Question: I drive a bus that carries 40 passengers each time. Can I continue working as a bus driver after my heart attack?
Answer: One of the most important things of getting people feeling good and healthy about their condition after a heart attack is to get them working again. So I think the general answer to the question would be: let's do everything we can to get you back to work, including driving a bus. When you're responsible for the safety of many other people, not only the people in the bus but the people on the street, we don't want you having a problem where you're putting your life and their lives in peril.
So this is a situation where we need to look at this, what kind of heart attack did you have? Was it a small heart attack? You have one narrowed artery that got opened very promptly, and your heart really didn't get damaged very severely, and now essentially it's healthy, and you're healthy, you're on all the right medications to reduce the risk of a second heart attack. You know, if you're a relatively healthy person after the heart attack, and your risk factors are being controlled, and you're having no symptoms, I see no reason why you couldn't get back to work, including that kind of occupation. But do so under the supervision of your doctor, and be sure that your employers are aware that your doctor says it's okay for you to do this.
There's other extremes here though, where you may have had a much bigger heart attack. You may have had damage to a heart muscle, and if you have a very weak muscle following heart attack, that increases the risk of several things, to you and to others. It increases the risk of symptoms of weak muscle, where you might be short of breath or having chest pain. But also increases the risk of rhythm problems that could lead to sudden fainting or collapse -- or even, worst case scenario, sudden death. This is why people who have severe heart attacks and heart muscle damage need to be evaluated very carefully for their own health, to determine what are the right medications to make your heart stronger, to reduce the risk of sudden death, and in many cases, we recommend devices -- defibrillators or pacemakers to regulate the heartbeat and to prevent sudden collapse and sudden death.
And so, if you're in that neck of the woods following your heart attack, we couldn't recommend an automatic return to work, especially if your work is one that could put other people in jeopardy. But with the proper treatment and proper controls, even people who have more serious conditions could return to work. But in this particular case, I think you have to have careful discussions with your doctor and your employer about whether returning to driving a bus with 40 people on a crowded street is the right thing to do. In some cases, the recommendation might be no, let's find a different thing for you to do to maintain your livelihood.
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