My husband has waited 16 weeks for cardiac rehab after a severe heart attack and today he was assessed at our local hospital (Southmead Bristol) by the rehab team.
From the research I’ve done, according to Bristol City Councils website, cardiac rehab in Bristol should consist of 4 phases; phase 1-3 takes place at the Hospital under medical supervision and phase 4 which takes place at a community centre and is unsupervised. I’ve also checked the Southmead Hospital website which mentions an 8 week programme supervised by nurses (I’m presuming this is phase 1-3). According to the website these sessions offer people a chance to meet others who have been through a similar experience, advice and practical support to help deal with the psychological and social effects of your cardiac event and practical advice about returning to work.
My husband has not returned to work yet, the heart attack has left him feeling depressed and because of his young age (40) he does not know many other people who have been through this.
He would definitely benefit from these phase 1-3 sessions but it seems my husband has been put straight to phase 4 and will be given a programme to do at home unsupervised.
I’m concerned that he’s not been given the correct programme because of his age and to get rid of him off the waiting list. Although my husband is young he has been left very unfit after his heart attack, has severe heart failure, an ejection fraction of 14% and very low blood pressure. Prior to his heart attack he has never exercised with weights and he was told he’d be given dumbbell exercises to do at home. How is he supposed to know whether he’s pushing himself too far if he’s not supervised?
I don’t trust the hospitals decision at all after several bad experiences with them prior to his heart attack and since. I’d love to hear everyone else’s experience of cardiac rehab and especially if they’re in the Bristol area!
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irishwife93
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Thanks so much for your reply Hidden , I will call the cardiac rehab team tomorrow and quote the NICE guidelines. If that doesn’t get me anywhere I’ll put in a complaint, too add to the three others I’ve put in over the past few months! Feels like a constant battle to get proper care, and unnecessary stress to be going through
I’m so sorry to hear about your experience, it sounds completely insufficient and like a tick box exercise from the Hospitals perspective. It’s very disappointing after having survived a cardio event or being diagnosed with a condition to know you aren’t been given the chance to recover properly and achieve the best outcome. To give you some reassurance we’ve been told my multiple cardiologists and nurses that walking is the best exercise possible so the fact you are walking 5km a day is excellent. The other piece of info we were given lately which might be useful to you is the heart rate you should be aiming for while exercising is about 70% of your maximum heart rate, which is 220-your age. I think the BHF have a calculator on their website! Your plan to find a private trainer to help your rehabilitation sounds like a good one, it’s a pity you have to pay out of your own pocket but it will be worth it for the long term health benefits!
Hi I understand how he feels about being young I’m older at 55 but I’ve just had a quadruple heart bypass most people don’t start having them till around 65. I still don’t understand why I don’t smoke, drink I’m a vegetarian and a I’m really fit none of it makes sense. So many people on here will say the same the physical side will heal but my mental side is going to take a lot longer, try and get him to go against his pride and speak to the GP about seeing a councillor. I have never had any mental health problems but I have now and the councillor and meds are helping. I went to action heart last week to have a look as I start in mid September, everyone there had 10 to 20 years on me. I went for a walk in the park after and there were two people getting out of a car both were around 25 stone, and you just look at them thinking Heart attack waiting to happen. It will always go through his head why me and why so young. Like me and all the others on here he has to think we are alive, he just needs the support now like your giving him, my wife and family have been great every time I’ve burst in to tears they have been there and that’s a lot of times a councillor will help.
