MIKE WILKIE - AN APPRECIATION

The following is a slightly modified version of the eulogy given by our Chairman, Lynn Warner, at Mike Wilkie's funeral on 31st march 2003 held in St marks Hospital church, Maidenhead.

When Gill asked me to speak at Mike's funeral it immediately brought to mind a colleague who had been asked to lead the singing at his friend's funeral. His friend's passion was rugby and the song he was to sing was Delilah. Fortunately for us Mike's passion was THROB and as far as I know we haven't got a song.

In 1989 I found myself having major heart surgery. Unbeknown to me a gentleman called Mike Wilkie had suffered a heart attack at about the same time A couple of weeks after coming out of hospital I had a visit from Lesley Richards a Cardiac nurse and she invited me to join a rehabilitation program. Mike on the other hand was having bypass surgery and I believe met Leslie whilst recovering in hospital. The rehab involved exercise classes, the equipment was basic rather like you remember from school days but we had the security of trained cardiac nurses running the classes. We checked our pulses and the nurses checked our blood pressure. We all aspired to having our treadmill test, which meant if you worked you could return and also join the Friday morning class, the last part of the rehabilitation course. It was at the Friday morning class that I met two newcomers, John Sandal and Mike Wilkie. The problem with the Friday class was that it was the only class and in order for everyone to move through the program you eventually had to leave. Also we found out that these classes were not run by the NHS but The Wexham Park and Heatherwood Heart Trusts. We were all very grateful that Berkshire was pioneering rehabilitation and knew that had if we lived in another part of the country things could have been very different. The need for more classes was evident; being able to continue the classes beyond the program was what we all wanted. And so the idea of THROB was born. I went one step further in my recovery and found I was expecting a baby - Mike and the others gave birth to THROB.

The cardiac nurses didn't have an office and the first thing purchased was portacabins, one was sited at Heatherwood but before we could find a home of the one for Wexham Park the nurses were brought under the wing of the NHS and offices at Heatherwood materialised. Mike then took on the role of a second hand portacabin salesman as well as being treasurer. We had many ups and downs with premises for the classes, the Gym at Heatherwood was turned in to a geriatric ward due to government incentives and Mike spent a lot of time trying to arrange adequate accommodation. We had tried to keep to premises within the hospitals but eventually the Heatherwood classes had to move to the Red Cross centre nearby. We then went further afield when we realised that we were probably fitter that the average person in the street that hadn't yet had a heart attack and we could go anywhere. We had purchased resuscitation equipment for the cardiac nurses and 999 probably worked just as well in an emergency as the internal phones in a hospital. So the classes grew, the patients confidence grew and although we had initially wanted to raise money for a purpose built gym and offices for rehabilitation we realised that so long as we provided the equipment, the local communities had suitable premises already. This meant that THROB really could be a driving force. Providing equipment to hospitals above that supplied by the NHS into areas where it had a direct link to rehabilitation and getting people back to the best possible level of health following heart problems, investing in the training of more instructors. Mike was instrumental in the bursary scheme that was put into place. THROB also has a social side and many good and lasting friendships have been forged through the classes and social functions.

In 2000 Mike retired and he told me that initially he wanted to invest his time in THROB and give it a boost before he moved away from the area with Gill. I don't think he envisaged giving use as much time as he did. I admit I didn't want Mike to leave the area as one person put it "Mike was THROB and THROB was Mike". I can honestly say that we have three people now on the committee just coping with the key roles that Mike had taken on. And only yesterday I thought of another area, possibly two, that we need to cover and that's apart from all the other things he did. If you told Mike you had a problem it wouldn't just be halved or shared he would say, "That's all right leave it with me, I'll sort it out". Your problem had just gone. Mike also had a mischievous wit. This brings me back to the beginning.

We would some times tease each other in committee meetings - they were always fun. During Mike's seafaring days he was once serenaded for days by a stowaway. Unfortunately that man's favourite song was Delilah, Well I won't tease Mike now by threatening to sing but if I did I can almost hear that wonderful voice of his saying, "Oh! No You Won't!

