Ms Esther O'Shea:

We spoke earlier about the absence of a policy and why there is one. I say the following to create awareness of living with cardiovascular disease. Most heart patients self-care. Therefore, the burden rests on the patient. It rests on managing your medications and taking care of yourself. There is a whole care plan associated with living with cardiovascular disease. Therefore, the burden is placed on the patient, which is a huge burden on a sick person, a vulnerable person, and there are no supports in the community for that. There are no heart failure supports within the community, no hubs, no psychological supports and nowhere to guide them to help them live better. I refer even to such things as changing your medications, the side-effects of changing meds, titrating up or titrating down and managing low blood pressure, dizziness, breathlessness, palpitations, aches and chronic fatigue. That is managed and borne by the patient. No other disease is borne by the patient himself or herself with very little support bar family. Therefore, there is a huge gap between coming out of a hospital and going to live at home or trying to cope or live with the disease. I spoke earlier to Deputy Shortall about living with a disease. To live with a disease does not mean it is easy. It is a struggle every day. You have to adapt every day. No one day is the same with any chronic disease, but definitely not with a cardiovascular disease. You get out of the bed in the morning and some days you can stand on two legs and other days you cannot. You have to roll with the bad days and you hope tomorrow will be a better day. That, again, is borne by heart patients, with zero support in the community. They have no one to ring.

Thankfully, we have the likes of Croí and the Irish Heart Foundation. They have been our lifeline in providing a heart failure nurse online and providing peer-to-peer supports so one can talk to other patients and say, "I am really dizzy, I have palpitations, I have a racing heart, my blood pressure is in my boots." It is a matter of being able to talk to someone about that because that is not going to change. This is my disease. I walk with it every day. It is a matter of being able to discuss that with someone, to sound it, to get reassurance and to say, "If you do not feel better tomorrow or if your weight has increased and you are retaining fluid, you need to go to accident and emergency." Going to accident and emergency, however, is a chore in itself. There should be direct access for cardiovascular patients such that they do not have to go to accident and emergency and there is a rapid chest pain clinic or a heart failure clinic to which they can have access.