Welcome to Dr. Warrick's podcast channel. Warrick is a practicing cardiologist and author with a passion for improving care by helping patients understand their heart health through education. Warrick believes educated patients get the best health care. Discover and understand the latest approaches and technology in heart care and how this might apply to you or someone you love. Hi, my name is Dr Warrick Bishop and welcome to my podcast and videocast station. Today I'm absolutely delighted to have as a guest to share his experience with cardiovascular disease and rehab, Darren Lehman, previous coach of the Australian cricket team. Welcome Darren, how are you? Yeah, good, thanks, Warrick. How are you? It has you a bit cold, I suppose, is it? Yeah, it's freezing down here. You look warm and well up in Queensland. Yeah, it's a little bit warmer up here, but hopefully, fingers crossed, everyone's going okay down there. We're always phlegmatic about it. We say we need the rain, so that's how we make it work for us. Well, look, for those who maybe haven't followed your career so much, tell us a bit about yourself, Darren. How old are you? Is there a family history of heart problems? Yeah, so I'm 50 years old, and on my 50th birthday, I had a heart attack and woke up on what's supposed to be a really enjoyable day in your life and quite relaxing. So 50-year-old, I've got a wife with four children. Oldest son's 28. He lives in South Australia. My daughter's actually 25 and stuck in COVID in Melbourne, which is a bit sad because I have not seen her since my heart attack, which is going on six months now. So that's quite amazing that you have your family around. That's the one I haven't seen at all. And then the twins obviously are 18 and Andrea live up here in Queensland. And I played cricket for... all my life, basically 30 odd years. So I've been involved in cricket, played for 20 and then been coaching for the past 10 at various teams. So cricket's been my life, but all of a sudden things changed, you know, February 5, you know, 4.30 in the morning. And I suppose looking back now, you look at things like my dad, you know, died of a heart attack as well. You know, hereditary was a big thing for me, and that's what the doctor said. But at 4.30 in the morning, and I'll just talk through this. I hope that's okay, Doc. Yeah. You know, for the people out there, I'm just trying to get them a better understanding. So at 4.30 in the morning, I woke up with, you know, cold sweats and, you know, someone was really heavy on my chest. I'm like, oh, God. And I don't mind telling people this. I was a smoker and quite a heavy smoker. And I thought, well, I'll go have a cigarette and see if that makes it feel any better. And I didn't. And I went, wow, if I don't want a cigarette, I must be in some sort of trouble. So I rang the doctor and they got the ambulance straight around. And they gave me a spray called GTN. I always call it GMT, but it's GTN, as you well know. And they gave me a spray first time and sort of eased off a little bit of the pain, especially the chest. chest pain and waited five minutes gave me another and the ambulance were fantastic they were talking me through the paramedics and and then they gave me the third spray and i felt really good and i said thanks very much lads off you go don't worry about it um and they said no no you're coming with us you're in a bad way and i went well i feel good you know what's wrong you're 50 year old i can't be you know having a heart attack this is ridiculous and i said well you know, we'll do all the tests that you've got to do. And, you know, an hour later I was in Gold Coast private hospital and getting, well, actually public hospital, the new one there, and getting the angiogram done. And then all of a sudden the tests come back and say you've had a heart attack and you've got blockages in three arteries and away you go from there. So we're going to actually open you up and you're going to have open up triple bypass surgery the next day. And a week later I was home. It was just a surreal experience of actually going through that whole scenario and not really understanding but trusting the doctors what they were saying. I've always been like that, just trusting what people say and go with the obviously expert opinions. So I'm so thankful I did. Well, it sounds like it happened really incredibly quickly. Did you have any forewarning at all, Darren? Did you notice you were puffy or short of breath or anything? Had anything changed in the lead up? Well, looking back now, I do because now I don't sleep. I mean, I used to sleep every afternoon after, you know, training and doing stuff. And I, you know, just have a nap on the couch for a half hour or 40 minutes. And when I did my fitness and my walk, I walk or bike every day. And I still do that now. But now I can breathe. It's just amazing that you don't know. And they're not warning you because you're a 50-year-old out. outside all the time working. But until you actually go through it and then you get these new arteries in your heart and you can breathe again, that was the big change I noticed. Being able to breathe and not smoking obviously