Sunday 16th August. Insurance companies are discriminating against heart patients

We have booked a holiday to Cuba later in the year.  Having cancelled 4 holidays we thought we needed to get away.  The holiday company includes free insurance with the package, so on Friday Helen rings the insurance company to provide the medical information they require.  They say they want to charge Helen £50 extra because she broke her shoulder skiing in February, and her leg when running in June.  no reason given other than "the computer says...".  She is understandably annoyed that they do so without giving any reasonable explanation.  Not to annoyed as we both are when they refuse absolutely to insure me at all.  Again the only reason given was "the computer..."   I suppose you cannot expect much more from the call-centre operative.  But she did not endear herself to us by refusing to accept that I was not suffering from high blood pressure and taking drugs to control it.    We decide to write to the insurance company for an explanation.

Why do insurance companies refuse to cover someone who does not have high cholesterol, who has had an operation to address coronary artery disease and who is less likely to be ill when travelling as a result?  The Times yesterday ran a major article about this very topic  "Taking Statins Doubles Insurance Costs".    It seems that that it is common practice to load premiums for people who are taking Statins whether or not they have the elevated cholesterol, and in some cases to refuse cover altogether.  In my case I take Atorvastatin not because my cholesterol levels are high but to keep my new coronary arteries clear of platelets but to help remove any clogging that Is still there.  

I accept that someone with a medical condition is a greater risk for an insurance company than someone without the same condition.  So refusing to insure, or charging a higher premium appears to be a case of simply limiting their exposure.  You might think this is no different to charging smokers higher premiums.  But the comparison is not valid because a smoker is someone who knowingly increases the exposure, whereas someone who takes Statins is someone who is reducing exposure.  Taking the drug may also be an indicator of poor lifestyle, since high cholesterol may be due to a bad diet or lack of exercise.  But it may also be for other reasons, as in my case.  

According to The Times, The British Insurance Brokers Association admitted that the additional risk is negligible but that a simplistic algorithm is used not to make quotations over the Internet complicated.  I applaud their quest for simplicity but is it fair that some people cannot get insurance, or pay too much as a result?

Friday 14th. Phase 3 physio begins

Back to the Sobell Centre, I and 6 or 7 others plus two physics do some warm ups then relatively gentle aerobics, followed by warm down stretches.  Feels like a real gym class, though not so stressful.  The others are all different sizes and states of health.  Some cope with the exercise pretty well others make a token effort.  The physio is quite attentive, ensuring that I don't do too much.  "No racing" she says.  Anyway, notwithstanding that the exercises were pretty pathetic by most standards I enjoyed the class and found it helped loosen up my chest muscles.

Tuesday 11th August. Physio Phase 3

Busy day today.  I walk down to the Sobell Centre, the local municipal sports centre for a physio assessment before starting the cardio rehab programme.  I have been logging lung capacity, blood pressure and pulse together with the length and time taken on my walks (very anal I know but the physics did ask that I keep some sort of record).  The physio is very impressed with the record keeping but somewhat alarmed by the fact that My pulse was going so high on my walks.  I was aiming for 120-130 on my faster tempo walks - what I called my "cardio range". and it was up to 140 on steep hills (even peaked once at 150).  Apparently it should not go above 100, which because of the Beta blockers is at least 20 beats lower than it would normally have been.  I am disappointed because I though my exercise programme was a good one, but I will comply anyway.  At 6 weeks it is still apparently too early to push the heart.

From the physio I go on to Stepney Green to the London Independent to see the surgeon.  Mr Shipolini is also delighted with my progress, and tells me that the soreness at the top of the sternum is  due to the damage caused to cartilage and other soft tissues during the operation.  This takes much longer to heal than the broken bones.  He also  wants me to take stronger doses of Statins and beta-blockers, "as much as I can stand". Unfortunately side effects may include tiredness, dizziness and even impotence!  Hopefully the drugs can be cut back until normal service is resumed.

But at the end of the day he signs me off (or over to the NHS cardiologist).  I give him a bottle of Arran single malt "founder's reserve" (I still had 3 bottles at home which I bought in 2000, when visiting Arran.  Made in 1995 it was bottled after 5 years so I had to wait to receive the bottles).   It seems to me that just saying thank you to someone who possibly saved my life and definitely extended it by 20 years, is not enough.  Unfortunately I don't think he likes whisky, but he said he knows someone who does.

Onward and upward then.

Tuesday 4th August. Visit to the Cardiologist

I walk to Whittington hospital, just 18 minutes at the usual "tempo" walk of 6kph.  The consultant asks how I am  and is pleasantly surprised that I had actually had the CABG 5 weeks previously. It seems that the paperwork is stuck somewhere between Barts and The Whittington.  Either that or the surgeon did not bother to write typo the referring cardiologist (on the other hand the CABG was done privately, so perhaps his secretary just forgot to cc the letter sent to my GP).

The Consultant is delighted with my condition.  She wants to see me again, in 9 months!