I had an interesting call towards the end of February from Yvette London at Lewisham NHS. They run NHS Phase III exercise classes and are keen that their patients get together and start a support group like THROB. They like the idea of launching a phase IV which is divorced from the NHS and which includes the self-help ethos we have, so I await a call from their management team to see how this could be progressed. We have never documented the structure of THROB, how we have achieved 28 exercise classes a week and how it could work elsewhere. Maybe this is something we could do by creating a 'THROB model'. This could be rolled out in other regions wanting to invest in rehabilitation, support and exercise. We have been lucky in the way local partnerships have boosted the classes and of course we have invested in projects that make a difference to the community. With what we know now we could help others do something similar.

Also I received a call this month from The Senior Citizen Open Forum. I believe they network a number of groups in the West Berkshire area and we have been invited to one of their meetings to introduce ourselves. This is more of an opportunity to let more people know about THROB and what we do, rather than increase membership. However this is an opportunity to network with more groups and who knows where that may lead.

Lynn Warner

Some years ago I had a Magnetic Resonance Imaging (MRI) of my back and remember that I had to be very, very still or it would not produce a good image. Last month I had an MRI scan of my heart and I thought "How can they do that - surely they won't switch my heart off to keep it very, very still!" "Fear not", says nurse (or words to that effect) "we put a heart monitor on you and take a quick image of your heart at the same part of the pulse for several beats and put the results together to get an image". (Simples!) Of course you have to hold your breath and stay very, very still while the pulses are recorded. As you probably know the MRI uses a powerful magnetic field, radio frequency pulses and the inevitable computer (how would we live without them?) to produce a detailed picture of any part of your body. The good thing is that the process uses no ionising radiation. Apparently MRI is better at imaging than all other methods such as x-ray, ultrasound, computed tomography (CT scanning) or thallium scanning since it more effectively differentiates between diseased and normal tissue. On the down side, it is more expensive.

In my case it was necessary to get contrast between bits of the heart at work and a line in one arm was used to inject a "dye", probably a gadolinium salt, into my blood stream. In the other arm I had a line to inject a drug which stresses the heart. Clearly one can't lie in a MRI tunnel and exercise at the same time in order to get the heart into a stressed condition. That part of the process I would not recommend for my worst enemy - let's just say it is an unpleasant experience and leave it at that............. Fortunately, the drug is quickly mopped up in one's bloodstream and the effect only lasts for about three to four minutes. Mind you that is long enough when a disembodied voice from the intercom is urging you to "breath out, breath in, hold it and stay very, very still!

The results of a cardiac MRI scan can be use by the cardiologist to evaluate the structures and functioning of the heart, its valves , major vessels and surrounding structures, thus allowing him to diagnose and manage any cardiovascular problems, such as build up of plaque and blockages in the arteries. The results also indicate cardiovascular problems and determine the extent of damage caused by a heart attack - my eighteen year old heart attack was identified! And what was the final outcome of the MRI scan? Well, the opinion was that heart surgery is not needed - at least not in the immediate future - and for that I am grateful.

David Read

TRAVEL INSURANCE

For most of us to obtain a satisfactory travel insurance for holidays abroad it becomes a problem both of our medical preconditions and because of age. It will be of interest to THROB members that the British Heart Foundation has a very good website with advice on obtaining travel insurance and a list of companies which can be approached. This can be seen at www.bhf.org.uk/publications and searching for 'travel insurance'.

It is worth mentioning that insurance companies regularly seem to change their underwriters and so a company which insured you last year may not do so now and a company which refused you last year may be helpful this year. However difficult, it really is not sensible to travel abroad without getting insurance.

Roger Mills