They start you off. First of all you do something like 5 minutes on perhaps an exercise bicycle but it’s set at quite a low resistance so that it’s just to get you warmed up. Then you probably do 5 minutes on a reclining bicycle at low resistance. And then you do a series of warm up exercises. After that then you go back to whatever machines they’ve chosen for you to do but at a much higher resistance and I’m now up to 10 minutes on each machine. And usually I get through 4 or 5 machines during the time I’m there and at the end of it then you also do a sort of 5 minute walking around just calming down and then another lot of their, we’ll say, wind down exercises but they are the same exercises you do like stretching and so on. So do that at the end. So overall it’s probably an hour and a half to an hour and a quarter that you are there although youre not obviously exercising the whole of that time. But it is probably 40/50/60 minutes of that hour and a quarter is actually exercise.

Do you remember much about the procedure [primary angioplasty]?

Oh I remember it completely yes.

Can you take me through that?

Yes. So other than the sort of being slightly uncomfortable because of the way my arm was, I remember them feeling and they talked to me about exactly what they were going to do all the way through. They sprayed my groin, and shaved it and obviously the spray was a local anaesthetic or something. And then they, I just felt a slightly sharp pain as they cut into the artery and then went up through that. And I was, could watch on the television, the same television screen that the surgeons oh sorry the cardiologists, were looking at and was watching this go through. I’d seen it on television as a process but slightly surreal watching somebody pushing something into your own heart on this. So it, and it was over quite quickly. So my main feeling was of slight discomfort rather than anything else and gratitude of course because the team was superb. And I was then taken out of the Cath lab and I had to wait in the corridor for five minutes I think it was on the trolley. And then was taken up to the Cardiac Care Unit and again superb. I mean the nursing staff were absolutely brilliant there.

As we got to the [Hospital name] they pulled up and as the doors opened a registrar got in, introduced himself to me and said, Do you mind if I ask you a few questions as we are making our way to the Cath lab?’ And so he was running alongside the trolley. At the time it seemed like it was only seconds but in fact their log which I had a copy of, they sent me a copy of their log, showed it was 3 minutes to get me from the ambulance to the Cath lab [catherisation laboratory]. We went into the Cath lab which is like a really 21st Century, almost 22nd Century lot of robotic equipment in there, massive amount of people. I think there were probably 8 people in there or something like that’ radiographers, surgeons and so on. I noticed this one guy who was already capped and gowned and he said, Oh Mr. [Name] you’ve had a heart attack, my name is Professor [Name] which filled me full of confidence at being dealt with by a professor and he said, We are going to go in through your groin and stent you. He said, There are three arteries which are suspect but only one of them is, you know, urgent. He said, So we are going to do that one which is the really urgent one and then you will have the option of either while you are here having them done or you could come back as an outpatient because they’re not urgent that we deal with the other two. They are mild in comparison.

So you had the angioplasty and the stent?

Yes

At the same time?

Yes, yes. So he went in and they blew up the artery with the balloon and then they put a stent in. The next thing, I mean it was slightly uncomfortable because I was still in my working clothes and they had sort of not even taken my shirt off. They’d sort of ripped open some of the button and I ended up being told, you know, Keep your hands away from there because this is a sterile area but it was amazing. I have nothing but praise for the team.

There was no time to do anything.

No [laugh]. But anyway with, and again their log shows that within fourteen minutes of entering the Cath lab I was out again with a stent fitted which is phenomenal.

Can you tell me what happens when you go there? How they assess you? What information they give you?

Right. I went. Well my wife drove me to [Town] and to the [Hospital name] and we had an appointment to see a cardiac nurse who went through the whole thing about what was appropriate. Then she took notes about my medication, everything like that and arranged for me then to go for the start of the programme. I think the following week I think I saw her, about a fortnight afterwards. And I went Week 3 after the heart attack and I went over again they, every time you go in they check your blood pressure and your pulse. And then the first time you go you are introduced to a physiotherapist, specialist physiotherapist who leads you through the sort of exercises and obviously starts you off at a fairly low level.

