I was not an invalid, I was fit 100% and better than a 100% fit, eventually I was talked into, well I wasn’t talked into it, I was told it would be better for me if I did leave work because the company were selling out to another company who basically didn’t want me. ‘Right’;

I was given the opportunity to go with a nice pension. Very good. Eventually, ‘yes I will go. But since then, I went to college for a while, learnt a bit about horticulture. I did two and a half years helping out in a primary school, helping the kids with IT studies. I have, since then I have become involved with the support group;

I’m also a member of the patient’s council at the local Acute Hospitals Trust. I’ve just been told I’ve been accepted for a post on the patient’s forum for the Primary Care Trust. Lots of things, it all goes on.

So you’ve been able to find other things to do?

[laughs] yes, I have no time for work. I couldn’t hold down a job now.

At the beginning it must have been quite a gap?

No, because I went straight from work into college. I went full time to college. It was a bit different, the other people on the course were considerably younger than I was for a start of [laughs]. It was going back to school, you know, strange feeling but very enjoyable.

So lots of good opportunities have come out of it really.

Yes, yes when I say I changed my life, you know I meant it. My life has changed tremendously.

Embed Print Transcript

Since early medical retirement he runs exercise programmes for the GP exercise referral scheme in…

Age at interview 61

Gender Male

Age at diagnosis 49

View profile

So I also started to think well I could get a part time job and started looking around. And one of the most depressing experiences is to go in to the labour exchange, it’s not a labour exchange, it’s a job centre isn’t it. Showing my age. And all the, the staff there are very nice people but they really weren’t interested in finding me something that I could use my talents and there was just nothing, and I really did think, well I’m on the scrap heap now.

I’m in my fifties, I’d been a teacher for thirty odd years. I’d worked for some time in Industry before that. I’ve got lots of skills and nobody was interested in making use of them and I thought that was short-sighted, but it’s also depressing.

I heard about a course of training you can do to get qualified in what they call ‘GP exercise referral. So I took the course and passed it and when I got back, I was put in touch with the local primary care trust, who asked me to write a scheme for a rural exercise programme, which I did in conjunction with the local surgery and we decided to put on an exercise scheme for people who’ve had heart attacks, bypasses and so on, some years ago who had stabilised and this would be a form of secondary prevention.

So I started that nearly three years ago and patients are referred from the surgery. It’s grown quite considerably over that time; we have about fifty patients who come to the classes. I do three sessions a week. Now that my wifes retired, she comes down and helps as well and just over a year ago, I took the course offered by the British Association for Cardiac Rehabilitation, which is quite a stiff course and I now work with the local non-acute hospital, who do what they call the phase three rehabilitation with patients who’ve just had heart attacks.

And then they pass them on to me and I do, what’s called the phase four, community-based exercise rehab and we have about a dozen of those who come now. And I put in to place an evening session for them, because some of them are men who have had heart attacks but are still having to go back to work afterwards, so they can’t do the day time classes. So we do a course for them as well and there are some women on it, but predominately they’re men.

Embed Print Transcript

One 59-year-old man had planned to retire when he was 60, but had to continue working because his savings had been reduced during the period he was off work. After his heart attack he was forced to use the money he had saved for his retirement.

After his heart attack he had to spend his savings.

Age at interview 62

Gender Male

Age at diagnosis 59

View profile

Well because I was doing locums at that time, so one day you had an income, the next morning you had nothing, because it all depends, the locums are paid when you work. So but I thought about that because if you are being self-employed you should keep a little bit on the side so if something happen at least for the first few months, you can cover it and that’s what I did so;

The, the thing which did surprise me is that when I went to claim the Social Security, I wasn’t entitled to it because they said you have got money in the bank which is more than your allowance, more than you can claim money. I said, ‘But this money is in the bank because of my retirement and you know saving money for my retirement, not to be ill and to spend it.

And they said that’s the law and I was really, really upset from there because one way the Government is telling us to save money and to have, you know, enough money for when you retire. And they don’t tell you that this money if for any reason we fall ill, we are not entitled to any help and we have to spend our money which weve saved for retirement, which I think is a big cheek for the Government to do it.

So I actually in that year I spend what like all the money or three quarters of the money I’d saved for retirement just to maintain the life style and particularly that I want also the, the family to feel that they are not deprived of anything, particularly for the children, I want them to feel that even when I am ill I can still support them.

Embed Print Transcript