My First Talk to Cardiac Rehab for 2017

This week I gave my first talk for the year to our local cardiac rehab unit. July will be ten years since my heart attack and triple bypass and have been privileged since 2008 to have been invited as part of the education program to talk to people who are now doing the rehab program as they start their journey after a heart event. 

I divided my talk today into three areas: I started off talking a bit about my heart event, the fact I did not have any of the classic warning signs or symptoms which I later found out was not uncommon for diabetics (amongst other groups in the community) - and mentioned that I am very passionate about spreading information about this whenever I get the opportunity.

The second part of my talk focused on my dealing with anxiety, depression, denial and the emotional headgames I went through in the months after my heart attack and during my recovery period. I talked about the positive role that cardiac rehab played in my recovery and also mentioned how at a certain point I reached out to one of the social workers from the program when I found things were a bit too much for me.

In the second part of my talk I also mentioned the importance of finding a hobby, an interest and talked a bit about how I rediscovered photography whilst helping my wife looking after injured wildlife (she was involved in Wildcare at the time) - where we live we have lots of wild birds visit us daily so I had many natural subjects of which to take photos. And I talked about how I have progressed my interest in photography to taking photos of live shows and tribute bands here on the Gold Coast.

In the third part of my talk I concentrated on how and what I did to change my lifestyle - stopped smoking, started exercising regularly, learnt how to deal with stress and improve my diet. I mentioned that it was my opinion that before anyone can begin their new journey after a heart event and make changes they needed to first assess where they were when they had their heart event and ascertain what parts of their lifestyle they needed to change or adjust.

All in all was a very good session with 28 people in attendance including the group co-ordinator, the unit's psychologist and a couple of university students doing a placement.

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In 2008, a year after my heart attack I was invited to give a “one-off” talk at the cardiac rehab unit on the Gold Coast. This happened not long after I had given a number of interviews for TV and our local newspaper in which I was asked about my heart event and my experience dealing with 29 cardioversions/resuscitations and having three stents for a 100% blockage to the right coronary artery and then five days later, a triple bypass for blockages on the left side of the heart.

"29 Lives" - TV Interview with Channel Nine - October 15, 2008
Click on photo to see interview on You Tube

Learn more about the LUCAS 2 Automatic CPR Machine and how it operates

In this video you will learn more about the LUCAS 2 automatic CPR machine. As someone who survived a massive heart attack that included full on cardiac arrests and 29 resuscitations/cardioversions I can totally identify with just how beneficial this machine can be.

The LUCAS Chest Compression System is designed to deliver uninterrupted compressions at a consistent rate and depth to facilitate ROSC (return of spontaneous circulation). It delivers automated compressions from first response in the field to ambulance transport and throughout the hospital. LUCAS facilitates consistent blood flow from the moment it is turned on, helping to improve a patient's chance for a successful outcome. With LUCAS, defibrillation can occur during ongoing compressions that can prime the heart for a successful shock. Also continuous compressions help maintain coronary perfusion pressure needed to facilitate ROSC. 

· Effective, consistent and uninterrupted compressions according to current AHA guidelines

· Maintain good blood flow

· Increasing operational effectiveness

· Easy to use and efficient to own

· Keep personnel safe during CPR 

You now have the choice between an air driven and battery powered LUCAS device. The original LUCAS 1, is a pnuematically-driven device and requires no electrical supply for operation. It is powered by compressed air from a portable compressed air cylinder or wall outlet. LUCAS 2 runs off of Lithium-ion Polymer battery technology, which has a long shelf life and requires no test-cycle maintenance. Both devices are equally easy to use and are designed to deliver uninterrupted compressions at a consistent rate and depth to facilitate ROSC.

Improving Operations in the Field 

Reduce the number of EMTs or firefighters to assist with CPR during a cardiac emergency 
Provide continuous, effective compressions, helping to maintain good circulation in the patient while medics remain seat-belted for better safety in a mobile environment 
Simple and easy to use with minimal training, keeping the cost of ownership low
For the clinically progressive agency 

Deliver chest compressions according to the guidelines -- ensuring compressions continue uninterrupted at a consistent depth to facilitate ROSC
Work in tandem with cooling therapies or impedance threshold devices for a comprehensive approach to patient resuscitation
Deliver effective, consistent, uninterrupted chest compressions and can help effectively manage the code scene while helping the patient to maintain good circulation
Help maintain coronary perfusion pressure without interruption which is crucial to improving patient outcomes 
Enable the intervention to continue in the event of a cardiac arrest in the cath lab by providing consistent, guidelines-quality chest compressions, which facilitates blood circulation to supply oxygen to vital organs.

