Nick

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53 year old Nick from Halifax suffered a heart attack which made him aware just how serious the effects of smoking can be. This made him determined to quit.

Here Nick shares his smokefree journey with us.

What made you decide to join Yorkshire Smokefree?

The service was recommended to me by the Cardiac rehabilitation unit at Calderdale Royal Hospital.

Tell us about your experience of the health issue(s) that meant you needed our services.

(Nick has kindly shared with us his experience of the heart attack he suffered. Please find his story at the end of this blog post.)

How has this affected your life? 

Everything has changed. Everything. It’s now nearly two months later and I am not back at work yet. I want to be. In some ways I feel better than I have for years, I actually have a fully working heart and arteries and I feel full of energy and really healthy and happy, most of all happy. 

But this comes at a price. I have to take a list of medication as long as your arm every day. Two pills to thin my blood, one pill to control my heart beat, one pill to control my blood pressure, one pill to prevent cholesterol build up and an anti-depressant. I have to carry a Glyceryl Trinitrate spray everywhere in case of an Angina attack. I have to exercise every day. I have to regulate my diet and be very careful about what I eat and I have to stop smoking and stay stopped. Literally everything about my life has changed.

What has the reaction of the Yorkshire Smokefree team been to your situation?

I was introduced to the team by the Cardiac Rehabilitation team at the hospital shortly after my discharge. While I was in hospital I had got through the days by using some nicotine gum I had brought for a long distance flight. I knew I had to stop. I knew from previous attempts that I needed more help than just my will power as I cannot really afford to relapse. As I have had one heart attack I stand a good chance of having another, about a seventy five percent chance I think, smoking takes me from the category of “may” have a heart attack into the “will” have another and I really don’t want to die.

The team and the group has been welcoming and accepting and above all keen to help and ready to listen.

What have the Yorkshire Smokefree team done for you? How have they helped?

The team suggested that I could improve my chances by using patches as well as the gum that I used last time and written the scripts for me to be able to get them from my local chemists.  Above all they have been there for me to be able to talk about stopping. Even with the motivation that I have it isn’t easy and it’s brilliant to be able to talk to people who understand exactly how hard it can be. 

What were the most positive changes you made to your lifestyle?

I exercise. I eat healthily. I am a lot more positive in my outlook on life. It’s hard to separate out the improvements from the stents from the improvements of stopping smoking. But overall it’s little things like for the first time realising that the froth on a cappuccino actually tastes faintly of coffee. It’s not waking up with mouth like an ashtray and the breath to match. It’s being able to run for a bus and catch it. It’s being able to climb a flight of stairs with no muscle pain or shortness of breath. It’s seeing the sun come up in the morning and knowing that things could have been a hell of a lot worse than they are. 

What did you find most difficult? And how did you overcome it?

Every day to an extent has its little problem moments. If I’m honest the only cigarettes I actually enjoyed were the first and last ones of the day. I have altered my behaviour at these times by using the times that I would have had these cigarettes to take my medication and then crack on with the day. 

About a fortnight after I was discharged my elder brother’s sister in law was killed in a car crash. I felt obliged to attend her funeral and did so despite knowing that a lot of the people who would attend smoked. I coped by going to the church only and avoiding the wake. I was successful in going through the whole period without having a cigarette. 

What health benefits/improvements in your life have you had since stopping smoking?

Happier, healthier and ended the month with thirty quid in my account.

How has stopping smoking changed your life?

What it comes down to is I am still alive and I’m actively planning on staying that way.

Is there anything trust services could have done differently or better for you?

No the help I have been given is perfect for my needs. It helps that everyone seems to have been a smoker and knows exactly how hard giving up can be. It really helps that they aren’t judgemental about relapses. The last time I stopped I attended a clinic at my local G.P’s and admitting to having a cigarette left you feeling that they thought you had strangled a kitten.

Has anything in particular helped you through your problems? (eg attending a support group, exercise, volunteering, art, gardening etc) Can you tell us more about this?

I try to distract myself as much as possible when I get a craving I walk for a bit. I clean my teeth. I do something that takes a degree of concentration to take my mind off it. 

The patches and gum help a lot.  But if all else fails I remember sitting next to my wife in the early hours of the morning telling her that I didn’t want to die. I remember the pain that I put her through when at first she thought that somehow it might all be her fault and I remember that we had an argument once about my smoking and Rachel, asked me when I was planning on stopping smoking? I rather cruelly told her I’d stop after my first heart attack. I am a man of my word and I love her too much to let her down.

Is there anything that you feel particularly proud of, that you may not have been able to do before you received support from Trust services?

I went out with my wife about a month after I stopped. I spent the whole night with her instead of running away every thirty minutes to have a smoke. It’s a little thing but I am really proud of that. 

