Caring for someone with a heart condition If you live with, or are caring for, someone who has a heart condition, this booklet is for you. It may also be useful for other members of your family and for friends.
It looks at:
• what it means to be a carer
• what has happened to your partner
• what you may need to know for the future
• how to help your partner develop a healthy lifestyle and prevent further heart problems
• financial help for carers, and carers’ assessments
• the emotional aspects of caring for someone and the effect this can have on relationships
• how to deal with stress and anxiety
• heart support groups, and
• who to contact if you need more information or support.
This could mean the person you live with, your mother, father, other relative or a friend. The advice is the same whatever your relationship to the patient. You may have picked this booklet up during your partner’s emergency admission to hospital with a possible heart problem. Or you may be reading it at a calmer moment, perhaps during or after a hospital visit for routine heart tests. Whenever you are reading it, and whatever the circumstances,we hope it will help you to cope with your current situation and to plan for the future. These notes may be useful in reminding you of what questions you want to ask when you talk to the heart specialist (cardiologist), doctors or nurses, or other members of the care team.
This site is not a substitute for any advice that members of the medical team may give you, but it should help you to understand what you may have been told already. At the end of some sentences there are small numbers like this one.
Caring for someone with a heart condition
Are you a carer ?
If you look after a partner who, because of illness, disability or age, cannot manage without help, you are a carer. Some people who have a heart condition may depend on another person. Hopefully your partner will get his or her independence back soon and your role as a carer will be temporary. But, even so, you are a carer. There are an estimated six million people caring for a relative or friend with some form of illness or disability in the UK.
When someone has a problem with their heart, life can often feel scary, confusing and insecure for a time. This can be the case whether you are the patient, or the person caring for them. It can feel especially uncomfortable in the beginning,when you may have more questions than answers. Caring for your partner can be very satisfying for you both, but the road can often be bumpy for a time ,with lots of twists and turns. Being diagnosed with a heart condition, and being the carer of someone with a heart condition, can feel like being in a strange place without a signpost or map. We hope the information in this booklet will point you in the right direction.
What has happened to your partner ?
There are many different heart conditions. You may be reading this site because your partner has had a heart attack, or has been diagnosed with angina. These are both forms of ‘coronary heart disease’. Or your partner may have a different heart condition.
Angina and heart attacks Coronary heart disease is the result of a process that may have been going on for many years. It happens when the walls of the coronary arteries (the vessels that supply blood to the heart muscle) have become narrowed by a gradual build-up of fatty material. This process is called atherosclerosis, and the fatty material is called atheroma. ‘Atheroma’ comes from the Greek word for ‘porridge’. Over time, the artery may become so narrow that it cannot deliver enough oxygen-containing blood to the heart muscle. The pain or discomfort that happens as a result is called angina. The heaviness or tightness is caused by the heart muscle becoming short of oxygen.
If the artery is suddenly blocked for more than a few minutes, the muscle cells in the area of the heart supplied by that artery may become permanently damaged. This is called a heart attack. Caring for someone with a heart condition.
Other heart conditions and illnesses
Your partner may have a different heart condition such as heart failure, valvular heart disease or congenital heart disease. Some people have more than one medical condition. For example, conditions such as high blood pressure or diabetes are also linked to coronary heart disease.
Whatever type of heart condition your partner has, you will both want to find out as much as you can from the doctor or cardiologist. The more information you have, the easier it will be for you to help your partner. When someone is admitted to hospital with a suspected heart attack, different members of the medical and nursing team have to do lots of things very quickly.
They will:
• take blood tests
• check blood pressure and pulse
• check the electrical activity of the heart with an electrocardiogram (ECG), and
• possibly give drugs and arrange other tests.