Lynn Warner

THE MIKE WILKIE MEMORIAL WALK

The Committee has decided that we should hold another Sponsored Walk in Windsor Great Park, and dedicate it to Mike Wilkie who organised the previous one we had there three years ago under the title of PROJECT 2000. The circular route will be exactly the same as last time and covers a distance of about five miles plus a wee bit further to get to the start of the circular bit..........and back! Sponsored walks have been good fundraisers in the past and everyone is urged to support this event either by walking or getting sponsorship, preferably both. A notice is included in this issue of your magazine giving all the details of date, time and route together with a sponsorship form to enable you to get contributions from your friends and families in support of our work for cardiac heart disease patients in the local community.

THE TRIAL AND TRIBULATIONS OF WARFARIN (Part 3)

A few months ago, I wrote about catching a virus while on holiday a couple of years ago in Spain. This affected my heart and eventually resulted in an aortic valve replacement operation which necessitates the daily intake of Warfarin for the rest of my life. This is to keep my blood density thin at an INR level of 3.0 to 3.5 in order to allow my carbon fibre "formula 1 valve" to operate effectively. I subsequently outlined the various factors affecting my INR levels, namely water, alcohol, medicine, life style / physical activities and food.

I explained that Warfarin partially blocks the reuse of Vitamin 'K' in our livers. Vitamin 'K' makes the clotting factors that help the blood to clot and prevent excessive bleeding. It is also believed to play an important role in bone formation and repair, in reducing bone loss (osteoporosis), in preventing kidney stones and liver cancer growth.

Vitamin 'K' is a "fat soluble" nutrient, found naturally in leafy green vegetables such as broccoli, spinach, cabbage, cauliflower, peas and lettuce, and in certain vegetable oils, cereals, cheese and liver. Unlike most vitamins, it is not lost during cooking. However, it is destroyed by antibiotic treatment, by freezing or radiation as well as air pollution. Although not synthetic, Vitamin 'K' is also made by the bacteria that line the gastrointestinal tract. Here, cultured milk, like yoghurt, plays a part in its production. The minimum daily dosage requirement for Vitamin 'K' for a male is 80 micrograms. For females, it is 70 micrograms. However, the average daily intake for most people is about 300-500 micrograms.

A word of warning thoug - a consistent regular intake of Vitamin 'K' is necessary to maintain a consistent blood density. If you don't eat much food rich in Vitamin 'K', don't start eating now in abundance. Likewise, if you eat out a great deal of food high in Vitamin 'K', don't stop this diet. So, try to remain on the same general diet if you are to maintain your INR at current levels. REMEMBER Vitamin 'K' helps to thicken the blood. For those who are not on Warfarin, feel free to take advantage of Vitamin 'K', but in moderation to maintain a balanced diet!

I do hope the information provided is useful. Please feel free to offer or share any additional information, advice or tips that may help us all to better understand and control our INR levels.

Stephan Stephan

Notes

- Source of information is the Internet - no medical background

- Any feedback would be welcomed - E-mail: helalstephan@aol.com

- In the last article, I mentioned that water thins the blood. This means the blood can flow more freely, picking up more oxygen on its way. However, I failed to explain that the extent of water absorption into the bloodstream varies from one person to another, depending on the level of electrolytes present, especially sodium, to maintain hydration. The test is having urine that is copious and a pale straw colour, and ideally odourless.

IN PRAISE OF SPRING

This might sound strange but I rather like February.

Yes, it is very cold but having been to my allotment I can see various bulbs pushing through the soil. and think how amazing what a bit of sunshine can do. For most gardeners a change in weather will allow them to tidy the front and back areas of their gardens, pruning, cutting back overgrown shrubs and fruit bushes and removing old vegetables. Gently does it must be the order of the day, but for those people that can venture out, well wrapped up of course, this can make you feel a lot better. A survey carried out by the British Heart Foundation in 2002 showed that gardening was second to walking as a pastime for heart sufferers.

