Exercise Guidance: I am wondering if... - British Heart Fou...

British Heart Foundation

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Exercise Guidance

baltibob profile image
22 Replies

I am wondering if anyone has had any good guidance on exercise levels from their GP / heart team.

I have been building up my exercise levels gradually after after my cardiac arrest in Feb (LVEF 30-35%), but am a bit worried about pushing myself too much, as I know I can be quite competitive (against myself).

I had an appointment with a heart nurse last week and the only advice she gave was to "listen to your body". The advice available seems to be very generic (eg 150 mins, 10k steps, talk test etc) , but we are all very different in terms of our conditions, age, medications, and what we are able and not able to do.

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baltibob profile image
baltibob
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22 Replies
DWizza profile image
DWizza

Hi Baltibob, have been offered cardiac rehab program? Do they have them in your area ? Perhaps you could confirm if they are available through your GP/consultant ? Usually a 6 -8 week or so programme with other heart patients that are recovering from various things . They are overseen by physios that measure your stats and increase exercise gradually according to response . Even though I found them way below my expectation that would be the route to go.

baltibob profile image
baltibob in reply to DWizza

I meant to mention cardiac rehab. Yes, I did this over 8 weeks and it was really good. I would definitely recommend it to people.

I was reasonably fit before my cardiac arrest and used to run 2-3 times a week. Thankfully I had an injury at the time and hadn't been running for a few weeks, otherwise I could have been out on a run on my own at the time of the arrest, instead of at home.

I have progressed from walking to the exercise bike, and walk/jogs, on the treadmill in the last couple of weeks. and will gradually increase what I do, but I don't want to push things too much.

Davey77 profile image
Davey77 in reply to baltibob

Some of the people at my ongoing Cardiac Rehab class are quite fit, but prefer to exercise under qualified supervision.

My class is at a local gym and we have to pay for the hire of the studio, but if you can find something similar near to you, I can definitely recommend it as a way to exercise with less anxiety

Ennasti profile image
Ennasti

I’ll be interested to read the responses from others on this topic. I’m also trying to figure this out.

I’ve not had a heart attack but have reduced function and am on beta blockers. I have an LBBB which doesn’t like me exercising but I know I have to increase my cv fitness. Im just not sure how to proceed or how much to do. My cardiologist also said ‘do as much as you can tolerate’ but that is pretty open. I’m waiting on a callback from a cardiac clinic for an appointment with a cardiac physiologist.

Throttleout profile image
Throttleout

Hi BaltibobThe advise does sound Generic, I do cardio and muscle exercise every other day, pretty much the same as I was taught by my community cardio team. Listening to your body is good advice, you should have been told about your RPE which is different for people, you should know how far you can push yourself before you need to cool down.

I got as far as 15 on the RPE which was more than enough for me.

I've climbed Mt Snowden since my HA but it wasn't easy, I'm still active and constantly listening to my body, you'll know when to stop.

baltibob profile image
baltibob in reply to Throttleout

Hi, no one mentioned RPE, but it makes sense that something like RPE or heart rate zones could be recommended on an an individual level. When I did the cardiac rehab I did the Chester Step Test at the start and the end of the course, and perhaps I could have got some more guidance on exercise, based on how I did during the course. Overall though it was very good, and given my level of fitness prior to my event, I was a bit skeptical about doing it, but it was very good and I would recommend it to others.

JAVA12 profile image
JAVA12 in reply to Throttleout

Hi there, can I please ask what RPE is. I’m worried about my husband as he jogs about 5-7k most days and doesn’t do a warm up (he says he goes so slow he doesn’t need to but he’s faster than me). His jog yesterday was fine but he had discomfort in his chest after and felt sick. He’s reluctant to speak to doctors as he thinks they don’t listen. I would be interested to know what this RPE is. Thank you.

baltibob profile image
baltibob in reply to JAVA12

I had to google it myself. It means "Rating of Perceived Effort". There is a good description here -> verywellfit.com/rating-of-p...

