tag:blogger.com,1999:blog-62126283112779477752024-02-08T03:26:13.372-08:00Alan's living with heart failure blogAlanhttp://www.blogger.com/profile/03159677289393309265noreply@blogger.comBlogger16125tag:blogger.com,1999:blog-6212628311277947775.post-59053189423220109382020-12-09T02:41:00.004-08:002020-12-09T03:42:05.008-08:00Still Counting<p><!--[if gte mso 9]><xml>
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</p><p class="MsoNormal"><span style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial Rounded MT Bold","sans-serif"; mso-bidi-font-family: Arial;">December 2020: <span style="mso-spacerun: yes;"> </span>still counting</span></span></p>
<p class="MsoNormal"><span style="font-family: "Arial Rounded MT Bold","sans-serif"; mso-bidi-font-family: Arial;">When she read my last blog, my wife, Lorraine,
complained that I should call it not “Living with heart failure”, but
“Gardening with heart failure.”<span style="mso-spacerun: yes;"> </span>Fair
comment, will try to do better. My message was :<span style="mso-spacerun: yes;"> </span>with heart <span style="mso-spacerun: yes;"> </span>failure you could still do important things
you always did, you just had to learn how to do them m differently and more
slowly. </span></p>
<p class="MsoNormal"><span style="font-family: "Arial Rounded MT Bold","sans-serif"; mso-bidi-font-family: Arial;"><span style="mso-tab-count: 1;"> </span>One
way I do things differently and more slowly is climbing stairs.<span style="mso-spacerun: yes;"> </span>I could do this, but my, it was hard work,
and a long period of shortness of breath awaited me at <span style="mso-spacerun: yes;"> </span>the top.<span style="mso-spacerun: yes;">
</span>So I took the plunge and bought a stair lift.<span style="mso-spacerun: yes;"> </span>Not as straightforward as I expected.<span style="mso-spacerun: yes;"> </span>I tried a local company; they had <span style="mso-spacerun: yes;"> </span>good salesman, but what a price!<span style="mso-spacerun: yes;"> </span>Tried a different one, another great sales
spiel, quoted the best part of <span style="mso-spacerun: yes;"> </span>£4,000,
for a straight stair lift, without <span style="mso-spacerun: yes;"> </span>problems.
<span style="mso-spacerun: yes;"> </span>Tried a third, decided to haggle
hard.<span style="mso-spacerun: yes;"> </span>Eventually got an offer for just
over £2,000, from a reputable firm.<span style="mso-spacerun: yes;">
</span>Accepted this as so much better than the other offers, though I suspect I
could have got a better deal if I had persisted, though doubtless sacrificing
some quality and reliability.<span style="mso-spacerun: yes;"> </span>Still I
have had a year’s use of the stair lift, not a hint of trouble; <span style="mso-spacerun: yes;"> </span>costly but I am so glad we bought it.<span style="mso-spacerun: yes;"> </span></span></p>
<p class="MsoNormal"><span style="font-family: "Arial Rounded MT Bold","sans-serif"; mso-bidi-font-family: Arial;"><span style="mso-tab-count: 1;"> </span>The
vaccine has brought welcome hope towards the end of a difficult year.<span style="mso-spacerun: yes;"> </span>Being over 85 and “clinically extremely
vulnerable” is sobering, but a small consolation is we shall be among first to
receive the vaccine.<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>A <span style="mso-spacerun: yes;"> </span>lot
of patience is required, and a lot more hibernation, but there is the prospect
of a holiday and most important, seeing my lovely family again – and the
opportunity to catch up on long overdue hugs.<span style="mso-spacerun: yes;">
</span></span></p>
<p class="MsoNormal"><span style="font-family: "Arial Rounded MT Bold","sans-serif"; mso-bidi-font-family: Arial;"><span style="mso-tab-count: 1;"> </span>So,
another year, a difficult, often depressing year, has gone by.<span style="mso-spacerun: yes;"> </span>I am a little more breathless on exertion, a
little slower, more easily fatigued, but still going, more or less independent,
and still COUNTING.<span style="mso-spacerun: yes;"> </span></span></p>
<p> </p>Alanhttp://www.blogger.com/profile/03159677289393309265noreply@blogger.com0tag:blogger.com,1999:blog-6212628311277947775.post-78138986973221156382020-11-11T04:24:00.006-08:002020-11-11T05:54:08.185-08:00Intermittent blog returns<p><!--[if gte mso 9]><xml>
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</p><p class="MsoNormal">Many apologies to the one possible reader of this blog.<span style="mso-spacerun: yes;"> </span>Must do better.<span style="mso-spacerun: yes;"> </span></p>
<p class="MsoNormal">Plus <span style="mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">ç</span>a change.<span style="mso-spacerun: yes;"> </span>4 years
ago in the blog I wrote: “<span style="font-family: "Times New Roman","serif"; font-size: 12pt; line-height: 115%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-GB;">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. <br />
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."</span></p><p class="MsoNormal"><span style="font-family: "Times New Roman","serif"; font-size: 12pt; line-height: 115%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-GB;"><br />
I have prepared the vegetable bed for runner beans, <span style="mso-spacerun: yes;"> </span>adding compost, also for the raspberries.<span style="mso-spacerun: yes;"> </span>For greenhouse tomatoes, I now replace old
soil with a bucket of compost where each tomato will be planted.<span style="mso-spacerun: yes;"> </span>This has worked extremely well, and this year’s
