I attended my first exercise session yesterday afternoon, looking forward to being monitored for safe exercising, and meeting people going through same.
The monitoring was minimal - resting heart rate at the start, and then once half-way through. My heart rate was well over the target mid exercise, but the nurse just asked if I felt OK, and carried on. The exercises didn’t feel that hard, so I kept going.
There was no opportunity to chat to the other people, so I didn’t meet anyone similar.
And by the time I had driven home, I felt really quite ill, exhausted, chilled, and with an ache in my chest. The smart watch my son had loaned me showed that my pulse had gone to 160bpm during exercise - not so safe after all.
I’m feeling better this morning, but still tired, and with less confidence that cardiac rehab exercise sessions will help me feel better.
I know lots of people have really benefited from these sessions. How can I make sure the level of exercise is right for me, if the nurses aren’t actually monitoring my heart?
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BlueDays24
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Sorry to hear that. I have just done 7 weeks for cardio rehsb. At ours they take your blood,pressure to start, pulse ,at,start during and about 10 minutes after exercise. The nurses always,ask if you have had any problems during the,week and,we have time before and after to chat and,ask any questions. We,also had,2 information sessions on diet structure of heart stress,exercise getting back to normal.
I did at the time, and I’ve since phoned and left a message on their answer-phone since I felt so much worse after. I think I am due my next phone call next week too. It was just quite busy with 20+ people and I was expecting a bit more in the way of monitoring and advice.
It does sound if you are having one on one sessions therefore you might not get to speak to any other 'patient' who is attending, also they might not want to speak to you and may have a completely different heart problem to you. I only spoke to one other when I did mine and that was in the car park, (however I didn't see it as a problem).
To be honest my monitoring wasn't much different, mind you I think I had blood pressure taken before and after.
Do remember it is only the first week. When you go next week, mention to the nurse when you got home how you felt health wise after this week's, keep a note of what exercise you have done this week and take it with you with any questions about your rehab which you may have.
I would suggest this would help them to adjust the programme as you go along and get a bit of rapport going between you and the nurses.
At the end of mine, I asked if they could do me a exercise programme to continue after the rehab, they told me no one had asked for this before, but they were very happy to help and did one for me based on my progress to that date.
There were only 2 ladies at my cardio rehab now only me unless another one joins,next week. At the end of our local cardio rehab you can get referred to a phase 4 follow up exercise group. In our case it's called Tickers which locally has,3 sessions a week. I think I am going along to a session to see if I can do it as,I have some joint problems. Hope you get and alright with your rehab. I know it has given me confidence finish myself a bit more
I’m on week 5 of rehab, they do BP before exercise, take heart rate after exercise, warm up, 6 stations with a different exercises per round, at 1 station (stepper) they measure your heart rate to try and keep under 105 ish, cool down, followed by weekly video on healthy eating, stress management etc. There’s only 6-7 people in the class luckily, any exercise that you are not ready for, you don’t do until you’re ready and do marching in the spot instead.
I hurt my shoulder mopping the floor the other week, so I didn’t do weights that side but could do the rest.
I’d probably have a word with the physio before or after, it’s important for your recovery.
My dad only went once and didn't like it. He said he was better doing the gardening and ballroom and sequence dancing with my mom . My brother didn't go as he said swimming for him and walking plus working full time was enough exercise. Since he retired he swims hour every morning,walks mini 10,000 steps and works on his allotment.
I go to sit fit class once a week as the sort of equipment they have in gyms aren't safe for me. Sit fit is not an easy option and you get a good work out . We do exercises behind a chair plus walking exercises. Have you tried walking both ways on your toes round a circle of 14 chairs not easy even harder doing it on your heels . We do sit down marching you try marching sitting on the middle of a dinning room chair full speed for 5 mins . Not easy but fun . Our instructor gave use 7 wake up exercises to do at home I do them every morning . Only one in the class who does but I like routine and planning ahead it's how my life had always worked. I thought I was weird turns out others with HPX are the same .
Plus I have some static pedals and do 300 rotations everyday . Been diagnosed with Osteopenia so do weight bearing exercises as well . We used ankle weights in class the rest use 1kg weights but I can't so brought pair of 500g weights and have 500g dumbbells. So also do 24 leg raises each leg then 12 each leg holding my legs up for count of 3 . Plus 12 bicep curls and then turn my hands over and do 12 raises that way. But I do feel better for the exercise.
But you have to find an exercise routine you enjoy and therefore can keep it up. Some people like pilates and yoga . But sit classes are available all over the country and my local council does an active aging 12 week course for free plus tea and biscuits afterwards . I did that before joining my class I have been going to for almost 2 years. But I did start to exercise doing a Age UK community fit club in 2018 where I used to live . The instructor gave me a chair for leg exercises and sat down for arm ones.
