Tag Archives: Cardiac Rehabilitation

Spring forward

Changing the clocks to British Summer Time seems to be more significant this year than just the loss of an hour’s sleep. For me it feels like it marks the beginning of an exciting new phase.

Hopefully this isn’t your first notification!

The fast approaching Cycle extravaganzas are a big factor. I’ve been working on my preparations throughout the winter, primarily putting in the miles on the Turbo Trainer. I’ve already been getting outside regularly over the past few weeks, the time change and the lengthening days will hopefully make this an increasingly frequent and pleasurable occurrence.

The countdown clock for the first event, the Euro City Cycle, will soon tick down to days rather than months, As it gets increasingly closer it’s going to be difficult to contain my excitement! I am really looking forward to it! (Did I mention that already? 🙂)

It’s nice to be reaping some of the rewards from the hours of training over the winter. As the saying goes, “It doesn’t get any easier, you just go faster.”, but at least I’ve established a solid platform for the summer’s activities.

We’ll be heading off to a Holiday / Activity Centre for a few days during the Easter break. This time I’m really looking forward to the things I can do rather than thinking about the things I can’t. This is a big change from the last time we went away as a family. I really enjoyed our time away, but my Heart Attack was still a major factor, both psychological and physical. It feels very different now.

OK, so there may be some activities that I won’t be doing!

It’s all a little bit more “normal” for all of us. We all have much more confidence in what I am capable of doing and my lifestyle choices are no longer “strange”. It should lead to a much more relaxed time away, albeit active! Again, I’m really looking forward to it!

***

I’ve generally tried to maintain a positive outlook on life since the Heart Attack. I’ve never really found this difficult to conjure up, but sometimes it was more to make me feel good rather than because I was feeling good.

At the moment it doesn’t take any effort at all. Life is good and there’s lots to look forward to!

Homeward bound

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We live at the top of a hill. It’s a hill of reasonable stature that gets gradually steeper as you approach the top. As a place to live it’s good it you’re concerned about rising sea levels or floods in general. It isn’t so good however as a starting point for exercise if you’re recovering from a Heart Attack.

There are some other benefits of living at the top of a hill!

In the early days of my rehabilitation, when I first arrived home from hospital, I tried to avoid the slopes as much as possible (see An athlete’s pulse and “little” walks). It was possible to do with a 5 minute walk, but I soon had to take them on. My twice daily walks would incorporate slow, steady ascents, allowing me to gradually build my strength and confidence.

Since I’ve been riding my bike I’ve avoided the hill completely. Instead, I’ve put the bike rack on the car and driven to a flatter area to start and finish my rides. It’s been a pain, but it reduced the risk of pushing myself too hard.

Given the girls have never managed to scale the hill on their bikes either it has held fear for the whole family. I have therefore had strong support for my conservative, risk averse approach.

Over the past few months the hill seems to have grown. Like a volcanic island, it has risen a few inches every time I have driven up it. Concern over the impact the hill might have on my health has allowed in to grow into a challenge of almost biblical proportions.

Yesterday, however, I decided to take it on…

The gentle ascent to our house

I finally managed to get away from work early enough to get out for a ride before darkness descended, taking advantage of another beautiful afternoon. I did a reasonable mid-week ride (my first), but the majority of it was just a warm up for the final ascent.

As I approached the lower slopes I felt strong but a little anxious. I applied the lessons learned at the weekend; low gear, steady cadence, maintain momentum. always try to keep something in reserve.

It turned out to be a bit of an anti-climax. I made it without any distress and not even a thought of getting off to walk. An anti-climax, but another major milestone! Overcoming this hurdle will take about 30 minutes off most of my rides. It’ll make heading out in the evening more doable, and also finish them off with a cheeky little ascent.

It also served as a reminder of how far I’ve come since last June and my “little” walks!

Inverness, here I come!

Gaining inspiration

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I’ve been fairly motivated to get myself in shape since my Heart Attack. It gave me the “kick up the behind” I needed to get of the sofa and start exercising.