Hi JakoI totally feel for you. I am 64, so older, and have been diagnosed with severe heart disease and, very luckily, recently been stented. Always exercised in some form, never smoked, vegetarian and only drink socially/in moderation. Apparently my condition is hereditary. Mum had her triple bypass at just 52. However she was a fairly heavy smoker and though she worked extremely hard, she never exercised as such. She never stopped smoking after the bypass and went on to live a long life with her bypass causing no problem at all. Things have improved so much since then as well. To say I was shell shocked is an understatement. My procedure was only on 9th August and I feel amazing already. I feel so much gratitude I’m going to just accept I am lucky to have been treated, follow a healthy diet and exercise regime and do some f und raising. My Niece was also fitted with a pacemaker at 19, which had to be replaced at 23 as a lead had fallen out. The broken lead had to be left in situ. That was shocking. She is 42 now and enjoys life to the full. It is difficult Jako but I hope you can find the strength to accept how very lucky we all are and move on/enjoy your life to the full. I fully intend to make the most of every day ❤️
Hi. I really feel for you and your husband going through this. If you feel that he has been put on the wrong programme I would urge him to ask them to reconsider. I’m learning very quickly that if you don’t speak up you can be overlooked. I’ve just finished cardiac rehab. I enjoyed it and found it beneficial. It lasted about 8 weeks and involved 1.5 hours workout followed by a 20 minute talk each week. You were told to follow the BHF exercises at home too. The home work outs are on the BHF website. There wasn’t much opportunity to talk to other participants really as the 20 minute talk was more about the physios doing a presentation. To be honest they didn’t tell us stuff that we didn’t already know. I would have welcomed the opportunity to speak more with the other participants but it was a case that as soon as the session ended we were sent on our way. What it did, however, was give me a kick start to getting fit again and the confidence to do it safely. I don’t know how you could achieve this virtually. In the area where i live the rehab team provided details of fitness instructors who work in council run gyms who do personalised fitness programmes for cardiac patients for free. Perhaps contact the physios at your hospital and ask if they have any links within the local authority gyms. I wish you luck and hope you get the support you need. X
Thank you Anon2023 your experience at the face to face cardiac rehab shows it is worthwhile! I’m worried from a safety perspective too as my husband has a very low EF and is waiting to have an ICD fitted. Surely he shouldn’t do weighted exercises by himself without being supervised or even having an exercise stress test done first. The attempts to reduce waiting lists is putting patient safety at risk!
My rehab was all done on line due to Covid restrictions and it was very good.Before it started I had a long telephone interview with the physiotherapist, she then sent me a pulse/oximeter and we had another chat I had to take various measurements of my pulse, from these readings she set me targets for my heart rate when exercising.
I then began doing the online classes, basically following a video....I thought it would be naff, it wasn't it was very good.
I had to fill in a daily exercise diary and once a week the physio phoned me and we chatted through the weeks activities, I have to say she was excellent.
The whole process lasted about 8 weeks and it was brilliant, it really boosted my confidence and helped in giving me my life back.
At the end of the program she did offer me more support in a gymnasium setting, she actually admitted that due to all the other things I'd started doing during the 8 weeks I didn't need it, I declined the offer.
9 months on I feel fitter than I've felt in years.
Cardiac rehab here was ALL home based telephone calls last year after severe attack. The mental side is more difficult than the physical and it takes forever and myself its now my life and talk about it every day. Would be so good if I had better support from the start. I hope you get it but in my experience hospitals apologise but do not do anything about it. Its not the nurses or doctors at fault. It's those that do the managing and of course the government.
If there is a will , there is a way. Sadly with this zombie government we have a lot of windbagging but they have a embedded NHS destruction policy. They had 12 years to solve care crisis but it just gets worse and very expensive for those that pay for it. etc etc etc ..
What you have been offered is terrible and I would definitely challenge. I used to do a Stage 4 class at my local gym before the pandemic. We were closely supervised with blood pressure taken before and after the session. I should be wary as well of using the BHF videos. A big warning comes up at the start advising you that they are only to be used if you've been assessed by a health care professional.
The stage 4 class my husband is being offered won’t even be in person - he will see them once and they’ll give him some exercises to do at home! If he was with other people being supervised I’d feel more at ease and there’s a social aspect too which I’m sure is beneficial
good morning to you all. this is my fist post since joining as i usually just like to read all the supportive comments and messages, but i felt i had to respond to this post as i too fall within the Bristol area.I had a cabg 8 weeks ago in Bristol after suffering a heart attack the week before. i was sent home 7 weeks ago with no idea what the next step involved.
i am due a telephone call this week as my follow up appointment with my surgeon, after being told no face to face appointment was needed. also i have received a letter advising that the local hospital ( weston super mare) which runs the cardiac rehab will not be running. so i have nothing to tell me how much i should be doing or trying to do. i have been in contact with the BHF but they tell me i need to be assessed and monitored.
i don't want to sound negative i just wanted to let you know of my experience so far.
i hope you manage to get the support for your husband x
Thank you for getting in contact about your experience in Bristol. The excuse from the Hospital that Weston isn’t running a class is pathetic. You should be offered an alternative slot at Southmead or the BRI instead. If that fails then there are apparently classes all around Bristol which I’ve found on the city council website;
As others have mentioned in this forum, cardiac rehab is so important and you deserve to be offered adequate rehabilitation. Southmead should at least assess your exercise tolerance, to determine a safe level for you to exercise at, especially if you are expected to do this yourself. Have they given you so much as a booklet? I would advise contacting PALS at the hospital about your care, raise your concerns officially. The department will have to provide a response within a week to any concern raised. If the response is not satisfactory I would raise an official complaint about not being offered cardiac rehab.
