Learning to live with heart disease: the fourth stage of heart attack recovery

by Carolyn Thomas  ♥  @HeartSisters

Let’s consider today the last of The Four Stages of Heart Illness as outlined by Dr. Wayne Sotile, a cardiac psychologist from North Carolina and author of the highly recommended book called Thriving With Heart Disease.  This book is a helpful guide for both survivors and their families on “how to heal and reclaim your lives”.

One important way to do this is to review the heart patient’s journey through a series of four “separate, identifiable stages” that may help you know what to expect along this journey.  (Links to the first three stages can be found at the bottom of this post).

Stage 4:  Learning to Live With Heart DiseasePatient and family have accepted the diagnosis and committed themselves to living with the illness, not in spite of it.

Dr. Sotile reminds us that most survivors take between 6-12 months to get somewhat comfortable with their new, heart-healthy way of life (that may not mean totally comfortable, but on the way to comfortable).

But even after that first year, you won’t be completely adjusted to your new way of life. As heart disease lasts a lifetime, so does its adjustment period for both patients and their families.

It’s a big transition to your new normal. Remember that a large part of the transition is learning to talk to the people you love and live with about what you’re going through, what you feel for one another, and what life is really about. 

Another part of the transition is learning everything you can about living with heart disease. Become an information magnet, Dr. Sotile advises.

One of the best ways to do this is to join a cardiac rehabilitation program, which will help you develop a realistic, appropriate recovery plan and teaches you how to measure your success.

And it works! Research shows that people who complete a cardiac rehab program, even if only for a few months, suffer less anxiety, depression, and disability that those who try to manage on their own. Both rehab patients and their families have a fuller understanding of the diagnosis and so are better able as a group to weather the inevitable storms that blow in.

What if you haven’t been referred to cardiac rehab?

Find out why! It may be that your physician has overlooked you as a rehab candidate. It’s alarming but true: two large categories of heart attack survivors tend to be neglected when it comes to rehab referrals: women and the elderly.

Recent research shows that doctors are more likely to refer men than women to rehab, and to favour younger, healthier patients in general. This happens even though women patients of all ages and seniors of both sexes have been shown to benefit from cardiac rehab every bit as much as do their younger male counterparts. See also:  Why aren’t women heart attack survivors showing up for cardiac rehab?

Dr. Sotile also stresses the importance of organizing your cardiac journey by setting reachable recovery goals. The best goals are both specific and realistic because they clearly establish what you must accomplish while ensuring that you have the ability to do it.  Put your goals in writing, as it formalizes your commitment to accomplishing them.  And be reassured: you don’t have to be a tofu-eating triathlete to heal your heart. Moderate exercise and reasonable dietary adjustments can provide quantum leaps toward better heart health.

Become more conscious of your behaviours. Acknowledge your healthy ones. Start getting into the habit of asking yourself these questions:

  • 1.  Did I eat more healthfully today that I typically did before I had heart disease? If not, how can I do better tomorrow?
  • 2.  Have I exercised as I planned to this week?  If not, what would help me do better next week?
  • 3.  Am I developing effective coping behaviours?
  • 4.  Am I letting my loved ones know how much they mean to me?

This is a stage when you and your family should be focusing on treating one another with renewed respect and compassion. When heart disease shocks people into realizing that life is fragile and can be profoundly changed or even snatched away without warning, behaviours sometimes change.

But everybody suffers setbacks. What works wonderfully during the early phase of rehab may prove useless later on. Individual differences and fresh family dynamics may develop. This too is normal, although not easy.  Because heart disease is with you for life and life means change, you’ll need to revise your coping plan as new concerns and issues arise.

Finally, Dr. Sotile offers these coping tips:

1.  Accept that living well with heart illness requires that you manage your mind, your body, your spirit and your relationships.

2.  Accept that you will need different kinds of support at different stages of your journey.

3.  Expect setbacks and trust that they will pass.

4.  Don’t be afraid of your emotions.

5. Take your medicine!

6.  Learn to express yourself.

7.  Know yourself, and pace your recovery accordingly.

8.  Be honest: look inward often, even if you flinch at what you see.

9.  Celebrate your successes.

10.  Draw strength from knowing that you do know how to cope with hard times.

 * Excerpt from the book Thriving With Heart Disease © 2003 Wayne M. Sotile

Find out more about the book Thriving With Heart Disease and about Dr. Wayne Sotile’s work with cardiac survivors.

Here is how Dr. Sotile describes the progress of all four stages of heart illness:

  • Stage 1 Surviving The Crisis –  Illness strikes, and patient and family begin the journey.
  • Stage 2:  Creating a Coping Strategy – Everyone starts to grasp what heart illness is, what’s involved in treatment and recovery, and that the patient and family must work as a team.
  • Stage 3 Handling the Homecoming Blues – You’re suddenly on your own; reality sets in and the team must adapt to its new normal.
  • Stage 4:  Learning to Live With Heart Disease(This blog post): Patient and family have accepted the diagnosis and committed themselves to living with the illness, not in spite of it.

NOTE FROM CAROLYN:  I wrote much more about this important transition in my book, A Woman’s Guide to Living with Heart Disease (Johns Hopkins University Press, 2017). You can ask for this book at your local bookshop, or order it online (paperback, hardcover or e-book) at Amazon, or order it directly from Johns Hopkins University Press (use their code HTWN to save 20% off the list price when you order).

6 thoughts on “Learning to live with heart disease: the fourth stage of heart attack recovery

  1. According to Dr. Arathi Rao, cardiac psychologies : “After a heart attack a person typically goes through 5 emotional stage. The true physical and emotional healing only occurs when one has dealt with the first four stages and reached stage 5.


  2. Excellent must-read info here, not only for patients but for their family and friends. This helps a lot to make me understand better what a longtime colleague has been going through and what challenges may still lie ahead for him. Those of us who’ve never been there tend to dismiss future consequences of heart problems – once he got back to work, we figured ‘well glad that’s over now back to normal’ but what I did not realize until reading this today is that his ‘heart problems’ are lifelong now. I’m forwarding this to all his friends at work. Thx for this.


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  4. Very valuable information here – it can be quite a ride from diagnosis to finally learning to live with this chronic progressive diagnosis, if one is ever actually able to “learn to live” with something so traumatic in life. I believe that many of us never really do learn this adjustment skill, we just learn to hide most of our fears from others.


    1. Its the fact that no one wants to hear it. For them its over, for us its never over. Our stomach is shot, our heart is weak, blood does not circulate like it should, hands go numb, legs hurt every day. You tell me how we go on? and my family wants me to act like its over. its not that i cant do it, because i can.


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