This whirlwind of activity can be very frightening for relatives, even if the patient may feel relief. At this initial stage of testing and diagnosis, the main focus of attention has to be on the patient. As a relative or friend you may feel excluded from what is going on, even though this is not deliberate. Sometimes you may need to wait a while before you get clear answers, as the hospital staff may have to carry out various tests and monitoring to find out what is wrong with your partner. Once your partner is a bit more stable, you will hopefully have more of a chance to ask questions and get some answers about their condition. Future tests, treatment and care - what to expect
Tests
A doctor may decide to arrange further tests to find out more about your partner’s heart condition. Some of these are quite routine, and are important to assess the condition of the heart. If you or your partner do not understand something about a test - why it is being done, what will happen during the test itself or the implications of the result - ask for an explanation in words that you understand. The more you both know about the test, the less anxious and concerned you are likely to be. Some people find it useful to write their questions down beforehand, and also to write down the answers. This means you can go back to your notes later on, which helps to make things clearer. Some of the more common tests and procedures include the following.
• A blood test that can show if there has been damage to the heart muscle.
• A blood test to check cholesterol levels.
• An exercise ECG (electrocardiogram). In this test, the doctor can check to see how the heart reacts to physical activity by looking at any changes on the ECG while the person is exercising on a treadmill (a running machine) or on an exercise bike.
• 24-hour ECG readings, also called Holter monitoring. This involves continuously recording an ECG (electrocardiogram) over 24 hours, using a portable recorder, similar in size to a personal stereo,which the person wears on a belt round their waist. This is to test for abnormal heart rhythms.
• An echocardiogram. A probe is placed on the chest and relays a picture of the heart onto a monitor. This shows the structure of the heart and how well the heart is pumping blood.
• An angiogram, also known as cardiac caricaturisation. In this test a catheter (a very
fine, hollow tube) is inserted in an artery in either the groin or the arm, and is fed through to the heart. A dye is injected into the coronary arteries through the catheter and a series of X-ray films are taken. This helps the doctors to see if there are any blockages in the arteries. The test is done using a local anaesthetic.
If surgery is planned
It is natural that anyone needing heart surgery will be concerned and anxious, and that their carer and family will be worried too. Some patients do not need urgent surgery, and will be put on a waiting list. Some waiting lists are shorter than others, so the surgery may be scheduled after a few weeks. For others, the waiting time could be months. A lot of people find this waiting time very stressful.
It is difficult to get on with life with this ‘wait’ hanging over you. You may postpone holidays and other trips because you are always waiting for the hospital to get in touch with a date for the operation. Some hospitals offer pre-assessment clinics before the operation so the person can go and see the place where they will be treated and ask questions about the surgery. It also allows hospital staff to assess the person’s care needs. This can help to reduce anxiety for some people. If you think this would be useful, ask at the hospital if a pre-assessment clinic is available. Going along to a support group can sometimes be helpful too. At a support group you can meet others who are in a similar situation waiting for heart surgery, or people who have already had surgery or have a heart condition.
Questions you may want to ask
There will be many thoughts going round in your head. Some of the most common questions that carers ask are shown below.
• Is it likely that my partner will have another heart attack ( or more angina attacks )?
• Why did this happen ?
• What can I do to help ?
• What drugs is my partner taking, and what are the side effects ?
• How much physical activity and what sort of activity should my partner be doing - how often and where ?
• Can my partner return to work ?
• What should I do if I think my partner is having a heart attack, or an angina attack that is not going away ?
• When do we come back to the hospital ?
• How often will my partner need follow-up at the hospital or by the GP ?
• Will anyone visit us at home ?
• What help is available from the hospital or community health team ?
You might find it useful to make notes of what the doctors or nurses tell you, and their answers to your questions.
Becoming the carer of a heart condition partner
Becoming a carer may be something that happens gradually or, in the case of a heart attack, is sudden and unexpected. Few of us are trained to be carers, so it can cause anxiety and stress to both patient and carer.
Caring for someone can be physically exhausting as well as emotionally draining. Some carers will juggle their job at work with home and family life as well as looking after their partner. It may be particularly hard for some carers if they are in poor health themselves, or have their own medical problems. A confusing mix of emotions is quite normal. You may feel love and concern, mixed with sadness, anger, hostility and guilt. At times you may also feel frustrated that life is not the same as it was before, and that it may never be the same again. Carers may sometimes feel isolated or frightened, and may feel that nobody listens to them or understands how they feel.