 

Nick’s Health Story  

If you had spoken to me on New Year’s Day 2016 and asked me if I was planning on stopping smoking this year I would probably have looked at you like you were slightly mad and edged quickly away.  I had smoked pretty much constantly since my early twenties and I enjoyed it. To an extent it defined how I saw myself as a person and after 33 years it was probably my longest lasting successful relationship with anything or anyone.

I did stop for a period of five years after the birth of our daughter, but it was a struggle, with many setbacks and relapses. In 2011 I was made redundant and I walked straight out of the office in Copley and down to Bolton Brow and the nearest shop. I brought a packet of cigarettes and a throw away lighter and it was a case of “hello again old friend” as I walked slowly back to the office.  

From there I puffed away like a mill chimney through the redundancy process, through being unemployed where as an economy measure I switched to rolling my own, through to getting a new job and afterwards.

I am a Software Test Analyst by trade. Like most I.T. jobs it is stressful with projects that are too big to be tested in the time you are given, and with Project Managers that seem to have got their qualifications of the back of a cornflakes packet.  It’s a pressure that I have always thrived on and through it all I smoked away, a running joke was that the only reason some of my colleagues hadn’t been murdered was because I never ran out of tobacco during the day.

Joking aside the five minutes break every hour or so was a really useful stress management tool, I was happy and I didn’t really intend to stop again despite the fact that several members of my family had asked me to.

In the run up to Christmas 2015 I caught a cold. In the great scheme of things it wasn’t a bad one, but we were in the middle of a fairly important project so I dosed up on Lemsip and cracked on.  The cold developed into a chest infection. The project was dragging on and so I took more Lemsip and ignored it and didn’t miss a day of work. By New Year, it seemed to have cleared and I wasn’t coughing anymore, I ached a bit but then I had been poorly. I expected to feel a bit under the weather. I carried on working and I carried on smoking.  

To get to work I travel by train to Morley railway station. The quickest way out of the station is up a flight of eighty four steps, not a pleasant way of starting the day but the only way of getting to my office on time, throughout January I complained that the steps were getting steeper every day, I got severe leg pains climbing the steps and while I never stopped on the steps to catch my breath, I sure as hell did when I got to the top and used that time to roll a cigarette. On the 20th of January as I reached the top of the steps I felt a pain in my chest it was sharp, stabbing and lasted about two seconds. I put it down to my lungs still being sore from the chest infection, I had my cigarette and kept walking. I had a job to get to.

Then, at about one o’clock in the morning on the 26th January 2016 shortly after getting to bed I felt a stabbing pain in my chest again. This time the pain got worse.  Much worse.

My first thought was that it was indigestion although I pretty much knew it wasn’t. I have had acid indigestion for years, the pain was similar but felt different.  Rather than waking my wife up, I got up. Walked down two flights of stairs and took an indigestion tablet and went back to bed again. 

The pain got worse and began to spread to my left shoulder. I couldn’t sleep through it and to be honest I was pretty sure by that time that something fairly serious was going on. So, I walked down the two flights of stairs and googled my symptoms while having a cigarette on the door step. I was really lucky in that the first result I clicked on was NHS Direct and it basically said that with the symptoms I had I should call an ambulance. 

I toyed with the idea of not calling. It seemed a bit severe. The pain while bad didn’t seem to me to be bad enough to warrant an ambulance?  In the end I decided that I had better do as the website suggested. I went back up the two flights of stairs to our bedroom and woke my wife with the following:

“I’m sorry for waking you. But I’ve got a pain in my chest and its spreading down my arm and google says call an ambulance.”

How she didn’t divorce me on the spot I don’t know. 

But she got up and held my hand while I called the ambulance. At this point the pain was so intense that the only way I could get any relief was to sit down and bend over so that my chest was pressed into my thighs, like the aircraft crash position. The pain got worse every time I breathed in, so I was breathing very quickly and shallowly and while she thought I was having a panic attack, she was seriously worried. While I was on the phone to the 999 operator I developed more symptoms I got hot and sweaty. I got nauseous and I felt dizzy. 

I sat still for as long as I could but at the same time felt I had to keep moving. It was a thoroughly strange experience. I went back up the stairs to the bedroom several times trying to find my slippers, the money I’d need to get a taxi home once the hospital told me I was a hypochondriac. I needed to use the toilet twice and finally at just before quarter to two I smoked my last cigarette while waiting for the ambulance to arrive. 

The ambulance came and I walked out to it. Still in pain but feeling like I was wasting everyone’s time. I went on my own to the hospital as there was no one to look after our daughter. I told Rachel, my wife, that I’d get a taxi home once A& E had finished with me. I got to the hospital where my blood pressure was taken and I was fitted with a shunt for drips. I had an ECG and a very long night started. 

