Cardiac Rehabilitation Programme

Support Group

The Cardiac Rehabilitation Programme is offered to people who have suffered a heart attack.  The information was provided on discharge from hospital, and I encouraged my dad to attend.  My dad was very apprehensive about attending this, but I assured him it would be useful to his recovery, and it would give him the chance to speak with others who had gone through the same thing.

My dad received details of the programme through the post within a week of discharge from hospital, with an appointment for his attendance at the local town hall.  We didn’t know what to expect, but when we arrived we were greeted by one of the cardiac nurses who discussed the programme with us, and proceeded to assess my dad’s condition, history, personal, and medical details.  This meeting lasted about an hour, and included procedures such as blood pressure check, heart rate, weight and height.

After the assessment were given an appointment to attend the programme starting the following week.

At the first session we were made welcome, and it soon became clear that this was a very active programme, with people of all ages, all of whom had suffered either a heart attack or had heart problems.  The sessions last 2 hours and consist of a number of exercises all done under strict monitoring, and a group therapy session.

When I collected my dad after the session, it was clear that he had found the first session a little tiring, but he was cheerful, and more talkative than I had seen him since his heart attack.  I was pleased to hear about the walking exercise he had completed, as well as a session on the exercise bike.

My dad was very tired, and didn’t do much for the rest of the day, but he understood that this was part of his rehabilitation and that it would take time for him to build up his strength.

He started to looking forward to each Friday session, and each week I could see he was getting stronger, the cardiac nurses commented on his progress and were pleased with how much he was attempting on the sessions with their support.

I was concerned that my dad had been losing weight, nearly a stone since his heart attack.  I didn’t know if this was due to the medication, as he had no taste, and no appetite.  This was a concern, and the cardiac nurses always made sure they weighed him, and kept me updated on his weight each week.  They also advised me how to introduce different foods, little and often throughout the day instead of the usual 3 meals a day.

I would strongly recommend this programme to anyone who has suffered a heart attack, or heart problems, as without this programme I don’t think my dad would have had the confidence to do any of these exercises, or the knowledge to know how much he was able to do safely.

The cardiac nurses are amazing, they reassure, encourage, and provide so much useful information on recovery and sustaining health after a heart attack.

This programme provides a safe and monitored environment, with experts on hand to encourage you at each session.

Details of the programme can be found on the British Heart Foundation Website:

https://www.bhf.org.uk/heart-health/living-with-a-heart-condition/cardiac-rehabilitation

I welcome any feedback, comments or questions on the form provided:

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Home to Reality

Discharged from Hospital:

was lovely to be able to bring my dad home from hospital,  he was very frail, and a little shell shocked by what he had been through, but he was home. . .

I had asked my dad if he wanted to come and live with me for a while, but he said no, he wanted to go home and sleep in his own bed, home was where he felt comfortable and still in control, and I respected his decision on this.

The reality of how things had changed was becoming very clear, and I was left wondering just how much this had taken it toll on my dad.  He was having episodes of confusion, and slight lapses in memory, i was aware he had been through a lot in a short space of time, but the changes in him was worrying for me as I had never seen my dad so vulnerable like this before.  I knew I couldn’t leave him to deal with any of this alone, therefore I made the decision to move into his home with him until he was fully recovered.

I had lots of unanswered questions at this point in time. . .

  • Would he fully recover?
  • Was he at risk of another heart attack?
  • Would I be able to support his recovery?
  • What help was available?
  • Was dad eligible for care and support?
  • Who could I speak to?
  • Where do I start?

I had no answers, but what I did know was that I was now his first point of care and support, which was worrying for me in the first instance, especially when I unwrapped the package that contained all of his medication, which I would need to administer throughout the day

I could see my dad was overwhelmed by the whole situation, but I assured him I was there to sort everything out, and that he didn’t need to worry.

The first thing I needed to purchase was tablet boxes. . .

My next posts will discuss the rehabilitation, and the first steps in dad’s progress. .

Medication

Medication is prescribed for a reason, is this true?

What if some of that medication is counter productive, due to a patients other conditions?  Such as COPD. . . .

Should the patient or carer be the one to question this?

Is it the Doctors responsibility to consider other long-standing conditions, and explain to the patient about possible side-effects they should be aware of?

Is it the pharmacist that should make the patient aware of the medication that may have adverse effects on current long-standing conditions?

The following list shows the medication that has been prescribed for my Dad prior to his discharge from hospital.  This was presented to us by the nurse on the ward, we discussed the medication in detail, when to take it, and how to take it (some with or after food, aspirin dissolved in water)

It was a lot to take in. . . We left the hospital armed with a bag full of medication.

List of Medication:

Atorvastatin

Atorvastatin is used to treat high cholesterol, and to lower the risk of stroke, heart attack, or other heart complications in people with type 2 diabetes, coronary heart disease, or other risk factors.

Ticagrelor

Ticagrelor is used to reduces the risk of stroke, heart attack, or death in certain patients who have had a heart attack or who have angina (chest pain) It should be used along with Aspirin as directed by a Doctor.

I had read that some medical conditions may interact with ticagrelor. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

If you have lung or breathing problems (eg, asthma, chronic obstructive pulmonary disease [COPD]) – The reason I questioned this!

Clopidogrel – This replaced the Ticagrelor after I raised concerns with my Dads GP on it’s use with patients who had COPD.  I was concerned that my dads COPD had not been discussed prior to this medication being prescribed.

Ramipril

Ramipril is used to treat high blood pressure (hypertension) or congestive heart failure, and to improve survival after a heart attack.

Aspirin

Aspirin is used to treat pain, and reduce fever and inflammation, it is also used to treat or prevent heart attacks, strokes, and chest pain (Angina).  Aspirin should be used for cardiovascular conditions only under the supervision of a Doctor.

Previous Medication:

Prior to my dad suffering a heart attack, he was taking the following medication for COPD (and continues to do so, along with the medication listed above)

Microgram Inhaler                                                                                                    (Tiotrpium Bromide) – A small blue tablet is inserted into the inhaler which contains Microgram inhalation powder.

Tiotropium is indicated as a maintenance bronchodilator treatment to relieve symptoms of patients with chronic obstructive pulmonary disease (COPD).

Tiotropium should be used with caution in patients with recent myocardial infarction – Something else I questioned with my dads GP!

Ventolin Inhaler  – To be used as and when required

Fultium (Vitamin D) – Prescribed due to vitamin D deficiency – This was resulting in Dad having difficulties with shaky legs, and not being able to stand for long periods of time, he had been taken this for over a year.

Prochlorperazine Maleate ( Stemetil)

Angiogram

Angiogram:

An angiogram is a type of X-ray used to examine blood vessels, the procedure involves an intravenous (IV) line which is inserted through a vein in the arm (or in my dads case his hand) this is guided through the vessels/arteries to identify the damage, during the procedure the possibility of applying a stent would be considered as an option of treatment.

The angiogram was successfully performed and I was asked to meet with the consultant to discuss the results.  A time was agreed for myself and my Dad to meet with the consultant, this was a worrying time as nothing had been discussed with my dad after the angiogram therefore the delay in information being provided had again caused some stress and uncertainty.

The consultant was very clear regarding the finding, and explained why a stent had not been performed at this point.  Fortunately the righ ventrical showed no damage, unfortunately the left side showed multiple valve damage therefore, the possibility of applying a stent was not an option at this point.

The consultant then discussed the possible option of a triple bypass procedure, but due to my dads age this was considered a high risk, therefore the decision was made to treat my dad with medication.  Dad was discharged home that day.

In my next post I will explain the medication that was prescribed, and the information we received prior to my dads discharge from hospital.