Heart Foundation of Australia 'Recognize Your Heart Attack' Campaign - February, 2010

In February, 2010 I was invited by the Heart Foundation of Australia to participate in the launching of their 'Recognize Your Heart Attack' Campaign here on the Gold Coast. The launch and interview took place on the ambulance ramp to the hospital and was covered by the local newspaper and TV station.

It was indeed a privilege and honour to be asked to address those in attendance and to participate in the launch of this important campaign by the Heart Foundation. It was also a very emotional moment for me.

More information on the can be found using these links:

http://www.heartattackfacts.org.au/

http://www.heartattackfacts.org.au/warning-signs/

Heart Disease and Heart Attacks

This is a great little video that very clearly explains the difference between heart attack and sudden cardiac arrest and explains the causes. It is in plain English and also explains some of the terminology used when doctors talk about coronary artery disease. Possibly the best presentation and easiest to understand explanation I have seen since I had my heart attack and cardiac arrest in 2007. Well worth watching.

Link: https://www.youtube.com/watch?v=_wre2WRPiFI

Don't expect everyone to understand your journey

A sad reality of life is that not everyone will appreciate what your are going through as you/we deal with the after effects of a major health scare like a heart attack or as you deal with an ongoing health concern such as diabetes or recovering from treatment or surgery for cancer.

This is a fact of life. For whatever reason, sometimes our 'friends' have more of a problem dealing with your/our health issues and more to the point and something that happens quite a lot, your/our friends sometimes have a harder time coming to terms and dealing with what we are going through.

Time and again I have seen this question raised when giving a talk at our cardiac rehab unit and no doubt I will hear it again down the track. Realizing this, understanding and accepting this goes a long way to not letting this get in the way of your/our rehab and recovery program.

Another 'favourite' I hear from time to time is: 'You've had your heart attack and had your surgery so now you are right to get back to living like you were before you got sick'.

There are people who just do not get for whatever reason that for some people getting back to 'normal' is never going to happen for any of a number of reasons but until such time as they have had to deal with a similar situation they will never understand what living with a decreased heart function is like or how too much exertion or stress could bring on an angina attack or for that matter how a hypo for a diabetic can sometimes come about without warning despite how vigilant you might be as a diabetic who takes insulin.

Understanding the above will hopefully be of assistance to some who may be doing it tough right now as they deal with recovering from a health scare.

Cardiac Rehab Talk - May, 2012.

In 2008, a year after my heart attack and bypass surgery, I was invited by our local cardiac rehab unit to share my recovery experience with others doing the rehab program. After my first presentation, I was asked to come back and give my talk on a regular basis and have been doing so ever since - at my time of posting this, it is December, 2014.

In my talks, I cover issues I had to deal with including depression, anxiety and changing my lifestyle. In this video presentation which is a recording of one my talks coupled with photos taken over the years since my heart attack you will get an idea of some of the material I cover in each talk including:

• assessing my lifestyle and making changes
• dealing with stress, exercise and poor diet
• coping with depression and anxiety
• the role of cardiac rehab in my recovery process - turning 'negatives' into 'positives'
• finding a new hobby - in my case getting involved in helping my wife look after injured wildlife and adopting birds
• rediscovering an old hobby, that of photography (some photos included in this video)
• volunteering - becoming involved in spreading the awareness of CVD, Heart Attack and Diabetes in the community including creating bumper stickers and T shirts to help spread the message.

Talk given in May, 2012

Please feel free to share this video with others.

It should be noted that topics can vary from talk to talk depending on circumstances and the time available to me and with this in mind I am listing links to two other talks to provide a better overview of the topics I cover.

Cardiac Rehab Talk, Oct. 2010 - Recovering from a Heart Attack and Dealing with Depression:
https://www.youtube.com/watch?v=7ZNX5oCdhO0&index=6&list=PLEBBB26999588AD14

Cardiac Rehab Talk, Sep. 2011 - Recovering from a Heart Attack and Dealing with Depression:
https://www.youtube.com/watch?v=cdEHO6VqyHg&index=7&list=PLEBBB26999588AD14

These are some items I have created to promote the awareness of CVD, Heart Attack and Diabetes in the community:

More of these items can be found at www.heartattackstore.com.