crop was one of the best ever.<span style="mso-spacerun: yes;"> </span>Potatoes
I plant in ten litre buckets, draining of course, which means replacing the soil
each year with fresh soil that has not grown potatoes.<span style="mso-spacerun: yes;"> </span>Then sowing caliente mustard.<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>Just
like four years ago, this was a slow business, now even slower.<span style="mso-spacerun: yes;"> </span>But completed!<span style="mso-spacerun: yes;"> </span>Other areas are neglected; there are too
many weeds and pruning is behindhand.<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>Fortunately the weather on the whole has
permitted some gardening, itself a welcome relief in lockdown. </span></p>
<p class="MsoNormal"><span style="font-family: "Times New Roman","serif"; font-size: 12pt; line-height: 115%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-GB;">Perhaps next year, perish the thought, I shall have to get the help of a
gardener.<span style="mso-spacerun: yes;"> </span></span></p>
<p class="MsoNormal"><span style="font-family: "Times New Roman","serif"; font-size: 12pt; line-height: 115%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-GB;">I haven’t been doing as much exercise as I used to, have to try to do
better. But here I am still, <span style="mso-spacerun: yes;"> </span>approaching
a rather ancient birthday, but COUNTING. </span></p>
<p class="MsoNormal"><span style="mso-spacerun: yes;"> </span></p>
<p> </p>Alanhttp://www.blogger.com/profile/03159677289393309265noreply@blogger.com2tag:blogger.com,1999:blog-6212628311277947775.post-74762930525296537602017-09-24T22:53:00.001-07:002017-09-24T22:57:51.527-07:00Emerging from the slough<div dir="ltr" style="text-align: left;" trbidi="on">
<span style="font-family: Arial, Helvetica, sans-serif;">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. </span><br />
<span style="font-family: Arial, Helvetica, sans-serif;"><br /></span>
<span style="font-family: Arial, Helvetica, sans-serif;">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. </span><br />
<span style="font-family: Arial, Helvetica, sans-serif;"><br /></span>
<span style="font-family: Arial, Helvetica, sans-serif;">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 <i>An American in Paris</i>, 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. </span><br />
<span style="font-family: Arial, Helvetica, sans-serif;"><br /></span>
<span style="font-family: Arial, Helvetica, sans-serif;">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”. </span><br />
<br /></div>
Suehttp://www.blogger.com/profile/11835205817921501248noreply@blogger.com0tag:blogger.com,1999:blog-6212628311277947775.post-87104553046915458002017-02-20T08:08:00.001-08:002017-02-21T05:55:32.679-08:00Long-lasting lethargy<!--[if gte mso 9]><xml>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: "arial" , "sans-serif"; font-size: 16.0pt; line-height: 115%;">Long-lasting
lethargy</span></b></div>
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<br /></div>
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<span style="font-family: "arial" , "sans-serif";">I originally
intended to write the blog fairly regularly, though not setting myself any
target frequency such as once a month.<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>I feel a bit guilty that the gap since the
last one is so long.<span style="mso-spacerun: yes;"> </span>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; <span style="mso-spacerun: yes;"> </span>and partly that there has not been much to
write, cardiac-wise as it were.<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>I am relieved that my ICD has remained silent,
though thoroughly checked to ensure it was working properly.<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>My
pulse rate is still irregular, but thanks to bisoprolol controlled pretty well
around 60 – 70.<span style="mso-spacerun: yes;"> </span>.I was feeling so well
that we booked a holiday in Tenerife, mainly for the sunshine.<span style="mso-spacerun: yes;"> </span>The flight was no problem, but lengthy
walking at the airport can be tiring.<span style="mso-spacerun: yes;"> </span>It
was .nothing to do with the heart, but I did have a successful cataract
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<span style="font-family: "arial" , "sans-serif";"><span style="mso-spacerun: yes;"> </span>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.<span style="mso-spacerun: yes;"> </span>I caught the prevailing adenovirus
infection around Christmas; as usual this went to my chest.<span style="mso-spacerun: yes;"> </span>I had terribly distressing coughs, and much
worse Shortness of Breath than usual.<span style="mso-spacerun: yes;"> </span>I
had to give up even my bedroom exercise (bedex) programme.<span style="mso-spacerun: yes;"> </span>Gradually I improved thanks to a course of
Co-amoxyclav.<span style="mso-spacerun: yes;"> </span>However as has happened
before, after a wonderful period of gradually getting better, back to bedex, the
wretched cough and SOB returned.<span style="mso-spacerun: yes;"> </span>I am
now on a course of Clarithromycin, and gradually improving.<span style="mso-spacerun: yes;"> </span>I have even resumed bedex, gently.<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>The
lethargy is getting less.<span style="mso-spacerun: yes;"> </span>Whether this awful
lethargy is caused by CCDF, COPD, depression or lasting effects of the adenovirus
