Tag Archives: Cardiac Rehab

Fighting back

Just over ten months ago I started my latest and most important attempt to get myself into physical shape.  Having just been discharged from hospital after suffering a Heart Attack it was long overdue.  Aged 42, years of neglect, complacency and idleness had taken their toll.

My quest for fitness started tentatively; a shuffle around the Cardiology Ward accompanied by daughter #1.  She was scared of her father’s mortality.  I was afraid of every twinge, every strange sensation.  We both pretended things were normal, trying hard to mask our fear.  Bravely, we managed a lap of the ward, perhaps 100 metres.  Afterwards I returned to bed, exhausted by the effort.

Tomorrow morning I will set out on a 280 mile journey to cycle from London to Brussels via Amsterdam.

I’ve come a long way!


So far there have been several distinct stages to my physical rehabilitation:

Stage 1:  Confinement

For the first 24 hours I was confined to bed, tethered to machines monitoring my heart, recording every beat.

Then I was cut loose of the wires.  I was free to move around but not in shape for physical exertion.  A shower was about all I could manage.

After four days of rest I was ready for the long shuffle out of the hospital to recuperate at home.

Stage 2:  Finding my feet

My journey really started with “Dad’s little walks”; shorts walks from the comfort of the house.  Five minutes was enough to start with, at a gentle pace.  Twice a day; morning and evening.  GTN spray to hand in case of emergency (fortunately never used!).

I added an extra minute each day as my strength and confidence grew.  Eventually I was able to venture out unaccompanied, walking further and faster, my independence slowly returning.  Occasional outings with Louise became a sociable evening stroll, slightly more relaxed each time, a pleasant change from anxious medical supervision.

Eventually I built up to 30 minutes twice a day.  A good walk at a strong pace.  The effort worked my heart, brought me out in a light sweat; proper exercise for the first time in a long time.

The results of the first 10 weeks

Stage 3: A helping hand

Eventually I was ready for Cardiac Rehabilitation, 40 minutes of supervised exercise twice a week. As part of a team, patients and staff, we worked together.  Week by week, for 8 weeks, the intensity increased.  My swagger returned as my stamina grew, as I was encouraged to (ever so carefully) push my limits.

My Heart Rate Monitor became my best friend, measuring my physical exertion, monitoring my well-being.  The magic number was 118 beats per minute, 80% of my theoretical maximum.

I started cycling.  Initially at home.  Stationary, In the garage.  I bought a Turbo Trainer and borrowed a bike.  At first it was painful in so many ways, the shoes were too small, the bike poorly adjusted, cleats at the wrong angle and the saddle… the saddle was a sadistic joke.

15 minutes was enough.  15 minutes and a walk, a stretch, some relief.  Day by day my tolerance levels increased.  I pushed myself.  Day after day:  “The Long Scream” over and over.

I invested in a bike of my own.

By the end of Cardiac Rehabilitation I could manage a full 30 minutes on a cross-trainer.  30 minutes of continuous exercise, at the upper end of my Heart Rate range.  It felt good.  I felt good.

It was time to sign up for a longer term challenge… the Euro City Cycle.

Before the winter hit we managed a few gentle outings, cycling’s equivalent of “Dad’s little walks”.  I was followed every mile by a good, caring and patient friend.  I started to find my legs; 17 miles became 25, then 30.

Cycling buddies… the early days

Stage 4: Laying the foundations

Continuity over the winter built my conditioning.  I exercised six days a week come rain or shine.  I rotated my cycling routines to provide a little variety;  The Long Scream, Angels, Hell Hath No Fury… “The Sufferfest” guiding every spin of the wheel, every turn of the pedals.

I ate well.  I looked after myself.  No alcohol. No caffeine.  Low fat.  High fibre.  I lost over 45 lbs.  A shadow of my former self, approaching my fighting weight.

I added swimming to the routine to provide some extra variety, to improve my flexibility and build my core strength.  Far from a natural swimmer, it worked me harder than anticipated.  It was a welcome rest for tired legs, and it’ll provide a challenge for another day!

Christmas came and went.  A brief relaxation of the strict regime allowed roast potatoes and gravy for Christmas dinner, a tasty treat!

Then back to the training, cranking the pedals, dreaming of warmer climes, of venturing outside.

Stage 5: Head for the hills

Emerging after a winter on the Turbo Trainer was literally a breath of fresh air.  The hours on the bike had prepared me well.

Flat and gentle at first, the weekend rides became increasingly long and challenging.  Hills were gradually introduced, providing a new challenge to my strength and stamina.

With reassurance from the Cardiologist, I became less obsessed with my heart rate.  I continue to monitor it, but focus more on the level of effort, my breathing.  Relieved of the tight constraints, my cycling has become less stressful, more relaxed, free.

Cycling has become part of my life.  It has made me strong and confident again.

Over 10 months of discipline, a new lifestyle, regular exercise have stood me in good stead.  It hasn’t happened overnight, no fads, it has taken time and effort.

With over 2,000 miles in my legs this year, I am ready to take on the Euro City Cycle.  A distant dream has become a reality!

I’ve come a long way, but my journey is not complete!


I am lucky.

I had a chance to fight back, a second chance.  A chance to make a difference, for my family and myself.

If I can do this anyone can.  I had a “wake up call”, but there’s no need for you to wait!

