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Colin

Age at interview: 72
Brief Outline: Colin gained weight after his wife died. Although he has since become aware of portion sizes, and has made small changes to his eating habits, Colin’s weight has remained stable. Colin has also been diagnosed with several health conditions over the years. Because of this, he finds exercise difficult. Colin has had mixed experiences with health professionals, but plans to ask for advice on diet in the future.
Background: Colin is 72, and is widowed with 1 adult son. Colin is white British.

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Colin has several health conditions, including osteoarthritis, cerebral palsy, emphysema, chronic cellulitis, and heart problems. Until his late 50s, Colin’s weight was fairly stable. He had an active job, and did chores around the house. After his wife died, Colin started gaining weight, putting on four stone in under three years, “I still continued to cook the same volume. I couldn’t get it into my head to half the quantities of things.” Although Colin has become more aware of portion sizes, he has found it hard to lose weight.

To manage his weight, Colin tries to reduce his portions, and eat lighter foods. Where before he was concerned that fruits and vegetables would upset his stomach, he now enjoys salads and fruits. He has also cut down on chips, and makes them at home using an air fryer. Colin has started to grill his food, and reduced the amount of sugar in his coffee. However, Colin finds planning meals difficult, “I’ve got a fair idea of the sorts of things I should be eating but it’s the imagination of making those ingredients into a meal that I think I suffer with”. He has tried using a recipe book for people with high cholesterol in the past, but found the meals “bland.” He still struggles to portion his food, as when he cooks he does not like to freeze or reheat food. This means that sometimes he chooses other options, opting for ready meals around half the time, “I know for a fact that if I made it for myself the quantity would be much more than would be healthy for me.” Colin would like to go on a cookery course, but isn’t sure how to access this.

Although Colin walks his dog every day, he finds it hard to be active because of his health conditions. Colin would like to find a way to be more active, “I could find some sort of exercise where I could gradually lose weight, I’d be a lot more happy.” At one point, as part of a physical activity programme, Colin was given a free gym membership. However, he had to stop this after developing foot problems. Colin’s weight has also made it difficult to do household chores, “it takes me a full day to do one room.” Colin is currently doing a cardiac rehabilitation course which involves an exercise class.

Colin has had mixed experiences with healthcare professionals. When he first gained weight, Colin was concerned and went to see the practice nurse for advice, ‘she looked me in the eye and said, ‘Keep your mouth shut is the one way that you will lose weight.’” Colin was later given dietary advice by a heart failure nurse and a cardiologist after his heart attack, as well as from a nurse when he was in hospital. However, Colin hasn’t found this particularly helpful. Colin now has a trusting relationship with the healthcare assistant and the new nurse at his practice. He is planning to ask them for advice on his diet at his next appointment, “I think I would get good advice from both of them.” Although Colin has a good relationship with a doctor at his practice, he is hesitant to make an appointment to talk about his issues, “I’m reluctant to go and speak to him, purely and simply because I know that I’ll be sat in the waiting room for two hours.”

Colin is aware of the impact of his weight on his health, “Every single one of the ones that I’ve got is definitely affected by being overweight. The heart condition, the lung condition”. Colin hopes to lose weight to improve his osteoarthritis, “I mean it’s not going to make it any better, but in the hope that it won’t get any worse…if I’ve got a lighter body to move around, it will make it easier.” He encourages others to seek help from healthcare professionals on how to lose weight, “don’t be as shy as I, as I’ve been. Don’t be as stupid as I’ve been. Ask the questions.”
 

After his heart attack Colin was scared to go out but he didn’t talk to anyone about his fears in case they laughed at him. Staying at home and being inactive led him to put on more weight. He now realises it would have been better to talk to someone.

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And then I go and have a blinkin’ heart attack and I get frightened of going out.

Have you talked to somebody about that?

No.

About our…

No.

….your being scared of….

No. To be honest with you, I’ve been frightened of talking to people about stuff like that in case they laughed at me and now I realise, I’m beginning to realise after that speaking to that nurse about the worries that I had, that wasn’t one of the ones I raised with her, but it was the worry about the five a day that she picked up on mainly and I found out she didn’t laugh at me about it so it, it would have been worth talking about these things to people.

 

Colin was the main carer for his disabled wife, doing the household chores and cooking. After she died he carried on cooking the same volume as before and put on more than three stone before he had a heart attack.

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Once the wife died, okay at first, I knew what it was. I was still, because she was an invalid, I was preparing meals and doing a bit of cleaning and all the rest of it for her and looking after her generally, and of course, I was cooking, I was cooking for two of us. Once she died, I still continued to cook the same volume. I couldn’t get it into my head to half the quantities of things and I’m one of these people, I can’t freeze food once it’s cooked. I can’t waste food once it’s cooked. I was eating it. So, weight gain was probably my own fault.

Okay.

But I fairly quickly, fairly quickly learned not to and I was fairly active at the time, but I still couldn’t lose this weight and I went up….

How much did you weigh?

I went up to fifteen stone.

Okay. From eleven or ten and a half?

I went up from eleven stone to fifteen and I went up even beyond that.

How long ago was this?

Two years ago when I had the heart attack, I went up to nearly fifteen and three quarters stone.

