A club you don't want to join

It was at 5.30 on a sunny July morning in 2008 that I finally admitted to myself that the chest pain that had kept me awake all night, was not indigestion. In truth, as someone with first aid training, I probably knew all along that something was wrong, but was too scared to admit it, even to myself. Normally, a pain of that level would not have kept me awake, however, and I sensed that my body was fighting something.

I wakened my wife and half an hour later I was wired up in a bed at Edinburgh Royal Infirmary. There, they confirmed that I had almost certainly had a heart attack, my first day’s illness in at least 20 years.

There followed lots of injections, pills and tests, then, the following day, an angiogram. This was a completely painless (with local anaesthetic), but very weird procedure, a tube being passed along an artery from my wrist to the heart, where a dye was inserted to enable the surgeon to see any arterial blockages. I was able to watch the whole procedure on the big screen! Thankfully, in my case, it was not deemed necessary to insert a stent or carry out a bypass, as, with drugs and certain lifestyle changes, my condition could be managed.

I had a heart-to-heart (no pun intended) talk with a nurse about my lifestyle and discovered that, whilst I thought I had been doing not too badly, I had slipped out of good habits and into bad ones, inadvertently and gradually over a period of years. I was working too long hours, which affected eating patterns; I was overweight and, due to not getting the lifestyle balance right, was taking far too little exercise.

I had, for example, only played three rounds of golf the previous year (although the subscription probably still seemed good value if calculated on a “per shot” basis!). I had just ended three years’ intensive involvement in rugby administration and had been sorting out work commitments in order to start a four-week “sabbatical”. The unsurprising net result of all of this was a heart attack. I remained in hospital for three days and returned to work after five weeks’ absence, starting part-time and, over a period of three months, extending to normal hours.

Six weeks after the event, I accepted the invitation to join the Lothian NHS Cardiac Rehabilitation Unit. This was without doubt the best decision I made during this whole episode, apart, of course, from going to hospital in the first place. I started classes twice a week at the Thistle Foundation gym in Craigmillar, joining about 10 others in similar circumstances. We were a motley crew, aged from our 30s to our 80s, from all walks of life, but we shared the same problem. We did not know how much our cardiac events might have debilitated us in the long term. We were in unknown territory and, I am sure, all a little afraid.

The rehab classes are run in various locations by specially trained nurses and physiotherapists – absolutely fantastic people, offering constant encouragement and advice, always with a smile. A lengthy warm-up leads on to two laps of circuit training, specifically designed to improve cardio-vascular fitness. This is followed by a relaxation session and, once a week, a short discussion and the setting of individual goals – all with the aim of returning us to full fitness and, crucially, to let us see what we can do, rather than having us wondering and fearing the worst. The circuits are graded so that, as the weeks go by, you can push yourself that little bit more. You are tested at the beginning and end of the 10-week course, to measure improvement, always under the watchful eye of a nurse and physiotherapist.

I was sorry in a way to leave. I had got to know my classmates pretty well and we were all invited to the Unit’s Christmas party at Astley Ainslie Hospital – no drink of course, but healthy foodstuff presents from Santa!

The key outcome for me was that the course restored my confidence. I realised that a heart attack was not the end of the world, but a harsh reality check, which made me take stock and make the necessary lifestyle adjustments. I am enormously grateful to the staff – more than 1,000 people attended the courses in the Lothian NHS area in 2008 alone.

One year on, where am I? Well, I have, surprisingly easily, lost two stones in weight, from a combination of better eating and more regular exercise. Where practicable, I walk instead of mindlessly jumping into the car, only use the lift in my office when carrying hot drinks – my room is on the third floor – and I attend the gym at Boroughmuir Rugby Club, something I would previously have regarded as unthinkable. I hardly ever eat cakes or sweets now, but have learned from the classes that you do not need to live the life of a hermit. There is nothing wrong with the occasional good meal out, and you need not lead a life of abstinence from drink, so long as you don’t lapse into any previous bad habits. I am back in the routine of a full (but not foolish) working day and, thanks to the tremendous support of my partners, colleagues and family, have been able to get back to normal at my own pace.

Then there are the pills! I doubt if I had had 50 pills in total in my first 57 years. Now I am on that number every week and the greatest challenge I have is remembering my repeat prescriptions.

What lessons have I learned and what advice would I pass on? Basically, if you are male, Scottish, over 50, overweight and involved in a profession as demanding as ours, you are a sitting duck. So, when you receive a letter from your GP suggesting you have your blood pressure and cholesterol checked, just get it done. I ignored the letter and see where it got me! Completely unbeknown to me, I was an accident waiting to happen. Thankfully, it turned out to be a minor accident in my case. I was extremely lucky.

George Clark is a partner at Morton Fraser LLPL