It is increasingly recognised that recovery from a heart attack or heart surgery presents a challenge to the individual and their family in terms of physical well being but perhaps even more so as a psychological issue. Cardiac ill health raises concerns about mortality. Sudden onset heart disease can become an ‘I could have died’ event.
For the person, their family, friends and work colleagues, an acute cardiac episode is hugely significant. This possibly relates to the millennia –old view of the heart as the seat of the emotions, so that cardiac issues touch our core in a deep way.
In the past, recovery after heart problems was left to time. Doctors certified the patient off work for several weeks, even months during which time it was assumed that ‘time would be the healer’. While time is all some people need to get back to themselves, health professionals noted that many heart people were slow, even afraid to resume normal life.
Recovering from a heart attack involves taking steps to prevent future related health problems. Lifestyle changes include dietary changes, reducing stress, starting and sticking with a suitable exercise regime, etc. Though the hospital cardiac team address all this and more in the immediate aftermath of an attack, very often the shock of being suddenly and potentially seriously unwell can make it difficult for the patient to take in all the changes and put them into action straight away.
Through research, psychologists identified that anxiety around the idea of physically stressing a damaged heart can be a major block to taking the message of exercise on board. Gathering groups of people together with similar medical conditions has been proven to be a powerful and positive learning environment. Giving time and practical support to come to terms with what has happened has been shown to be one component of moving forward.
Enforced rest in the immediate aftermath will have weakened the heart, lungs, circulatory and muscle systems of the body even over a few weeks. In the same way that injured athletes return to sport in a progressive manner, cardiac patients are encouraged to retrain their body in a structured fashion.
Cardiac rehabilitation has been developed to bridge the gap between short term recovery and to cultivate good health strategies for the long term. Usually offered some six to twelve weeks after heart surgery or discharge from hospital, cardiac rehab assembles patients who have each come through a cardiac event. The message of taking long term care of the heart is then delivered by the multi-disciplinary team. The idea is based not just on ‘talking the talk’ but also encouraging these ex-patients to ‘walk the walk’… or rather ‘jog the jog’, enabling them to get fit and well again.
Though actual programme delivery may differ from one location to the next, the principles are the same. A format of 2-3 classes is used for 6-8 weeks. Each individual undergoes various physical stress tests before commencing, to ensure the heart is sufficiently recovered to start exercise. Everyone starts at a level that is appropriate to their baseline heart reading and then undergoes a circuit of exercises that gradually challenge the body in a safe monitored environment, retraining the body to perform well again.
One of the main planks of cardiac rehab is to encourage regular exercise.
Learning through personal experience that exercise is safe again after heart problems is a powerful motivator for adding exercise to a daily schedule.
Exercise is also a terrific anti-stress agent, but only when performed at a rate that physically challenges the cardiac system. Getting the heart pounding, pumping blood around the body releases endorphins in the brain, the body’s natural happy chemicals.
Classes are performed under the watchful eye of a chartered physiotherapist and one of the medical team. The pace and difficulty of the exercise programmes is progressed week on week. Patients are taught how to take their own pulse and are encouraged to self monitor changing heart rate after each set of exercises. This allows each person to understand and become comfortable with the significance of resting heart rate, the rise associated with different types of exercise and speed with which resting baseline returns. Simply experiencing and surviving everyday heart rate changes in a fully supported medical environment can be hugely helpful in the recovery process for many patients and their families.
The regular class structure includes short slots for specialist doctors and allied health professionals including public health nurses, chartered physiotherapist, occupational therapist, social workers, dieticians and clinical psychologists to address the multitude of issues present after a diagnosis of cardiac ill health. They advise in detail on necessary lifestyle changes.
The multitude of factors impacting on cardiac disease can be teased out within the group. Improved lifestyle habits are monitored and acknowledged to assist implementation of improved healthcare habits.
So the therapy message for today extols the positive benefits of exercise after heart trauma. If you or someone close to you has recently experienced a cardiac event, seek out your nearest cardiac rehabilitation class. Use this service to assist recovery and to a healthy lifestyle in the future. Take the opportunity to turn a negative event positive. May you have many years of good health ahead!
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