There are probably many things going through your head if you’ve just been discharged from hospital after a cardiac event or been newly diagnosed with a cardiac condition.
Perhaps you’re recovering from a heart attack, heart surgery or stroke. Or you've been newly diagnosed with a condition such as atrial fibrillation or heart failure. What now? Can you go back to work? Can you do all the things you were doing before this all happened? Can you or should you exercise and be physically active?
The short answer: Yes.
The long answer: It may take some time to work out what is best for you and your circumstances.
The first thing is to have an initial follow-up with your doctor as soon as possible after your discharge. Your discharge letter will summarise what your preliminary diagnosis is or what has happened regarding any procedures performed by the hospital. Your doctor will be your main port of call and help you keep track of your recovery and medications, especially if you've been prescribed new ones. They are also the person you need to consult prior to returning to physical activity or starting a new one.
Exercise and the heart
The heart is a muscle that has now become injured or sick, and just like when you get sick with the flu or a cold and need some time to get better, the heart also needs time to convalescence and get strong again. It will take time to get back to what you were doing beforehand and now, also, to become healthier by becoming more active to help prevent another event.
It is well-known that exercise is good for your body – it protects your heart and blood vessels, helps your immune system, keeps you limber and can help make you stronger. It is also good for your mental and emotional wellbeing, as stress can also put pressure on your heart. Basically, it can increase your quality of life, improve your functional capacity and can help prolong your life.
The best type of exercise is the type that makes you sweat, as it increases brain-derived neutrophic factor (BDNF) in the brain. Improving neuron health helps us adapt to change faster, as well as helps to improve immune function and increase endorphins, which help us destress.
Starting physical activity
If prior to the event or diagnosis you were exercising, there should be no issue returning to your previous level of activity so long as you take it slowly in the beginning and gradually work your way back.
If you weren’t exercising beforehand but would now like to, work on gradually getting stronger and fitter. You don't need to start going to the gym seven days a week or train for a marathon – you can set up your own routine. If the thought of exercising makes you cringe or makes you think of chores, try to reframe your thinking. Think of it as ‘being active’ and ‘taking care of yourself’ rather than ‘exercise’.
Finding the right type of activity really all depends on you, your body and your individual circumstances. What's important is that you do something that you enjoy to keep active and that you want to do it. A cardiac event could happen to a 35-year-old father of three young kids who works full time and with no other medical conditions, or it could happen to a 74-year-old retiree who has bad arthritis in her knees, is a smoker and becomes short of breath simply walking up the driveway to the letterbox. Your age, physical capability and overall lifestyle should be considered when choosing an activity. It’s also important to warm up properly to avoid injuries.
Types of activity for cardiac rehab
If becoming more active is a new concept to you, finding an activity or the motivation to start is the first hurdle, especially when you're also trying to be mindful of your heart. Always start with something that gets your body gently moving, but doesn't put too much stress on your heart and breathing. A good way to gauge this is if you can carry on a conversation while doing the activity.
You may even already be more active than you realise through incidental activity: physical activity that is part of your everyday life. Gardening, housework, vacuuming, playing in the park with your kids or a pet, walking to the shops and so on all count. You can even exercise without leaving the house!
Your doctor might know of community groups that you could join, or you could start doing an activity with family or friends. Some activities you could try are tai chi, pilates, dancing, aqua aerobics, short walks around your neighbourhood, bushwalking, swimming, hydrotherapy, or yoga.
Yoga is an ideal activity because there are so many styles to choose from, from the slower, restorative-style yin classes to the faster, flow, yang classes or something in between. There is also chair yoga and props available for those who are less mobile. With yoga, you can work at your own pace, but it can build overall strength and flexibility, help you with balance, and help you relax in the one session.
You can do yoga in the comfort of your own home as well as in a studio. Some basic poses you can try are: mountain pose (tadasana), downward dog (adho mukha svanasana), cobra (bhujangasana), plank pose (khumbhasana) and tree pose (vrksasana). Hold these for five to 10 breaths, relaxing into them with each exhale. These can all be done with a chair or using a wall to help with balance. As you get better at them, you can link them together and flow with your breath.
When people are motivated to do something, they are often enthusiastic and rearing to get going. But the hard part is continuing once you’ve started. Signing up for a gym or fitness class membership or finding someone to do an activity with can help keep you more accountable. You can also motivate each other to keep going.
As you become fitter, you'll find that you'll be able to do more – so don't give up.
Header image: Pexels
About the author
Maggie has been a paramedic with NSW Ambulance since 2015, working mainly in the Western Sydney and Blue Mountains areas. She has degrees in Paramedic Practice and Science (Psychology). She is passionate about health education and training and also runs her own first aid training courses with a first aid course specially designed for parents and carers. Maggie also has a passion for pain management and yoga therapy, human movement and biomechanics, enhanced by a Diploma in Sports Kinesiology and over 15 years of yoga teaching. She is currently working towards tertiary qualifications in Physiotherapy.