Talking to each other can be comforting and helpful. You may also find it helps to talk to a friend or other member of the family. Sharing your thoughts and feelings can often take the ‘sting’ out of the stress. Talking helps to get your fears out Caring for someone with a heart condition l 17 into the open, and can help you to keep them in proportion. Hopefully this role as a carer will not be permanent, and the help and support your partner needs now may get less with time.
Try to take time for yourself too. In order to continue in your caring role, you also need to take care of yourself. We are not always very good at asking for help, or accepting it. But asking for or accepting someone’s help is not a sign of weakness, or of not coping. Offering help is one way that other people show their affection and support for you and your partner. Beware of neighbourhood experts! Everybody knows somebody who has a heart condition, and they often want to tell you all about it. On the one hand, this direct experience can be useful - to see how other patients and carers coped. On the other hand, every patient is an individual, and scientific knowledge and medical treatments have advanced, so what was right for one person in the past may not be relevant now.
Here are a few tips for carers.
• Try not to let your partner’s illness take centre stage all of the time.
• Try to make time for yourself, and keep doing the things you want to do.
• If you are feeling down or depressed, talk to someone about it and get help.
• If people offer any help, learn to accept it.
• Inform yourself - facts and information can be very reassuring, if they are from reputable sources.
• Find support from other carers who are in similar situations.
How to help your partner reduce their risk of further heart problems
Many carers of people who have coronary heart disease want to know what they can do to help their partner avoid future heart problems. This section explains what your partner can do, and how you can help. There are several ‘risk factors’ for coronary heart disease. A risk factor is something that increases people’s likelihood of getting the disease.
The main risk factors are:
• smoking
• high blood pressure
• high blood cholesterol level
• physical inactivity
• obesity and being overweight
• diabetes, and
• a family history of coronary heart disease.
You and your partner can reduce some of these risk factors by making lifestyle changes such as:
• eating a healthy diet
• being physically active
• keeping to a healthy weight
• not smoking, and
• reducing the amount of alcohol they drink (if necessary).
You can help and encourage your partner to make these lifestyle changes. Below,we give some information on what to do.
Eating a healthy diet
This can be one of the main concerns for those caring for someone with any kind of heart problem. You may want to know what sort of food you and your partner should buy and cook from now on. Following a healthy diet can help to reduce the risk of developing coronary heart disease, and can also increase the chances of survival after a heart attack.
Below we give a summary of the main points about eating healthily. Following these will help your partner, and will make for a healthy diet for you, the carer, too.
Fruit and vegetables
Eating at least five portions of fruit and vegetables a day can reduce the risk of coronary heart disease, probably by helping to prevent atheroma from building up within the inside walls of the coronary arteries.
Fats and cholesterol
Reducing the amount of saturated fat you eat can reduce the amount of cholesterol in your blood. Replacing saturated fats with polyunsaturated fats and monounsaturated fats may help to improve the ratio of ‘protective’ cholesterol to ‘harmful’ cholesterol in your blood. You could also ask at your GP’s surgery for advice on reducing your cholesterol levels.
Fish and fish oils
Eating oily fish can help to protect against coronary heart disease, and there is evidence that it also helps improve survival after a heart attack. Try eating oily fish once or twice a week - for example, mackerel, herring, pilchards, salmon, sardines or fresh tuna.
Salt
Reducing the amount of salt in your diet will help keep blood pressure down. High blood pressure is a major risk factor for coronary heart disease and is the most important risk factor for strokes.