I have a Garmin watch and it asks after a workout how much effort you exerted and how you felt, which I guess is a similar approach.

JAVA12 profile image
JAVA12 in reply to baltibob

Thank you for the information. Very helpful.

baltibob profile image
baltibob in reply to JAVA12

fyI my garmin watch has an emergency alert function, which allows the wears to send an alert to an emergency contact. I have never had to use it, but its good to have it. Other brands probably have something similar.

You could also look at sharing your phone location with each other. This could give you some piece of mind, as you could see where you husband is when he is out on his jog if he were to take his phone with him. You can share location in google maps for example and in my family we use an app called Life360 so that we know where the kids are etc at all times, which is really useful.

Snowflake01 profile image
Snowflake01 in reply to JAVA12

I had discomfort in my chest whilst running anything over a jog - I would do 10k no problem, though only at a jogging speed without the chest discomfort being felt (5mph?).

The discomfort was the only reason I went to the GP - I had no issues in day-to-day life. After then being referred to the Cardiologist and several tests, I was then on the waiting list for an elective bypass, CABGx4 😮

Worth getting checked out properly if there's still any doubt in what is causing the discomfort!

JAVA12 profile image
JAVA12 in reply to Snowflake01

Thank you, he's feeling quite anxious at the moment but I will try and persuade him to go to the doctors.

DWizza profile image
DWizza

RPE is the standard currency for cardiac rehab , I’m amazed it was never mentioned ! I carried on training on my own, always been fit and strong up to having Nstemi and quadruple bypass on 25th July 2023. Started back running , 5k goals , then got some help from an online cardiac coach who was the opposite of the cardiac physios in that he was keen for me to push on👍🏻 I could much more than I was allowed to in classes, he understood my previous sporting history and fitness levels post surgery. Plenty f others on here that are pushing on and monitoring their active/resting heart rates , recovery , rates of exertion and blood pressure and how they are feeling. Enjoy the journey Bob 👊🏻👊🏻👊🏻

Post quadruple bypass surgery ❤️
Murderfan58 profile image
Murderfan58

My brother had permanent AF and found the best exercise for him is swimming he swims for a hour 5 days at week at 6.30am and always does 10,000 steps a day. Gardening is good exercise and he and my sister in law have an allotment plot each . Hers has raised beds so she can do it from her wheelchair. He has some weights and does workout with them once a week.

Because of losing weight I didn't start to do regular exercise until 2018 before my heart condition was properly diagnosed my old GP missed diagnosed me. I went to an age UK community fit club. The instructor changed the exercises for me and I used a chair for leg exercises and sat down for arm.

When I moved here joined at sit fit class that closed because of covid. But found a GP referral sit fit class run by my local council. It was sit down ,stand up exercises using a chair and walking exercises . When that course finished . I found a sit fit class every Monday afternoon and love it . Our instructor gave us 7 wake up exercises to do in January I have done them every morning since once I am dressed . I also had static pedals and do 300 rotations every morning after taking my BP.

In the class we use ankle weights she supplies 1kg weights which I can't use but brought 500g ones which I can . I have PAF and a rare hereditary neurological condition which effects my mobility and a host of other things. We use long resist bands and a circular one . Exercises sitting down ,ones behind our chair and walking ones . Once a month we do circuit training which is usually 7 exercises with various equipment.

Don't think sit fit is an easy option because it's not . We have a good work out . But it's fun and we encourage eachother other. In her morning class she had some men so don't think it's only for women. Costs £5 for 60-70 mins. She likes us to do everything she has planned for the lesson. .

I couldn't do heart action classes as I couldn't use the equipment because of my mobility.

michellefisherm profile image
michellefisherm

Hi. I am 61 years old and got 4 stents in Jan 2023 and then another one in April of this year.

I do strength training of 50 minutes 3 times a day (M, W, F). On these days I also do a 30 minute walk in the evening.