An allotment is only an extension of a garden but with many advantages. People fail to understand how it is important to be able to walk away from gardening. In what state you leave your allotment becomes less important than your front garden! Also, what you intend to grow is purely a matter for yourself and, of course, your partner. This is where you will become aware of what can only be called a true understanding of home-grown vegetables. Being able to grow something and take it home just before you need to cook it is a delight not afforded to many.

Brian Barratt

HEARTS IN SLOUGH

This new support group was officially launched at a public meeting in the Centre at Slough on Thursday, 20th February, attracting an audience of just over 100 people. The proceedings were kicked off by a doctor from the Slough Primary Care Trust who said that the local area was the worst in the south east for Coronary Heart Disease (CHD). This unsavoury fact was backed up by Dr. Kundu who presented a statistical run-down of the problem in Slough. A recent Government white paper had proposed health improvement targets for a number of important diseases and for CHD had set a target of 40% reduction by 2010. While this might be achieved in Berkshire as a whole Dr. Kundu said that is was unlikely to be met in Slough. The hospital admissions for CHD in Slough were currently running at 4.35 per 1000 of population compared to 2.68 for Windsor and 2.38 for Maidenhead.

A representative of the British Heart Foundation briefly outlined the requirements of a support group and stressed the need for it to cater for the carers as well as the patients. CHD affects the whole of the family unit. We were then given three brief case histories by members of the West Berks Heart Support Group, the first a simple (!) heart attack, the second a valve replacement with associated arrhythmia and lastly a myocardial infarction followed by a triple bypass. In the last case the patient stressed the terrible time he had had due to anxiety associated with his medical condition.

There then followed a brief chat from a local pharmacist who explained how one could get help in understanding the drugs used in CHD and the importance of taking prescribed drugs regularly. Eddie Robson the spoke about THROB, the services we offer to the community and the donations we make to the Cardiac Departments of the local hospitals. The evening was rounded off by the showing of a short documentary made by Richard Hill (who is currently studying film production) and who appears to be the motive force behind the new group.

If any THROB members are interested in joining this new group they should contact Richard Hill on 01753 581 290. If you know anyone who is not a THROB member but might benefit from membership of Hearts in Slough then please pass on the information.

David Read

LONDON MARATHON SUCCESS

Stephan Stephan, he of the Warfarin problem, has just completed the London Marathon in 5 hours 21 minutes, a very creditable time for a first effort. He managed to get a place in the event through the British Heart Foundation and raised over £4,500 for that well worthwhile charity. I am sure that everyone would join me in congratulating Stephan on his achievement.

David Read

MUSCLES

Latissimus dorsi (Back muscle)

Where is my latissimus dorsi muscle?

The latissimus dorsi muscle is situated in the upper back. It originates from the top of the pelvis, thoracic and lumber vertebrae, and from the lower 3 or 4 ribs. The muscle inserts into the top of the humerus (arm bone).

What is the action of my latissimus dorsi muscle?

The Latissimus dorsi is an important muscle in relation to movements such as climbing, walking with crutches, swimming and chopping wood. The muscles main action is to adduct the shoulder joint (brings the arm towards the middling of the body) towards the body.

How can I strengthen my latissimus dorsi muscle?

In order to strengthen this muscle you will need a resistance band. Stand in a neutral position (feet shoulder width apart, with knees slightly bent). Hold the resistance band in both hands. Raise both arms together overhead. Lower arms to shoulder height and pull the band down in front of your head. Repeat this exercise in sets of two-three, performing 10-15 repetitions using slow controlled movements.

How can I stretch my latissimus dorsi muscle?

Stand in a neutral position with the left elbow slightly bent and across the body. Grasp the upper left arm just above the elbow with the right hand. Pull the left arm across the chest (toward the right) with the right hand. Repeat onto the other arm holding the stretch for 30 seconds each time.

Always consult a BACR exercise instructor before engaging on a new exercise regime.

OUR CHINA EXCURSION

When we planned our holiday in China it was to see the Three Gorges Dam site on the Yangtze River before they flood it in May this year. We decided on a short, three day cruise down the Yangtze and looked for a tour that would enable us to go to the Great Wall and see the Terracotta Army as well.