After building some initial momentum at Cardiac Rehabilitation, the Euro City Cycle has given me the focus to keep pushing through the winter. Having something to work towards has really helped maintain my motivation through the cold, dark days.

Despite this, I sometimes find my work-outs tough. I stay within my limits as far as pushing my Heart Rate and Stamina is concerned, but at the same time I try to work hard enough to push those limits further, to slowly build my strength and endurance.

Today marks 10 weeks until I head south to start the Euro City Cycle. I really need to start upping my training to ensure I’m properly prepared. To do this, I have to push myself a little harder.

I would like to avoid feeling like this on the Euro City Cycle!

When I’m tired it’s tempting to take short cuts, to give myself a break, to find an excuse to ease off or slow down. Often the tiredness is mental rather than physical. It’s difficult to keep pushing.

On Sunday I fortuitously stumbled across “Race across America (with James Cracknell)”. I joined the story as he arrived in Death Valley, during his attempt to travel from West Coast to East Coast in 18 days. Having arrived by bike, he had to cover about 80 miles on foot, the equivalent of 3 marathons in temperatures of 120+ degrees. It was brutal! If his challenge wasn’t great enough, he had an injured foot that made every step painful.

He lost 35 litres of sweat during this little stroll!

To be honest, the whole thing was bordering on nuts, but the effort and mental strength was amazing, a real source of inspiration. Since I saw it, whenever I start to feel tired I compare my position with what he had to deal with. It’s never failed to give me an extra boost of energy so far!

I also liked the fact that he really didn’t enjoy his ice bath afterwards. I’ve always wondered how pleasurable they must be. The answer appears to be “not very!”. I understand the rejuvenational benefits an ice bath may have, but I’ll be giving them a miss if that’s OK. If I were to have one it could literally turn out to be the last thing I did!

The part of the James Cracknell story I wasn’t expecting was that he got knocked off his bike and suffered a serious head injury from which he’s still recovering. Ignoring how the injury happened, I also found his recovery inspiring. It certainly helped me put my rehabilitation into some context. Again, what he went through in the months after his accident was on a different scale to what I’ve had to deal with. I am very lucky!

So, over the coming weeks I’m going to knuckle down and do the work. No excuses.

Cardiologist says “You’re good to go!”

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Today, 235 days after I was discharged from hospital, I had my follow-up Cardiology Check-up. Having waited for such a long time I had mentally built it up to being a big deal, and I was apprehensive as the time of my appointment approached…

Aren’t hospitals are strange places! As I ran the gauntlet of smokers alley and approached the Main Entrance, it occurred to me how different this visit was from my last one. Are there any other buildings where the various users can have such vastly different experiences? As an individual, each visit can have such dramatically different purposes and impacts; births / deaths, delight / despair, mundane / eventful, excitement / dread, etc..

Fortunately for me, this visit was short and positive. I had an ECG on arrival, again bringing back memories of my previous visit as my chest was shaved to improve the contact points. One big difference this time, however, was that everything was a little more relaxed!

After only a few minutes, the Cardiologist was ready to see me. He reviewed my notes, took my Blood Pressure and asked a few questions:

“Everything’s Perfect!” Dr, Noman (My Cardiologist)

I took this to mean “Thing’s are as good as they could be.” Which is also pretty good!

Again, everything was more relaxed, so I had a chance to ask some questions:

Dizziness? Due to medication. There are some options, but I am on the optimal dosage and should stick to it if I can. The best approach is to take my time when getting up (See Golden Rule #1).

Sensations in my chest area? Consider them normal, as long as it doesn’t feel like I did before I was admitted last time (i.e. as long as I don’t feel like I’m having a Heart Attack!).

Exercise? To be encouraged, as long as I don’t feel pain in my chest. Make sure I eat properly to minimise the dizziness.

How hard can I safely exercise? The drugs should prevent me from going “over the top”, but keep an eye on my Heart Rate (120 is a sensible upper limit).