In York we have a wonderful voluntary coronary care support group which has strong links to the hospital but is independent. They organise a number of weekly exercise classes under the watchful eyes of a professional instructor plus an attendant nurse. Not only is this physically good for us but we get the chance to chat with other “hearties”. These sessions are fun and provide a great support.
Is there anywhere in your area doing something similar?
Hi Clare. Sorry for what your husband is going through. I can relate and understand across a couple of points - I suffered a HA a year ago today and had just turned 42. I was completely unaware of what was happening til I was eventually advised by the ambulance service to go to A&E and my life was turned upside down. Had 99% blockage and 2 stents. I was discharged with some information from a rehab nurse and told the rehab team would contact me. I also required an echo cardio gram. Nothing happened for a couple of months until I did have a rehab assessment and put on the rehab programme. My only intervening contact was my gp to discuss meds as the bisporolol was too strong for me. Rehab was 6 weeks twice a week and it was great - getting a structure, giving me confidence. Not sure about stages - I did the course and I was on my own, which was fine. I also had 5 months off work which helped. I understand your concern with his age - there was nobody remotely my age to talk to abs I felt incredibly alone until I started searching and using forums like this and through Facebook. There are loads of young people in a similar position and we are definitely not alone. It all massively helped. Rehab is different based on where you live - demand, staff capacity etc. I have the added benefit of working in the NHS in terms of understand the pressures (I had or sought no preferential treatment) and he will get seen eventually. It’s all about making the most of the opportunity available unfortunately as we are all statistics. Good luck and please contact me if you want to talk more. I’m lucky and still recovering well now I’m getting over mentally what happened. Physically I’m now as fit as a teenager. It does get easier. Take care. Chris
I had a STEMI in august 2020. The hospital did a good job doing an angioplasty etc.
Subsequently there was NO real follow up. No face to face cardio rehab, and only a phone call from a cardio nurse which pointed me at online rehab.
Like your husband, I was in a pretty bad state mentally, and it has taken until now and several sessions of rehab which I have paid for (£30 a session) to get me remotely fit and mentally OK ish.
In my case we were in the middle of Covid, , but now I can't see any reason for lack of rehab. I would talk to PALS
Hello Just to say I am in a totally different age group (75) but I did start in 1982 with a HA. I had bypass surgery in 2015 further stents in 2018 and again in April of this year 2022 further stenting. So that is a potted history. Last week 4 months after latest stents I did a Functional Capacity Test under the Supervision of a Cardiac Rehab Nurse along with two BACPR qualified Instructors. The test was about 20 minutes of Step up Step down to a Prescribed Beat, O2 and HR was measured and Blood Pressure taken. On completion the Rehab Nurse said your fine to start the course which I do start tomorrow !!! This is carried out in a Local Leisure Centre with the Cardiac Nurse and BACPR instructors present. I have also been given a booklet to fill in over 12 weeks. The booklet also shows warm up and cool down exercises and an important scale called BORG - rating of Perceived Exertion 6 -20
6 No Exertion
9Very Light
11 Light
13 Somewhat Hard
15 Hard
17Very Hard
19Extremely Hard
20 Maximal Exertion
I managed to reach 13 which is a little short of Breath but can still Communicate OK.
WHY oh WHY can every Trust not offer such a structured programe I just don't know.
My EF is not to bad at 39 % one thing that surprised me was I could get up to the HR for my age etc even though I did have a 7.5mg Bisoprolol 2 hours before the start of the test.
I would get to speak to whoever is in overall charge of rehab and demand a re-assessment by someone else. After my HA I was simply told I wouldn't get rehab because I'm in a wheelchair- all the more reason for needing it. That decision was made instantly by the nurse i happened to see. I desperately wanted the supervision to boost my confidence. I discovered a year later from the head of dept that I could have asked to see a different nurse who didn't just assume I wouldn't have been capable. Level 4 for your husband is totally unsuitable. When , over the past 2 years it was impossible to hold exercise sessions they were done online but there's no reason for that now.