helps. Getting rid of all the crap in your lungs and all of a sudden feeling better and realising now that I was probably pretty sick and overweight and quite stressed. And they're probably the main things looking back now that's easy to understand why. I think certainly for someone listening and certainly from my own experience, one of the really important things that you describe is you didn't have chest pain. There was no sign of something ominous occurring. And we know, and you've observed it, that if you reduce your shortness of breath or exercise capacity gradually, It's like watching your kids grow. If you see them every day, you don't notice how quickly they're growing. It's the uncles and aunties who see them between time to recognize the difference. So these symptoms of reduced exercise capacity can creep up on you. It sounds like it crept up on you. Yeah, it certainly does. Because now when I go for a walk, I mean, the perfect example for everyone out there is, you know, we live in quite a hilly suburb in Brisbane. I'd go walking and by the end of it, I was really short of breath and, you know, just tired. You know, I couldn't keep going. But now it's fantastic. You know, I go up these hills and, yeah, my heart rate gets up there, but I'm up and down and keep going. You know, I stop when I want to stop now, not because I have to stop. So, you know, those are the things that the warning signs. And the doctors and the paramedics were fantastic because they said to me, you know, you're a 50-year-old male. You actually listen to your body for once. That doesn't happen. You know, normally I had, what do they call it? The widow's... Widow maker. Widow maker. That's right. Thank you. And that's the other thing I have noticed with my heart attack and since the operation, I actually forget a lot of things now. They said it's, you know, I forget a lot of things in the past and like a little bit of, not amnesia or such, but, you know, I just... find it hard to pick up words or remember things. And that's starting to come back. And they said that's just one of the byproducts of, I suppose, going through this whole open-heart surgery. But for me, not, yeah, just going a 50-year-old male. This is why you see on TV and, you know, the reports, someone dropped dead on a footy field. I know you know all about this or a lady riding a bike. all of a sudden just has a massive heart attack, they can be as fit as anything. But hereditary is the main cause. Obviously, lifestyle is not – my lifestyle wasn't great and I take full responsibility for that and I've had to change that. But hereditary is one of the biggest things that you don't know and that just creeps up on you. Yeah. No, it's – And even predicting within families is complicated. It's a disease we don't fully understand. And I think the more respect we give it and the more open we are to investigating for it, then the more lives we can save and the more prepared we can be. But I'd like to swing back and just ask you a bit more. Was it the 5th of February you said? Yeah, it's on my birthday, yeah. Extraordinary that it was on your birthday, an amazing birthday present, probably in two different ways. Yeah, I'm glad it happened on my 50th because it sort of wakes you up for the second half of your life, hopefully. Extraordinary. But what I was going to ask you, Darren, is in that process, were there times when you were scared? Was an angiogram a scary thing being rolled into theatre to have bypass surgery, knowing that they were going to open your chest up? How did, was that, did you just cruise through that or was it? Oh, you certainly don't cruise through it. You have a lot of questions and you really, because you don't understand. And even today, you know, they've explained it well to me, but, you know, I might say the wrong thing, but I know what I mean, if that makes sense. The scary was probably the kids and my wife, you know, that day we were supposed to all catch up for a great. you know, birthday party dinner. And that changed in the morning and all of a sudden they're just meeting me in hospital. And then the next day we moved to Prince Charles and I had Dr. Tessa, who's a fantastic surgeon, and his team, you know, do the open heart. And I remember they explained it so well. I mean, doctors don't, and I'm not blowing wind up your backside doc, but everyone, all the doctors explain it so well and they have a real calming influence on you. So for me, it was actually quite a calm experience. It was a really hurtful experience. I mean, that pain when they're sawing your chest and, you know, three months after, I mean, that's, you know, pain. I don't have any pain with it. And I was one of the, you know, the first, as you know, these days, and I don't mind showing people, you know, they took them out of my arms. Yeah. Which is sort of newer now because it's a stronger muscle and I've had DVTs in my legs, for example. It's more the mental side of it, you know, trying to gauge through that. And that was the tough process. My family were great support. I mean, you know, and you're scared because you could leave them behind. That's the first realisation that, you know, you're