Sunday, 24 September 2017

Emerging from the slough

It is more than six months since the last blog, once again apologies for long delay. Much of what I wrote last time could be written again. Since I last wrote, it took weeks and weeks to get over the recurrent chest Infections, with attendant lethargy. But eventually it ended. Always remain positive; it takes patience, which with me is in short supply. I got back energy and determined to exercise as much as possible while health remained good. I resumed regular bedex, and slowly (because aging muscles need treating with care) increased repetitions.

Recently I have added light weights (about 4 Kg) to sit/stands, and even 1.5 Kg ankle weights. I have several times beaten my time for the round the block walk, several times under 11 minutes, and even one specially exhilarating day when I managed 10.30 minutes. As nothing for the fit, but near miraculous for a heart patient like me. Three months ago I had endured a dispiriting period of low energy and shortness of breath which I feared would never end. The point of writing this is to encourage fellow sufferers that even a long period of ill health, lassitude and depression can come to an end. Then grab the improvement and steadily increase exercise.

This weekend, Lorraine and I went to London to celebrate the birthday of my grandson, Tim. He is a teacher, young and fit, and walking a few miles rapidly is nothing to him. Travelling round London, finishing up with the amazingly wonderful An American in Paris, involves lots of changes of trains, lots of stairs (escalators not working), and generally lots of walking. We managed, walking in total far more than we had done all year. I won’t claim we kept up with Tim, he adjusted his pace to ours, but we did keep going, including one short burst of fast walking to catch a train with literally a minute to spare. I must add that I salute Londoners. Three times over the weekend we got into a train when all seats were occupied. On each occasion someone promptly gave up their seat for the old gent with a stick, and twice for Lorraine as well. Much appreciated.

I have emerged from “The slough of despond” fearing it would never end. Now I am experiencing a period of energy and wellness. I am determined to do all the tiring autumn garden jobs: loads or compost to vegetable beds, digging it in etc. We are so encouraged we hope to go to on holiday Tenerife this season. Fellow sufferers, remember Sir Winston’s words: “Keep b*****ing on”.

Monday, 20 February 2017

Long-lasting lethargy

Long-lasting lethargy

I originally intended to write the blog fairly regularly, though not setting myself any target frequency such as once a month.   I feel a bit guilty that the gap since the last one is so long.  Partly this is sheer laziness, partly this was due to a lack of energy on many days such that it took a huge effort to do more than read the paper and watch TV;  and partly that there has not been much to write, cardiac-wise as it were.   I am relieved that my ICD has remained silent, though thoroughly checked to ensure it was working properly.   My pulse rate is still irregular, but thanks to bisoprolol controlled pretty well around 60 – 70.  .I was feeling so well that we booked a holiday in Tenerife, mainly for the sunshine.  The flight was no problem, but lengthy walking at the airport can be tiring.  It was .nothing to do with the heart, but I did have a successful cataract operation at the end of November.
        The last few weeks have been uneventful as far as my Chronic Cardiac Dysfunction (CCDF) is concerned, though this can be difficult to interpret, as my medical condition is complicated by co-existing COPD.  I caught the prevailing adenovirus infection around Christmas; as usual this went to my chest.  I had terribly distressing coughs, and much worse Shortness of Breath than usual.  I had to give up even my bedroom exercise (bedex) programme.  Gradually I improved thanks to a course of Co-amoxyclav.   However as has happened before, after a wonderful period of gradually getting better, back to bedex, the wretched cough and SOB returned.  I am now on a course of Clarithromycin, and gradually improving.  I have even resumed bedex, gently.   The lethargy is getting less.  Whether this awful lethargy is caused by CCDF, COPD, depression or lasting effects of the adenovirus infection  I do not know.  I have resumed my walk round the block.  I can’t measure the distance, probably about half a mile, mostly flat, but the inclines, though slight, can be a bit challenging.  Last week it took me 15.18 minutes, today, a trivial triumph,  14.05 minutes.  I know most people could probably do it in half that time, but to me it is a sign of progress; I like to think a harbinger of recovery to “my usual normal.”  Is it too much to hope that the period of cold and damp will soon be over, and we can welcome Spring? 

Monday, 24 October 2016

Autumn garden chores completed

Autumn garden chores completed

Every year  since I returned from working abroad, I have set myself the target of adding a good dose of compost to the vegetable beds, sowing mustard (green manure), digging it all in when the mustard had gown well, then sowing some more mustard and letting it grow and then die over the winter.  Once upon a time I could manage this effortlessly.  The last few years it has required a big effort, and frequent stops.  But little by little, and a bit later than usual, I have completed the tasks.   There is nothing to match home-grown vegetables; this requires attention to the soil.  Not cost effective, no doubt, but well worth it.  Tomatoes, potatoes and runner beans were this year some of the best ever. 

Suffering from cardiac failure, however inaccurate the term, leads to some soul searching.  Will I still be here next year? If still here, will I be fit enough to do all the raising from seed, planting and tending etc?  Am I foolish to waste valuable time preparing veg beds that may not be used next year?  Who knows?    I prefer to be positive.  However tiring, I actually enjoy managing the beds.  I would be extremely sorry if in a fit of pessimism I left the veg beds untended, and found next year I was fit enough to do the usual garden work, but the beds were not properly prepared. 