infection <span style="mso-spacerun: yes;"> </span>I do not know.<span style="mso-spacerun: yes;"> </span>I have resumed my walk round the block.<span style="mso-spacerun: yes;"> </span>I can’t measure the distance, probably about
half a mile, mostly flat, but the inclines, though slight, can be a bit challenging.<span style="mso-spacerun: yes;"> </span>Last week it took me 15.18 minutes, today, a trivial
triumph, <span style="mso-spacerun: yes;"> </span>14.05 minutes.<span style="mso-spacerun: yes;"> </span>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.”<span style="mso-spacerun: yes;"> </span>Is it
too much to hope that the period of cold and damp will soon be over, and we can
welcome Spring?<span style="mso-spacerun: yes;"> </span></span></div>
Alanhttp://www.blogger.com/profile/03159677289393309265noreply@blogger.com0tag:blogger.com,1999:blog-6212628311277947775.post-62225717152882613602016-10-24T05:42:00.002-07:002020-12-09T09:58:15.757-08:00Autumn garden chores completed<div dir="ltr" style="text-align: left;" trbidi="on">
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<div class="MsoNormal">
<span face=""arial" , "sans-serif"" style="font-size: 12pt; line-height: 115%;">Autumn garden chores completed</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span face=""arial" , "sans-serif"" style="font-size: 12pt; line-height: 115%;">Every year<span style="mso-spacerun: yes;"> </span>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.<span style="mso-spacerun: yes;">
</span>Once upon a time I could manage this effortlessly.<span style="mso-spacerun: yes;"> </span>The last few years it has required a big
effort, and frequent stops.<span style="mso-spacerun: yes;"> </span>But little
by little, and a bit later than usual, I have completed the tasks.<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>There
is nothing to match home-grown vegetables; this requires attention to the
soil.<span style="mso-spacerun: yes;"> </span>Not cost effective, no doubt, but
well worth it.<span style="mso-spacerun: yes;"> </span>Tomatoes, potatoes and
runner beans were this year some of the best ever.<span style="mso-spacerun: yes;"> </span></span><br />
<span face=""arial" , "sans-serif"" style="font-size: 12pt; line-height: 115%;"><span style="mso-spacerun: yes;"><br /></span></span></div>
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<span face=""arial" , "sans-serif"" style="font-size: 12pt; line-height: 115%;">Suffering from cardiac failure, however inaccurate the
term, leads to some soul searching. <span style="mso-spacerun: yes;"> </span>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?<span style="mso-spacerun: yes;">
</span>Am I foolish to waste valuable time preparing veg beds that may not be
used next year?<span style="mso-spacerun: yes;"> </span>Who knows?<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>I
prefer to be positive.<span style="mso-spacerun: yes;"> </span>However tiring, I
actually enjoy managing the beds.<span style="mso-spacerun: yes;"> </span>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.<span style="mso-spacerun: yes;"> </span></span><br />
<span face=""arial" , "sans-serif"" style="font-size: 12pt; line-height: 115%;"><span style="mso-spacerun: yes;"><br /></span></span></div>
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<span face=""arial" , "sans-serif"" style="font-size: 12pt; line-height: 115%;">I am keeping reasonably fit, though wonky knees make
walking hard on some days.<span style="mso-spacerun: yes;"> </span>I am sticking
to bedroom exercises (Bedex) several times a week, and have now refined them:</span></div>
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<b style="mso-bidi-font-weight: normal;"><span face=""arial" , "sans-serif"" style="font-size: 14pt; line-height: 115%;">Warm-up</span></b><span face=""arial" , "sans-serif"" style="font-size: 12pt; line-height: 115%;">:
alternate knees up, then legs up and back, heel raising (single leg raising
much harder for me) and deep breathing.<span style="mso-spacerun: yes;">
</span>Aim for at least 10 repetitions for each.<span style="mso-spacerun: yes;"> </span></span></div>
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<b style="mso-bidi-font-weight: normal;"><span face=""arial" , "sans-serif"" style="font-size: 14pt; line-height: 115%;">Main
exercises</span></b><span face=""arial" , "sans-serif"" style="font-size: 14pt; line-height: 115%;">.</span><span face=""arial" , "sans-serif"" style="font-size: 12pt; line-height: 115%;"><span style="mso-spacerun: yes;">
</span>Sit/stands, slowly with control), wall press-ups, single arm curls with
dumbbells rather than bands, single arm <span style="mso-spacerun: yes;"> </span>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.<span style="mso-spacerun: yes;"> </span>For each I aim for at least 10 to 20
repetitions</span></div>
<div class="MsoNormal">
<b style="mso-bidi-font-weight: normal;"><span face=""arial" , "sans-serif"" style="font-size: 14pt; line-height: 115%;">Cool
down</span></b><span face=""arial" , "sans-serif"" style="font-size: 12pt; line-height: 115%;">:
marching and lots of stretches, especially hamstrings.<span style="mso-spacerun: yes;"> </span></span></div>
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<span face=""arial" , "sans-serif"" style="font-size: 12pt; line-height: 115%;">Unfortunately there are days when lethargy makes even
these exercises hard.<span style="mso-spacerun: yes;"> </span>I work on the
notion that even doing some of them is better than doing nothing.<span style="mso-spacerun: yes;"> </span></span></div>
</div>