Physical activity
People who are not physically active are twice as likely to have a heart attack compared with active people. Even if your partner has already had a heart attack, a programme of exercise can reduce the risk of having another attack. For physical activity to benefit the heart, it has to be ‘moderate intensity’ activity. This means activity that makes you feel warm and slightly short of breath. Your partner should aim to do 30 minutes of moderate-intensity activity a day on at least five days a week. Examples of physical activities include brisk walking, swimming, cycling and gardening. If your partner isn’t used to doing this much activity, it’s important to build up gradually. If he or she has heart disease and is in hospital, talk with the cardiac rehabilitation nurse, hospital doctor or cardiac nurse about how much activity your partner should do when they go home and the best way to increase their level of physical activity.Once your partner is at home, you can ask the GP or practice nurse about this.
Keeping to a healthy weight
For people who are overweight, reducing weight will help to reduce the workload of the heart, help keep blood pressure down, and reduce the risk of coronary heart disease. Losing weight means both eating healthily and doing more physical activity. If your partner needs to lose weight, it’s better not to lose the extra weight too quickly. Losing weight slowly and steadily (about a pound a week) is more healthy and means that the person is more likely to keep the weight off for good.
Smoking
If your partner smokes, stopping smoking is the single most important thing he or she can do to protect their heart. Talking to friends and relatives who have stopped, joining a stop smoking group, or talking to the GP or practice nurse may help. It may be possible to get nicotine replacement products such as nicotine patches either on prescription or from your local pharmacist, and these can really help.
For practical help in stopping,
contact QUITLINE on 0800 00 22 00, or the BHF
Smoking Helpine on 0800 169 1900.
Alcohol
Too much alcohol can damage the heart muscle, increase blood pressure and also lead to weight gain. However,moderate drinking - between 1 and 2 units of alcohol a day - may help to protect the heart in men aged over 40 and women who have gone through the menopause. Caring for someone with a heart condition Cardiac rehabilitation Most areas in the UK have some form of cardiac rehabilitation programme. The programmes vary but they usually include exercise, education sessions and some relaxation. These programmes are usually for patients who have had a heart attack or heart surgery. It is well worth your partner going on one.
To find out where your nearest programme is, ask your GP or call the British Heart Foundation on 0207 487 7110. If your partner can’t get to a local programme or isn’t eligible to join one, he or she may be offered a rehabilitation programme to follow at home.
Over protectiveness
Regaining independence is an important factor in recovering from a heart condition. It may seem a tough thing to do, but sometimes it helps to remind yourself that you need to motivate your partner to get back to being independent. If you treat them as independent, they will hopefully be more independent. It is interesting that many people prefer not to think too much about their heart condition, or try to get back to some sense of normality, but their partner constantly reminds them that they have had a problem. Being overprotective really isn’t helpful. It can even hamper recovery. Although you may feel that you want to wrap your partner in cotton wool, this might not be a good thing in the long run.
You can’t make your partner live a healthy lifestyle, but you can encourage him or her to do so. For example, it could be part of your role as a carer to help your partner become more active day by day. But if you are overprotective, it may make your partner feel more dependent on you.‘Shielding’ You may need to ask yourself why you stop your partner from doing certain activities. Is it because you are afraid it will lead to another heart attack, angina or high blood pressure?
It can be difficult to get the balance right. Tell your partner why you feel afraid, and why you don’t want them to overdo things. Some people with a heart condition say their carer suddenly starts to watch their every move. This is often unhelpful for the person with the heart condition and, although difficult, you may need to give them more space to do things on their own and at their own pace.
If you have young children, you may have asked them not to fight or argue in front of your partner. You may have chosen not to talk to your partner about any family problems or financial difficulties in case this causes distress. Rather than avoiding the ups and downs of everyday life, try talking about problems as they arise. Let family life continue as normal, and let your partner be the judge of what he or she can and cannot do.
Financial help and carers’ assessments
There are various benefits that carers may be able to claim. However, the benefits and assessment system for carers can be complicated. For advice on whether you may be able to claim financial benefits, see How to find out more, below.
