Chest, Heart or Stroke conditions can affect all parts of life, not just our health. If you are living with these long term conditions you may also have to learn to how to cope with changes to other aspects of your work, social or family life.

NICHS deliver a range of support services to people affected by chest, heart and stroke conditions and their families. We help thousands of families every year to cope with the impact, and to support them to live to the full.

Anxiety & Depression

Living with a long–term health condition affects many aspects of your life. There are the physical symptoms like getting out of breath, feeling tired or having pain. But long–term health conditions can also affect your feelings and may have a major bearing on how you cope.

Anxiety is a feeling of unease, such as worry or fear, that can be mild or severe. For some of us, anxiety starts after a long, slow build–up of stress. It can also start when we don’t feel in control of certain aspects of our lives, such as our health. This can make us worry about the future in general. For others, anxiety may be brought on by a single stressful event.

Feelings of anxiety can cause physical symptoms such as:

• A racing heart
• Sweating
• Feeling a need to go to the toilet
• Loss of concentration
• Irritability
• Breathlessness

If you start to feel anxious, it may help to try some breathing exercises or relaxation techniques. Often just concentrating on your breathing will take your mind off your immediate worries and help reduce your heart rate.

If you feel depressed or anxious, the first step is to talk to your loved ones about your concerns. Talking may also help them, because they will have their own worries about you.

Communicating with your Healthcare Team

Your GP is just one of a number of healthcare professionals who may be involved in looking after you and treating your condition. Good communication with your doctor and other specialists such as your practice nurse, pharmacist or physiotherapist will help you manage your health.

It is important that you understand what they say – and that they understand your concerns, and take your views into consideration when they are planning your treatment.

Tips when visiting your doctor:

• Make a list of questions and concerns before your visit. List these in order of priority.
• If you have many questions, ask for a longer appointment or make a second one.
• Show your list to your doctor and decide together what you will discuss during this visit.
• Do not avoid asking questions because you are embarrassed. Your doctor is there to help.
• Bring a friend or family member for support.
• Do not leave your appointment feeling that you do not fully understand what your doctor is saying. If something is unclear, ask for more information.
• Ask your doctor to write answers down for you to refer to later.

Community Care

Community support services to help you manage at home are usually arranged through Social Services within in your local Health and Social Care Trust.

Contact with Social Services can be in a number of ways. You may:

• Self refer by contacting the Social Services team in your area
• Be referred by a GP or someone who works for the Health Trust
• Be referred by a voluntary organisation
• Be referred by a family member or informal carer.

You will have to have your needs assessed by Social Services before they will provide support for you. This is called a community care assessment or, for carers, a carer’s assessment.

Once you have been assessed, the social worker can tell you about what services are available and whether you have to pay for them. Services can vary from area to area but might include:

• A home help or care assistant
• Delivery of meals to your home
• A place at a day centre or within a community group

While community care assessments and carer assessments are free, Social Services can charge for some community care services. The regulations about which services must be paid for, and how much can be charged, are complicated, so you should seek advice.

Computers and Accessibility

If your condition has affected your vision, you may find using computers difficult. The RNIB’s website has lots of useful information to help you make your computer more accessible.

If you are unfamiliar with computers, CLICK HERE for a website may be able to help you get started. It explains all the jargon and explains how Facebook and other social media work.

Driving

If you’ve had, or currently have, a medical condition or disability that may affect your driving you should speak to your doctor or check with the Driver & Vehicle Agency (DVA).

You should also seek advice from your insurance company to make sure it covers your medical condition.

EHIC

With a little forward planning, you can protect your health when travelling to Europe and avoid unexpected medical bills. Your existing European Health Insurance Card (EHIC) or a new UK Global Health Insurance Card (GHIC) gives you the right to access state-provided healthcare during a temporary stay in the EU.

If you have a UK European Health Insurance Card (EHIC) it will be valid until the expiry date on the card. Once it expires, you’ll need to apply for a GHIC to replace it.

An EHIC or GHIC is not a replacement for travel insurance - make sure you have both before you travel.

If you have a pre-existing medical conditions, you should make the insurance company aware so that you are adequately covered.

Flu Vaccinations

Flu is a highly infectious illness that spreads rapidly through the coughs and sneezes of people who are carrying the virus.

Anyone can get flu, but it can be more serious for certain people such as:

• those aged 65 or over
• those with a serious medical complaint, such as a lung condition, a heart condition or stroke

If you are in one of these groups, you are more vulnerable to the effects of seasonal flu (even if you’re fit and healthy) and could develop more serious illnesses, such as bronchitis and pneumonia.

Flu can also make existing medical conditions worse.

The best time of the year to get a flu vaccination (flu jab) from your GP is in the autumn. It’s free and is effective against the latest strains of the virus.

You need a new flu vaccination every year because the viruses that cause the illness are constantly changing.

More information can be found at Flu Aware NI www.fluawareni.info/

Flying and Holidays

Most people with existing medical conditions are able to travel by air without difficulty. However, certain precautions sometimes need to be taken. If you plan to fly, consult your doctor before you book.

You will need medical clearance to fly if:

• You need any special medical provision e.g. oxygen
• Your fitness is in doubt as a result of:
  • a recent illness
  • a period in hospital
  • surgery
  • you have an acute or chronic condition that is unstable

If any of the criteria above apply, you and your doctor will need to complete a Medical Information Form (MEDIF), which is available from the medical department of the airline or your travel agent.

Remember that many airlines will charge extra for providing oxygen and will not allow you to use your own on board.

• Think about your destination and how it suits your needs
• Allow yourself plenty of time to get to the airport or the holiday location.
• Don’t carry heavy pieces of luggage.
• If your mobility is limited or walking long distances in an airport will be difficult, you can request Special Assistance. The service is provided by the airports for free but should be arranged through your airline.
• Plan your activities so you do not need to rush around
• Take time to relax each day.
• Eat and sleep well to avoid becoming run down.
• Take enough medication for the whole holiday. If you are flying, carry it in your hand luggage.
• Take a list of your medications and a brief medical history in case you need it.
• Make sure you have a European Health Insurance Card (EHIC)
• Make sure you have travel insurance

The information above is general and not exhaustive.

Medication

Medication can play a big role in how well you feel and the way you take your prescribed medicines can make a big difference to their effectiveness. But it is easy to make mistakes without even realising. Be careful always to follow directions when taking any medication. If you have questions, concerns or are experiencing undesirable side–effects, speak to your doctor, nurse or pharmacist.

A full list of basic guidance on issues often experienced by people living with long–term conditions is available by clicking here.