I am keeping reasonably fit, though wonky knees make walking hard on some days.  I am sticking to bedroom exercises (Bedex) several times a week, and have now refined them:
Warm-up: alternate knees up, then legs up and back, heel raising (single leg raising much harder for me) and deep breathing.  Aim for at least 10 repetitions for each. 
Main exercises.  Sit/stands, slowly with control), wall press-ups, single arm curls with dumbbells rather than bands, single arm  dumbbell presses (lying on back to reduce pressure on back) and the “dead bug” exercise for the back (watch the elegant demo on U-tube), and more sit/stands.  For each I aim for at least 10 to 20 repetitions
Cool down: marching and lots of stretches, especially hamstrings. 
Unfortunately there are days when lethargy makes even these exercises hard.  I work on the notion that even doing some of them is better than doing nothing. 

Wednesday, 21 September 2016


I don’t normally use many exclamation marks, they are often unnecessary and it is easy to overuse them.  Today I make an exception.  I have just come back from Worcester, and got the all clear from the arrhythmia clinic.   I have been extra careful the last six weeks, in fact over seven weeks, since the implant; during this time.  I have not been allowed to vacuum, mow lawns, lift anything with my left arm heavier than a book, or to raise the left arm above shoulder height.  Even putting on a jacket or tying a tie needs concentration to keep the left arm below shoulder level.  One of the doctors put the fear of God into me if I didn’t observe these restrictions, how the electrode could become displaced, when the device would need reinserting. 
         However this morning, with great speed and efficiency, the cardiac technician had her machine talking to my implant.  “All good, no runs of fast beats, just what we want.”.  Then she mentioned something not included in the mass of literature provided at the initial consultation.  She made my implant vibrate.  This is rather subtle, a gentle buzz by the ICD, easy to miss if I hadn’t had the test.  If this happens it is not serious, but the clinic should be informed so that they can check and make adjustments to the implant if necessary.  So my next appointment is six months away; I can mow lawns, dig veg patches,and do wall press-ups with both arms.    Hooray!  This is an Oyster Bay day. 

Saturday, 3 September 2016

Heart failure misnamed

Heart failure by another name would sound less bitter

I wish I could write a witty line to parody Shakespeare.  I believe, however, that this sentence contains good sense.  Heart failure sounds deadly serious, almost terminal.  I shall never forget, following a day in hospital after an attack of atrial fibrillation and a battery of tests, the visit to the consultant cardiologist to review treatment.  I learned I had heart failure.  Both my wife and I were shattered.  I knew I had COPD and got short of breath on too much exertion, and knew I had an irregular pulse.   But the diagnosis of heart failure was new and devastating.  I am a doctor, however, and soon recovered a sense of perspective.  
I read up about heart failure.  I read the British Heart Foundation booklet and the excellent book I have mentioned before, Kasper and Knudson’s "Living well with heart failure."  It is subtitled  “The misnamed, misunderstood condition.” Their title “Living well with heart failure” carries this positive connotation. Heart failure is misnamed I believe because the word failure is so negative, almost terminal.  Heart failure, though serious, is compatible with a happy and useful life when treated effectively.  The problem is that the misnamed term is so well established that it won’t be shifted easily, and there is no obvious alternative.  Comparable to COPD, I would tentatively suggest CCD as a less emotive term than heart failure, and I hope sufficiently accurate.  CCD would stand for chronic cardiac dysfunction. 

Tuesday, 30 August 2016

Increasing confidence with ICD

Increasing confidence with ICD

The doctor who assisted with the ICD implantation put the fear of God into me by warning that I must not put pressure on my left arm, raise it above shoulder height, etc.  And keep this up for six weeks.   It is exactly four weeks today since the implantation, and I feel increasingly comfortable with the device.  Of course I can feel it, neatly nestling under the skin, but there is no trace of tenderness.  I can move my arm with no discomfort, and I have even managed, comfortably, to sleep on it, my normal position for sleep. 
The problem now is that I feel fine, and am at risk of forgetting the restrictions on movement.  I potter in the garden, but I have to remember it must be in a one-armed way.  I have to get my wife or someone in the family to lift eg compost bags when I cannot do this comfortably with the right hand, or move a wheel-barrow which certainly requires both arms. 
In response to my informing the DVLA of the ICD insert, I had a formal response asking lots of questions about my condition, demanding a list of clinics, addresses of consultants and requiring me to give permission for medical information to be obtained.  Today I received a brown envelope with a formal response from the DVLA,, stating that I could retain my normal licence.  Praise the Lord!  I have still three days to go until a month has elapsed since the insert, when I can drive again.  I find it strange that in a legal requirement, the imprecise month is used, rather than 28, 30 or 31 days.  I would prefer it to be as short as possible
Today we went to Stratford, accompanied by my lovely Susan, my elder daughter visiting us from Cyprus.  Lorraine drove.  It was a lovely sunny day.  I was able to do a lot of walking, albeit slowly because of wretched osteo-arthritic knees.  No shortness of breath, thanks to medication and magnesium supplements.   This amount of walking is something I could not imagine doing earlier in the year.   All for the sake of retail therapy.  The principal retail therapy,  requiring Susan’s expertise,  was buying a refurbished Sony laptop, on which I am typing this blog.  Next Friday I will be allowed to drive, and in two more weeks, if the check-up is OK, to move a wheelbarrow and such other routine activities we take for granted.  Wonderful things to look forward to.   There are times when living with heart failure is not too bad.