NERS Case Studies

Jane's Story - Cancer patient PDF version

I was diagnosed with colorectal cancer in July 2011. I underwent a bowel resection in August 2011 which was followed by 6 months of chemotherapy. As I neared the end of my treatment I felt the need to become more active so that I could increase my level of fitness to improve my general well-being. I also felt that should I require any further surgery or treatments this would put me in the best possible condition going forward.

I visited my local leisure centre in Wrexham where I had an informal chat with an Exercise Professional where I was able to discuss my cancer and how I could be referred onto NERS. The Exercise Professional sign-posted me to my GP and they liaised on the process that enabled me to start exercise.

Since starting my exercise programme I have noticed that I now move a lot quicker and feel less out of breath after a brisk walk. My physical ability was evaluated and assessed and I was given support throughout my referral period. I had forgotten how enjoyable exercise was and I now take part in a number of activities on a regular basis. I thrive on that feel good factor that I experience with each exercise session whether it be a gym workout, an aqua circuit class, cycling or Nordic walking. I love being able to do more in my everyday life and the physical and mental strength that I have gained through exercise helps me on a daily basis allowing me to tackle all of life’s hurdles that come my way. I have found that through trying a variety of exercise sessions my stamina has increased and in a nutshell, I simply feel great!

I have found that since completing the scheme, although I’ve never been the best sleeper, I do enjoy sleep more than I used to, I feel this is down to my body being more naturally tired these days as aresult of regular physical activity. I also feel that I have more “get up and go” in me, especially after exercise. Mentally I feel more wide awake and more invigorated which helps me with my daily activities.

As a stage 4 colorectal cancer patient I’ve already had to come to terms with a second round of surgery and I found that I was in a stronger place going into that surgery, both mentally and physically. Further more my recovery was quicker and easier as I was so much fitter going into my liver surgery, so much so that 2 days after leavin g hospital I was using an exercise bike for 10 minutes or so at a time a number of times a day.

In terms of the future and managing my condition, cancer is still a massive constant concern to the point of devastation and it rarely leaves my thoughts. I have found though that doing regular exercise has enabled me to focus my thoughts and it has made me a stronger person. I’m well aware that the odds are not stacked in my favour but I do feel better prepared for any future surgery or treatments that I may require.

I would actively recommend the NERS programme to other cancer patients and I regularly discuss the benefits of regular activity at various seminars around the country, online via social media and by giving talks at well-being events. I am also active with the Macmillan Physical Activity Project where I encourage more people to do what I’ve done and get more active.


Joan’s Story PDF version

My name is Joan and I am 92 years old. I was referred to the Strength and Balance Classes because I was falling. 

I had a nasty fall in Asda which resulted in me being taken to A&E where I found out I had fractured my right hip. I had to have surgery on the ball of the joint and stayed in hospital until it had healed.

When I got home a physiotherapist from the hospital came out to visit me to assess my ability to function at home. I was given handrails in my shower and by my front door and I also had a raised toilet seat and a frame around the toilet fitted as a result of the visit. I can get around at home by using my 3 wheeled trolley and I am able to transport things from one room to another using the tray on the front without spilling or dropping things. Having these objects and aids has made me feel able to manage more independently.

The physiotherapist who came to see me at home had referred me to the Falls Clinic at the Wrexham Maelor Hospital, where I did physiotherapy exercises. I attended these sessions for 12 weeks before I was told that I was being referred onto the Strength and Balance Classes so that I was able to continue doing the exercises after the course at the hospital had finished. It wasn’t long before I had a phone call from the girls who run the classes, they told me what to expect and booked me in for an assessment.

In the class we do some exercises sitting down followed by some standing, not everyone stands you only have to do what you can. We use a Thera Band to do work on strengthening our muscles and then do some very important balance exercises. We even have a booklet to take home with our own band so we can practice the exercises between classes.

I am very pleased to have had the continuation in care and to be doing exercises for such a long time they are vital to my health and wellbeing. The classes are super and I love coming  along  to meet people. I feel much more mobile and confident and the classes give me the incentive to exercise. It is also helping me to be a more active grandma, I even felt well enough after doing these exercises to get a cat which I am able to look after myself. I have received super care and would recommend the classes to other people like myself.


Bob's Story - Stroke case study PDF version

In February 2013 I had a stroke caused by a clot in my carotidartery (90% block). The stroke affected my right side and I have been left with weakness in my arm and leg and I wear a splint (AFO) to support my ankle. I also have expressive dysphasia which means that I can understand what people are saying but my speech is limited so communication can be a problem. I was referred by my physiotherapist at the Hospital to the Exercise referral scheme in August 2013.