My sponsored cycle, 300 miles over four days? (This prompted a little more thought…) I hadn’t previously had a Physical Stress Test, so we went back to the images of my Angioplasty. [I should have realised, but the whole procedure had been recorded. Not me on the hospital bed being brave, or the attentive staff, but the business end of proceedings (i.e. my Heart).]

My Heart post insertion of Stents

Last time I saw the images, I had a lot on my mind! I’ve spent so much time thinking about what’s going on inside me since last June, it was amazing to see them again!

The conclusion was that the damage to my Heart itself was minor and the narrowing of my other arteries was not sufficient to restrict blood flow, so I’m good to go! So good in fact that there’s no need for any further follow up visits unless something happens at my end.

So, the final “thumbs up”, I can really start training rather than exercising now, as long as I obey the rules…

Golden Rule #3: Make sure I am properly fuelled before (and while) doing exercise.

Golden Rule #4: If I feel dizzy while exercising, stop and refer to Golden Rule #3.

Golden Rule #5: If I feel chest pains while exercising, STOP!

Back in the saddle

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I’ve been out of action for three days since my toe trauma*. I’ve been fighting through the pain, hobbling from place to place, putting on a brave face. Sympathy has been hard to come by. It seems that comedy toe injuries demand laughter rather than sympathy, sniggers rather than tears, giggles rather than concern. So be it!

Time to “Man Up!”.

I’ve been getting lots of sympathy from the ladies in my life!

After three days of enforced rest, today was the day to get back in the saddle…

Over the past week I’ve “connected” with people doing both the Euro City Cycle and “Ride the North” events. It’s all feeling a lot more real now. There’s less than 3 months to the start of the Euro City Cycle. Time to start getting focussed!

It’s clear from early interactions that people are at different stages of readiness and very different levels of experience. I guess that’s always going to be the case. Everyone will be starting from a different base level of fitness and stamina, Everyone’s preparation will be different. So I’m expecting a real mix of fitness levels for the event.

Personally I’m keen not to hold anyone back on any of my rides over the summer. I also want to make sure I’m fit enough to enjoy them. This will obviously require me to be able to complete the events without pushing myself too hard, or putting myself in any physical danger.

I’ll be seeing my Cardiologist on Monday. It will be our first meeting since I was discharged from hospital in June (technically it’s my 3-6 month check-up). I’m looking at this to trigger a change in focus for me from “laying the foundations” to “getting ready to ride”. I realise I need to spend more time on my bike, and get outside.

My preparation approach is:

Start now. Don’t delay any longer.
Build up slowly; there is no need to go nuts. It’d probably do more harm than good.
Don’t panic!
Make a preparation plan. Set targets. Do your best to meet them.
Re-plan if necessary. There’s still time.
Enjoy it!

Personally, I’m really looking forward to the switch in focus. Bring it on!

***

* I could show you, but you may find it too distressing!

The biggest hurdle

Changing treatments

Just the three of us

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The maintenance work at the Local Pool finished yesterday bringing the week-long closure to an end. I don’t usually swim on a Saturday, but I was keen to get back in the pool, particularly as we have visitors this weekend and an early morning swim seemed like a good way of getting some exercise without impacting our plans for the day.

Not being a regular on a Saturday, I didn’t quite know what to expect. Given it had been shut all week I assumed the pool be busy.

I arrived to find 6 lanes marked out. Normally the swimming team would have been using 4 of the lanes but today they were all available to the public. There were some early comings and goings, but shortly after my arrival there were only three of us in the pool, and it stayed that way for the duration of my session. What a difference it makes to have a dedicated lane. A rare luxury. Bliss!

Sharing a lane can be frustrating!

After the session, one of my fellow swimmers asked me a question:

“What are you training for?”

I thought this was a fantastic question to ask in a Swimming Pool / Gym type setting. There’s no real downside… if you’re not training for something you’re likely to be pleased that someone considered you might be, and if you are it’s obviously a good conversation starter.

Personally, I was really pleased to be asked. It’s the first time anyone’s openly mistaken me for someone who’s fit for a long time. I took it as a sign that I’m making progress.