Cheers.

Dani

Heart Medical Terms

The following will be of interest to anyone who has had a heart event and/or for family and carers of someone who has had a heart attack.

ACE—Angiotensin Converting Enzyme Inhibitor

Medication given to reduce the workload of the Heart

AF—Atrial Fibrillation

Irregular Heart Rhythm

AMI—Acute Myocardial Infarction

Medical term for a Heart Attack

Angiogram

Procedure for examining the Coronary Arteries

Angioplasty

Procedure to stretch narrowed Coronary Arteries to improve the Blood Flow to the heart

Angina

Chest pain or breathlessness caused by lack of Blood Flow to the Heart.

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Anti-arrhythmic

Medication given to treat an Arrythmia.

Anti-platelet

Medication which prevents the Blood clotting

Arrhythmia

Medical term for irregular Heart Rhythms

ASA—Aspirin

Anti-platelet medication

ASD—Atrial Septal Defect

Small hole in the top part of the heart

Atheroma

Build up of fatty deposits in the blood vessels which restricts blood flow

Atherosclerosis

Build up of fatty deposits in the blood vessels which restricts blood flow

B-B—Beta-Blocker

Medication given to control the Heart Rate and Rhythm

BNP—Brain N Peptide

Blood enzyme which can be measured to diagnose Heart Failure (HF)

BP—Blood Pressure

Measurement of the pressure within the Arteries

Bradycardia

When the Heart Rate (HR) is slow (< 60 beats per minute)

CA—Coronary Artery

Blood vessel which supplies blood to the tissues of the heart.

CABG—Coronary Artery Bypass Grafts

Surgical treatment for severe heart disease

CAD—Coronary Artery Disease

Narrowing of the coronary arteries which supply blood to the heart

Cardiac

Medical term for all things to do with the Heart

Cardiac Arrest

Emergency where the Heart stops beating

Cardiac Enzymes

Found in a blood test to diagnose a heart attack

Cardiology

Medical term for all Heart care

Cardiomyopathy

Disease of the Heart muscle which can impair its movement

CCU—Coronary Care Unit

Ward of a hospital where you would be taken with an emergency heart problem

CHD—Coronary Heart Disease

Narrowing of the coronary arteries which supply blood to the heart

CHF—Chronic Heart Failure

Condition when the heart muscle is weakened and less efficient at pumping blood around the heart

Cholesterol

Fat which leads to fatty deposits in the Arteries

CK—Creatinine Kinase

A Cardiac Enzyme used to diagnose a Heart Attack

CVD—Cardiovascular Disease

Disease affecting the Heart and its circulation

CVP—Central Venous Pressure

A measure of the pressure in the internal Vessels in the body

CVS—Cardiovascular System

Describes the heart and all the blood vessels in the body

Defibrillator

Machine used to deliver an electric shock to the heart to correct abnormal fast Heart Rhythm

Diuretic

Medication used to remove excess fluid from the body in Heart Failure (HF)

ECG—Electrocardiogram

A tracing on paper of the activity of the heart of the Heart Rate and Rhythm.

ECHO—Echocardiography

An ultrasound to look at the structure and movement of the heart muscle

Embolism

A clot in a Blood Vessel

EP Studies—Electrophysiological Studies

A detailed look at Heart Rhythm.

ETT—Electrocardiogram Treadmill Test

A recording of the Heart’s Rate and Rhythm while walking on atreadmill

Heart

Muscle which pumps Blood around the body, its Rate and Rhythm are controlled by electrical conduction

Heart Attack

Damage to the heart caused by a clot in the Coronary Arteries—requires emergency treatment in hospital

HB—Heart Block

Interruption of the electrical pathway causing a slowing of the heart rate

Heart Rhythm

The regulatory rhythm with which the Heart is beating

Heart Transplant

Operation which involves replacing diseased Heart with the healthy Heart of a donor

HBP—High Blood Pressure

When the pressure within the arteries is too high

HF—Heart Failure

Condition when the heart muscle is weakened and less efficient at pumping blood around the heart

HM—Heart Manual

A manual given to patients which details their cardiac rehabilitationprogramme after heart illness.

HR—Heart Rate

The speed at which the heart is beating

Hypertension

High Blood Pressure

Hypotension

Low Blood Pressure

ICD—Implantable Cardioverter Defibrillator

A device put inside the chest to correct Ventricular Tachycardia (VT) and Ventricular Fibrillation (VF).