Alanhttp://www.blogger.com/profile/03159677289393309265noreply@blogger.com0tag:blogger.com,1999:blog-6212628311277947775.post-16491720392548467602016-09-21T04:06:00.001-07:002020-12-09T09:55:32.186-08:00Hooray!<!--[if gte mso 9]><xml>
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<span face=""arial" , "sans-serif"" style="font-size: 12pt; line-height: 115%;">I don’t normally use many exclamation marks, they are
often unnecessary and it is easy to overuse them.<span style="mso-spacerun: yes;"> </span>Today I make an exception.<span style="mso-spacerun: yes;"> </span>I have just come back from Worcester, and got
the all clear from the arrhythmia clinic.<span style="mso-spacerun: yes;">
</span>I have been extra careful the last six weeks, in fact over seven weeks,
since the implant; during this time.<span style="mso-spacerun: yes;"> </span>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.<span style="mso-spacerun: yes;"> </span>Even putting on a jacket or tying a tie needs
concentration to keep the left arm below shoulder level.<span style="mso-spacerun: yes;"> </span>One of the doctors put the fear of God into
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<span face=""arial" , "sans-serif"" style="font-size: 12pt; line-height: 115%;"><span style="mso-spacerun: yes;"> </span>However
this morning, with great speed and efficiency, the cardiac technician had her
machine talking to my implant.<span style="mso-spacerun: yes;"> </span>“All
good, no runs of fast beats, just what we want.”.<span style="mso-spacerun: yes;"> </span>Then she mentioned something not included in
the mass of literature provided at the initial consultation.<span style="mso-spacerun: yes;"> </span>She made my implant vibrate.<span style="mso-spacerun: yes;"> </span>This is rather subtle, a gentle buzz by the
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that they can check and make adjustments to the implant if necessary.<span style="mso-spacerun: yes;"> </span>So my next appointment is six months away; I
can mow lawns, dig veg patches,and do wall press-ups with both arms.<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>Hooray!<span style="mso-spacerun: yes;"> </span>This is an Oyster Bay day.<span style="mso-spacerun: yes;"> </span></span></div>
Alanhttp://www.blogger.com/profile/03159677289393309265noreply@blogger.com0tag:blogger.com,1999:blog-6212628311277947775.post-76592951097447305862016-09-03T04:24:00.001-07:002020-12-09T09:53:47.089-08:00Heart failure misnamed<!--[if gte mso 9]><xml>
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<b style="mso-bidi-font-weight: normal;"><span face=""Arial","sans-serif"" style="font-size: 12pt; line-height: 115%;">Heart
failure by another name would sound less bitter</span></b></div>
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<br /></div>
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<span face=""Arial","sans-serif"" style="font-size: 12pt; line-height: 115%;">I wish I could write a witty line to parody Shakespeare.<span style="mso-spacerun: yes;"> </span>I believe, however, that this sentence
contains good sense.<span style="mso-spacerun: yes;"> </span>Heart failure
sounds deadly serious, almost terminal.<span style="mso-spacerun: yes;">
</span>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.<span style="mso-spacerun: yes;"> </span>I
learned I had heart failure.<span style="mso-spacerun: yes;"> </span>Both my
wife and I were shattered.<span style="mso-spacerun: yes;"> </span>I knew I had
COPD and got short of breath on too much exertion, and knew I had an irregular
pulse.<span style="mso-spacerun: yes;"> </span>But the diagnosis of heart
failure was new and devastating.<span style="mso-spacerun: yes;"> </span>I am a
doctor, however, and soon recovered a sense of perspective. <span style="mso-spacerun: yes;"> </span></span></div>
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<span face=""Arial","sans-serif"" style="font-size: 12pt; line-height: 115%;">I read up about heart
failure.<span style="mso-spacerun: yes;"> </span>I read the British Heart
Foundation booklet and the excellent book I have mentioned before, Kasper and
Knudson’s "Living well with heart failure."<span style="mso-spacerun: yes;">
</span>It is subtitled <span style="mso-spacerun: yes;"> </span>“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.<span style="mso-spacerun: yes;">
</span>Heart failure, though serious, is compatible with a happy and useful
life when treated effectively.<span style="mso-spacerun: yes;"> </span>The
problem is that the misnamed term is so well established that it won’t be
shifted easily, and there is no obvious alternative.<span style="mso-spacerun: yes;"> </span>Comparable to COPD, I would tentatively
suggest CCD as a less emotive term than heart failure, and I hope sufficiently
accurate.<span style="mso-spacerun: yes;"> </span>CCD would stand for chronic
cardiac dysfunction.<span style="mso-spacerun: yes;"> </span></span></div>
Alanhttp://www.blogger.com/profile/03159677289393309265noreply@blogger.com0tag:blogger.com,1999:blog-6212628311277947775.post-38886300697123557702016-08-30T12:05:00.002-07:002020-12-09T09:51:11.480-08:00Increasing confidence with ICD<!--[if gte mso 9]><xml>
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<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12pt; line-height: 115%; mso-ascii-font-family: Arial; mso-bidi-font-family: Arial; mso-hansi-font-family: Arial;">Increasing confidence
with ICD</span></b></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-size: 12pt; line-height: 115%; mso-ascii-font-family: Arial; mso-bidi-font-family: Arial; mso-hansi-font-family: Arial;">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.<span style="mso-spacerun: yes;"> </span>And keep this up for six