Epic journeys

There are just 31 days until I start the Euro City Cycle (London to Amsterdam to Brussels, 300 miles over 4 days) and I’m entering the final stages of my preparation.

When I originally signed up for the event it really was a stretch target.  No-one was in a position to tell me I would be able to do it.  I was still in Cardiac Rehab.  The medical professionals weren’t going to encourage me to push myself too hard, and the rest of us had no idea what I’d be capable of.  I really was heading into the unknown.  To be honest, it would have been considered a challenge even without the Heart Attack given my lack of physical activity.

Committing to the event was scary too.  It set a hard deadline.  If I hadn’t been able to do it due to medical concerns it would have said something about the impact my Heart Attack was going to have on the rest of my life.  It would have been much easier for me to “wait and see”, to only to commit to something I knew I could do, but that’s not really me, and certainly not how I want to live.


Yesterday’s  cycle served as a reminder of how far I’ve come…

80 Miles

Having got a solid winter’s training under my belt, primarily inside on the Turbo Trainer, I’ve been slowly building the distance outside.  Yesterday saw a big jump to 80 miles!  If the truth been told, it was probably too big a jump (from just under 60 miles).  We weren’t really monitoring the miles, we just followed a route.  It was a tough ride, but good to complete!

A few weeks ago I took on “proper” hills for the first time.  My initial hilly cycle resulted in me walking for part of two of the three main inclines.  I hadn’t considered that I would need to develop a strategy for hills, to learn how to cycle up them, but that’s exactly what was required.  Now I’ve got to the point where I enjoy a good climb.  Each one represents an honest, visible and tangible challenge, laid out right in front of me.

Over time I’ve also become less obsessed by my Heart Rate.  I constantly monitor it, but I’m more relaxed.  The last time I visited the Cardiologist he was comfortable with me cycling and was happy that the medication would prevent me from pushing myself too hard.  It’s therefore become less of a concern for me, less of a constraint.

The drugs are working.  My short term recovery is amazing.  It’s a combination of the medication and my improving fitness but, after having pushed myself hard, my Heart Rate can drop off by 30 beats per minute in a couple of minutes.  I feel it too.  I enjoy regular breaks to eat / drink, but I don’t need long before I’m good to go again.


Having completed yesterday’s epic cycle I’m going to take a few days away from the Road Bike.  Instead, I’ll have some fun on the Mountain Bike, a machine that has been horribly neglected over the past few months.


There are just four more Saturday outings before I head south for the Euro City Cycle itself.  It’s just a milestone on my rehabilitation journey, but it’s an important one.  My key goals at this point are to stay fit and healthy.  Fingers crossed!

(Not) Hitting the wall

I sometimes worry about the frame of my Turbo Trainer failing and me being catapulted into the wall of my office at 25-30 miles an hour…

… but I’ll take my chances.

I am definitely an indoor cyclist at the moment.  I’m clocking up the miles on my Turbo Trainer, without moving an inch (and long may it stay that way!).  Cycling standing still.

Not the most glamorous location, but it works!

I’m sure the cyclist purists wouldn’t approve, but it’s a convenient way for me to get regular exercise.  It will also help build the strength in my legs and my “engine”.  Given I had precisely zero miles under my belt in July, every little helps.

The weather really hasn’t been conducive to getting outside either, so this is what it has to be.  Having negotiated the winter solstice, the days will start to get longer again offering the promise of evening outside on the bike… in time.

Working out on the Turbo Trainer is different to cycling outside in many ways:

Firstly, you have to pedal continuously as you don’t get any benefit from free-wheeling.  This means continuous pressure and continuous effort.  A good, controlled work out is guaranteed!

Unexpected Turbo Trainer incidents to one side, it’s obviously safer.  It’s very hard to fall off a fixed bike, and there isn’t any traffic to negotiate.  Being seen isn’t an issue and there’s no need to navigate pot-holes, ice or any other obstacles that may present themselves.

A very high tech set-up… the picnic table and cardboard box work a treat!

When you’re standing still you obviously don’t get any wind resistance or experience any friction from the road.  This makes clocking up the miles a bit easier.  The difference when cycling outside amazing, particularly the impact of dodgy road surfaces.

It feels much hotter cycling inside.  That sounds a bit silly as it is much warmer, but without a cooling breeze to help moderate the temperature, the only outlet is sweat.  I sweat a lot.  A variety of towels have been commandeered to help fight back.  It’s really not a pretty sight!

One of the areas that concerns me a bit is that I’m not getting a chance to build my bike handling skills.  As a result, I’m less elegant and generally more of a liability when I get outside.  I just have to gain comfort from the fact that this will come in time.  The more time I can spend outside when I finally get there, the better.

Finally, and importantly for me, working out at home eliminates all concerns about me experiencing issues when I’m out and about cycling on my own.  Fortunately I haven’t experienced any problems yet, but the concern is always there (for others as well as myself).  Being within earshot gives everyone an increased level of comfort.

The Euro City Cycle in May has given me a real focus.  When I first decided to do it, it seemed like a HUGE challenge.  I’m feeling increasingly confident that I’m going to be physically capable of completing the 300 miles over 4 days.  The fact that I can continue to train despite the worst the winter weather can throw at me is a real bonus.

Happy cranking!

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.


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.

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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!