HEART ATTACK EXERCISE AND RECOVERY

HEART ATTACK, EARLY DAYS Many people find that having a heart attack is an enormous shock, often coming out of the blue. You may feel that you are too young, too fit or active to have a heart attack. Recovering from a heart attack takes time and you may feel you are on an emotional roller-coaster.   You may experience a number of emotional reactions including:-

SHOCK – this is an early reaction and you may feel numb about things going on around you and you may also find it difficult to concentrate and take things in. DENIAL– some people’s reactions can be to deny that they have had a heart atack.  This can help in the immediate situation, in that by denying it we feel we can cope with the turmoil going on around us but  it is very important to learn to accept the situation and find out what can be done to improve things for the future.   Having a heart problem can be thought of as a negative thing, but there are many positive steps that can be done to aid recovery.  Many who have been through this experience will tell you that there is ” a rich life after a heart attack” and it can be of a better quality than before. FEAR – can be as a result of feeling that life and your health is out of control.  These feeling will subside as you begin to understand what has happened and learn how you can take control again. ANGER – it is possible to feel anger at hospital staff, family and friends, along with that is also the feelings of guilt.   Talking to those around you will be very beneficial, be open and honest about how you are feeling. DEPRESSION this is extremely common after any life changing experience.  Symptoms include loss of appetite, poor sleeping patterns, lost of interest in the outside world.   Some find that they are weepy for no apparent reason.   There is no shame in crying and it can often be a way of releasing emotional tension.   If feeling of depression continue, then go and peak with your Doctor. ACCEPTANCE of what has happened is the stage at which you will find that you can move forward.  Your life will have changed but it can be both happy and rewarding. You will also find that family and friends can also go through similar mix of emotions.  As a result relationships can be deepened as you both share your emotions and hopes and dreams for the future.