As it turned out, the chap I was speaking to is training for an Ironman event in South Africa in April next year (2.4 km Swim, 120km Cycle and a 28km Run). Clearly he has a little more conditioning under his belt than me!

The delights of competitive Open Water Swimming!

I have to admit, I was a little bit jealous. I suspect I’ll never be in a position to take on such a gruelling challenge. I’ll continue to set myself challenging goals, but they will always be within the context of my medical history, long term medication, etc.

I was recently asked a question about what I can’t do as a result of my Heart Attack. The list of things didn’t extend much beyond “some rides at Disney” and “scuba diving”. I suspect in reality the list is much longer, but I’m not going to add Ironman events to it just yet. Instead I’ll focus on doing what I can, taking it one step at a time. Who knows where the journey will end up!

Probably a step too far for me right now!

Going solo

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This morning I was presented with a dilemma. Due to a combination of (1) an unexpectedly heavy night and (2) a communication break down, I found myself all ready to go for a ride but no-one to cycle with.

So far, whenever I’ve cycled on the road I have done so with a wing man to accompany me. Initially this was as a safety precaution. Cycling as a pair provided comfort that any unforeseen Heart issues could be attended to quickly, and also meant that I could rely on someone a bit more experienced to help with any more “run of the mill” cycling problems (flat tyres, minor accidents, getting lost, etc.). It therefore helped build confidence; mine and everyone else’s.

The risks of cycling alone…

Up to this point I have not really considered cycling on the road by myself. It’s just not been a factor. This morning I was ready to ride, but alone. Hence, my dilemma.

***

There were plenty of reasons not to head out… besides all the reasons I prefer to cycle with company… it was a bit cold and clouds were gathering (a hint of snow perhaps?). There were plenty of flimsy but credible excuses if I wanted one.

Having had one abortive trip already this winter due to cold weather, I now have all the kit necessary to keep me warm. So, the decision came down to whether I was up for it or not. As it turned out, it really wasn’t that much of a decision. It turns out that cycling is just something I do now.

So, I headed out. I followed a route I know well. I kept my cadence high, gears low. I stayed well within my physical limits and I had a rest en route. I returned safely after an uneventful ride, feeling good. No biggie!

I felt good as I approached the end of my ride!

I feel like I’ve moved beyond the stage where I cycle as part of my Cardiac Rehabilitation. Now I just cycle. Of course it’s good for me. Of course I constantly monitor my Heart Rate to keep in “in the range”. However, I think I’ve graduated beyond being a Heart Attack Survivor that cycles a bit, to being a “Novice Cyclist”. A small but significant milestone!

Totes Emosh

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Today I received some fantastic news…

I recently presented the medical form for my Charity Bike Ride to my Doctor for his consideration. I had two main concerns: (1) that he wouldn’t think that embarking on a 300 mile cycle was a sensible thing to do less than a year after having a Heart Attack and (2) that his insurance company might have an issue with the wording of the statement I was asking him to sign.

A “No” would have left me lacking direction somewhat!

On one level I would have understood if either of these issues had arisen. I was potentially asking a lot given my recent medical history. I would even have understood if he had asked me to come back in a few months so he could see how my health and fitness have progressed.

On another level, I would have been totally gutted if he had said “No”. It would have thrown the ride into some jeopardy. Given it’s been my main focus for the past few months (at least as far as motivation for exercise is concerned), it would have felt deflated. I think I’m progressing well, and I want to stay motivated. Having something to work towards really helps.

***

Today I received the form back, signed and stamped by my Doctor. As far as he is concerned, I am “good to go”. I just need to continue to gradually build up my training and listen to my cardiologist.

For the record, I have never used these words before!

It was just some ink on a bit of paper, but I felt quite emotional as I left the Surgery. I’m not sure exactly why. It may have been the removal of doubt about whether he’d sign the form. It may have been the fact that the ball is now in my court as far as the ride is concerned – no excuses. It may also have been the small vote of confidence that he recognises the progress I’ve made and trusts that it will continue.

Whatever the reason, it reinforced the fact that the ride is important to me. 180 days to go!