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's Dr Warrick Bishop and I'd like to welcome you to my podcast and videocastation. Today I have the opportunity to speak with a patient, Dan, who's joined me to share with us his story. Hi Dan, welcome. Hi Warrick and it's nice to be here. Look, I'm really very pleased to have the opportunity for you to share your story. It's extraordinary. Very briefly, Dan's background is he's young. He's had coronary archer bypass grafting and he's now sitting here having a cup of coffee with me and now we're going to dig in and get some more details around that. So, Dan, tell us a bit about yourself, your age, where you live, your kids and what you do. Yes, so I'm 45 years old, live at Clifton Beach in Tasmania. A young family, an 11-year-old daughter, 13-year-old son, an engineer, have a construction background. And I'd say I keep myself reasonably fit, do a lot of long distance running, surfing, water sports. And the furthest thing from my mind was open heart surgery. So I'll let you in on a secret, guys. Dan and I have just been for a run. And it'd be fair to say he showed me a clean pair of heels for most of the way. But it's quite possible that we wouldn't have been able to undertake the run we just did if things had gone differently. Dan, do you want to just share with me your journey and what's brought you to where we are right now? Yeah, it started last year. I play what I call old man soccer. It's at a slower pace than back in my younger days, but it's still a pretty competitive little game. And I was playing, it was back in September. And just after the game, the keeper of the other team had a heart attack. We had a... a nurse there who was able to assist and a police officer and do CPR and unfortunately later that evening he passed away and I left that day thinking apart from the tragedy I don't think I was able to assist in the way that I could have so I signed up to do a life-saving course Clifton Beach Surf Life Saving and ironically during that I got an ear infection. which took me to the doctors. And the doctor said, oh, at your age you should do a couple of blood tests, check your cholesterol, see how you're travelling. I hadn't been sick for 10 years. I hadn't been to the doctors for seven. And in doing so, my cholesterol was, I think, high eights. And I was like, oh, that's unexpected. So he sent me to Warrick. And off I went to see Warrick. I think both of us at the time thought, well, I presented healthy, I'm fairly fit. But as a preventative measure, I was directed to do some further testing. I think it's a CTCA scan. You might want to correct me, Warrick. So when you came to see me down, as far as I recall, no history of smoking and no real history of premature coronary disease within the family? No. I think your dad had had some problems with his heart, but at a slightly later age, is that? No, it was my uncle. My uncle had had a bypass, but that was in his late 60s. Yeah, okay. And I had no telltale signals. It was only when I was running or sprinting in soccer at full pace that I felt that I was a bit short of breath, and I was putting it down to a year of less activity. With COVID lockdowns, I wasn't exercising as much as I probably could have. I got a bit complacent and I just thought I'm getting old and unfit. That was my only telltale. So for those who are listening in and don't have the benefit of video for this, we're not actually doing it by video, but Dan is a tall, slim-looking figure. In no way does he look an unhealthy specimen. And it would be fair to say that he looks like an unlikely candidate for anything to go wrong. When he came to see me, he asked about risk exactly based on the background that he shared. And we talked about trying to be more precise, either just treating his cholesterol, which was high, or doing some imaging to try and find out what was going on with his heart and be most precise about next steps. Dan's risk profile would be low based on current risk calculators. But because of the raised cholesterol, he'd be considered low with risk enhancers. And so a reasonable candidate to have a conversation about CT imaging with. So we spoke about that, Dan, and you're happy to proceed. And I'll underline and emphasise that at the time Dan and I caught up, there was no clear history of symptoms, nothing clear cut. had, in keeping with current guidelines, signed up to self-fund for his CT scan, which was all quite appropriate. Yeah, in fact, one of the things I actually was thinking at the time, if I can get this imaging, it might show there's nothing wrong, and then I won't have to go on tablets. That's actually what I thought. I thought, well, I'll show that I'm actually fine. And I'm happy to do the scanning to show that because... I don't want to sign up for a lifetime of cholesterol tablets and aspirin. Did I put you on medication when I first saw you? So I