So you went and you saw the physiotherapist?

Yes and so the physiotherapist then took me around and showed me the machines and then put me on obviously a very low taxing exercise regime. And then after each sort of mini session on a particular machine she would come along and check blood pressure, sorry and pulse particularly interested in pulse. So she came along and checked each time how that was and gradually upped it until she felt comfortable it was something I could do which was, as I’d said earlier and, that was just on the edge of your comfort zone but not over taxing you.

And how often were you going to these sessions?

I went twice a week which was the most you could do but you do have the option of just going once a week if you wanted to.

So have you completed your 10 weeks or?

I complete it tomorrow.

Ok.

Yeah

And then do you have any plans to continue?

They have what they call the graduate programme. So when you finish that you graduate and they will offer you either a place there. Excuse me. They come, you go at different times to the normal programme but they do have supervision a cardiac nurse and physio there or they will offer you a reduced rate at a local gymnasium. I am hoping and I will talk to them tomorrow about it but it will be there. I prefer, it feels quite comfortable to be there and have those facilities on hand.

Now in retrospect my wife says she should have come in the ambulance and I can see that would have made sense. But that would have left my daughter to drive on her own over to the [Hospital name] which she doesn’t know the way or anything like that. So they drove there. When they got there they couldn’t remember what they’d been told by the ambulance crew to go to the Cath Lab so they couldn’t, neither of them under the stress could remember where they had been told to go. So they found their way up to the Cardiac Care Unit, knocked on the door of, I assume it was the sister in her office outside and said, Could they, could she tell them where I was. And she said she felt as though she had interrupted her in doing something. So sister went off, came back, was much more consolatory and said, Would you like to come into this room?’

Well of course they then feared the worst. So my daughter was in floods of tears and she [the sister] said, No it’s ok. He is in the lab, sorry, in the ward. You can go through and see him. But by not being there in the ambulance they missed out on that bit so some unnecessary anxiety was raised because they weren’t there. And I think that’s true all the way through the thing.

So I was immediately wheeled in there. I was then wired up to an ECG monitor which monitored not only the heart but the breathing and blood pressure as well. So I was connected by all these wires for quite a while. And if the things went out of range then an alarm would go off but I very quickly realised that some of these alarms were quite unnecessary, well I mean they were necessary in one sense but for example I normally breathe quite slowly but the alarms are set, I think it’s to 12 breaths a second and when I’m concentrating I probably reduce to something like 6 breaths a second. The moment I’m starting to think about something I stop breathing. I breathe in quite deeply but then it stops and the alarms would go off which at first I found slightly concerning but then I worked out what it was I realised I only had to breathe again to get out of the situation.

Clopidogrel the main impact of that is I bruise very, very easily and slight knocks, I’ve got some massive bruises on my arm which looks as though I have been assaulted by something. I threatened my wife that I’d say it was her but it can be just a gentle knock and because it’s stopping the clotting it just bleeds and so you get these huge bruises. If I go for a blood test I know that I’m going to have a massive bruise on my arm. And if I just nick myself shaving it takes a lot of stopping. it’s not like bleeding to death or anything but it, whereas normally it would have clotted up very quickly now I have to really press on it for quite a long time to stop it. So that’s been a slight disadvantage to that and it’s a slight worry because you think, if I’m in a car accident or something like that ambulance has got to be there a hell of a lot faster than it normally would to avoid me bleeding out.

Then they put me on clopidogrel which of course is a very, very powerful blood thinner, anticoagulant. They put me on to a ß-blocker and then they. What else did I have? Oh yeah I was on statins and sorry I was also on a olmesartan [olmesartan medoxomil] before any of this had happened to reduce blood pressure. So they kept me on the Olmesartan and, don’t think, there’s one other drug. I can’t think what it is offhand which they then said to me, You need to keep on this for the rest of your time here and you’ll have to be on the clopidogrel for a year at least because they don’t want the stent thrombosing. And so that’s and that has been a major problem because when I then got, just after I came out and I saw the urologists and the oncologists who wanted to operate on the prostate because it was 8 on the Gleason Scale which is pretty high up on the Gleason Scale. But they couldn’t operate because of the clopidogrel and hence the compromise was radiotherapy for that.