Carer’s assessment
The Carers (Equal Opportunities) Act 2004 says that all carers have a legal right to an assessment of their needs. This is usually called a carer’s assessment. It means that social services assess what help you, the carer, might need in order to look after the person you are caring for, and how caring for him or her will affect your lifestyle.
The emotional aspects of being a carer
No two people have the same experience of life or illnesses. This means that emotional responses will also vary from person to person. Patients may be feeling the same sorts of emotions as carers, but the carer may be frightened to show how they feel. Carers may feel the need to put on a brave face, and always appear cheerful and optimistic. There is a tendency to bottle feelings up which, in itself, could eventually lead to high levels of anxiety and depression in the carer. Talking about your feelings - to a friend or relative, or maybe even to someone who doesn’t know your partner - can be a great help. If you feel very anxious or depressed, you should see your GP.
Resentment
A lot of things could make you feel resentful. If you feel resentful about the changes to your life, this is quite natural. If at times it feels like your partner has had a personality change, you may well resent this too. If they cannot do the things they used to do around the house, you may have to take on some of those tasks yourself. If your partner is irritable, and seems ungrateful or moody, you might feel unappreciated. The most important thing is to talk about any resentment and to try and clear the air. If you feel you can’t talk to your partner about this at the moment, talk to a friend or relative.
Anxiety
You may feel anxious because you don’t know what is happening to your partner, or because you have no control over their health. If your partner is also very anxious, it is hard for you not to share their anxiety too. Anxiety is one of the most common emotions so, again, try to talk to each other if you can. Try to think about what is really worrying you. If it is fear about the future, it may be a good idea to talk to one of the health professionals who are caring for your partner or for you.
Depression
There will be times when you feel low. Life may seem to be like a rollercoaster. You might feel very positive and reassured, then feel quite depressed and insecure, and this may change from day to day. It is quite common for patients and carers to feel depressed after any major illness or health problem, but this should lessen as life starts to get back to normal. However, if you feel low a lot of the time, or have feelings of panic or despair, you may need medical help. If you feel like this,we advise you to talk to your GP. Getting in touch with a carers’ organisation may help to make you feel less isolated.
Anger
It is perfectly normal to feel angry that your partner has a heart problem. Your partner may be young, or have led a fairly healthy and active life. You may wonder why it had to happen, and so feel angry. Or you could simply feel angry with your partner - perhaps you feel that this would not have happened if they had stopped smoking or exercised more. Try to find a way of dealing with your anger before it builds up. Talk to your partner. Talking to a counsellor or to another carer may help. Talking to someone else who really tries to understand can reassure you and help you to feel less angry.
Isolation
It is understandable if you feel that you are on your own and that nobody else can possibly appreciate what you are going through. You may become so focused on caring that you forget about everything else in life. Once you get into this habit, it can be hard to break it. Try to keep in touch with family and friends. Even if your partner is waiting for more tests and treatment, life should not stop.
Guilt
At times we all feel that we could have done more, or done something differently. You and your partner may both feel guilty. If the person who has the heart condition used to do a lot of the manual work around the house, roles may be reversed. Someone who has done the shopping or mowed the lawn for the last 20 years or so may feel guilty and frustrated that they cannot do it at the moment. Talking about these feelings with your partner can help both of you get rid of any guilt, or to stop any guilt developing. Noticing changes in your partner You may notice changes in your partner. He or she may sometimes feel helpless, or unable to take responsibility for anything - for example taking his or her medicines. Or he or she may appear overconfident, or deny that anything has happened. You may notice some loss of memory in your partner, especially if he or she has had heart surgery. Your partner may become more irritable, or unable to share feelings with you. Fortunately, in many people these changes are only temporary.
For more advice
For more advice and support for you as a carer, contact one of the carers’ organisations
Dealing with stress
Caring for someone with an illness can be stressful for many reasons. You may have anxieties about their illness and what will happen in the future. You have the extra pressures of the caring role, and also managing the rest of your life including home and work. A combination of all these factors can lead to exhaustion, and feeling unwell yourself. What does the term ‘stress’ actually mean? Stress is a word we hear a lot, and is sometimes used to describe the very fast pace of life that many people lead, or the way we feel when pressure is intense. It can produce a combination of symptoms when our emotional, mental and physical systems go into overdrive. This may reflect our current emotional state, or a feeling that we don’t have control over the situation. For example, if you already feel upset, anxious and concerned about your partner’s heart problems, you may fee the symptoms of stress more easily.