weeks.<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>It is exactly four weeks today since the implantation,
and I feel increasingly comfortable with the device.<span style="mso-spacerun: yes;"> </span>Of course I can feel it, neatly nestling under
the skin, but there is no trace of tenderness.<span style="mso-spacerun: yes;">
</span>I can move my arm with no discomfort, and I have even managed,
comfortably, to sleep on it, my normal position for sleep.<span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal" style="text-indent: 36pt;">
<span style="font-size: 12pt; line-height: 115%; mso-ascii-font-family: Arial; mso-bidi-font-family: Arial; mso-hansi-font-family: Arial;">The problem now is that I feel fine, and am at risk
of forgetting the restrictions on movement.<span style="mso-spacerun: yes;">
</span>I potter in the garden, but I have to remember it must be in a one-armed
way.<span style="mso-spacerun: yes;"> </span>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.<span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal" style="text-indent: 36pt;">
<span style="font-size: 12pt; line-height: 115%; mso-ascii-font-family: Arial; mso-bidi-font-family: Arial; mso-hansi-font-family: Arial;">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.<span style="mso-spacerun: yes;">
</span>Today I received a brown envelope with a formal response from the DVLA,,
stating that I could retain my normal licence.<span style="mso-spacerun: yes;">
</span>Praise the Lord!<span style="mso-spacerun: yes;"> </span>I have still
three days to go until a month has elapsed since the insert, when I can drive again.<span style="mso-spacerun: yes;"> </span>I find it strange that in a legal
requirement, the imprecise month is used, rather than 28, 30 or 31 days.<span style="mso-spacerun: yes;"> </span>I would prefer it to be as short as possible</span></div>
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<span style="font-size: 12pt; line-height: 115%; mso-ascii-font-family: Arial; mso-bidi-font-family: Arial; mso-hansi-font-family: Arial;">Today we went to Stratford, accompanied by my
lovely Susan, my elder daughter visiting us from Cyprus.<span style="mso-spacerun: yes;"> </span>Lorraine drove.<span style="mso-spacerun: yes;"> </span>It was a lovely sunny day.<span style="mso-spacerun: yes;"> </span>I was able to do a lot of walking, albeit
slowly because of wretched osteo-arthritic knees.<span style="mso-spacerun: yes;"> </span>No shortness of breath, thanks to medication
and magnesium supplements.<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>This amount of walking is something I could
not imagine doing earlier in the year.<span style="mso-spacerun: yes;">
</span>All for the sake of retail therapy.<span style="mso-spacerun: yes;">
</span>The principal retail therapy,<span style="mso-spacerun: yes;"> </span>requiring
Susan’s expertise, <span style="mso-spacerun: yes;"> </span>was buying a
refurbished Sony laptop, on which I am typing this blog.<span style="mso-spacerun: yes;"> </span>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.<span style="mso-spacerun: yes;"> </span>Wonderful
things to look forward to. <span style="mso-spacerun: yes;"> </span>There are
times when living with heart failure is not too bad.<span style="mso-spacerun: yes;"> </span></span></div>
Alanhttp://www.blogger.com/profile/03159677289393309265noreply@blogger.com0tag:blogger.com,1999:blog-6212628311277947775.post-86800347985979666792016-08-23T08:05:00.003-07:002020-11-11T06:01:42.155-08:00No longer implantable, now implanted<!--[if gte mso 9]><xml>
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<br />
<div class="MsoNormal">I have had an ICD implanted.<span style="mso-spacerun: yes;">
</span>This was done as an outpatient at Worcester<span style="mso-spacerun: yes;"> </span>On the appointed day, there was initially a
long wait as the patient before me proved “tricky” and had to be kept in
overnight.<span style="mso-spacerun: yes;"> </span>When my turn came, it was
done under local anaesthetic.<span style="mso-spacerun: yes;"> </span>All done
very efficiently and painlessly, the procedure lasting less than an hour, then
recovery, checks that all was well and X-ray to confirm the wires were in the
correct place<span style="mso-spacerun: yes;"> </span>It was not nearly as scary
as the letter to my GP, copied to me, by the Arrhythmia Consultant.<span style="mso-spacerun: yes;"> </span>My ambulatory monitoring showed: “Narrow QRS
complexes and a high burden of ventricular ectopy.”<span style="mso-spacerun: yes;"> </span>Not really sure what that means, but I am
definitely at risk of something nasty such as ventricular tachycardia or
fibrillation, hence the need for the ICD.<span style="mso-spacerun: yes;"> </span></div><div class="MsoNormal"><span style="mso-spacerun: yes;"><br /></span></div>
<div class="MsoNormal">I am not
allowed to drive for a month, not just for medical reasons,<span style="mso-spacerun: yes;"> </span>but by law.<span style="mso-spacerun: yes;">
</span>I have informed the DVLA and my motor insurance company.<span style="mso-spacerun: yes;"> </span>This is a nuisance as now I feel fine.<span style="mso-spacerun: yes;"> </span>I have, for four to six weeks, to avoid
lifting or carrying anything heavy in my left arm (not vacuuming or lawn mowing
for example) and should not raise my left arm above shoulder height.<span style="mso-spacerun: yes;"> </span>I have studiously observed these requirements,