By looking at your lifestyle,with the help of the cardiac rehabilitation team, you will be helped to identify risk factors that are having an adverse affect on your health, and which brought you to this point in time. There are risk factors which increase the risk of having a heart attack and some people have a lot of these risk factors while others have none. Some risk factors we cannot change, such as whether we are male or female, our family history and the colour of our skin. Other risk factors are modifiable (changeable), and by making and continuing to make some lifestyle changes, these will bring down the risk of future health problems.  It is also worth noting that some of these risk factors also apply to other health problems such as diabetes and some cancers.   These modifiable risk factors are:- .         Smoking .         High cholesterol levels .         High blood pressure .         Overweight .         Inactivity .         Diabetes – having poor control .         Waist measurement – females 31½” or less, males 37” or less .         Alcohol – Government guidelines males 21 units. Females 14 units  per week with two days per week alcohol free. After a heart attack it is important to gradually ease back into your normal routine.  Whilst in hospital you will have been gradually encouraged to walk gently around.  All the current research into recovery after a heart attack suggests that gentle activity in the days following the event helps towards a better and quick recovery than long periods of bed rest. When going home allow yourself time to settle in. For the first week take plenty of rest and take time out to relax, it is very normal to feel stressed and uptight. Getting Back To Normal. Everyone who has a heart attack is very different,  there are no hard and fast rules to your recovery.  You must increase at your own pace, be confident to go with your own feelings.     For the first six weeks after returning home you need to slowly, try to get back to your every day light activities (no cutting the grass!). Please note that before commencing your daily walk to always allow 2 hours after your main meal, and avoid walking in very hot and humid or very cold and windy weather. Week one at home, limit your activities to just pottering around the house and garden.  It is acceptable to go up and down the stairs from day one. You will be able to do such things as lay the table, make yourself a snack, play board or card games, craft work such as sewing, washing up! Week two begin your daily walks (weather permitting).   Start off slowly and only walk a short distance.  Then gradually increase the distance you walk.       During this time make sure that you only stroll along the road, and take the stairs at a comfortable pace, no brisk walking. Week Three.  You should try and aim to walk (Stroll) most days – weather permitting – and each week to increase the distance you can cover.   Start initially with a five to ten minute walk.  It is very important that when you walk you are feeling comfortable and are not experiencing shortness of breath or chest tightness. Week Four Try to stroll for 15 – 20 minutes every day.  Light housework such as dusting and  light gardening such as repotting plants – NO digging or cutting the grass. Week Five Increase your walking time to 25 – 40 minutes. It is also around this stage that sexual intercourse can be resumed.  Everyone is different, the main rule is to wait until you feel comfortable.  Some people find that they get angina, but this can be solved with a GTN spray or tablet. Week Six By this week you should be able to to walk (stroll) comfortably for 40 minutes or more.  You must judge it by how you are feeling, don’t push yourself and if it takes you longer than six weeks to get to this stage do not worry. By this point in your recovery you should be more or less  back to normal every tasks, with the exception of returning to work.  It is around this time that you can resume driving unless otherwise advised by your Doctor.  Other activities such as sweeping and walking the dog, can be done. Everyday light activities do not demand a lot of energy, the following table will help you judge how hard an activity is.  Obviously the higher the number the more energy it will take. Lying awake                            1      –        2 Eating                                       1       –       2 Driving a car                            1       –       2 Taking a shower                    3      –       4 Vacuuming                              3      –       4 Cleaning windows                 3      –       4 Bed making                             2      –       6 Sexual intercourse                 3      –       5 Walking 1mph                        1       –       2 Walking 2mph                        2       –       3 Walking 3 – 3.5 mph             3       –       4 Tennis                                      4       –       9 Cutting grass                          5       –       7 Swimming breast stroke      8      –        9 Front crawl                               9      –       10 You will see from the above chart that not all forms of exercise are good for you at this stage whereas walking is an ideal form.   As you exercise you will have “good days” and “bad days”.   Don’t be disheartened if you are unable to do as much as you would wish. From week 7 your daily walk pattern will change Always start with a  fifteen minute stroll to increase the heart rate and warm up. Then walk at a slightly brisker pace where you are beginning to feel a little out of breath.   Aim to walk briskly for five – ten minutes.  Do not finish your brisk walk at your front door or car, it is very important to then take a  ten minute stroll home to cool down. All this must be symptom free ie no chest pain or  discomfort.    Try and aim to repeat  this at least 5 – 6 times during the week if you feel able to. If you find that you cannot do a ten minute stroll to cool down then you have done too much. Weeks 8 & 9 Warm up 15 minute stroll. Brisk walk 15 – 20 minutes or 1 mile in twenty – twenty-five minutes. Cool down – 10 minute stroll home. Aim to do 5-6 times per week. Weeks 10 & 11.  A 15 minute stroll to warm up, brisk walk 20 – 30 minutes 10 minute stroll to cool down. Week 12 Warm up 15 minute stroll brisk walk 30 + minutes, 10 minute stroll. Do not worry if you cannot do all this by week 12, everyone is different, you must work at your own pace.  Remember that you will have good days and bad days.  Do not force yourself, remember to listen to what your body is telling you.  You are the best expert on how you are feeling.  If you are tired then rest. Going back to work.  If you are employed you will be able to start thinking about returning to work at around 6 weeks after your heart attack.  If you have a strenuous job or have a job that involves driving you may have to have an exercise treadmill test before you go back. It is extremely important to keep taking your medication, you will be on this for many years to come and some for the rest of your life.  You should also be contacted by the local cardiac rehab team whilst you are at home inviting you to join them in Phase III.   Taking up this invite will make an enormous difference to your well being and long term recovery and can result in less chance of readmission to hospital. References : BACR (British Association for Cardiac Rehabilitation) Darent Valley Hospital recovery guide Department of Health – recommended alcohol intake BHF (British Heart Foundation) RETURN TO MAIN PAGE

 

 

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