It was very easy to get started, the Exercise Professional rang us and spoke to my wife and arranged an appointment. I went in for an assessment and we discussed my stroke and general health, what the scheme was about and the best class for me to attend, which for me was a specific stroke rehabilitation circuit class which has been set up to specifically improve the functional capacity of stroke survivors.

The scheme has been excellent for me, I didn’t want to go to a gym or have to mix with other people because of my speech but the stroke rehab class has enabled me to mix with other people who have had a stroke. I realised that I was not on my own and that I could get better.There were a wide range of participants in the class in both age and ability, some people in wheelchairs and some you wouldn’t realise have had a stroke, and everyone who has been coming a while is keen to tell someone new how they were when they started and how they have improved. The two instructors in the class work with you, encouraging you to do the exercises safely and adapting any exercises you find a bit more challenging so that you can do them all.

I have enjoyed the whole experience and have been coming for 8 months now. I regularly attend two classes a week and I feel part of the group, everyone is friendly and we have a laugh. My fitness and stamina have improved and I now use a walking stick for support instead of a quad stick. My wife likes being able to come along as she can assist me with the exercises and feels that she has an active role in my recovery and she finds it helps her to chat to theother participants and their partners.

Since completing the scheme I find myself being more active, I am doing my exercises and walking every day at home with longer walks around the park when the weather is nice. I can write a bit now as my arm is much stronger and I can now do Sudoku again! I feel better, Iam less tired and doing much more, both at home and in class, and I can play with my grand-daughter again. I feel that I am improving all the time in both my fitness and functional capacityas well as my speech and communication skills.

I would highly recommend the National Exercise Referral Scheme to anyone who has had astroke.


John's Story - The rollercoaster ride of a lifetime – or almost a deathtime PDF version

In December 2013 I went to see the doctor as I had indigestion all night, and as the doctor was unavailable, I was seen by the nurse who gave me an ECG and told me to get taken to hospital where I was expected. Thus started the slow uphill bit of the rollercoaster ride.

Three weeks later I emerged from Morriston hospital after a quadruple bypass operation, and I suppose I was still in a state of shock. After the initial visit three weeks earlier, things had steadily worsened – ECG: tests at Withybush; transfer to Morriston for angiogram; and operation.

Having been rowing out at sea the day before this all started, to emerge from hospital able to climb one flight of stairs with some difficulty was a bit unexpected, but the exhilaration was about to begin.

Changes were very slow to start with. I kept a diary of changes, measured in the number of steps I could get up with without stopping, and there were daily developments. However, the visit of the BHF Cardiac Liaison Nurse was a major step forward, with enrolment on the Phase 3 Rehabilitation course being a big event. The support of the Cardiac Nurse and the Cardiac Exercise Referral Professional helped me through my initial worries about overdoing things, which were helped by close monitoring by them, and a commitment to the course, which was bringing about improvements every time I went. The speed of the journey was picking up!

It was a bit scary at first, watching my heart rate rise rapidly – especially when the monitor picked up a neighbouring measure, and my heart rate went through the roof. Nevertheless, the support of the team meant that I improved in the course sufficiently to move onto Phase 4 Rehabilitation after the minimum time, where things became more demanding. Once again, monitoring by the Exercise Professional and making every effort to attend every session meant that I could see things getting better every week – again, the diary was a good record.

By this time I was going on the walks organised jointly by the NERS Exercise Professional and Pembrokeshire Coast National Park Walkability Coordinator and these were not just carefully planned and supported, but gave another chance to meet others and enjoy a social occasion in splendid scenery. Things were moving past really quickly.

Soon enough Phase 4 was left behind, and I entered the Generic Exercise Referral rehab stage, which was very similar, with 2 or three sessions a week and a walk every fortnight. I was now quite confident about the exercise regime, and began to compare my efforts with other people online, and improvements continued.

Eventually, after 12 months and a final check with the Exercise Professional, I was finished with all the programmes, and the rollercoaster ride had dropped me at the station, where I was free to discover the delights of other exhilarating adventures. It has been exciting, frightening, but very rewarding, and impossible without the very close support of the Cardiac Nurse and particularly the Exercise Referral Professional. I think that I owe them - and the rest of the people involved, from the extremely perceptive nurse at the GP's, through the staff at Withybush, the surgical team at Morriston, and my wife, family and friends who have cared for me and encouraged me every day-my life.

Have I any advice to anybody else in a similar situation? – yes. Enter the programme, and commit to it. Do exactly what you are told by the staff, and try to improve day by day. Take your tablets as instructed, follow a sensible diet, and finally, realise how lucky you are! It could easily have been a trip in a hearse instead.


For more information contact: Jeannie Wyatt Williams

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