but have had to check myself once or twice from doing something as simple as
putting both arms behind the neck when relaxing in bed.<span style="mso-spacerun: yes;"> </span></div><div class="MsoNormal"><br /></div><div class="MsoNormal">Still the six week check up is getting
closer, though it seems tediously slowly, while garden jobs are piling up, in spite of Lorraine nobly doing many of them.<span style="mso-spacerun: yes;"> </span>I just have to hope that the check up will
show the electrodes have not become displaced and that the device is working
properly.<span style="mso-spacerun: yes;"> </span>Then I can go full speed to
catch up on gardening and wall press-ups etc.<span style="mso-spacerun: yes;">
</span>Not to mentioning vacuuming.<span style="mso-spacerun: yes;"> </span>Dear
Lorraine has
undertaken extra work brilliantly, including driving me.<span style="mso-spacerun: yes;"> </span>I’ll take her for a celebratory meal when the
check-up is over.<span style="mso-spacerun: yes;"> </span></div>
<div class="MsoNormal">
<br /></div>
Alanhttp://www.blogger.com/profile/03159677289393309265noreply@blogger.com0tag:blogger.com,1999:blog-6212628311277947775.post-42178950860551255302016-07-03T14:14:00.001-07:002016-07-04T00:31:50.437-07:00Death and defibrillators<div dir="ltr" style="text-align: left;" trbidi="on">
<br />
<div class="MsoNormal">
Anyone who is diagnosed with heart failure is bound to think
about death.<span style="mso-spacerun: yes;"> </span>The heart is vital.<span style="mso-spacerun: yes;"> </span>Failing suggests the end is nigh, right?.<span style="mso-spacerun: yes;"> </span>Well, we know it is not as bad as that.<span style="mso-spacerun: yes;"> </span>Kasper and Knudson in their useful book
“Living well with heart failure” subtitle the book: The misnamed, misunderstood
condition.”<span style="mso-spacerun: yes;"> </span>Unfortunately a more
accurate term has not found favour.<span style="mso-spacerun: yes;"> </span>But
apart from gradual deterioration, sudden death is a possibility for some
patients.<span style="mso-spacerun: yes;"> </span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
All this is a preamble to my latest visit to a cardiologist,
who specialises in ICDs (Implantable cardioverter defibrillators).<span style="mso-spacerun: yes;"> </span>My cardiac specialist nurse had suggested it
was not necessary in my condition.<span style="mso-spacerun: yes;"> </span>So I
expected it would be a nice quiet chat.<span style="mso-spacerun: yes;"> </span>However
I was more than a little shaken to be told, very nicely and considerately in
the event, that I was at risk of a serious arrhythmia.<span style="mso-spacerun: yes;"> </span>How likely this was he couldn’t say, but I
was at risk.<span style="mso-spacerun: yes;"> </span><br />
<br />
He discussed the pros and
cons of ICDs.<span style="mso-spacerun: yes;"> </span>They are inserted in the
chest, under local anaesthetic, with a wire attached to the heart.<span style="mso-spacerun: yes;"> </span>This can usually be done as a day case.<span style="mso-spacerun: yes;"> </span>You are forbidden from driving a car for one
month afterwards.<span style="mso-spacerun: yes;"> </span>There was a risk of
bleeding, puncture of the lung etc, but the risks were rare and usually easily
treated.<span style="mso-spacerun: yes;"> </span>The ICD contained a clever
computer that monitored the heart beat, and in the event of a serious
arrhythmia developing, would produce a shock to correct the abnormality.<span style="mso-spacerun: yes;"> </span>Just like the “stand clear, charge at 200”
episodes in medical soaps on TV.<span style="mso-spacerun: yes;"> </span>Except
it is done instantly, in your own chest.<span style="mso-spacerun: yes;">
</span>It doesn’t treat the heart failure or make you feel better.<span style="mso-spacerun: yes;"> </span>The cardiologist used the analogy of an air
bag: <span style="mso-spacerun: yes;"> </span>“They won’t make you drive
better, they can’t prevent accidents, but in an accident they could save your
life.”<span style="mso-spacerun: yes;"> </span>All good. <span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>The
only real snag appeared to be that on occasion the ICD could misinterpret the
heart beat and fire off a shock when it wasn’t necessary.<span style="mso-spacerun: yes;"> </span>Ouch!<span style="mso-spacerun: yes;">
</span>You get a big thump on the chest.<span style="mso-spacerun: yes;">
</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Having discussed this with my wife, Lorraine, we decided to go ahead with
it.<span style="mso-spacerun: yes;"> </span>There will be the usual NHS delay,
some six weeks or so.<span style="mso-spacerun: yes;"> </span>Interestingly, the
fact that I am currently feeling well, as well as I was a year ago, before the
attack of atrial fibrillation and the diagnosis of heart failure, was a strong
point in favour of having an ICD.<span style="mso-spacerun: yes;"> </span>If I
were in dire straits, miserable, in serious decline, having an ICD would not be
indicated.<span style="mso-spacerun: yes;"> </span>So the decision is made, and
we just have to hope nothing bad happens while we wait.<span style="mso-spacerun: yes;"> </span></div>
<div class="MsoNormal">
</div>
</div>