going into open-heart surgery, but if it goes wrong, you just don't know, do you? So, you know, the doctors and nurses and all the staff are fantastic. So... You were in hospital for about a week or five days or something like that? Yeah, they kept me in a couple of days longer because of my smoking and making sure I could breathe properly, all the breathing exercise you have to do through the tubes and all that to get your lungs open and going again and just making sure all the wounds had healed well enough to go home. But it was a long process. I mean, I only feel good... really good now in terms of physically. I still have the mental scars, which we can talk about as well. But the side you notice is, you know, just making sure the scars are healed and there's no infection there and you come home and you basically spend 12 weeks just rehabilitating. And I was so lucky to have a, they have a rehabilitation, you know, like a course. at the hospital that i went to prince charles and all that actually running out of saint vincent that actually goes through all the you know dietary understanding the the pills you're on i've got that many pills now i don't even know you know what all of them are i know they do something for me But going through that, changing the way you think, your lifestyle, psychology, the physio, you know, twice a week. It was a great course. I did it for six weeks, actually. It's a really good course that I recommend anyone do if you get a chance to do those sort of things on the back end, mainly because I got to speak to people who had suffered the same issues as I. And there was also a couple of younger people in there at my age, but most of them were, you know, I would say 70 plus. But discussing how they're feeling and having open dialogue with other people and patients that have been through it was really therapeutic for me. I'm glad you mentioned the rehab because I was going to come around to it and say, you know, what did you get out of it? But it sounds like it was a very supportive and educational process for you. Did you find, because you touched on the smoking, and I get the sense that you've now canned that, but did you find that rehab was... required for you to give the smoking away or had you just made a decision yourself? No, it was pretty easy, obviously, when you're sitting there with an open heart and coughing up crap. So that was an easy one. The rehab came about because they offer the service and they recommend you do it. They don't say you have to do it. But because I was, you know, in the unknown and how I was feeling, mentally as well, I wanted to get a better understanding of the whole issues that transpire throughout the body and especially with the heart. So for me, it was a great educational process. You had twice a week, it was Tuesdays and Thursdays, you'd go in and you'd do an hour of physiotherapy and walking and all these exercises to get you moving again. And then also, then you have an hour and a half lecture and it'd be on the heart or the drugs you're taking, the operation itself, nutrition, I'm just trying to think, the mental side of it, family side of it. You had your partner come in as well, which I thought was, I almost think it should be compulsory, not recommended. There you go. That's how important it was for me to get through those issues. Yep, yep. While you're talking about all that education, I'm going to do a plug for one of my own soapboxes. You mentioned you're on a whole heap of tablets. I'm going to say to you, I hope you're carrying a list with you. One of the most valuable things you can do is carry a list of your medications. Because if you fell over in the street, banged your head, went to hospital and someone said, what are you on, Darren? You go, oh, a little white one, a little pink one. It's nowhere near as valuable as giving that list over and the doctors know exactly what you've got. So it's a little, it's a soapbox of mine. carry a list it is a good one it is a good one and like for example i didn't know that and you correct me if i'm wrong here that you know if you ran out of tablets you can get an emergency uh now if you have the connections with your your doctor and wherever you are so those lists uh are essential but you know that that simple rehab i think it's a must do for everyone i think you have to do it i wouldn't even think twice of you know if If part of the reason you sign up for open heart, well, you do open heart, part of the discharge thing is you have to attend a rehabilitation part because that was so good for me to understand what I'm feeling and why I'm feeling it as well, just for conversations with fellow open heart surgery patients. Well, look, as we discussed, in fact, Darren, part of this interview will go into a book I'm writing. called cardiac rehabilitation explained because it really is such an important component of someone's journey through this process so yeah i suppose the biggest one for me has been the mental side of it i know you're going to discuss that in your book and and you've discussed that in in your other book as well so um which i have right here doc for you so if anyone needs a plug there you go get that