Some people seem to cope well with stressful situations, while others feel less able to cope. Sometimes people look like they are managing to handle the stress but actually aren’t.
Recognising the symptoms of stress
There are many symptoms linked to stress, and these will be different for different people. It is important to know when your stress becomes ‘distress’, and when you feel ill effects.
The following signs can sometimes result from stress.
• Difficulty in sleeping, disturbed sleep, and waking up early (if this is a change to your normal pattern, as some people always wake early)
• Headaches
• Feeling tired and having no energy
• Palpitation and a rapid pulse rate
• Either overeating or not eating enough (unless you’re trying to lose weight)
• Weight changes - either a gain or loss
• Skin problems
• Poor concentration
• Feeling angry and irritable
• Feeling unhappy and depressed
• Smoking more
• Drinking more alcohol.
These are just a few of the ways that people react to the strain, but often you will know when you feel stressed. The important thing is to recognise when you are not coping with the extra stress placed on you. Think about what seems to be the main cause of the stress, and see if you can perhaps change the pattern or do something about it.
At times, caring for someone who is ill can be like a juggling act. It can be stressful and there are often other important pressures in your life. It is important to get the balance right between tension and relaxation. Trying to juggle your needs with your partner’s needs is not easy. But the more you can do to feel that you are in control of the situation, the less stressed you are likely to feel.
Coping strategies
One of the best ways of coping is to work out the different things that are causing your stress. It may be useful to keep a ‘stress diary’, even if only for a few days. You can then look back to see what was triggering your stress. Once you know the cause, perhaps you can think of ways to change the pattern. Here we suggest some ways of reducing stress, and coping with it.
Share the job
This could mean sharing the caring or sharing other workloads. Accept help when it is offered. Don’t feel you are not coping if someone offers help. If you cannot cope due to stress, it will only make the whole situation more difficult. Don’t try to solve everything at once Some carers feel they must try to find a solution to every problem their partner has. But you may find that you just want someone to listen to you, rather than having to come up with all the answers. Set realistic goals, rather than trying to achieve everything at once. Look after yourself If you also try to eat healthily, do regular physical activity, and try and have some time for relaxation, you should feel better. If your partner is doing some physical activity as part of a rehabilitation programme,maybe you can do your own exercise programme to support your partner and make yourself feel better too. Try to get things into perspective Often when you worry at night, problems seem huge, and cause high levels of anxiety. In the morning, they may not seem quite so overwhelming after all. Try to concentrate on the main issues you need to face, and try not to worry about smaller problems that can be put on hold for now.
Relaxation
Some people find relaxation sessions very helpful. If your partner is invited to relaxation sessions, perhaps you could go along too. You may want to ask the health professionals caring for your partner if there are any local relaxation sessions. Making a list of activities that help you to relax and then trying to do those things regularly can help. It can also be useful to learn some simple breathing techniques. Taking a few deep breaths in, then slow breaths out can help calm you down.
Talking it over with someone Some people who are finding it hard to cope with their partner’s illness, and with the stress and anxiety that go with it,may find it helpful to talk it all over with someone. This is not always easy, and you will need to think about who you can talk to. You may choose to talk to a close friend or member of your family, a health professional, another carer, or a trained counsellor. Sometimes it helps to talk to another carer who is in the same situation as you. You may want to get in touch with other carers of about your age who are looking after someone with a similar heart condition. For example, if your partner is diagnosed with heart failure, try to find a carer whose partner also has heart failure. Your local heart support group may be able to put you in contact with someone.
