A User’s Guide to Cardiac Rehabilitation

After 8 weeks and 16 sessions, I’ve finished my Cardiac Rehabilitation Programme.  Yahoo!

The course is complete however graduation will need to wait for my final assessment – to measure my progress since I started back in mid-July – I’ll do this in a couple of weeks.

A huge thank you to all the staff!

Rehab Team 1

The Rehab Dream Team: Kirstein, Maggie, Brenda and Bernard

The experience has been a wholly positive one for me.  Helping me to come to terms with the whole Heart Attack experience and get back to some sort of normal routine (although it will change again now Rehab is finished!).

One of the things I’ve never understood about the Cardiac Rehab is why more (eligible) people don’t make more use of it?

After you’ve had a Heart Attack, or been treated for some sort of Heart condition, you would imagine that you’d be past the denial stage – the game is up!  For many of us, we are in the fortunate position to make changes that will improve (and extend) our lives.  So why doesn’t everyone?

From my perspective, it’s time to make a positive change!  The Cardiac Rehabilitation Programme is what’s on offer to help… so take advantage of it!

I thought Rehab was a really important opportunity to take action, regain control, learn and reflect.  I’m therefore dedicating this update to de-mystifying Cardiac Rehab for people that may need it in the future…

The Structure of the programme

There were 3 distinct sections to Cardiac Rehab which ran two sessions a week:

  1. Exercise – 30 minutes of exercise tailored to your personal capability (using Treadmill, Cross-Trainer, Step Machine) with a facilitated warm up / cool down to get your heart working
  2. Relaxation – 30 minutes of relaxation to help you learn how to take control and chill out
  3. Education – 60 minutes of education on a variety of Heart & Lifestyle topics (once a week only)

In addition, your first (and last) session will be a Physical and “Happiness” Assessment.  You will be asked to do a “Beep Test” and to answer some questions on your state of mind (e.g. Are you happy?  Yes / No) .

Wear clothes that are suitable for exercising in – I went for full gym kit, but it really depends on what you’re comfortable in.  Don’t worry, it’s definitely not a fashion parade!

Free up time

The Cardiac Rehab sessions will take a minimum of 2 hours per week.  That’s if you just do the Warm-Up, Exercise and Cool-Down.  You’ll need to add an extra 1 hour per week for the Post-Exercise Relaxation and another hour for the Education session.  Factor in the journey to and from the hospital, and the time it takes to shower and change, and you’re looking at a fair commitment of time over the 8 weeks.

Personally, I considered this an investment in myself, in my future, for myself and my family.  A long overdue investment in my health and wellbeing.  Worth it?

Before you start

If you’ve followed the guidance, you will have been exercising regularly since leaving hospital.  Starting very gently, maybe 5 mins twice a day, and building up slowly.  You may be up to 30 mins twice daily, and feeling good, stronger and fitter. You will hopefully have gained confidence and be ready for the next stage.

As you start Cardiac Rehabilitation, you may well feel like you’re being held back, forced to go backwards even.  You will likely start your exercise sessions with 1 to 1 or 2 to 1 (minutes on a Heart Exercise Station to “rest”), slowly working up the amount of time you spend working your heart.

As you demonstrate your fitness and strength, the duration of exercise will steadily increase.  “Steadily” being the operative word!

Monitor your status

The Exercise sessions start and finish with Pulse and Blood Pressure measurements.  Changes in medication are also recorded.  I’ve found seemingly small changes in medication have had a big impact on how my heart responds to exercise – well worth monitoring so exceptions can be identified more easily.

I used my own Heart Monitor to keep an eye on my pulse throughout each exercise session.  It’s not really a requirement as there are monitors on most of the machines, but personally I found it reassuring to know where I was against my upper limit.

One of the key outcomes from Rehab will be to have an increased awareness of what you can safely do and how you feel when exercising at the right level of intensity.