Alanhttp://www.blogger.com/profile/03159677289393309265noreply@blogger.com0tag:blogger.com,1999:blog-6212628311277947775.post-74090758236646716532016-06-15T07:33:00.000-07:002016-06-20T02:39:40.574-07:00Managing medicationMy cardiologist and his deputed Specialist Cardiac Nurse Natalie, tell me that the aim for my medication is gradually (0ver 1 - 2 weeks) to increase the dose of beta blocker (bisoprolol) and ACE inhibitor (ramipril) from the original dose of 1.25 mg/day to 10 mg/day. This is in line with the American Cardiology Society and Nice in the UK. Such a big increase is dependent on the patiant's response; blood pressure must be measured regularly. I personally wondered how the dosage was decided, now that such recommendations are supposed to be based on hard evidence (usually a double blind controlled trial). Would anyone really go to the trouble of a large double blind trial to compare say the dosage of 5 mg/day with 10 mg/day, comparing symptoms and more important, outcome, ie duration of life? To be meaningful, it would take many months, probably years. If so I would love to read the study. The authors of my favourite book on the subject "Living well with heart failure" state: "there are likely to be ony small differences in efficacy between low and high doses."<br />
<br />
In my case it was decided for the time being to fix the dose of bisoprolol at 2.5 mg/day, and to increase the dos of ramipril every few days. This went on till the dose of ramipril was 5 mg/day; daily blood pressure readings were near the ideal of 120/80. Natalie was pleased with my progress. But I was beginning to experience frequent light headedness when I stood up. I tried rising slowly and deliberately but this made little difference. One day at a friend's house I felt severely dizzy, which didn't pass away for several minutes. Scary..... I didn't pass out or fall, but it was close to it. I saw Natalie ASAP. Although sitting blood pressure was normal, when measured standing it fell to something like 70/45. It was agreed to reduce the dose of ramipril to 2.5 mg/day...This has remained the dose for several weeks now, and mercifully the attacks of light headedness have stopped. It is clear to me that blood pressure routinely must be measured standing as well as sitting. <br />
<br />
I have tried to be as active as possible with regular exercise, though I am not managing enough. Proper aerobic and resistance exercise is not easy when energy levels are low, as mine were for week after week. The last few weeks have been much better, and I have plenty of energy for gardening, sometimes dodging between showers in this wet, wet June. Gardening may not be aerobic exercise, getting the heart rate up, but at least it is better than sitting down reading. It uses many muscles gently, and involves bending and stretching. Meanwhile I have increased my personal record for sit/stands to 53 in 4.0 minutes. Increasing that will be hard. At any rate the garden is looking preety good. Alanhttp://www.blogger.com/profile/03159677289393309265noreply@blogger.com0tag:blogger.com,1999:blog-6212628311277947775.post-17288611892521560792016-05-31T09:19:00.005-07:002016-07-04T00:33:30.500-07:00Exercise is essential<div dir="ltr" style="text-align: left;" trbidi="on">
My elder daughter Susan was only too right when she thought even my modest BedEx programme was too ambitious ! Still I have struggled through some moderately bad days when energy levels were low, did three proper BedEx exercises, and managed at least some serious exercise most days. as well as two to three days gardening when the weather was nice. I am very pleased that I have increased sit/stands from 45 through 50 to 51 today, all in under 4.0 minutes by a stop watch and without undue distress. Difficult to get comparative facts but I reckon this is not bad for an octogenarian with heart failure and COPD. Days with not much energy are now fewer than they were, but still depressing when they happen. <br />
<br />
I am currently having a bit of trouble with my medication. The targets for dosage and what the patient (that is me) can withstand are not the same. I am making progress getting it sorted out. I'll report next blog. <br />
<br />
<br />
<br /></div>
Alanhttp://www.blogger.com/profile/03159677289393309265noreply@blogger.com0tag:blogger.com,1999:blog-6212628311277947775.post-49759095995011600732016-05-16T10:36:00.002-07:002020-12-09T09:38:30.506-08:00Laid low by lassitude<!--[if gte mso 9]><xml>
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The last few months I have been laid low by two bad chest
infections.<span style="mso-spacerun: yes;"> </span>Three courses of antibiotics
managed to keep me out of hospital.<span style="mso-spacerun: yes;">
</span>However during much of this time I was afflicted by severe lassitude; it
was an effort to do even minor things.<span style="mso-spacerun: yes;">
</span>Until the last fortnight or so, I had no energy for exercise, so I am extremely
unfit.<span style="mso-spacerun: yes;"> </span>Walking a short distance is quite
a triumph.<span style="mso-spacerun: yes;"> </span></div>
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It seems to be generally agreed
that most patients with heart failure benefit from exercise, and indeed it is,
with medication and healthy eating, considered an important part of
treatment.<span style="mso-spacerun: yes;"> </span>There is a helpful chapter on
exercise in the excellent book “Living well with heart failure” by Kasper and
Knudson.<span style="mso-spacerun: yes;"> </span>They point out that it is
desirable to carry out varied exercises as well as the standard advice to walk
for half an hour or so regularly.<span style="mso-spacerun: yes;"> </span>Over
the years I have devised many exercise programmes which were fine, but
