Many years ago, the treatment for people with heart problems consisted primarily of plenty of rest. Those with even the most minor of heart ailments were treated gingerly, and the idea that such people could participate in exercise would have been greeted with horror. But times have changed, and research has proved that, when it comes to treating heart problems, exercise might indeed be just what the doctor ordered. In fact, it is exercise which may prove to be one of the most powerful factors in returning you to a lifestyle which is not only as good as it was before you were diagnosed with heart disease, but better. Still, as a heart patient, there are some very important things you need to know.
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CONSIDER EXERCISE AS THERAPY |
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If you are like most people, you probably do not think of exercise as therapy. You may think of it as work or, if you enjoy it, as a relaxation or stress releaser. But exercise is, in fact, potent medicine for people with heart disease. Even a brisk daily walk can result in better cholesterol levels and blood pressure. Regular exercise can help prevent diabetes. If you are diabetic, exercise can help control your blood sugar levels.
Studies also show that aerobic exercise improves your heart's capacity for work and, most importantly, can affect your metabolism, resulting in changes which can slow or even halt the development of atherosclerosis, the process which narrows down your coronary arteries.
Exercise can also:
- Help you lose weight and keep it off.
- Help you quit smoking and stay off cigarettes.
- Tone your muscles.
- Help you sleep.
- Reduce stress.
- Enhance your self-esteem.
No matter what your age or physical condition, exercise can benefit you. You may feel that you get enough exercise just working around the house or on your job. To benefit your heart, you need to participate in a regular exercise programme. As a heart patient, you need an individualized, safe exercise plan. The best way to do this is by participating in a cardiac rehabilitation programme, which brings tremendous benefits.
If you do not have a cardiac rehabilitation programme at hand, talk to your doctor. He could recommend an exercise physiologist who can help you design your own programme and give you tips about exercising safely. Sometimes, doctors are not up-to-date on the details of prescribing exercise and do not know how best to advise their patients to do it. They may simply advise you to 'take a walk' when you could derive far greater benefits from an individualized exercise programme. Or, they may not be familiar with studies that have shown that some patients who were never encouraged to exercise before, such as those with congestive heart failure, may indeed be able to exercise safely and improve their well-being.
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CONSIDER CARDIAC REHABILITATION |
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If you have survived a heart attack, you may have already participated in a cardiac rehabilitation ('cardiac rehab') programme. But if you have not had a heart attack, you might be unaware that cardiac rehab benefits more than just heart attack victims. Indeed, almost anyone with heart disease can greatly benefit from participating in a well-run programme. The benefits afforded by cardiac rehab are often overlooked in today's cardiology world, which focuses on high tech, 'quick fix' treatments like balloon angioplasty or dramatic procedures like coronary bypass surgery. Cardiac rehab can be an important adjunct for many, and the primary therapy for some.
Cardiac rehab is a specially structured programme of exercise, education, and psychological and social support designed to strengthen your heart's ability to perform exercise and return you to normalcy or better. A good cardiac rehab provides you with more than just exercise; you benefit from the expertise of professionals with years of training and experience working with people who face the very same problems you face. You also make new friends, friends who know what you are going through because they have been there.
In the past, cardiac rehab was considered mostly for heart attack victims. Since then, the number of patients who have benefited has broadened. If you have chest pain ('angina') from heart disease, physical conditioning can increase endurance and delay the onset of chest pain. If you have had a heart attack, cardiac rehabilitation of more than twelve weeks duration appears to reduce the likelihood of your dying, especially in the first year afterward. Such programmes will also benefit you if you have had coronary bypass surgery or balloon angioplasty. Studies show you can experience a 50 to 90 percent improvement in your ability to exercise after four months in such a programme. It also places you under the watchful eye of a professional who can help you detect problems in case they occur. Cardiac rehab has even proved to be beneficial for people with badly damaged heart muscles or heart failure because it improves their capacity to perform their daily activities.
In addition, if you have been diagnosed with a cardiac problem, you may suddenly feel very fragile. A cardiac rehab programme provides you with a safe environment in which you can improve your strength and endurance to a point you never expected to achieve. A good rehab programme also provides a variety of regular education sessions such as lectures, group discussions, fireside chats, workshops etc. They offer support for lifestyle changes you must make, providing low fat cooking sessions, tips on quitting smoking, and a place where you can deal with the emotional issues that accompany heart problems.