Some groups have lists of carers who are willing to talk to other carers. It can be reassuring to know you share similar problems and anxieties. You can also share feelings and coping strategies with each other. Talking to a counsellor can be helpful for many people. It gives you the chance to talk in confidence with someone who will listen carefully, and try to help you understand and make sense of your feelings. The counsellor can help you to come to terms with your partner’s illness, and support you to find your own way forward. Counselling is never an admission of weakness - it is about you making a positive choice to help and look after yourself.
There are several ways to find a counsellor.
• Some GPs can refer you to their own counsellor if they have one attached to their practice.
• If there is no counsellor attached to your doctor’s surgery and there is no free counselling available locally, ask the British Association for Counselling and Psychotherapy to give you a list of private counsellors in your area.
• If you want to talk to a counsellor about relationship problems, you may want to phone the organisation Relate to find out about the services they can offer and to get contact details for counsellors in your area.
Restarting your sex life
As far as the heart is concerned, sex is no different from any other kind of exercise. It is usually safe to have sex again two to three weeks after a heart attack. For other heart conditions, if your partner can walk about 300 yards (300 metres) on the level comfortably, or climb two flights of stairs briskly, without getting chest pains or being out of breath, then it is usually safe to have sex. If you are not sure whether it is safe for your partner to have sex, it would be wise for your partner to talk to their GP. There is no right or wrong time to start having sex again. Many couples worry that sex may put a strain on the heart and so prefer to wait until they are both ready. For some this may take several weeks, and for others it may be several months. It may be that neither of you feels in the mood. Anxiety and stress are often barriers to a relaxed and happy sex life, and these feelings can suppress the desire to make love.
Some men may have physical difficulties in getting or maintaining an erection. This could be due to a temporary loss of fitness, and may sort itself out as they become more physically active. However, it may be due to certain drugs. The doctor may be able to review and change their medication if impotence seems to be a side effect. Impotence can also be a side effect of emotional upset. Or it may be because the person is afraid of having another heart attack or angina attack. Try to talk about these problems together. If they are ongoing, or if you had problems in your sex life before the heart problem, you may want to consider counselling. The organisation Relate offers some very useful help and counselling. Some sexual health clinics offer counselling for impotence or for a low sex drive. You can ask your doctor to refer you to one, or make an appointment yourself. To find a local sexual health clinic, look in the phone book under the name of your local health authority, or ask at a local hospital. If your partner tends to have angina attacks brought on by physical exertion, here is what you can do to try to prevent them.
• Avoid having sex within two hours of a heavy meal.
• Keep the bedroom warm and avoid very cold bedding.
• Encourage your partner not to drink alcohol for at least three hours before.
• Create a relaxing atmosphere.
• Avoid sex if either of you is tired or tense.
• Make sure your partner is in a comfortable position. You may choose to take the more active role.
• If your partner takes GTN medicine, he or she may want to take some beforehand and keep it by the bedside. Your partner should not take Viagra if he is taking nitrates such as GTN.
It’s worth remembering that there are alternatives to full sex. Touching and caressing may be a good way to build confidence. There are many myths associated with sex and heart conditions. People often think that a heart attack or angina may be triggered by sex, but this is something that happens very rarely. If you feel too embarrassed to talk to your doctor about sex,we have a video called Sex and heart disease which has information on sex for people who have coronary heart disease. It may be useful to watch the video together and then talk about it afterwards.
Heart support groups
You may find it helpful to join a ‘heart support group’. A heart support group gives you, your partner and your family the chance to meet and talk to people who are going through similar experiences. Groups vary. They usually meet once a month. Some hold exercise classes or invite speakers to talk on medical as well as general topics. They are often informal and sociable too. There is a possible danger that people who have made an excellent recovery - for example after a heart attack - may continue to think of themselves as ‘patients’ at a time when they should be trying to put the heart attack behind them. The organisers of good self-help groups recognise this and can help people to take a positive approach to life, and to play a part in helping others through their difficulties.
© 2008 highbloodpressuresymptoms.co.uk
