Accepting your changing body after a heart event

It’s normal to worry about changes to your body after heart surgery or having a pacemaker fitted. Emily Ray finds out how two people learnt to accept their body after a heart event.  

More people than you might think struggle with how their body looks. A report from the Mental Health Foundation in 2019 found that just over one third of UK adults (34 per cent) felt low because of their body image in the previous year.

Dr Helena Lewis-Smith, Appearance Psychologist at University of the West of England, Bristol, says, “Many people suffer with body image concerns. However, when your health condition needs treatment in ways that change your appearance, body image concerns can become even larger.”

Visible signs of a heart condition, like a scar or pacemaker, can be difficult to talk about, especially if it’s mixed with feelings of guilt - that you should feel grateful for having been treated. But while some people have no issues at all, it can cause distress for others.

Body image issues can affect people of all ages, and according to Dr Lewis-Smith, men are just as worried as women about these issues.

“It’s common for women to experience body image concerns, as they live in a society where, sadly, their value is based on their attractiveness,” she explains. “However, men can suffer just as much. And they may feel less able to talk about it, which can make things harder.”

“Remember your value beyond your appearance,” she adds. “Think about why your friends and family love you – it’s not based on how you look, it’s about who you are.”

Adjusting to a scar

When Karl Bithell, then 32, had a health check offered by his employer in August 2016, he never expected it to lead to a diagnosis of a heart valve problem. The faulty valve, which had been there since birth, was putting extra strain on his heart, and with a partner and a stepdaughter to consider, he decided to have surgery to repair the valve before things got worse.  

While he recovered well from the operation in June 2017, the surgery left him with a large scar down the centre of his chest. It was this scar that had a lasting effect on him.

Karl says, “I remember seeing my scar for the first time in the hospital bathroom. It was quite upsetting to look at myself and think I will never look how I used to.”

I tried to look at this six-inch scar in the middle of my chest as a good thing. My friends talked about it like a medal of bravery and said that I should be proud of it.

Karl Bithell 

It’s very common for people who feel unhappy with their appearance try to cover up the aspect of their body that they’re not happy with. Karl changed how he dressed, to try to minimise how much of his scar was visible. Gone were the V-neck tops or shirts with one or two buttons undone - they were replaced with higher necked tops and extra layers.

Situations where your body is on display can feel particularly difficult, which means some people avoid places such as swimming pools. It took Karl around six months to show his scar in public, at the pool or on a beach. But even then, he felt self-conscious that people were looking at it.

“I tried to look at this six-inch scar in the middle of my chest as a good thing. My friends talked about it like a medal of bravery and said that I should be proud of it. But I still didn’t like it.”

Despite the scar starting to fade, Karl didn’t notice a reduction in his self-consciousness. This prompted him to contact his GP in August 2019 to ask to be referred to a dermatologist.

Karl says, “I’m usually comfortable with my self-image: this was the first time in my life that I’ve wanted to go and get medical treatment purely for an aesthetic reason.” 

The treatment, which was available through the NHS, involved four sessions of corticosteroid injections to reduce the redness of the scar and soften the scar tissue. After every session Karl noticed the appearance of the scar improving.

“It was the first time I’ve felt any positivity about the scar, if I’m being honest.”

Following the treatment, Karl now views the scar in a positive way. He puts this down to various factors, including connecting with people with a similar experience on social media.

“I’m a member of a few forums on Facebook. Everyone celebrates all the different scars they have as a result of their conditions. We call ourselves ‘heart warriors’. You’ve got to feel a little bit proud of what you’ve been through.”

Feeling confident after a pacemaker

When Denise Foord, then 55, attended a pre-wedding dinner for her future daughter-in-law in 2008, the last thing she expected was to be rushed into hospital after collapsing.

Denise was diagnosed with Mobitz II heart block, which means her heart beats more slowly. After a few days in hospital, she had a pacemaker inserted to help regulate her heartbeat.

I'm determined to renew my efforts to see the device as a helpful companion allowing me to lead a normal life, rather than something invasive.

Denise Foord 

Twelve years on, she still runs 5km every day and enjoys travelling, but the pacemaker has affected her body confidence. Denise, now 67, says: “I’m a slightly-built person, so I can see the outline of the pacemaker box even through my clothes.”

“When I’m shopping for clothes, I always consider the pacemaker and the cut of the neckline, the tightness of the garment, the clinginess of the fabric.

 “I don’t wear vest tops in public. Thankfully I can feel totally relaxed with my body when I’m with my partner as he has always been supportive. I knew he wouldn’t be fazed by the pacemaker lump – he’s that sort of person. He saw it as something to celebrate. After all, I was still alive!”

• Read our expert tips on coping with a changing body

At the end of August 2020 Denise returned to hospital to have her pacemaker box changed. It was an emotional experience because the events surrounding the initial implant came flooding back. The replacement box is a similar size, though Denise thinks that the leads may now be slightly less visible below the skin.

“I’ve resigned myself to the fact that this change to my body is permanent,” she says.

“Perhaps it’s the pandemic that has made me review what’s important in life or perhaps it’s just that I’m older – and hopefully wiser. But I'm determined to renew my efforts to see the device as a helpful companion allowing me to lead a normal life, rather than something invasive - and to be less self-conscious of my somewhat quirky shape!”

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