in here i i think one of the things for me is is the actual mental side of it. I have good days and bad days for everyone that's listening. And that's no secret. I mean, there's days where I just don't feel like doing anything or I just feel like sitting outside and smelling the fresh air, something I didn't know whether I would do again or not. But you have good days and bad days and you've just got to have people around you and being able to talk to someone about what you're feeling is so important. And that's hard to describe to everyone on the Zoom here and the podcast because you sort of wake up and you feel, you know, I'm up and I'm ready to go again, but then you feel flat, you know, why did it happen to me? Why is this? And you look back on your journey and you understand why then. So you can't look back. I'm at stage where what's happened is in the past and I can't worry about that. I've got to actually worry about... You know, things are important to me, which is my family, obviously, and the future and living life to the fullest as long as I possibly can. And as the doctor said, you know, we just put a V8 engine back in you, but make sure you look after it this time. So, you know, that's the hardest thing. And, you know, I might be just sitting quietly at home and, you know, I do things I've never done before now. I read a lot more. I listen to... podcasts and music and do things. And if I don't want to do something, I just don't do it now. It's a really strange way you get to that point in your life where you might do something to keep someone happy. I don't do that anymore. I just say, no, I don't really want to do that. Thank you, but I'm not doing it. So you don't have so much politics in your brain. If that makes sense, you simplify things because everything brings it back to a really simplistic view that your family are the most important in your life. And we worry about everyone else where we really should be just looking within and really concentrating on the really important ones. And with that, I mean, when you go through this whole process, you get a lot of really good messages and messages of support, et cetera. And that's so important. But the ones you just really go, wow, this is going to affect my family a lot. And I've been lucky enough to have a great support of family and friends and very understanding as well. I mean, correct me if I'm wrong, but it almost sounds like a mixed blessing. It sounds like it's been an extraordinary event, which has perhaps changed the way you view things in a positive way. for the future in a positive way. Yeah, that's totally correct. I mean, things have a reason. I wouldn't wish a heart attack was it. No, no, I don't wish anyone. I don't wish anyone saw through the chest and go through that. But for me, it's a second chance of life and enjoying what I've got, not what I want to try and achieve, what I've got. and really simplifying. So I've got to the stage where, yeah, I'm still coaching a cricket team, et cetera, like that. But if that went tomorrow, I'm not too worried about that. I'm trying to learn how to fish. The only problem with that is I've got all these hook marks in my fingers at the moment. That's a nightmare because I just don't know what I'm doing. I'm learning stuff I've not done before. So for me, I like that. It's really stimulating. and seeing another side to life. So I think it was a blessing in disguise even though you don't wish that upon anyone like you said, but you just get a chance to re-evaluate your life and where you're going and only keep the people that are important to you in your life and looking after other things. Charity work's always been a big thing of mine, but probably throwing myself more into that as well because I'm fortunate enough to have a second chance and you want people to have as much as you possibly can. Well, certainly it's an extraordinary sequence of events. One of the things that you mentioned of good days and bad days, and I really hope and I get the sense that you're probably getting more good days and bad days now. My own experience in that space is that I almost think that some of those feelings that people describe are part of a grieving process. And we grieve. We grieve an awareness of loss of health or we grieve an awareness that we are mortal and not immortal. I'm not sure about what your thoughts are. And grieving is a normal thing with loss. Do you think it's a sort of a... We don't put a term to it normally, but that sort of process that you work through. Looking back now and the way you put it then is probably correct, actually. Why me? Yeah, why me? Yeah, processes of grieving. Process, the grieving process. I mean, I lost my dad at three, obviously said a heart attack, and you probably go through the stages of that grieving process. So for me, it was a case of going, wow, why? how many people I'm going to hurt through this and realise all you've got to concentrate on is yourself getting better and you'll feel better, then you'll actually help people again. And you can't look back. And as you said, my bad days get less and less. It might be bad days, it might be once a fortnight now. for example, that's