State of the Art Gym

Our “State of the Art” Cardiac Rehab Gym

The warm up

I found the warm up quite uncomfortable the first couple of times I did it (embarrassing uncomfortable not physically uncomfortable).  If you imagine the lightest, lowest impact aerobics ever, and then tone it down (right down) you’ll get a sense of the level of exertion.

I realised after a while that it is, after all, a warm up for a group of people suffering from Heart Disease.  Gentle is probably the way forward!

I got used to the Warm Up after a few weeks.  I guess this is a reflection on how well you’re coming to terms with toning down your behaviour to take account of the fact that you’ve had a Heart “Event”!

The cool down is similar, but even more gentle!

Pace yourself

You need to bare in mind that 8 weeks is quite a long time.  Although I’m sure you’ll be keen to get back to normal, it’s an opportunity to build up at a sustainable pace.  You will make progress, just don’t be in too much of a hurry.

If someone turns down the resistance on your work-out machine, reducing the intensity of your work out (and they may well do!), take a deep breath and, if you’re feeling strong, increase your speed.  You can still do the same amount of work, but in different ways.

Build confidence

You’ve probably already realised that the aftermath of a Heart Attack isn’t all about you.  To a large degree, the people that you’re close to, that you interact with from time to time are more important.

Part of the recovery process is giving everyone (including yourself) time to re-build confidence in what you can safely do, to trust that you’re not going to do yourself damage or put yourself in danger again.

Well, the Cardiac Rehab Team are people too.  They too will build confidence over time, but it does take time.

Do your homework

I think it’s important to continue to exercise regularly while you’re on the Programme.  That means continuing to exercise at home, between Rehab sessions.  That way you’ll really feel the benefit of the exercise and build your strength over the duration of the course.

Relaxation

The Relaxation sessions followed a common routine…  participants either lie on a bed / floor mat, or sit in a chair, and start by focussing on deep breathing, followed by tensing and relaxing muscles from Toe to Head.  The process is facilitated by an instructor reading a well-worn script.

There then followed a variety of other relaxation techniques, again following instructions.

Imagine yourself in a warm, comfortable place…

To be honest, for the last few weeks, I switched off by the time the initial relaxation was complete.  Overly relaxed perhaps?  I have to admit, I was guilt of being the rogue snorer on one occasion (one that I’m willing to own up to anyway!).  I definitely wasn’t the only one!

The relaxation techniques are useful for winding down in everyday life, both to take a few minutes out from a stressful day, or to help respond positively to difficult situations (deep breath, drop your shoulders…).

Education Sessions

The education sessions included:  Diet, Medication, Preparing for the future, Stress Management, Anatomy of the heart, Getting back to “normal”.

One of the major benefits of Cardiac Rehab is having the opportunity to talk to other people in a similar situation.  As the members of the group change over the 8-weeks, you will meet and share experiences with people at different stages of their Rehabilitation.  This is informal, but valuable and rewarding.  I really enjoyed seeing people’s confidence growing week by week.

And then it’s over…

I’m more or less on my own now, at least for the time being.  I already have a gym assessment scheduled and I’ve signed up for swimming lessons.

untitled (31)

Swimming… yes. Butterfly… I don’t think so!

For me, Cardiac Rehab created some structure to the recovery process.  I had come through my initial 4-week recuperation, and was ready to return to work.  Cardiac Rehab made me focus on myself 2 mornings a week.

Memories of the initial feelings to the Heart Attack are quickly forgotten.  It’s all too easy to fall back into bad habits, to proceed as if nothing has changed.  The 8 week Rehabilitation process provides some extra time to fall into good habits, to seek guidance and support.

It was also really nice to be part of a little group.  Although there were a diverse range of individuals participating, we all had something in common, none of us were strange (at least not because of our Heart conditions!).  Most importantly, I think everyone genuinely cared about each other.

Good luck to my fellow participants current and future!!!

Artists impression of my Cardiac Rehab group!

One thought on “A User’s Guide to Cardiac Rehabilitation

  1. Justin

    What an inspiring story! At 46 and recently gone through a similar experience it was great to read this. Best Wishes for the future X

    Like

    Reply

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