Physical support

Exercise

Programmes have been shown to reduce cardiovascular mortality, reduce hospital admissions and improve quality of life. Edward admits that he has become somewhat sedentary and acknowledges that he needs to do more exercise. He is offered an individually tailored exercise programme to folow at home and attends a weekly cardiac rehabiltation exercise class at his local gym.

The following video gives an idea of the type of structured exercises that may be undertaken at home:

• East Cheshire NHS Trust: Cardiac rehabilitation exercise video – from the Cardiac Rehab Team (YouTube)

Sexual Activity

At a one to one meeting with the cardiac rehabilitation nurse, Edward confesses that he is reluctant to resume sexual activity as he is afraid of having another cardiac arrest. She signposts Edward to some useful resources. Although these are not aimed specifically at cardiac arrest survivors, they contain helpful advice:

• Heart failure matters: Sex and heart failure
• CHSS: Living with your chest condition: Relationships and Sex
• CHSS: Living with your heart condition: Your sex life
• Relationships Scotland: I’m having sex problems

For information on sexual problems, the Sexual Advice Association can be contacted on 020 7486 7262 or email: [email protected]

Diet

Edward attends frequent business dinners and he and Fiona are enthusiastic “foodies”. He recognises that he may need to adapt his eating and drinking habits in future. SIGN Guideline 150 recommends the Mediterranean Diet, as it has been shown to be beneficial in preventing coronary heart disease.

A guide to the Mediterranean diet can be seen below:

• NHS choices: What is a Mediterranean diet?

Despite his love of food, Edward is not overweight. If an OHCA survivor requires support an advice regarding weight management, they should be given advice and support to achieve a weight reduction. The Eatwell Guide (below) should be used to support the Mediterranean Diet advice offered.

• NHS choices: The eatwell guide

Recipes for healthy, cheap meals and advice on cooking skills can be found at:

• Scottish Government: Healthier Scotland: Eat Better Feel Better

Fatigue

Once home, Edward finds that he becomes easily fatigued, both mentally and physically. This is not uncommon in post-cardiac arrest survivors and the fatigue can persist for some time. Although the resource below is intended for heart failure patients, it contains useful techniques and strategies for conserving energy. Edward introduces some of these in to his everyday routines.

• Heart Failure Matters: Living with heart failure: Techniques to conserve energy

Medications

Prior to his OHCA, Edward had no diagnosed health problems and was on no medications. He is unhappy about having to now take drugs for the foreseeable future. Evidence suggests that concordance with long-term medication is only around 50%. Clear explanation from a pharmacist, to both Edward and Fiona, regarding the purpose and benefits of medication may improve his willingness to take his drugs.