The Effect of Heart Disease on the Patient and Family

Any major crisis, injury, or major illness such as heart disease effects us emotionally as well as physically. For instance, we hit our toe on the leg of a table, we get angry. This anger is an emotional response to hurting ourself. When someone has a cardiac event, such as a heart attack or cardiac surgery, he experiences a wide range of emotional responses. It is an important part of a patient's recovery to be aware of the emotional responses he and his family may experience and to realize that these responses are normal.

A cardiac patient may find it very difficult to accept that he has had a heart attack or that he must undergo some type of cardiac surgery. It is devastating to admit that "I may die" or, perhaps worse, that "I may be disabled." To think about the possibility of having to change his life style or to know he is now a different person can be overwhelming and frightening.

Since none of us wants to experience something unpleasant or painful, we may deny that symptoms exist. In our minds, we may rationalize or tell ourselves that we are experiencing something else, something that is not quite so serious. This process is called denial, and it helps us get past the immediate crisis. It is normal to feel this way initially.

As this denial process begins to break down, anxiety and depression may be experienced. These feelings often relate to a sense of sadness or fear over the loss of health. We expect most cardiac patients to experience some degree of discomfort because of anxiety and depression. Many times these emotions are a consequence of the many unknowns associated with the disease and the immediate crisis: loss of control, the thought of possible death or the idea of physical or emotional limitations.

Many patients and spouses feel fearful after returning home from a hospitalization. The dependency that developed in the hospital may continue after the patient goes home. This is partly due to feeling insecure about not having medical people looking after him 24 hours a day. He may lack the confidence that he can take care of himself and that everything will be alright. Additionally, the spouse may overprotect the patient, thereby helping him to maintain his dependent, or sick role. The spouse may believe that he is fragile now and should not exert himself. Initially, this may be true, but as time passes and the patient does more and more for himself, he will become stronger and gain more confidence. Thus the general rule becomes "the more you can do for yourself, the quicker and healthier will be your recovery."

It is normal for the patient to feel frustrated as a result of all that is happening to him. This frustration may be expressed in anger and irritability that can be directed at those closest to him, especially his spouse and family. As a result, he may push them away and become isolated and that is not beneficial to his recovery.

After a cardiac event, it may be difficult for the patient to be aware of the needs of those around him. He can become so wrapped up in himself (this is appropriate at first) that his spouse may begin to feel angry, unappreciated and unloved. The spouse, like the patient, may be feeling a sense of loss, anxiety, fear, resentment and loneliness. It is very important for the spouse and family to take an active part in the patient's recovery. Both need to have an understanding of what each is experiencing and learn how to help each other.

The patient's recovery and return to his normal life style requires him to take care of himself. What seemed most important to him prior to his cardiac event may no longer seem so. His priorities may change completely. Closeness to family and friends may become more important and he may find himself spending more time and energy in pleasant, productive ways and less at work. He may also notice an emotional side of himself that up to now he has not expressed or even noticed.

The patient may experience emotional ups and downs. This doesn't mean he is "crazy." This is a natural response to a life crisis. In order to cope with these emotions and work through them, he needs to share them with his spouse, close family or friends. It is normal to experience these intense and changeable emotions which tend to resolve themselves as the patient gets better. If he finds himself "stuck" in one emotional state, he may wish to talk with a third party who can be more objective. There are many health professionals who can aid the patient in his physical and emotional recovery. The patient and/or family can consult the doctor or call and talk to the staff in Delpit Cardiac Rehabilitation Center (310) 517-4737.

Each patient plays a crucial role in his own recovery! His successful return to a happy, normal lifestyle depends on his participation, emotionally and physically, in his treatment, as well as having the support and cooperation of his family. Heart disease is a family disease and it requires a commitment from all who are involved.