Infarct

Area of tissue damaged by lack of blood and oxygen

IHD—Ischaemic Heart Disease

Narrowing of the coronary arteries which supply blood to the heart

MI—Myocardial Infarction

Medical term for a heart attack

Myocardium

The heart muscle

NSTEMI—Non-ST Elevation Myocardial Infarction

A ‘smaller’ Heart Attack, not requiring Thrombolysis

Pacemaker

Small electrical device implanted surgically to correct an abnormal heart rhythm

Palpitation

Small bursts of fast Heart Rhythms

PCI—Percutaneous Coronary Intervention

Term for any investigation or procedure which looks at the coronary arteries

PHT—Pre-Hospital Thrombolysis

Thrombolysis given by the Scottish Ambulance Service en route to hospital.

PTCA—Percutaneous Transluminal Coronary Angioplasty

Procedure to stretch narrowed coronary arteries to improve the blood flow to the heart

RACP(s)—Rapid Access Chest Pain Service

System of referral from Primary Care to Secondary Care for the assessment of chest pain

Septum

The area of the Heart which divides the Atria and the Ventricles

Statin

Generic name for cholesterol lowering medications

STEMI—S-T Elevation Myocardial Infarction

A serious heart attack

Tachycardia

When the Heart Rate (HR) is fast (> 100 beats per minute)

Thrombolysis

A ‘clot busting’ drug used to dissolve a blood clot which is causing a heart attack

Thrombosis

Blockage in a blood vessel due to a blood clot

TOE—Trans-Oesphageal Endoscopy

A procedure to view the structure of the heart from the oesophagus (which leads into the stomach)

Tn I/T—Troponin I/T

A Cardiac Enzyme used to diagnose a heart attack

Valve

Controls the flow of Blood into and out of the Heart

VF—Ventricular Fibrillation

Life threatening irregular heart rhythm

VSD—Ventricular Septal Defect

Small hole in the bottom part of the heart

VT—Ventricular Tachycardia

Irregular heart rhythm (can be life threatening)

Courtesy of: http://www.chss.org.uk/voices_scotland/glossary/heart.php

Support Groups on Facebook and Volunteering

One of the things that some of us may need after a life threatening episode is some sort of support group or a group of people who have been through a similar experience. A year or so after my heart attack I was asked be involved in creating a Heart Support group here where I live, which would be part of a national network of such groups. That was in September, 2008 and in December of that year the group was launched and I was elected Publicity/Information Officer.

Around the same time I found and joined a number of heart support groups on Facebook and became active in some contributing comments on my recovery process and trying to lend support to others going through the same recovery process that I had gone through a year earlier.

Having a background in teaching and wishing to share information, I also would post relevant items in these groups that I believed would help others understand what they had been through and what lifestyle changes they (as indeed I) made after my heart attack. And also, having dealt with depression, anxiety and panic attacks, I would talk about these - something which was not a common thing for males to do.

My greatest desire, however, in joining these groups was to spread the word that:

DIABETICS MAY NOT NECESSARILY HAVE THE CLASSIC WARNING SIGNS WHEN HAVING A HEART ATTACK.

This desire to spread this message came about after I did an interview with one of our local TV stations in which my cardiologist confirmed this message - at an earlier date we had discussed this when I had raised the question.

Channel Nine interview - "29 Lives"

And it would be fair to say that the principle motivating factor for me becoming involved in creating a heart support group here where I live (and joining some Facebook groups) was to get this message out into the wider community and to also spread the word about cardiovascular disease awareness and the links between diabetes and heart disease.

In the second half of 2008, soon after the TV interview, I was invited by our cardiac rehab programme to give a talk about my recovery and rehab process which included what I did to deal with depression and lifestyle changes I made. I can vividly remember talking about not having any pain or discomfort at the time of the heart attack and seeing a number of people in the room nodding their heads in agreement. When I queried them about this they told me that they were also diabetics and had never heard of the link regarding diabetics not always having pain when having a heart attack.

The supposed one-off talk at our cardiac rehab programme became the first of many and to this day, I continue to give my talk every six weeks.

In early 2009, a month or so after the local heart support group I was involved in got off the ground, I withdrew from the group due to personal and health issues. I returned to the group around August of that year and resumed my position on the executive and made it clear that I believed that part of the direction of the group should be sharing our experiences and educating the community about CVD and heart attack warning signs. I was given a free hand to develop this.