Hi everyone, thanks so much for your advice and really useful input! I would be lost without this forum. I contacted the cardiac rehab department in Southmead today and one of the specialists called me back very promptly. Apparently because of the pandemic and massive waiting lists the service at Southmead has been reduced to what they consider to be phase 3, which is all delivered at home due to staff shortages. It’s disappointing but there’s nothing that can be done about it, aside from the government sorting the NHS out. The specialist I spoke to did say we could call the rehab department any time to ask for advice even after discharge and that they will refer to phase 4 after my husband has completed phase 3 if he wishes. He also encouraged us to get into contact with the department after his ICD is fitted so they can adjusting the exercises. At this stage it will just have to do, a lot of people have had much worse experiences and it does seem to be a postcode lottery unfortunately. We will make the best of it!
A good private pysiotherapist should know all about the exercises your husband needs. Some of them work/ or have worked for the NHS.I know this is money to be spent in difficult times so forgive me if I sound intrusive.
Thank you for your comments. i have to be honest and say i hadn't heard of NICE. i have clicked on the link which you very helpfully added and it looks quite involved. i hear your point of complaining but its hard to do that when i don't really know what level of aftercare i should expect to receive. i have never been in this kind of situation before and i went from having a HA, being admitted to hospital and then surgery all within a week. i have been given no booklets and no information, only guidance from the BHF website, so ive just sort of tried to get on with it and hope for the best x
I've read some of the replies and would concur! They didn't want to give me rehab so I made a song and dance about it( I was like Violet Elizabeth Bott...I thcreamed and thcreamed until I was sick!) Not really but not far off! Rehab on your own sounds as if it would be worse than useless...you need to see people,talk to people,have a reason for going to the place,be able to ask questions,swap stories etc etc.I have just finished my eight week course and it was hugely beneficial in all those ways!Enlist his doctor's help..and don't stop mithering them!It will help his frame of mind and the turmoil we allexperience after this has happened to us!
Clare, with an EF that low he should be considered by his consultants for max meds and possibly a CRT-D or ICD to get his EF up before contemplating any unsupervised gym based exercise. After a major HA and 5 stents in 2012 I did stages 1-3 in 2013 at the local hospital including advice on diet, medication and limited physical work. Locally we have a Community group with suitably trained staff and patrons from the local cardiac team. I still attend for heart failure long term condition.
He’s waiting to have an ICD fitted, his ejection fraction was 35% when he first had his heart attack but it’s dropped massively during his recovery! His heart failure nurse is trying to gradually increase his medications but she is concerned about his blood pressure. It has always been low and he has tolerated all the adjustments to his medication so far but she’s reluctant to increase his Ramipril dose any faster and will only move him onto Entresto once he can tolerate max dose of Ramipril. Knowing his ejection fraction has dropped over 50% while we wait around to get on the proper meds is incredibly frustrating and quite scary. Our cardiologist did explain that as his heart attack was so severe the medications may not be sufficient to compensate. I might contact his cardiologist and ask his opinion on the exercise programme to see whether it’s safe!
hi, there is a group on face book called under 55 survivors group if you put a search and join, very insightful and lots of people similar age, it was actually someone in this group who told my about the group when I had my HA last year and I've been a member ever since. the group has members from all over the world they provide great advice and support, just like this community, hope this helps, wishing your husband all the best in his journey, and you take care to it can be hard on partners to ❤️🩹
Aw thank you jeelpie that is really thoughtful, I will search for that group! I will try and encourage my husband to join but he is quite shy - hence why I’m on this forum asking all the questions and not him 🤣 It would hugely benefit him to speak to others who are going through the same thing at a young age! I hope you are making a good recovery from your HA xx
hey, thank you my HA was September last year, I also had 2 cardiac arrests! but I tonight I'm sitting here with my gym clothes on after going to my body attack class! I never thought it would have been possible but I'm proof that it is! I hope you can encourage your husband to join the under 55 survivors page, he doesn't need to post anything or reply to anyone he can just read other people's posts but I bet you he will soon be conversing with other people who can totally relate to how he's feeling, keep me posted, I know the early days are very scary but it does get better promise x
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