After a heart attack
His fate will sometimes depend on the attitude of a person who has suffered a myocardial infarction, to his condition, to medical recommendations, whether he returns to a full-blooded life, overcomes a disease or reconciles with it, turns into an invalid. It is not by chance, according to statistics, it is psychological factors that are the main reason preventing the return to work of every second patient who has had a heart attack.
This disease, appearing most often suddenly, disables a person, breaks his life plans. Patients react differently to what happened. According to our observations, about two-thirds of patients are reasonable, without panic, refer to what happened; they carry out doctor’s prescriptions, actively fight disease and its consequences. However, a third of patients respond differently. Some experience constant fear, although the danger has passed. Others give up, lose all hope of recovery. Still others go into a disease that all their interests are focused on it, they do not think or speak about anything else, while doctors assess their condition as quite satisfactory and consider that there are no grounds for pessimism.
Fear, depression, anxiety not only exacerbate the suffering of a patient with myocardial infarction, but also greatly complicate treatment and rehabilitation. Moreover, strong negative emotions lead to unfavorable shifts in the neuroendocrine system of the body, which, in turn, aggravates cardiac disorders.
Why does the formation of a patient’s response in response to a myocardial infarction occur? Primarily on the personality traits, character. People with a strong, strong-willed character, a harmonious warehouse of personality, who are accustomed to actively overcome the difficulties of life, having suffered a heart attack, strive to restore health by all means. And those who, before the illness, were distinguished by increased vulnerability, suspiciousness, who had neurotic failures in difficult situations before, react panically to a heart attack, go into the illness.
A significant role in the formation of the patient’s psychological attitude is played by information about the nature of the disease and its possible consequences that come to him in various ways. Of course, the main source of such information is the attending physician, who is trying to morally support the patient, instill in him confidence in a favorable outcome of treatment. And it is good when the family members of the patient agree with him. But it happens that the patient reasonably relates to what happened, and the wife is anxious and fearful, “infects” her husband, visiting him in the hospital, and the person develops a neurotic reaction to the disease with all the ensuing consequences.
The psychologically particularly difficult period for both the patient and those close to him is the first weeks after his return home. Having been deprived of round-the-clock medical supervision, which is no longer required at this stage, a person sometimes begins to experience fear again, is afraid to move, walk, do physical work, even to the extent recommended by the doctor. During this period, psychological support of close people is very important.
There is one more important problem – intimate marital relations. Numerous observations of doctors have shown that in the vast majority of cases myocardial infarction is not an obstacle to their recovery. However, the patient himself, and often his wife, are also afraid, afraid that no matter what happened to their heart during intimacy. And such a mood. not conducive to the return of the patient. to a normal, active life.
In order to prevent the development of neurotic reactions, doctors from the first days of the patient’s admission to the hospital conduct explanatory conversations with him and his relatives. The main goal of such conversations is to strengthen the patient’s confidence in their abilities, to restore their previous positions in the family, at work. If necessary, he is prescribed special medication to eliminate anxiety, fear, insomnia, depression, and teach autogenic training techniques.
A huge role in psychological rehabilitation is assigned to family members, the closest relatives of the patient. But, unfortunately, not well enough imagining how to help the patient, they often do him a disservice and make rehabilitation difficult. Judge for yourself: the doctor, when discharging the patient home, recommends a certain amount of physical activity for him, and the wife seeks to reduce it in every way.
The patient must limit the intake of fat, and the wife. wanting to “strengthen the health” of her husband after suffering a heart attack, on the contrary, she adds butter wherever she can to increase the caloric content of food. The list of these examples could be continued.
Not only does such a “help” increase the threat to health, but family conflicts also flare up, and they are completely useless to a patient who has had a heart attack. a special school has been organized at the Scientific Center of the Academy of Medical Sciences of the USSR in which doctors bring to the attention of their students the necessary hygiene advice, recommendations on nutrition, regimen, answer questions.
What do we advise the sick? First of all, they should not be afraid of exercise, but, of course, strictly dosed according to their individual abilities. Successful psychological rehabilitation is largely facilitated by participation in physical training conducted under the supervision of physicians at cardiological sanatoriums, cardiologic dispensaries, and polyclinics. As our experience shows, increasing physical abilities, like nothing else, eliminates unnecessary fear, returns the former confidence in their abilities. Training normalizes sleep, improves mood, increases endurance not only to the physical, but also to the mental load, increase sexual potency.
Of course, the efforts of the patient himself to restore their own health are of paramount importance. Unfortunately, there are many patients returning from the hospital, where they are usually. they didn’t smoke, because the medical staff strictly monitors this and, naturally, they didn’t apply to alcohol, they again began to “go with the flow”, quickly wasting what they managed to achieve in the hospital. Naturally, their condition is deteriorating, and the matter here is not in the inevitable gait of the disease: the responsibility for the deterioration of the condition lies with themselves. And, conversely, the implementation of metered physical exertion and a complete cessation of smoking and alcohol help to quickly restore health.
In conclusion, some advice to relatives and friends of the patient, who can do a lot, help him to get on his feet faster, to return to work. In the first days of the disease, when visiting a person, try to calm him down, if necessary – help him to settle matters. suddenly interrupted by disease. It is important that he should not worry about anything, tune in only for treatment, be an active medical assistant, and strictly follow all his recommendations. Before discharge from the hospital, you will certainly discuss with your doctor all the hygiene and organizational issues related to home rehabilitation. It is important to help the patient to overcome the difficulties that sometimes arise in the first weeks after returning home, to ensure systematic physical education. Talk to your doctor about the possibility of restoring intimate relationships, since, as already mentioned, they are of no small importance for the psychological rehabilitation of the patient.
Do not forget that a heart attacker needs a diet, discuss with your doctor what and how best to cook. Try to create such conditions so that the patient does not start smoking again: remove cigarettes, ashtrays, do not smoke yourself, try to occupy him, distract him, go for walks with him, read aloud. Gradually, more and more include him in housework or in the garden plot, if you have one, entrusting what you can do. So, gradually assimilating to work, a person will believe in the real possibility of a full restoration of health.