Someone asked if I'd been to the gym. That's all. A normal, well-meaning, slightly clumsy question.
My brain didn't hear a question. It heard a verdict, and went looking for evidence to support it.
I opened my health app. 7,593 steps a day, on average. 43 minutes of exercise. Resting heart rate down to 57. None of that mattered. What mattered was the cheesecake I'd had the night before, and whether I should have walked the dog instead of renovating my house, and whether needing a walking stick to get up my own stairs most evenings is a character failing rather than what happens when you take the Crohn's drugs away.
I didn't defend myself, I put myself on trial instead.
What rehab actually is
I'm in cardiac rehab now. My exercise plan is heel taps and wall presses. My diet plan is "be more Mediterranean." That's it. That's the whole prescription.
Rehabilitation isn't the time to be heading to the gym, or cutting out sugar like it's Lent. Rehabilitation is more sleep and less stress. Gentle movement. Caring about myself, not punishing myself. Six weeks ago my heart nearly stopped. My body is not currently in negotiation for a six-pack.
Nobody asks what that actually looks like. They ask what lifestyle changes I'm making, like the answer is a gym membership and some willpower.
What the medication actually does
I can walk up the hill to the shops now without getting breathless. I feel better than I did before the heart attack. That's the medication working. It isn't me being fixed.
I'm on dual anti-platelet therapy, beta blockers, a small pharmacy's worth of tablets. A new side of the NHS to navigate through. Rehab clinics, new specialists, new processes, prescriptions I have to collect instead of delivered to me in a chiller van. Nothing like the Crohn's side I've lived in for years. The side effects change daily. Some of my Crohn's medication had to stop to make room for the heart drugs, and two months of relief from those aches is already wearing off. Feeling stronger doesn't mean I'm well. It means I'm on drugs strong enough to compensate.
The lifestyle question
"So what are you doing differently now?" sounds like concern. It isn't. It's a request for a confession — tell me what you did wrong, so I can file this under explainable and stop feeling uneasy about it.
I don't have an answer yet, and I'm not sure I owe one. I haven't seen the cardiologist. After posting this I'm off for a fitness test, so I can join a 6 week workout group with other heart attack survivors. I am not, currently, in a position to hand out a plan, and I resent being asked for one like it's overdue.
Back to work
I went back to work the week of my heart attack. I'm self-employed — no work, no pay. The recovery booklet says most people take six to twelve weeks off after something like this. I don't know yet if I'm lucky that I could work early, or unlucky that I had to.
What no one asks
I wasn't allowed to have sex until last week. There's a whole page in the booklet about how to do it safely. Not that I wanted to.
I'm still dealing with the shame and embarrassment of a body that broke. My body, specifically, at 42, without warning, while I was trying to live my life. No one asks what that does to you, being betrayed by the thing you live in, with no say in it, and then being expected to have opinions about cheese three weeks later.
Get lung cancer, or a heart attack, or even Crohn's, and the sympathy comes with a form to fill in first: what did you do wrong, and how sorry are you about it. The world sorts illness into innocent and guilty long before it asks a single real question.
Not even 5 weeks in, I'm still in shock. Not the medical kind, the ongoing kind, the kind where some part of me is still lying on that floor in August wondering if this is a panic attack, and the rest of me is supposed to be back at work, back to normal, making decisions about my own recovery like a competent adult, when actually I still flinch at chest tightness that turns out to be nothing. I don't know yet what it means to trust this body again. Nobody's asking about that either. It's easier to ask about the gym.
I'm not fixed. I'm not broken in the way people mean when they ask what I'm doing about it. I'm just still here, still shocked, still working out what any of this means, on medication that's doing more for me than I am right now.
What I actually know
I know I had a heart attack. I know I'm still in shock about it. I know rehab is heel taps and wall presses and more sleep, not a gym plan.
So, no, I'm not going to the gym and I don't have a lifestyle plan for you.