The health coach

While I was enthusiastic about cardiac rehabilitation as an exercise programme, I was reluctant – maybe even haughty – about receiving any heart-healthy lifestyle and diet advice.

What could anyone possibly tell me that would make a difference now?

Before my heart operation, I had done everything humanly possible to avoid heart disease and yet I still needed heart surgery!

This post is about accepting help and “knowing your numbers”.

ultimate health coach

Your Health Coach is ultimately you

The offer I almost refused

One morning, a month after my Coronary Artery Bypass Graft (CABG), I was dealing with a lot of sternum pain. Oh, the endless, endless pain! It was wearing me out. I needed a distraction.

My phone rang.

It was a “health coach” from my health insurance company. She said my insurance cover included a  coaching and support programme during my recovery.

Hah!

I was about to tell her,

“No thanks, I’m doing fine, I know what I’m doing, I’ve got a degree in medical science.” … blah blah blah …

But wait a minute…

Perhaps having a person call every month to ask how I am feeling would be nice.

Perhaps I could keep track of my recovery and benchmark my progress.  I am a bit competitive that way. So I said,

“Yeah go on, let’s do this.”

How health coaching works

For the next 6 months, I was guided (over the phone) through the health targets I needed to achieve. I also had the opportunity to talk about how I was feeling and ask questions.

The main aim was to chart how my modifiable coronary risk factors were tracking. It may seem like a lot but many interrelate:

  • Biomedical Targets
    • LDL-cholesterol
    • HDL-cholesterol
    • Triglycerides
    • NHDL-cholesterol (non-high density)
    • Blood pressure
    • Fasting glucose
    • BMI (Body-Mass Index)
    • Weight
    • Waist measurement
    • Kidney function
  •  Lifestyle Targets
    • Smoking status (never and never will)
    • Alcohol intake
    • Nutrition
    • Physical activity
    • Keep up to date with vaccinations

The targets used by the Health Coach programme are set by

  • The National Heart Foundation of Australia
  • Kidney Health Australia
  • Cardiac Society of Australia and New Zealand
  • National Health and Medical Research Council

I’ve linked the references at the end of this post.

The health coach noted my most recent results as the baseline. A few days later I received a copy in the mail. All my factors and medications had been tabulated and assessed as “met” or “unmet”, along with suggested things to ask my doctor at the next visit.

Seeing your health status in a table is rather nice.

My baseline was actually quite good but there were a few things I had to ask the doctor.

An unpleasant reality

It dawned on me that the heart isn’t the only organ affected by heart surgery. Other organs are affected too, sometimes due to the drugs needed for maintaining heart health.

Just for example,

  • Liver is affected by cholesterol-lowering drugs
  • Kidneys are affected by ACE-Inhibitors
  • Mental and emotional health are often disturbed

It was an added bonus to talk about my mental health to the health coach. I was frequently in tears over the phone. Just having someone listen to me uninterrupted and without judgement was wonderful.

I firmly believe that mental health coaching during cardiac recovery needs a similar programme.

I’ve since discovered that there are programmes available in Perth, Western Australia. At the time of writing this, I’m checking to see if these facilitators are OK with me sharing the details. Check the references section if you return later.

Over the top?

I asked my doctor about some of the recommended tests. He gave a little smile, then explained why they didn’t apply to me. I am young, fit and not typical.

The recommendations are general (they are guidelines after all) and they aren’t designed to apply to everyone.

Health coaches, the reputable associations – they’ve never met me nor treated me for other medical matters. They do not know me or my unique case. Or yours.

So if this happens to you, ask for an explanation why it doesn’t apply to you. Don’t assume your doctor is brushing you off or trivialising your concerns.

On the other hand, the health coach continued to address and explain everything with me every month. She did a fabulous job. I looked forward to talking with her and sharing my journey with another person. I am so glad I’d said, “Yeah go on, let’s do this”.

You’re on your own now

When the 6 sessions were over, I had successfully achieved ALL the target levels for my modifiable coronary risk factors.

I had reduced my risk of having a future cardiac event or procedure by 80%. Go me!

Also, I had a better understanding about the medication and tests I needed. I had had a shoulder to cry on, then received support and encouragement. It was a great feeling.

From now on, it’s up to me to look after myself, see doctors regularly, and record my numbers.Wait for walk Signal

Your life begins now (Photo Credit Ashim D’Silva)

What I learnt from my experience

Our internal organs don’t work in isolation.

We each have unique physical, mental, spiritual, emotional and medicinal experiences. We should not be generalised nor make comparisons.

The company we choose affects us. Surround yourself with supportive, encouraging, friendly, non-judgemental, sensitive people.

When recovering from serious surgery, it is vital to

  • Be gentle on yourself, but push a little
  • Be careful but courageous.
  • Accept help and good advice
  • Realise that recovery takes a long time. Sometimes for the rest of your life.

And always….

Ask questions

  • Do you know your blood pressure, cholesterol, blood sugar readings?
  • How long since you had a check-up?
  • Do you smoke?
  • Do you take regular exercise?
  • Do you eat a healthy diet?
  • Are you absolutely certain that you are doing everything possible to reduce your risk of a heart attack?

References specially selected for you

I asked my health coach to help me locate useful guidelines for reducing cardiovascular disease for this blog post.

The references here are aimed at health professionals. However, if you want quality patient level information, some of these links have simpler versions if you look around their websites.

The main reference used by my health coach programme, and upon which it based the targets, are found in this brochure which was created jointly by The National Heart Foundation and the Cardiac Society of Australia and New Zealand 

Reducing risk in heart disease An expert guide to clinical practice for secondary prevention of coronary heart disease – summary (2012)

The Cardiac Society of Australia and New Zealand

“This is the professional body for cardiologists and those working in the area of cardiology including researchers, scientists, cardiovascular nurses, allied health professionals and other healthcare workers.”

Kidney Health Australia

This publication “Chronic Kidney Disease Management in General Practice is for health professionals but you might be a health professional!

National Health and Medical Research Council 

The NHMRC is Australia’s leading expert body promoting the development and maintenance of public and individual health standards.

Royal Australian College of General Practitioners

This website provides guidance to General Practitioners  for assessing cardiovascular risk in patients.

Baker IDI Foundation

The Baker IDI Heart and Diabetes Institute is an independent, internationally renowned medical research facility. It specialises in research into diabetes AND cardiovascular disease together.  Very important work.

Here is a list of their guidance documents.

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