ultimately too ambitious, as I gave up before there was much chance for them to
do me any good.<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>I hope I am now more realistic, time will
tell.<span style="mso-spacerun: yes;"> </span>I plan to spend some twenty
minutes, say five mornings a week.<span style="mso-spacerun: yes;"> </span>Start
with<span style="mso-spacerun: yes;"> </span>warm up (marching, heel raising,
stretching, wobble board or standing on one leg etc), deep breathing,
sit/stands from a chair for four minutes,<span style="mso-spacerun: yes;">
</span>wall press-ups for two minutes, biceps curls with a medium rubber band
for two minutes, and a gentle cool down with more dreaded stretches.<span style="mso-spacerun: yes;"> </span>Perhaps, in the fullness of time,<span style="mso-spacerun: yes;"> </span>I could add abdominal crunches, wrist and
back exercises, stepping up and down on a stair – the possibilities are
endless.<span style="mso-spacerun: yes;"> </span>For the moment I plan to keep
it simple: twenty minutes of morning exercises, plus walking.<span style="mso-spacerun: yes;"> </span>Watch this space.<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span></div>
Alanhttp://www.blogger.com/profile/03159677289393309265noreply@blogger.com0tag:blogger.com,1999:blog-6212628311277947775.post-7074324821185686702016-05-10T04:43:00.001-07:002016-07-04T00:36:20.104-07:00Dizzy dangers<div dir="ltr" style="text-align: left;" trbidi="on">
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The last few days have been like a bumpy ride, high highs,
and low lows.<span style="mso-spacerun: yes;"> </span>A week or so ago, I was on
my way to a good recovery from the chest infection.<span style="mso-spacerun: yes;"> </span>I had started an exercise programme, spent
2-3 hours each day in the garden, making good progress.<span style="mso-spacerun: yes;">
</span>Then Wednesday evening, feeling unwell, I experienced a return of
lethargy, chills but no raised temperature.<span style="mso-spacerun: yes;">
</span>Cough back with a <span style="mso-spacerun: yes;">vengeance. </span>Also continuing dizzy spells.<span style="mso-spacerun: yes;"> </span>Doing the least thing was a huge effort. Feared I may not be fit for weekend in Manchester.<span style="mso-spacerun: yes;"> </span><br />
<br />
Saw my GP: chest noisy, put back on doxacycline. Was dose of ramipril too high? Basic blood pressure close to 120/80, but standing
it was down to 70/40s accounting for the dizzy spells.<span style="mso-spacerun: yes;"> </span>Told to cut ramipril from 5 mg a day to
2.5 mg a day.<span style="mso-spacerun: yes;"> </span>By the weekend started to feel
better.<span style="mso-spacerun: yes;"> </span><br />
<br />
Son in law Steve drove us to
Manchester with Judy and Joey to see the Manchester University Theatre Group.<span style="mso-spacerun: yes;"> </span>My grandson Andy was Musical Director of
Grand Hotel the musical, and it <span style="mso-spacerun: yes;"> </span>went
really well.<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>Andy conducted with great enthusiasm, and kept
his band in perfect synchrony.<span style="mso-spacerun: yes;"> </span>Hugely
enjoyable.<span style="mso-spacerun: yes;"> </span>.<span style="mso-spacerun: yes;"> </span>Three days on with lower ramipril
dose and dizzy spells seem to have gone.<span style="mso-spacerun: yes;">
</span>Really cheered as in addition my energy levels are getting much
better.<span style="mso-spacerun: yes;"> </span>Looks as if standing blood
pressure monitoring should become more routine.<span style="mso-spacerun: yes;">
</span></div>
</div>
Alanhttp://www.blogger.com/profile/03159677289393309265noreply@blogger.com0tag:blogger.com,1999:blog-6212628311277947775.post-11817910168145367882016-04-29T02:49:00.000-07:002016-07-04T00:35:11.232-07:00Uplifting ups and depressing downs<div dir="ltr" style="text-align: left;" trbidi="on">
I am baffled by good and bad days. I asked around in rehab, and it seems to
be a common experience. Three days ago I did my usual round the block
walk. Hard work from the start; soon I was puffing, and try as i would
could not beat 15 minutes. No obvious reason; there was a bit of a cold
wind, but no more than usual.<br />
<br />
Then yesterday, encouraged by grandson Tim,
much better, around twelve and a half minutes. Today I did the best
sit/stands for ages, X 35 and then X 40, with a minute to get my breath
back. No-one seems to know why patients get good and bad days. I
suppose it is not a topic for research. Which is a pity: we know there is
no cure for heart failure though one can improve with medication. If only
we could mange more good days and less bad days it wold be a huge boon.
In my book, research to solve this problem would be worth a Nobel prize.
</div>
Alanhttp://www.blogger.com/profile/03159677289393309265noreply@blogger.com0tag:blogger.com,1999:blog-6212628311277947775.post-79804335657403644842016-04-20T05:38:00.001-07:002016-06-20T02:51:47.209-07:00My heart historyIt's a little over six years since my heart attack and subsequent triple bypass. With attacks of atrial fibrillation and a bad chest infection, the last few months have been depressing. But now, with sunshine, things are at last looking up. Better day today, managed round the block (about half a mile) in approximately 13 minutes. No big deal for most people, but when last two walks took 18 and then 15 minutes, progress indeed. Even managed some two hours pottering in the garden.<br />
<br />
<br />
<br />Alanhttp://www.blogger.com/profile/03159677289393309265noreply@blogger.com0