Thursday, December 15, 2011

Getting Back into Your Life after a Heart Attack

How soon can I return to my regular activities?
The amount of activity you can do after a heart attack will be based on the condition of your heart. Your doctor will work with you to develop a recovery plan. Most people can return to work and the activities they enjoy within a few months of having a heart attack. Others may have to limit their activity if the heart muscle is very weak.
You will need to start slowly. For the first few days after your heart attack, you may need to rest and let your heart heal. As your heart heals, you’ll be ready to start moving around again. A few days after your heart attack, your doctor may want you to move around more. You may do stretching exercises and get up and walk. You’ll then slowly become more active based on advice from your doctor.

Once you’ve gotten through the early period after a heart attack, your doctor may talk to you about how to be active within your limits. Your doctor will probably want you to do an exercise test, also called a stress test. During this test, your doctor will ask you to exercise (usually walking on a treadmill) while he or she monitors your heart. Based on the results, your doctor will develop an exercise plan for you.
Reprinted with permission from “Heart Attack: Getting Back Into Your Life
After a Heart Attack,” September 2000, Updated April 2008, http://familydoctor
.org/online/famdocen/home/common/heartdisease/recovery/002.html. Copyright
© 2000 American Academy of Family Physicians. All Rights Reserved.

How can I improve my recovery plan?
Your doctor may recommend that you get involved in a cardiac rehabilitation program. Cardiac rehabilitation programs are super-vised by exercise specialists. Many hospitals sponsor these programs to get people started with a safe level of exercise after a heart attack. After a while, you’ll probably be able to exercise on your own. But if you have any of the symptoms listed below, call your doctor. You may be working too hard.
Exercise alert! Call your doctor right away if you have any of the following symptoms during exercise:
• Shortness of breath for more than about 10 minutes
• Chest pain or pain in your arms, neck, jaw, or stomach
• Dizzy spells
• Pale or splotchy skin
• Very fast heartbeat or an irregular heartbeat
• Cold sweats
• Nausea and vomiting
• Weakness or fainting
• Swelling or pain in your legs
Why is exercise so important?
Exercise strengthens your heart muscle. It can also boost your energy, help you feel more in control of your health, and help you lose weight and keep it off. Exercise may also lower your blood pressure and reduce your cholesterol level.
What kind of exercise is good?
The best types of exercise are those that involve your whole body, such as walking, cycling, jogging, cross-country skiing, or swimming. Your doctor or rehabilitation therapists may also prescribe activities to increase your strength and flexibility.
Risk factors for another heart attack: Taking charge of the things that put you at risk for another heart attack can help you feel better and reduce your risk of future problems. The following factors can put you at risk for another heart attack:
• Not exercising
• Alcohol in excessive amounts
• Being overweight or obese
• High cholesterol level
• High blood sugar level if you have diabetes
• High blood pressure
• Smoking
• Too much stress in your life
How often should I exercise?
This depends on your exercise plan. You’ll probably start slowly and gradually add to your routine. Your doctor may want you to exercise three or four times a week for about 10 to 30 minutes at a time. Be sure to warm up before exercising by stretching for 5 minutes or more.
What is a MET?
You may hear your doctor talk about METs when he or she discusses your activity level. METs stands for metabolic equivalents. Different activities are given different MET levels depending on how much energy they take to do (see Table 64.1).
The higher the MET level, the more energy the activity takes. Your doctor may ask you not to do things that take more than 3 or 3.5 METs right after your heart attack.
What can I do to speed my recovery and stay healthy?
Your doctor will probably recommend that you make some changes in your diet, such as cutting back on fat and cholesterol and watching how much salt you eat.
If you smoke, you will have to quit. Your doctor may also suggest that you learn better ways to deal with stress, such as time management, relaxation training, and deep breathing.
When can I go back to work?
Most people go back to work within 1 to 3 months after having a heart attack. The amount of time you are off from work depends on the condition of your heart and how strenuous or stressful your work is. You may have to make some changes in how you do your job or you may have to change jobs, at least for a short time, if your job is too hard on your heart.
What about sex?
You can probably start having sex again in 3 to 4 weeks after your heart attack. As with other types of activity, you may need to start out slowly and work your way back into your normal patterns. Don’t be afraid of sex because of your heart attack. Try different positions if one position seems to make you uncomfortable. Let your partner be on top to reduce the amount of energy you use during sex. Talk with your doctor if you or your partner has any concerns.
Table 64.1.
MET Activities
Sitting in a chair 1.0
Sweeping the floor 1.5
Driving a car 2.0
Ironing 3.5
Showering 3.5
Bowling 3.5
Sex 3.7–5.0
Golfing 4.0
Gardening 4.5
Playing tennis 6.0
Lawn mowing 6.5
Shoveling 7.0
Skiing 8.0

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