getting less. It was once a week, you know, going back a few months ago. And everyone's talked about COVID being, and I know COVID's a really, you know, it's been a world-changing event and pandemic for everyone. But, you know, open-heart surgery is like a COVID as such because you are isolated by basically three months. You know, you don't drive, you don't do anything, you're actually just recovering. And you're slowly getting back into day-to-day living. So it certainly is a wake-up call. But the grieving process, because you are probably leaving one life behind and starting another one, and that's probably the best way to put it, really. It's hard to quantify in words, isn't it, because everyone says grieving, someone's died. Well, in essence, you sort of have in a way because they've given you new tools to actually work again, a new engine to start again and have a second crack at it. Yeah. Look, some practical things. How are you going with your tablets? Any side effects, any problems? No, I've been lucky enough that all my tablets, you know, blood pressure tablets, warfarin, I'm about to go to cardiologists back again this week. So hopefully I'll go off warfarin. So I stop all those needles every week and go to Zerato, which I was on before, obviously with my DVT. So I know that's a better tablet. Obviously you don't want to get hit in the head with Zerato. But hopefully I can get back to that, which will lessen the dose. You know, the dose will still be the same, but one tablet instead of, you know, a five and a three or a three and a three and a one and a half and, you know, all those. So I think, you know, I'm going to be on a lot of them for the rest of my life and that's okay. I understand that. I carry, you know, I've got tablets. you know, in the little pill boxes, which I think is really important just to remember which day you're at because some of the things with my memory is I forget what day I'm at. So, you know, I've got a two-week box, a little travel box, which is quite small, which I reckon is really important. I keep that with me all the time. And I've got the one by the bathroom, which carries a month. So I've always got probably six weeks of medications up, which I think... In this day and age, I always like to have that much just in case something happens or I've got to go somewhere for six weeks. In my job or my profession, which used to be quite travel a lot, I don't travel as much anymore. I mean, I have not been out of Queensland since Australia Day this year. So I've been a little bit lucky there, but that's because of COVID and everyone's in the same boat. And what about stuff at home? How's the family? Now living around you, how's your relationships at home? Are they better? They're stronger than ever, to be honest, because you almost lose something. So they're stronger than ever, the relationship side of it. So that's been a really interesting one. Them having to deal with some of the issues that come up post heart attack, because for probably three months there, even though, you know, you get the second chance, you get quite short. The concentration span is not there. So, you know, there's things that frustrate me. I just say it and I don't think about it sometimes. And then I go, well, I shouldn't have said that like that. So understanding that that's just part of the rehabilitation, I suppose. And now, obviously, I'm a lot more able to concentrate a lot more. But I wouldn't say I can concentrate for hours on end. You know, if I'm in a conversation like this, you know, I've probably got, you've probably got me for 30 minutes, then I'll sort of lose a little bit, if that makes sense. That's just a natural thing. So the family members know that. They sort of see it in me when I might be a little bit frustrated and they sort of give me my space and they'll say, go for a walk, Dad, or take the dog for a walk or something. You know, they sort of, the cues come for them. So they've been unbelievably supportive. Look, we'll come towards the end now. I think we'll look to start wrapping up. Are there any things in particular you'd like to share with others, any particular points you'd like to leave people to think about from your own journeys, from your own journey and your own experience? The post-operation, the five days, is some of the hardest days you'll go through. That is the hardest time physically. Physically, that's the toughest time. I mean, and I can't commend the nurses or the doctors enough, but some of those nurses, you know, putting up with me for five or six days and doing things, you know, because you're on drugs and different pain killers and things that, you know, you're constipated. you know, for a while, then you're not constipated. So I'll put it that way. They're dealing with those things all the time. That's probably, and the way they make you feel and trying to get through that and know each day is going to get better because they've seen it with so many patients and you say, no, it's not, it's not getting better, but gradually it does. And the little increments over that period of time are quite important. Once you get home rest. It is a really important part of the