We were lucky to find just what we wanted and set off with the China Travel Service for our adventure.. After all we're very unlikely to make the journey again and wanted to see as much as we could.

The holiday fulfilled all the brochure promised, and more. MUCH more.

We knew there would be quite a lot of walking but the brochure didn't tell us just how many temples they have in China and that ALL of them are set on hilltops for a panoramic view (or to be nearer heaven!) and NONE of them have lifts or escalators.. (Tell a lie, one did but it was out of action the day we were there!) We estimated we must have climbed over 2000 steps in two weeks. Well it is supposed to be good for you. It wouldn't have been so bad but a lot of the panoramic views were shrouded in mist. At the Great Wall Ken would not walk down a very interesting set of steps on the grounds that he would only have to walk up again..

Then there was the food. I love Chinese food but it isn't Ken's favourite.. He was sure he'd come back looking like a rake but he managed to find enough to keep him going. On the two evenings we had to cater for ourselves we had, guess what?, a McDonalds!

The tour company had done wonderfully well in ensuring that we had as many different styles of food as possible. Obviously some were nicer than others but the most memorable was the "country style" one we had at the Great Wall. There were only three dishes plus a large bowl of stewy soup, in contrast to the twenty or so dishes at all the other meals. The chicken stew tasted nice until one of our party shrieked and jumped back from the table. There was a complete chickens head, complete with comb, floating on the top. Everyone kept moving the central turntable away from them except Ken who delighted in taking a video. Needless to say the stew went untouched.

We were lucky enough to see the baby Panda at Chongqing Zoo. Even our guides hadn't seen it before.

The Terracotta Army was fantastic but you have to see it for yourself to comprehend just how amazing it is.

The Three Gorges Dam project is well on the way to completion. The idea is that they hold back the natural flood waters when they come, thereby controlling the floods in the gorge and using the power to provide electricity. Again, to comprehend the vastness of the project you need to see it for yourself. Thousands of acres will be covered by water as well as hundreds of villages having to be relocated. They have already built lots of new towns above the predicted waterline. Considering you see hardly any modern machinery you wonder how it's all been accomplished.. They're really smart, modern towns as well. Naturally all the youngsters are delighted but some of the older people maintain that they will not move. I must say that there were a lot of crops growing that will have to be harvested very quickly if they are to avoid drowning.

In addition to all this we were taken to various factories for pearls, cloisonné ware, jade and silk as well as a tea making demonstration. All were extremely interesting but ,of course, they hoped we'd buy something, which mostly we did.

We also put on life jackets and raced two dragon boats, urged on by the dragon master beating the drum. Our boat won! Ken paid 10 yuan (80p) to beat the massive millennium bell and we went in rickshaws to visit the Hutong area. Ken told our poor rickshaw man that he'd drawn the short straw, but of course he didn't understand a word and just smiled. Ken also wanted to be carried up a hill in a sedan chair but I said it would be too cruel.

The SARS virus was on all the news coverage and we've since heard that people walking the wall have contracted it. At the time of going to press we seem OK…….

This doesn't cover half of what we experienced but I hope it's given you a taster and perhaps you'll experience China for yourself one day. You'd better hurry because it's fast catching up with the western world.

Ken & Margaret Humphreys.

IBUPROFEN

There was a report last year that Ibuprofen blocked the inhibition of platelet aggregation (i.e. thinning of the blood) by Aspirin . A recent clinical trial at Dundee using 7,000 patients with coronary heart disease discharged from hospital on low-dose Aspirin has found that there was double the risk of mortality in those taking Ibuprofen as well. There appeared to be no increase in risk for people taking Aspirin with other anti-inflammatory drugs. The authors of the research do suggest that the findings are not conclusive but that it does lend support to the hypothesis that Ibuprofen can antagonise the cardio-protective effects of Aspirin. It would seem prudent that anyone taking Ibuprofen regularly with low-dose Aspirin should talk with their doctor about this trial, as other anti-inflammatory medication might be more suitable. For most of us who buy Ibuprofen (Nurofen) over the counter and use it only occasionally for headaches or general aches and pains, there is probably no reason to make any change.

Roger Mills