This post is well overdue, I’ve now had 6 rehabilitation sessions with another 6 to go, so that makes it half-way … right?! Of course there’s a serious point to that comment. CHD does affect your short-term memory, but not your reasoning or analysis – as far as I can tell. So what is cardiac rehabilitation and how is it helping me (and hopefully others)?
The idea is this. Your body has had a bit of a battering – you may have had surgery like me, or a heart attack, or had some stents put in. All are manifestations of CHD, and all have had a number of effects on your heart which need to be tackled through physical exercise full-on if you’re going to have a good recovery, and you also need to understand how and why you got to where you are, so that you can attempt to change your life-style.
Life-style changes (including exercise) are of the greatest importance if you’re going to attempt to minimise the risk of recurring CHD episodes. So this is important stuff. It’s also important as a guide to how to minimise your risk of having CHD in the first place, though (as in my case one suspects) your genes may have a say in the matter and of course (as is said) you can do something about your friends, but not your family – so you MAY be stuck with genes that are not too helpful; but you can try and postpone (or reduce) that genetic effect.
So for me rehab is about a) getting my brain in gear to understand what and why all this happened; b) getting my heart working well – understanding the amount and type of physical exercise I require to get it supporting my ambitious life plans; and c) learning a little bit about relaxation as this may, just may, be helpful in preventing me get into the wrong place in the future. There have been other unforeseen consequences of rehab which I’ll cover in another blogpost which are linked to the personal reflection that has been a consequence of having so much time to think, rather than do, and some of that has been very revealing and scarey as well.
The rehab programme at UHW is organised by cardiac rehabilitation nurses in a multi-discplinary team that brings in physiotherapists, organisational therapists and other specialists such as pharmacists and dieticians as well.
For me the programme started with an assessment of my physical fitness and the range of heart-rate that I should attempt to keep within for moderate activity which I know now I should attempt to do for 30 mins every day, maybe in three slots, but I should try not to miss a day out. The exercise is important not only in getting my heart as a muscle working efficiently and well, but also in balancing my cholesterol; so if you see me sitting down in front of a screen too much – tell me to go and have a 10min walk! Now after 6 sessions of aerobic exercise in circuits, I’m about to move into the final “advanced” phase of rehab where I use equipment and learn how to use all those torture devices that I’ve shied away from learning how to use (and why) in the gym. So one outcome of this is that I may join a gym. I may also ask for a GP Referral, which is available in Cardiff( and Wales I think) to get an induction to the gyms in our leisure centres.
The exercises I’ve been doing to date are not in any way that extending, but what is important is the recognition of what actually constitutes “moderate exercise”. That is what I need to do regularly, so the class aims through the use of “the Borg Scale” to teach you to relate how you feel about the exercise (perceived state of exertion) against the actual heart-rate that has occurred during the exercise. It’s tempting to push yourself – I do – but that’s not the object. It’s an educational session rather than a fitness session – that comes later and it may be still a number of months before I climb a Lake District or Snowdon peak.
Before the exercise session there have been a number of talks on for instance physiology and exercsie, on diet, on stress, on cardiac drugs – which have been interesting an rewarding and which have served as a stimulus for the participants to also talk about their experiences all of which are different – that’s been the surprising thing! There’s so much information on the web but these sessions allow you to bring much of it together and contextualise it into your personal situation. Really worthwhile.
And then there’s relaxation … I enjoy these sessions, whilst I’m there, but can I remember to put what I’ve learnt into practice and use it away from the sessions? Of course not! That’s so alarming. I know I should relax more, but I can’t for the life of me apply the techniques at times when I really need to. It’s just so easy to relax after physical activity. Can I remember to do it before I get “het up” – no! So, MUST do better is the lesson here.
In all, half-way through, I can honestly say that cardiac rehabilitation is the most important part of the episode I’ve been experiencing. I (as readers of earlier posts will well know) was in denial for all the period pre-operation; had my anger and operation-related depression afterwards; but it was not until cardiac rehab that I, yes me, took some control over what was happening to me. Everything before then was essentially being done for, or to, me. So now it’s down to me. Do I want to come out of this better than when I went in, or don’t I care? Do I want to have a fit and healthy life from now on, or don’t I care? Do I want a second chance that really means something, or do I just want to drift?
The answers are easy.