recovery process. But then take yourself out for that hour a day or, you know, because you can only start, I think I could only start walking 250 metres or 500 metres and it sort of then went to a K and then 20 minutes and then half hour, then 40 minutes and then an hour, basically. And don't try and push it too much because... I found when I did, you know, my first walk was the shops, which is about 250 metres away. And I thought, oh, yeah, you know, I walk home, you know, so that's safe, 600 metres. But I was only supposed to do 250. I got home and I was just knackered. I was just so out of breath. I went, oh, this is no good. But, you know, it does, I'd say be patient with it. And I'd also, if I had one bit of advice, it'd be... apart from the rest and make sure you listen to everything, it'd be do the rehabilitation course. That'd be number one. Yep. That'd be all the pain and the understandings, the most important one for me, understanding, you know, the operation, the drugs you're on, why you're on them, what happened, the heart, how it works itself, you know, just the conversations you have with that course. Again, I would say it should be compulsory. that that's what i would say i would say there's no way you should go out whether you have a stent or an open heart without having the information well i think the research actually supports that but so many people echo exactly your sentiment and it is an incredibly important component of the overall care Look, we're just about at the end. Is there anyone in particular you'd like to thank? Obviously, you said the AMBOs were fantastic. You said the docs were good. You said the nurses put up with you. The physios flogged you. The rehab people were great. Was there anyone in particular you want to thank? Or you really just... If I would thank one person in particular, I'd probably thank my wife. Andrea, she's a nurse by trade. So she's quite calming. And when I was having all these bad thoughts or why is this happening or what's that, you know, why is that scar not healing? You know, there was on my arm, there was a couple of spots that were red and inflamed and I had to go on antibiotics. A local GP for actually reassuring me. All the people that sort of had me day to day. The specialists were fantastic. And I can't speak highly enough for all the doctors and nurses out there. But, you know, the general day-to-day feeling of ups and downs, probably my wife and children for understanding what I'm going through and actually just giving me the space to heal, both physically and mentally. And you need that. You definitely need that. And, you know, nothing's too uptight or worrying now. But that's where now, what are we, eight, six? We're six months down the track now. So, you know, it does take a while. But as I said, I'm still going through that process because there are days where I don't feel mentally quite right. And as the doctors and everyone said, it'll take a year, might take a year and a half to you feeling really good about everything about what happened to deal through those issues. So probably my wife. Yeah, that's a good... Sorry. That's a good pick. And in fact, when we spoke about getting together to have this interview, I did invite Andrea to join us. So I'm going to put you a bit on the spot and say, even though she's not here, what do you think she, what would be her headline from this process? Time to slow down. you know, and time to look after yourself and not others. And that's probably where you have that wake-up call. I was always worried about everyone else and probably not looking after my own health well enough. So that would be the one thing she would probably say. And spending time with people that really mean a lot to you than other people that probably allow you to get to where you want to get to from a work position, I suppose. Really understanding that life and family is a lot more important than jobs. We're all going to have jobs, I know that. Don't get me wrong to the people out there, but probably just understand that the reason we are on this earth is to actually have a great family and enjoy what's a beautiful country and a beautiful world. Well, I think that just about sums up everything, actually, and we might call it quits. I'm going to invite you to say goodbye. Well, thanks for having me, Doc, and everyone on the podcast. And hopefully I've given you a little insight to what's transpired in my life over the last six months. And to everyone that goes through what I've been through, good luck. It does get a little bit easier each day, and I'm thinking of you. And just listen to the doctors and the nurses. Darren, thanks so much for sharing today. For those who are listening, I'm sure you've taken pearls away from this. I'm really grateful for your openness, Darren. If you have any queries or questions, drop us a line. Thank you for joining us. Until next time, I wish you the very best. Take care and please don't die from a heart attack. Goodbye. You have been listening to another podcast from Dr. Warrick. Visit his website at drWarrickbishop.com for the latest news on heart disease. If you love this podcast, feel free to leave us a review.