All the instructors I have had always say you should feel the exercise but if it hurts stop. And to go at your own speed.
Firstly do not necessarily believe your smart watch . was it just a peak or constant?Take your pulse manually & listen to your body.I don't think you could carry on exercising at 160.
Do you set a specific excercise routine .One that measures heart recovery rate is useful. I have 2 smart watches.One has shown readings that high on walks & no way could it be that.Not breathless & pulse at wrist not that fast
My husband has experienced peaks that high when exercising and again no way could it be that.
Yes you could feel worse afterwards.Allow recovery time.
I have been going to health trainer supervised excercise classes for about 10 years and cardiac rehab excercise classes for a few months back in 2008.
I have had several set backs and crisis which have caused breaks in attendance and returned.
My husband likes a higher level of excercise than me but all the instructors understand that and say go at your own pace.
As regards integration it should come .We Brits are are naturally cautious.
I'd endorse the opinion that a smartwatch shouldn't be considered to be 100% reliable. I have the current Google Pixel/Fitbit smart watch and the latest Oura 4 smart ring that I wear all the time, plus a Frontier X2 heart monitor that I use during strenuous exercise. And it's not unusual to find a spike on one of them that's clearly wrong.
I think rehab is only as good as the people delivering it so it varies a great deal.
The sessions I went to had no consistency. I worked with whoever happened to be available when I arrived and the quality really varied. The best was a student physio, she was the only one that referred to my notes and really adapted the session. One guy who described himself as an exercise physiologist just kept pushing me to do more - I ended up flat on my back with my legs elevated and the whole team in a panic around me. I recovered after about half an hour, but was disappointed there was so little knowledge there. I have been surprised to hear many people have nurses present.
If you get a good team I think the benefits are huge. If you are unlucky with the people then you have to take responsibility and make decisions about what they suggest.
When I did my cardiac rehab after my TAVR they took my weight, temp, pulse and BP before and then the pulse and BP again after but they also told us to stop if we had any problems during. They would walk around checking up on each person during the exercises. We wore heart monitors as well and they had a person keeping a close eye of the computer screen to see if anyone was getting into trouble.
I think the quality of the rehab' offered very much depends on the area where you live and the people who are doing it. I completed my six week course. BP and heart rate checked at the start and again at the end of each session. Very much encouraged to monitor and record everything yourself and continue with the exercises at home. No chats about diet, healthy eating etc. No talks by any specialists. And no time for chatting to the other people in the group. It was okay, and I'm glad I did it, but certainly not the experience that other people have been offered. Was told I could move on to Level 4, but I would have to pay. I have a border collie and I walk him for half an hour four times a day. That's enough for me.
Did your instructors explain the perceived rate of exertion scale ,? You say the exercises didn’t feel hard , what would you have scored them on the perceived rate of exertion , did you fill in a card after each exercise with a score ? I can assure you that the physios would have been looking out for everyone of their patients in that class , can you imagine the carnage if someone keeled over , the paperwork and enquiries 🤦🏼. I found the physios overbearing and felt they were holding me back. I didn’t go to classes to make buddies but inevitably after first class you start talking to people when you swap stations etc. My fellow patients couldn’t believe I was in their rehab class , I looked so fit and strong and was smashing the exercises, but had the scars to prove I’d had a quadruple bypass 🤦🏼.. It was a very mixed class , definitely not tailored to individuals or 1:1 but at least I worked my butt off within the rate of exertion rules , much to the annoyance of the lead physio , who was obviously more concerned about keeping everyone alive and healthy in her class . There were a couple of patients that could barely walk and a others that could jog and got told to slow down 🤦🏼. I’d say it’s worth completing the course, they will listen to your feed back and probably tell you work at a lower pace. I guarantee you that would not want you to leave their class and feel worse /be re admitted to hospital for over doing it.
Yes, they did the Borg scale, but the exercise didn’t feel that strenuous at the time (about 12 tops). I am/was used to just getting stuck in with exercise, not holding back - and I was hoping for advice on finding the right (lower) level now that my heart is “moderately damaged”. That’s why I went. If the exertion scale doesn’t tally with the post-exercise effect on me, and heart rate monitors can’t be trusted, I still don’t know how much I should be doing.
Yep, I agree ! That’s frustrating as hell. I think it’s good that you’ve got a bench mark though , you can use this experience to build on . Luckily for me I only had Nstemi, but 4xcabg 🤦🏼.. new pipes , just got to keep the clear . Please keep us updated on next session, really hoping you find the right level and can crack on 👊🏻👊🏻👊🏻
I had a similar experience during my cardio rehab Phase 3. Honestly, I think I would have been better off just walking—it would have been less stressful on my knees. On your next visit, I recommend sharing your experience with the instructor; they should be able to adjust the exercises to suit you better.