Okay. So after your, after your wife died, you put on weight and…

Very rapidly.

….you kept it for a while?

Yeah. Yeah, I’ve kept it for a long while and I still, I’m still around about the same now. Still around the hundred kilo mark…..

Okay.

….which is around about fifteen stone.

 

Colin used to have chips with everything but is now increasing the amount of fruit and veg he eats.

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Since I came out of hospital this last time, I’ve been eating a lot more fruit and veg. I don’t get the recommended five a day every day, but I usually manage four. Sometimes more  and over, over a week, I would say I probably average four a day  either through bits and pieces  like yesterday when I was out shopping, and I was starving hungry I bought a sandwich in the local sandwich shop which contained a bit of salad which all goes as part and parcel of course even though it’s got to add up with other things.

I had a few pieces of dried fruit yesterday, again counts towards your five a day. I’ve been eating bananas like they were going out of fashion. I’ve been eating apples like they’ve been going out of fashion and I don’t know why but I’ve suddenly, well I do know why actually, I suddenly acquired a taste for satsumas. When I was in hospital they, they restricted my fluid intake to one and a half litres because of fluid retention and the nurse there advised me if I felt thirsty the best thing to do would be to eat an orange or a lemon.

Okay and what are you eating less of, or trying to eat less of?

Just about, just about everything to be honest. I suppose chips was my big downfall. My son will tell you it was chips with everything. It was almost getting to the stage where if I had cereal for breakfast, I’d have chips with it. But I’ve stopped those not completely but I’ll maybe only have chips now once a week where, whereas it would be three, four or even five times a week. I try not to eat potato unless it’s new potato and I tend, I tend to bulk up on fruit and veg because I found it’s not that that upset my stomach at all even though something in the old grey matter told me it would do, and it didn’t.

 

As part of cardiac rehabilitation, Colin was referred for exercise sessions in his local leisure centre. He was unable to make use of the referral because of problems with his feet.

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They actually, they actually advised in 2015 that I do this cardiac rehabilitation. So this is the second session that I’ve had at that and at the end of it, they, they gave us the option of carrying on with an organisation called physical activity and recreation service I think it is. PARS which was running in city at the time and basically it was, for the first thirteen weeks, it was a similar sort of exercise class to the one, in fact it was in the same place, the gymnasium at the physiotherapy at the hospital and it’s just simple circuit training. After that you, you do a thirteen-week session and after that they pass you on to someone else for thirteen weeks and then to someone else after that for thirteen weeks. I’ve no idea what was to follow the second thirteen weeks because I got to the second thirteen weeks.

And they sent me to one of the local leisure centres, to the gym there and they gave me a free membership. I thought it was great. I thought I’m doing great but at the time I had sore feet and there was like thick hard scaly skin on one foot causing the soreness. Nobody knew what it was.

I hobbled down to the gym at the leisure centre. Mentioned to the young lady there who I saw what the problem was and she said, “Well, you’re not really fit to do the exercises that we would plan for you while that’s the case.

Tell you what, go away, keep your membership and get in touch with us when you’re back.” Well it’s, it’s taken until this year. So, like two and a half years to get my feet right, and about six weeks after the initial visit there, they just, they just wrote me off their books.

Okay.

So, I’ve no idea where it would have gone, where it would have taken us subsequent to that.

 

After his wife died, Colin put on weight and went to see the practice nurse who ’was really quite rude’ to him.

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The weight gain started roughly twelve months after or was noticeable twelve months after my wife died. I was so worried about it. I went to see the GP and the practice nurse about it and the practice nurse was really quite rude.

Really?

Yeah, oh yeah. She told me, “You’ll lose weight if you keep that shut.” [Gestures to mouth]

That’s what she said?

Yeah, and that’s as much as she said, and I mentioned it to one of the GPs on a subsequent visit and they just laughed it off. But she was deadly ser-, I, tend to know when people are joking because I can be quite sarcastic and quite joking myself at times. I think sarcasm is something of a release as far as I’m concerned and she was deadly serious. She looked me in the eye and said, “Keep your mouth shut is the one way that you will lose weight.”

But she didn’t give you any...?

Didn’t give me any advice on how I should change my diet or anything or, you know, anything similar.

 

The advice Colin wanted from his cardiac team was to find an exercise programme for weight loss that took into account his osteoporosis as well as his heart problems and epilepsy.

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The only dietary advice I’ve been given was basically in connection with the heart condition and I was told in 2015 that I had, had a heart attack and that I was also suffering from heart failure and as a consequence of that they didn’t actually send a dietitian to speak to me but the cardiologist and the heart failure specialist nurse advised me on dietary matters and how much fluid to take and all this, that and the other. But because of the drugs I was taking at the time for the epilepsy he couldn’t find a diuretic to reduce the fluid retention. They have done now.

How did you find that advice? Was it sufficient?

No.

What else do you think?

No, I could, I could do, I think with finding some form of regular exercise that’s not going to exacerbate the problems that I’ve already got and the main one there when it comes to exercise of course is the osteoarthritis. The secondary one would be the shortness of breath through the lung condition and the heart condition. But apart from that if I could find some sort of exercise where I could gradually lose weight, I’d be a lot more happy.

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