On the other 2 days Tues and Thursday, I do a 50 minute run. Since I am on Metoprolol 50mg and Losartan 12.5mg, I am targeting my Maximum Heart Rate at 130 beats per minute.

I run 4 minutes at Zone 2 keeping my heart rate between 60% to 70% of my max heart rate and then 1 minute pushing heart rate to slightly below 90% (zone 4).

Before April 2024 stent, I used to do 40 minute zone 2 run on treadmill and then 10 minutes zone 5. Now after April 2024 stent, I am still building up to it.

Sometimes I will do a run on Saturday or Sunday too.

I would love feedback on others on what can I improve or change.

Hi Baltibob,

as others have mentioned you should be or been offered cardio rehabilitation.

It's the best , safest way of getting back into excericse after anything heart related.

It boosts your confidence and is done at a pace which suits you with steady progress.

Ask your cardio nurse about it, I'm surprised they haven't mentioned it already.

baltibob profile image
baltibob in reply to

As I mentioned above, I have already done cardiac rehab. It was very good but 1) I think I am above the fitness level of the class 2) it's finished so what now? What ongoing advice can we get post rehab that factors in our age, condition, fitness level etc.?

in reply to baltibob

Ahh I see sorry.

It really depends on how fit you were pre heart condition, your age and how you feel after what I was told are the more gentler levels of cardio rehabilitation .

I'm going to give myself as an example. I was pretty fit pre HA.

I'm 53, had a HA last Nov . Was put straight to the advance level of cardio rehabilitation ie weight training, cycling rowing, treadmill ( walks first then progress) 6 weeks after my HA after a period of doing sod all.

I found it bloody difficult, but over 2 months built myself up to half the weight training I did pre HA. The rowing, cycling, treadmill was my main focus. Ie get that heart working.

Now seven months on I'm back to 90% of my pre HA weight lifting and probably double the cycling , rowing and walking. I come away from these sessions with a good sweat, my heart rate hits 130bpm at times, average is probaly 120bpm.

My sessions ( which i do 4 times a week) consist of 35 to 40 minutes of weight training, 5 to 6 miles on bike, 3000m on rowing machine, then a walk at 5-6kph to cool down. I absolutely feel the effort in a healthy way after each of these.

I go for 1 to 2 hour walks on the Saturday and rest Sunday.

Am I saying you should do the same? absolutely not, but if you're after some examples of what us hearties can do , in a patient and sensible way then this is mine.

baltibob profile image
baltibob in reply to

Thanks. As you say, it really depends on age, condition etc, and my original question was really about has anyone got any non-generic advice that takes into account their personal circumstances.

Its sounds like you are doing really well though, and very active which is great. Hopefully my echo scan next month will show some improvement in my LVEF, which might give me a bit more confidence to push on a bit more. At the the moment I am doing a lot of walking, exercise bike and walk/jogs on the treadmill. I would like to go out for some jogs, but at the moment the idea of being out on a jog on my own terrifies me, in case something happens.

in reply to baltibob

my cardio rehabilitation nurse who was a running geek said walking in his opinion is just as healthy or even better then running and he was a running fanatic.

running/ jogging isn't the only way to get cardio fit.

Snowflake01 profile image
Snowflake01

I'm starting my Rehab next week - got the impression it was quite tailored to me rather than as a group, but will see.

Thanks to everyone for replies to baltibob for the post Rehab advice / stories - I'm sure I can make good use of as well! Looking forward to getting active again 🙂

baltibob profile image
baltibob in reply to Snowflake01

It sounds others rehab was different to mine. Mine was basically a long warm up and cool down at the end, with circuit type activities in between - walking, exercise bike, star jumps etc, weights. Everyone did the same, but for different lengths of time depending on health/fitness. At each session they checked everyone's bp and heart rate at the beginning and end, and took occasional heart rate readings during the session too.

Before I started rehab I had an assessment where they took my weight, bp etc and I did the Chester Step test. At the end of the course I did another chester step test and they calculate the difference between the two.

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