Cardiac rehab differs from a regular exercise programme in that you follow an exercise programme that is highly individualized for you and your heart is monitored as you exercise. The pace is increased gradually, and modified according to your individual needs. The programme may take place at a hospital, fitness centre or gym.
Unfortunately, women are less likely to join these programmes and more likely to drop out. Some older women do not drive and find transportation an obstacle. Also, women sometimes tend to place their health on a lower priority and do not want to 'inconvenience' anyone. So, if you are a woman, persevere, and find a programme which is convenient and comfortable for you.
Remember, even if you had your heart attack or surgery years ago, it is not too late to join a cardiac rehab programme. Such a programme can improve your health, increase your knowledge and your sense of well-being, and help you to meet new friends. Cardiac rehab can be a major ally in your fight to conquer heart disease. What you can do is to ask your doctor if you are a candidate for cardiac rehabilitation.
Explore the cardiac rehabilitation programme in your area.
If you are a woman you may feel more comfortable if other women are in the programme as well. Since women are less likely to be in cardiac rehab programmes, you may have to check out a few to find the right programme for you. Once you find a programme, check to make certain it meets these qualifications:
- Is the programme supervised by a cardiologist or otherwise qualified physician?
- Is there a qualified nurse or someone else with training and certification on hand at all times to handle medical emergencies?
- Do the exercise instructors have a college degree in physical fitness or a related and additional training in cardiac rehabilitation?
Get On Target
Before you embark on an exercise programme there are two essential musts:
The first is that you must get your doctor's clearance before you start and this is very important.
The second important thing is that you need to know your target heart rate to get the most you can from aerobic exercise, whether you are doing it as a part of cardiac rehabilitation programme or part of an exercise programme approved by your doctor. This knowledge both ensures you will be exercising vigorously enough to strengthen your cardiovascular system while at the same ensuring that you will not overwork your heart.
Some people mistakenly think that if pushing your heart rate to its target rate is good, pushing it higher is even better. This is not true. If your heart rate goes up too high, this indicates that instead of exercising aerobically, which strengthens your cardiovascular system, you are exercising an-aerobically, which means you are working too hard. To reap the benefits of an aerobic exercise, you must stay within your target heart range.
To find your target heart range subtract your age from 220. Then multiply the figure by 0.60 and 0.80. That figure will give you a heart rate value if you are working at 60 to 80 percent of maximum, which is considered a good level for cardiac conditioning. For example, if you are forty, your maximum heart rate should be about 180 (220-40) beats per minute. Your 60 to 80 percent target range is 108 (180*0.6) to 144 (180*0.8) beats per minute. Often, when doing aerobics, the instructor will have you take a ten-second measurement. Dividing by 6, this means your target heart rate should fall between 18 and 24 beats for a ten second count. If it is higher than that, do not stop abruptly, but slow down. We have various pulse points in our bodies; the two convenient places the pulse can be found are at the wrist and at the neck.
By the way, if you are in a cardiac rehab programme and were tested for exercise capability, your heart rate may differ from the above calculations. Use the target heart rate you were given in your programme, since the rate is specific to your body.
When you are exercising, if you find your pulse rate is running too high, slow down the vigourousness of the activity a bit. If you are in an exercise class, for example, march in place. If your pulse rate is too low, put a little more intensity into your activities. If you are in an aerobics class, raising your arms up and down over your shoulder level will generally raise your heart rate.
There is another easy way to test the intensity of your activity, especially if you and your friend are walking or using a treadmill or stationary bike. This is called the "Talk Test." If you can talk to your partner easily, the level of your activity is probably below 80 percent of your maximum exercise capacity.
Regardless of your heart rate, if exercise makes you feel too strenuous, or if you suffer from chest pain or other cardiac symptoms, stop! When you stop exercising, if you arc still winded (breathless) after ten minutes or still tired after an hour you are overdoing it. Contact your doctor if exercising brings on difficulty in breathing, faintness, dizziness, nausea, confusion, chest pain, extreme fatigue or leg pain.
Exercising can bring you great benefits, if you follow the few essential rales which are outlined, and you will be exercising not only effectively, but safely as well. What you can do is practice finding your heart rate. See how your rate fluctuates when you do different types of exercise. Take it easy while getting started. If you experience any symptoms such as chest pain, shortness of breath, dizziness or undue fatigue, be sure to consult your doctor before any further exercise.