remember you saying, look, and I don't want this to sound harsh, I'll put you on a low dose of aspirin and cholesterol tablets because it doesn't look good in the interim if anything goes wrong. So it was definitely precautionary, but yeah, I started a low dose. um aspirin and um cholesterol just daily but just as a precaution because we were going to then use the imaging to determine what the best strategy was so that was a bit of that was a bit of good planning well that's good planning in hindsight it was uh it was a yeah strike of good fortune well it also represents that we just don't know what's going on in people's arteries and if you assume the worst and prepare for the worst and hope for the best, then at least you've covered all bases. And it sounds like we at least started that with you. Yeah, definitely. I mean, I left the meeting with you and I wasn't concerned or scared. I just thought, yeah, this is a nice, you know, a nice approach, prevention, just, you know, what can we do to harm or risk, you know, the worst case scenario. But I wasn't scared when I left you. Also, by way of a bit of background, we'd actually been surfing on the same break only, oh, soon after that consult, actually. It was actually a couple of days later. It was a couple of days later. It was a coincidence. We were out there surfing. I was there with my daughter. Your daughter was out there. At that time, it was just a normal life and a normal journey. So what I was going to say to you is that after the consult, apart from us surfing together, What do you remember your journey after our consultation? What happened next? So because of the ear infection, I actually had to have ear surgery, and that was from surfing exostosis removal or bone growth in the ear. So I had the surgery for that, which actually meant that my scanning got pushed forward till after Christmas, so I couldn't get it done before the surgery, so I had to put it off a little bit. And in that month, this was in November, late November, early December, so in that month of recovery from my ear surgery, I felt that I was not as fit as I had been. And if I was doing even some walking or something, I was getting shorter breath, and I just thought, oh, this surgery's really knocked me around. And I remember trying to start running just after Christmas, doing a few short runs, and got shorter breath within one or two K, and I'm like, this is not normal for me. And just after the New Year's, I was running with my wife and just up a shallow hill, a small hill, and about 300 or 400 metres in, I had to stop and walk. And I thought, that can't be just, you know, a lack of fitness. And that was the first time, so that was early January, that was the first time that I'd ever thought, oh, there might be something going on. Because this is for a 44-year-old. bloke, who's basically got a history of running regularly, has run a sub three-hour marathon, surfs regularly, looks after themselves, and you couldn't run up a gentle slope with your wife. Yeah, well, that was it. And, yeah, I'd never, ever experienced, like, that kind of fatigue. But even still, even still, after stopping to walk, I was 100% fine. So if I was running, that was the only time I had even the slightest symptom. So if I was sitting on the couch, I'd have been none the wiser. And then when was your scan after that? The scan was the following week. So I had the scan less than a week later. Well, the scan was fairly normal. A couple of days after the scan, or might have even been the next day after the scan, I got a message from Warrick to come in and see him. And I thought, that's a little bit too early. I was thinking, I don't really want to hear from the doctor within 24 hours of the scan. So when I report these scans, I look at them, and if there are potentially high-risk features or suggestions of any narrowings, we try and bring people in sooner rather than later. And often my staff are excellent at sort of saying, we've just had a vacancy pop up. Would you be interested in coming a bit sooner? Because the last thing we want to do is create fear and terror. Well, that's right. But coincidentally, my brother had just had a scan, I think even the day before. And I'd said to him, have you got a message to go and see Warrick? And he said, no. I'm like, oh, that's disappointing. Well, we might take the stress test. coming in for the stress test is a natural break. We'll take a pause there and look to come back maybe for part two, if that's okay with you, Dan. You're happy. All right. So that's part one of Dan's journey through coronary artery bypass grafting as a man at 44 years of age. He's now turned 45 during the time of rehab, I might add. We're going to come back with part two and stay tuned. I hope you found this interesting, informative. And you appreciate the sharing. Take care and bye for now. 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.