By the end of 2010 it became clear that the primary aims of the group was to be social and to revolve around BBQ's, social outings, weekly walks and Tai Chi sessions and fund raising. It also became clear to me that reaching out to the community to spread awareness and education about CVD was not what the new leadership (nor much of the membership) was interested in and following a couple of disagreements, sadly, I walked away from the group.

I had put a lot of time into the group since it was was created and was very disappointed but felt I was knocking my head against a brick wall in trying to get the group as a whole to understand, realize that we, as survivors, had a lot to contribute to the community where we live. I tried to get the executive to see the relevance in members of our group 'getting close' to our Heart Foundation and suggested that we should look at seeing if we could provide some speakers to their volunteer speaker's programme. That proved to go down like a lead balloon!

In 2010 I fought hard to get a training program implemented where members of our group would be trained and qualify to volunteer at our local hospital to talk to people who have just had a heart event and/or maybe were awaiting surgery for a heart related issue. Again, sadly, I watched as the training course took place, and the program fell apart due to a lack of direction and commitment by the executive and those who had completed the course. To say the least I was totally disillusioned having put in over six months of effort to get the program off the ground in the first place.

After leaving the group I joined Heart Foundation of Australia and was trained up to become a volunteer speaker for the organization and and continue to be volunteer speaker today. Around the same time I also became a volunteer patient at Bond University and not long after became a volunteer patient for the Australian Institute of Ultrasound. I found pretty quickly, and easily, that there were plenty of places where I live where I could volunteer and share my experiences which is basically very much what I would have liked to have seen our local heart support group become involved in.

At the same time I became much more involved in support groups on Facebook and also decided to create items that I could use to promote CVD awareness. Here are some of these.

I also created a Facebook page dedicated to just CVD, Heart Attack and Diabetes Awareness where I post items I feel are relevant to heart disease and diabetes:
https://www.facebook.com/CHADAwareness

I found I was able to quite readily on Facebook and in Facebook groups do what I would have liked to see our local heart support group do - spread CVD and Diabetes Awareness. I was heartened many times when comments would be made in a group by others confirming that, like me, they had not had the classic symptoms and then on reflection after some prompting they would add that they also were diabetics. Not saying that this happens to all diabetics who have a heart attack, but there is no doubt it is a common enough and as I so fervently believe, this message needs to be spread as it is clear to me that many people are not aware of this.

Following are links to a number of support groups that may be of interest to people who have had a heart event and/or diabetes:

Zipper Club: https://www.facebook.com/groups/zipperClubHeartSurgery/
Heart Attack and Stents: https://www.facebook.com/groups/632446853435296/
Survivors: https://www.facebook.com/groups/162862610420905/
Heart Attack Families and Friends: https://www.facebook.com/groups/Heartattackfamiliesandfriends/
Open-Heart Surgery. "The Zipper Club": https://www.facebook.com/groups/2256590992/
Heart Attack Survivors Unite!: https://www.facebook.com/HeartAttackSurvivorsUnite
Living with Diabetes: https://www.facebook.com/groups/livingwithdiabetes/

There are many more support groups on Facebook, the above are just some that maybe worth a visit if you or someone you know is looking for some encouragement as they deal with a heart issue or diabetes.

Sharing Knowledge

One of the things that I will be doing in this blog is sharing knowledge. Being a member of a number of support groups on Facebook and elsewhere means I am constantly seeing different topics being raised regarding cardiovascular disease, recovery after a heart attack and diabetes.

Intentionally, I will be 'pinching' some of these topics from time to time and posting them here with additional information which hopefully will be of use to others out there dealing with that issue. It is fair to say that most of these topics will be close to my heart - no pun intended - given that I have heart issues, have had a heart attack requiring stents and bypass surgery and am a Type 2 Diabetic.

I will also post about breast cancer from the perspective of a husband watching and helping his wife deal with this from the initial diagnosis of being told in early 2013 she has stage 3 breast cancer to having a lumpectomy and finding out she has a triple negative form of breast cancer to having radiotherapy and then over a year later finding out she has the BRCA1 gene mutation and then soon after having an oophorectomy and double/bilateral mastectomy.

This blog, by intention, will be about me and issues I have and continue to deal with following my heart attack and health issues.

Fellow diabetics will be fully aware of the UPS and DOWNS of the HIGHS and LOWS that confront us on a day to day basis.