I much prefer Phase 4, which takes place in the gym. The equipment provides a constant heart rate reading, which is really helpful. Plus, you get more time during the exercise to chat with the nurse and connect with other people recovering alongside you. I love it!
I thank that these sessions vary, I have heard that some people have a very positive experience but unfortunately my experience was very similar to yours, I felt very ill during my second session, attempted to speak to the nurse but was told to carry on. I was several weeks post STEMI with an underlying heart condition as well and have no idea how I got home after the session, I felt dreadful. I said I would not be returning and had a phone call from them to try and get me to go back but I didn't feel confident that I would be appropriately monitored and given I had to travel 20 miles there and back I didn't return, the sessions were not a positive experience for me. I then did the cardiac rehab sessions on the BHF website ( and in fact still do, they are very good)
Sorry to hear your rehab experience has been rough. I can only praise the team I had. They were terrific. Maybe say to the team you’re worried and can you build your confidence and fitness up at a slightly lower pace.
Hi, I think you're being a little premature in condemning it after only 1 session, perhaps, and understandably, you're a little anxious. Report your exhaustion to the nurse at your next session, they will take good care of you. Momentarily high heart rates are not so dangerous, prolonged high HR is what to look out for, it's the speed of the return to the lower HR which is far more important. As for not speaking to others in the class, did you try to open conversation with them, or were you waiting for them to approach you? It is a 2 way street. Give it time, you'll be glad you did.All the best for a speedy return to health.
There are two types of cardiac rehab, I have experienes of both.e.g : 1) My Mrs, after bypass operation, had cardiac rehab in small groups, where you had others in same situation. This type of rehab lasted 1 hour with rigorous activity. 2) In my case stents, the rehab was mainly online for two months mainly about diets and educational. At the start appointment, by myself, quick monotoring and mild walking for short periods. Then at the end of the 2months back for monitoring and slightly increased walking tests. In between I/we were expected to do our own walking, gently increasing time from 10minutes to half hour.
Certainly felt the change in strength after 2months! The secret being to start gently and work your way up in easy stages. Don't stress yourself out!
My mum starts her's next week. We ate expecting it to be patronising and with too much chatting so I'm relieved you said there wasn't time for chatting, however a tea break might havd beeb nice for isolated people without Internet.
Isn't it just one session focused on exercise?
I'd just stop if I didn't feel well enough to continue with the exercise. We are all different and so go with your gut. If it doesn't feel right then sit that part out.
My first one was an assessment either on the bike or walking to set your your heart rate zone for exercising. Blood pressure and pulse check and was,weighed. Then 15 minutes of warm up ( which I found harder at first) then about 20 minutes of doing the circuit 8 different types at our class interspersed with weight training. Then 10 minutes of cool down.pulse is,checked during the exercise. I find the rehab. nurses check you are ok during the circuit. We have 10 minutes at the end when you can ask the rehab team any questions and they check your resting heart rate. I have 1 session to go we have 2 information evenings . Which I found very helpful. Hope your mum.gets on ok. She might find its mostly men that was,only one other lady at my group and she finished before me. I am doing a couple of catch up sessions,ask missed with having that respiratory virus that is doing the rounds
Mine doesn’t start till January, but I have an assessment appointment next week. Sounds like it’s an ECG on a treadmill; the letter said it would take 20 to 40 minutes.
sorry to be reading this my cardio time was completely different the nurses and staff were brilliant, maybe as next time you go tell them how worried you are, we are all different I did need extra help and it was there for me
I went back for my second session this afternoon. I told the cardiac rehab nurse how tired I had felt after last week, and my difficultly in judging what level of exercise was enough but not too much. There was even less monitoring this time as they were a staff member down, but when my pulse was taken at the mid-point, and again was significantly over my target range, I was allowed to keep the finger-tip monitor on to see for myself what level to aim for. And it seems my target heart rate happens when I’m not doing very much at all, maybe 11 on that Borg scale - so odd to be in an exercise class and thinking how to put less effort in!
Don't forget you are at the class as you have had a heart episode so you need time for your body to recover. I have just finished my last class and found I could push myself more than when I started. I don't know if you have been advised to do things at your own pace and do what your body tells you. That is,what we were told, not to worry what anyone else was doing. I am hoping to go and do stage 4 cardio after Christmas now and I have a feeling that maybe a bit more energetic. Going to see how I get on with my dodgy knees and hip.
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