Initially, it seemed like apart from really low blood pressure there was nothing wrong with me. A nurse told me that because I had presented with chest pains they were going to treat me for a heart attack anyway. I was given and aspirin and some codeine and eventually I went to sleep curled up under my coat on the trolley. I tried to text and call my wife, but she had gone to bed. I can’t say I blamed her, I knew there was something wrong but didn’t really for a minute think it was bad as it was. 

The following morning when I woke I was moved to a side room in a surgical assessment ward as the cardiac care unit had no beds. I told my wife, who was a bit surprised that I was still in hospital and she popped in with some clothes and toiletries so I could at least come home clean. 

The pain by this time had died down I just felt like I’d been kicked in the chest. The stabbing pain had gone and apart from feeling really worn out I didn’t actually feel that bad. I was waiting to be discharged and to be honest thinking I had wasted every ones time and really glad that I lived in a country where I didn’t have to pay for things like this.

I saw two doctors that morning, they had looked at my results and my ECG’s were normal and everything else was nearly normal. I did have an infection which they gave me antibiotics for and they advised me that there was a blood test that had to be done to rule out a heart attack and once that had come back clear I could go home and I would probably be discharged about three o’clock that afternoon.

Then about an hour later he came back and very apologetically told me that whatever my ECG said I had actually had a heart attack and I wouldn’t be going home.

I asked him if he was sure. (It feels odd looking back on it but the pain, while bad, wasn’t incredibly bad. A few months ago I had a bout of constipation and the pain from that was much worse.) The doctor told me he was sure and that I would be getting moved to the Angioplasty Ward for an Angiogram to be done to assess the damage to my heart. That’s a fairly chilling sentence, assess the damage.

For a little while everything went into a blur. I don’t really remember getting moved to the Angio ward. I remember there was a chest x-ray done but couldn’t tell you if that was before or after I was moved. I remember there was a Doppler scan done on my heart and for the first time saw my own heart beating and the valves opening and closing and realised that the valves actually have long frond like bits that look like seaweed when they move. It’s fascinating to see. A little morbid, but fascinating. But again I can’t tell you when it was done everything got a bit jumbled.

At some point I rang my wife and told her the bad news. I don’t ever want to have to do anything like that again.

There isn’t really an easy way to tell someone you love that sort of news. I pretty much just blurted it out. If you imagine, “hi Darling I’ve had a heart attack!”  Then you have the gist of it.

I rang my boss and told him. He asked me if I was joking. I said no.

Then I sat there for a bit and wondered how the hell this had happened. 

The Angiogram was one of the more unpleasant things I’ve had done in my life. It happens under a local anaesthetic and to get the wires into my artery they cut my wrist. Feeling your own blood leaking out leaking out and dripping off your arm is really, intensely, unpleasant. The wires get pushed up the artery until they reach your heart. You get told that there are no nerves inside so you won’t feel it but you do and it’s not a good feeling. Then to assess the damage, they release a dye into your heart. They warn you when it happens that you will get a hot flush and your skin will feel wet. What they don’t tell you is that as the dye spreads out through your body and it reaches your groin it feels exactly like you have just wet yourself. They could really do with telling people that. I spent the rest of the operation paranoid that I had wet myself and actually asked to stop and urinate twice to make sure that it didn’t happen.

The results were not good. The Circumflex artery on my heart had a reduced flow of blood and the Right Coronary Artery had none at all.

The Doctor told me that there was no damage to my heart valves which meant that the heart attack had not been triggered by a blood clot. That the furring of my arteries was not bad enough to have cut of the flow and that in his opinion the chest infection I had had had moved from my lungs and somehow attacked my heart. Smoking for over twenty years had not helped at all either but ignoring a simple cold had bloody nearly killed me.

Then I had stents fitted to open the Arteries. One to the Circumflex artery and two to the Right Coronary. The stents are a tube, they look a little like the mesh on a pot scourer only they are made out of titanium. The balloon and the stent are slipped in down the wire in your arm and if you think just having the wire in there was bad, having that little lot wedged in there feels like it has to be pushed in every step of the way and getting it to turn the corner at your shoulder genuinely hurts. 

Then the fun starts The balloon is inflated stopping the flow of blood through the artery, helpfully giving you an idea what an Angina attack feels like, while the stent is slipped into place.

When it was all done the artery is closed with a screw on clamp and you have to lie still for what feels like forever, but is actually only a couple of hours before they loosen it gradually and then finally take it off.  Imagine getting your hand stuck in a lift door for an hour or two? 

Then you get to go home and you think it’s all over and it isn’t. It’s just beginning.

 

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