Making healthy choices before surgery: David's story

At 23 David Joshua was told he needed to lose weight before he could have heart surgery. He tells Rachel Healy how healthier choices have helped him change his lifestyle.

David Joshua

When David Joshua, 23, found out he needed his second heart surgery, he knew it was time to lose weight.

David, from Port Talbot, was born with aortic stenosis – where the valve that connects the heart to your body’s main artery can’t open properly. Aged 10, he had an operation to solve the problem, but when he turned 17, his health began to decline.

I couldn’t even walk up the stairs without getting out of breath

“It got quite bad and by the time I left college at 19, I couldn’t really go into work,” David says. “It would take very little to bring on breathlessness. I couldn’t even walk up the stairs without getting out of breath.”

In October 2015, David was told he needed open heart surgery as soon as possible. But the surgeons were worried that operating on David would be too dangerous. He had to lose weight.

“I weighed 130kg [over 20 stone] and my BMI was about 52,” David says. “The surgeon didn’t give me a target of how much to lose. He said: if you can lose any amount of weight, that’s going to benefit you.”

David Joshua

Getting dietary advice and eating healthier meals

David was ready to change his lifestyle, but didn’t know where to start. “I wasn’t exercising, because my symptoms were so bad I couldn’t do much,” he says. “Even walking around was difficult. I was just going in and out of cupboards for snacks all day, eating pork pies, crisps, chocolate and things like that.”

He asked his GP to refer him to a dietitian. “They explained to me about calorie control and made me understand I was eating the wrong foods,” David says.

I went away from the appointment setting myself the goal of having three meals a day

“I wasn’t eating regular meals – I was binge eating. I went away from the appointment setting myself the goal of having three meals a day.”

David found that calorie counting and aiming to get his 5-a-day really helped. He used a free app to log all of the food he was eating and made sure he didn’t go over his daily target.

A new menu of healthy meals helped David lose weight. A typical day now consists of wholewheat cereal and fruit for breakfast, scrambled eggs on wholemeal toast for lunch, then fish, vegetables and wholewheat pasta for dinner. He also snacks on fruit and yoghurt. “My diet is balanced, so I get a bit of everything,” he says.

David Joshua on his bike

Additional benefits and getting active

David lost nine-and-a-half stone simply by changing his eating habits. He soon felt ready to start exercising again and began to notice other improvements. “Breathing was a lot easier,” he says. “I had sleep apnoea [where the walls of your throat block your breathing during sleep – it’s more common in people who are overweight] and I suspect that’s gone. My blood pressure has come down. It’s helped my depression as well. It’s changed my life.”

In summer 2017, David’s surgeons decided he’d reached a healthy weight for surgery. “The recovery time was remarkable,” he says. “I was out of hospital within six days and within four weeks I couldn’t wait to get back in the gym.”

You may have a heart condition that makes it harder to lose weight, but it doesn’t mean it’s impossible

David now goes to the gym five or six times a week, working out on the cross trainer, treadmill and rowing machine. He wears his own heart rate monitor, so he can make sure he’s working hard, without overdoing it. This was especially reassuring after the operation. “I kept a close eye on it,” he says. “You have to listen to your own body.”

David feels that state of mind is important if you’re trying to lose weight. “You need to be ready to make changes,” he says. “If you aren’t, it won’t happen. For me, the health scare helped, but it doesn’t need to get to that stage. Set yourself a realistic goal, then set another when you reach it. You may have a heart condition that makes it harder to lose weight, but it doesn’t mean it’s impossible. My surgeon and dietitian really helped to motivate me, too.”

David is enjoying his lifestyle and has just started a new job installing fire sprinkler systems – the first since his health declined as a teenager. “It’s like a new life,” he says. “It’s brilliant. I’m looking forward to what the future will bring.”

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