So I’m now going to have two months of radiotherapy every day or every weekday I should say. So that’s something coming up. But it’s amazing how one medication impacts everything else.

So the radiotherapy was decided by your consultant around your needs?

Yes, yeah.

As an option to surgery?

Yes. Because of the clopidrogel they can’t. You can’t possibly contemplate surgery because it’s too aggressive, the type that I’ve got, they can’t use the radioactive grains that they can use in some cases. And so it’s only a one choice, there is no choice. Its radiotherapy or just being held on Zoladex [goserelin] which is the sort of hormone implant that I’m on at the moment just to hold it because Zoladex turns off testosterone and because prostate cancer thrives on testosterone. So it’s
So that was the only alternative that would. But then to keep you on Zoladex for a long period of time actually brings a risk of, guess what, heart attack [laugh]. So yeah it’s all wound in with one another.

We took the dogs for a walk and coming back I started to feel a bit out of breath and I also felt slight pains, just on the side of my chest and started coughing a bit but thought no more about it. And especially two days after that I was talking to my sister on the telephone and she happened to mention she’d had this terrible cough which she couldn’t shake off. Described the symptoms and it sounded very similar to what I was going through so I assumed that’s what it was.

On the Monday, I spoke to her on the Sunday, on the Monday I went up to my study to go and do my 2011 self-employed tax assessment. Not that it was that stressful but it just struck me as ironic that it was then. And as I sat down at the desk I had pains, these pains came back in the side of my chest and I had sort of down the sides of my throat and to some extent like a pain in the forearm but not terribly intense. So I sat there thinking, It will pass off’ but already slightly suspicious then it might be heart. I then went downstairs to my wife who was sitting in the kitchen and I said, I think you’d better call NHS Direct because I’ve got these pains and see what they think.

So she phoned NHS Direct which looking back was a mistake because NHS Direct weren’t really geared up to deal with this sort of thing. Spoke to a lay person. Went all through the thing with her. She then said, I am going to get a nurse to talk to you. The nurse then went through it and said, It sounds like it might be heart. Where is your nearest hospital?’ so my wife told her and she said, Well you could drive him there. Which, of course, everybody else I spoke to after that said, That was the worst possible thing you could have done.

Or he said, We can get you an ambulance. So my wife elected to get an ambulance. We were phoned back I guess about 10 minutes, quarter of an hour later to say there was no ambulance available in the area but they had alerted HeliMed and they would be there fairly quickly but they’d got to come from [Town].

So it’s really weird because the symptoms weren’t that chronic for me. They were, they seemed quite ok but I did accept that it was a heart problem at that stage. They actually came into this room and sat in the armchair you are sitting in now and while I was there I saw a helicopter going around looking for somewhere to land and they had difficulty finding somewhere but they actually went up the hill the other side of the church into a farmer’s field. So they came chasing down and came in. They put an ECG on but the stickers that they had, you know, they said were new. They were one-use-only stickers and they didn’t work properly and they were complaining about how the old ones were much better. And while they were trying to do that they couldn’t get an output, not because I’d stopped, you know, heart beating but because they were just saying, This is really frustrating.

Anyway a few minutes later a land ambulance arrived. They came in with the old fashioned stickers and put it on and said, Yes it was definitely a heart attack. They then debated whether it was best to take me by air or by land ambulance. So they decided they’d decide that when they got me to the helicopter. So they drove the ambulance up the road to the helicopter. There was some discussion about whether to go. The pilot eventually said that he thought there was nothing in it in terms of time because they would have to take about 10 minutes to load me onto the ambulance this end and ten minutes to unload me the other end and it’s about a 40 minute drive to the hospital anyway. So li