Exercising Heartrate

[wgreene]

From my reading I have seen that to get a maximum heart rate and what I should exercise at I need to have my Cardio doc do this. However I am 10 weeks post op and will not see the doc again for another month. I have a mechanical valve and currently taking beta blockers. I have been doing cardio exercise for the past 7 weeks increasing a little each week. I have been seeing my average heart rate go up each week with intensity. I wear a HR monitor to record this. My question is can someone give me a rule of thumb or experience on what I should use as a maximum and average? Again I know the doc needs to do this but right now I just need some guidelines.

Thanks

Wade

 

[tprice54]

Ok, so I am not a medical professional, but some advice:
-the old adage is your maximum HR is 220-your age, and your exercise should not be more than 75% of that number. Now, it also depends on how good of shape you are in: the better your physical shape, the lower your resting HR is but the higher your max is.
Also, your Beta Blockers are meant to hold down your HR medically, so you will have trouble trying to elevate your HR too much, depending on your dosage.
I wouldn't consider your "average" hr too much, look at your HR during your cardio, and resting HR.

 

[SumoRunner]

I'm old school. I learned how to work out decades before HR monitors were invented so I never had any need to know my workout rate and I've never known what my true max HR was either. What I learned ages ago was that you can control your resting heart rate. The better shape you are in, the lower it gets.

When you first wake up in the morning, this is difficult to do BTW, take your pulse before getting out of bed. Record what it is each day in your training log. After a few training cycles, months, maybe a year, you'll be familiar enough with it that you don't need to log it. You MUST keep a training log though, how else do you know what it takes to get into good/better/best shape?

If you had an especially tough or long workout yesterday, the morning resting HR will be a few beats higher than normal. If it's within 2 beats of normal, then you recovered fully and that level of exertion is good. If you're a bit higher, back off on the next workout. For me 55 is normal, 53 or lower means I'm in tip top condition, but if it's 60 then I need a day off.

Oh BTW, why is it hard to take a morning pulse? Open your eyes, turn to face your clock and put your fingers on a pulse point, then start to count. 1-2-3-4,...snzzzzz. You may have to repeat two or three times to get the count.

 

[wgreene]

Thanks for the advice. My resting is 52-53. Prior to surgery it was 62. I have been exercising aggressively and my HR only goes to 110-120. Prior to surgery it would run about 140-160. Guess the beta blocker is holding it down. I know the formula 220 - age, but since I am on beta blocker I don't think that works. Guess I will has my cardio doc a in a month.

 

[tprice54]

There are very good resons to be on a BB...but if you can get off, then I would. Ask your cardio why you ar eon it....for example, there are better drugs for high BP.....

 

[scott.eitman]

The Beta Blocker definately holds the HR down. That is its main purpose as I understand it. I am not a fan of Beta Blockers only because Metroprolol made me feel lousy. With that said, I recommend you work with your cardio about working out and HR. More importantly, I recommend Cardiac Rehab. I only went 5 times, so I am not saying you need the entire Cardiac Rehab, but at least go. They will hook you up to monitors and give you good feedback as to how your heart is doing. In addition, they will share this info with your cardio.

You do not need to wait a month to see your cardo. See them now and then again if need be. It could just take a phone call rather than a face to face appointment.

 

[Jason]

As others have said, beta blockers intentionally keep the heart rate down. I vary from 50-55 bpm in the morning to a max of 120 during exertion. When I was on a higher dose of bb's I would max out at 100 bpm, but never felt as though I was not pumping enough blood. My pre-surgery exertion heart rate was in the 145-150 range, also. The folks at my cardio rehab told me that all bets were off on recommended heart rates with beta blockers, as everyone responds differently. They gave me some recommendations after watching my exercise patterns, and I agree with others here that you should definitely investigate some cardio rehab if you can!

 

[AgilityDog]

Hey I'm battery operated AND on BBs. My resting rate is about 54, my highest permitted rate is 150. So who knows???

Seriously, I'm 52, so 75% of my max = 126 bpm. This morning on the elliptical (fat burner program, not cardio) I worked at an average of about 105, with an "accidental" high of 123.

Of course, when I walk, because pacemakers are vibration activated, I hit 145 pretty regularly.

When I was in rehab post surgery, I think they tried to keep me around 105, 110. I'll second the vote for cardiac rehab.

 

[RobThatsMe]

I had a similar question after my first OH surgery. There was a nurse on WebMD that provided a good answer and thought I would share it.

Topic: Heart Disease: Laurie Anderson, RN, BSN >> Discussion: Exercise with
low pulse from medication (by Arlyp (WebMD))
Re: Exercise with low pulse from medication
by ljandie91 (WebMD), 8/18/00 10:09 PM
Hello,
Your heart is getting an adequate workout as long as you raise it 20-30 beats
per minute over your resting levels. You can't calculate a target heart rate
based on the traditional method of subtacting your age from 220 and
multiplying it by 70-85%, because of the beta-blocker.
In the cardiac rehab setting we usually use 70-85% of the highest heart rate
achieved on the pre-exercise stress test, if the medication(s), especially
beta-blockers, were taken before the test. If the medication(s) were held,
the highest heart rate achieved must be further adjusted for these meds;
typically a range of 10-20% more depending on the size and frequency of the
beta-blocker dose and the dose(s) of other medications being taken that may
also be lowering the heart rate. Sometimes this method of calculation is
ineffective; in this case we often use the simple formula of resting heart
rate plus 20 to 30 beats per minute. This range is decided upon based on
whether or not the person is still ischemic (blockages that are preventing
adequate blood flow to the heart), the amount of heart muscle damage from the
heart attack, the ejection fraction and other individual considerations.
In regard to your question about time of day to exercise, in my opinion you
are actually better off to exercise earlier in the day, when your
beta-blocker is having the most efffect on your heart rate. I can't evaluate
this in relation to your condition, because I don't know what the situation
is with your heart's blood flow. In general the effect of the beta-blocker is
to improve blood flow to the heart muscle, so it is better protected from the
potential effects of decreased blood flow and thus you are less likely to
have angina. Hope this is clear and helpful; I will watch for additional
posts from you should you have another question.
Sincerly, Laurie Anderson, RN, BSN

 

[67walkon]

Heart rate issues are confused by all this. When I was on beta blockers after my AVR and when I began exercising, my cadence, or rpms, on my road bike would sometimes be higher than my HR. That is pretty weird. Even now, more than 4 years after surgery and close to 4 years of being off beta blockers, my HR doesn't get real high when I work out. My surgeon said everything would find a new normal; my new normal is a resting HR about 10 beats higher than pre-surgery.

Keep exercising, but be careful.

 

[JeffM]

Thanks for the advice. My resting is 52-53. Prior to surgery it was 62. I have been exercising aggressively and my HR only goes to 110-120. Prior to surgery it would run about 140-160. Guess the beta blocker is holding it down. I know the formula 220 - age, but since I am on beta blocker I don't think that works. Guess I will has my cardio doc a in a month.

Based on my own experience, I'd bet your current beta blocker influenced 110 - 120 is equivalent to your pre BB 140 - 150. Just guessing. Or somewhere in that vicinity. So you're working out pretty darn hard, as you've indicated. Given that you're only 10 weeks out of surgery, I'd keep your high intensity sessions where they are for another 4 weeks and only do 1 high intensity session per week. Let the other workouts be more aerobic or technique centered. I think you'll be happy with the results and you will be less likely to injure yourself trying to recapture your previous fitness level too quickly. And by the way, even if/when you get off the BB, you may find that your heart is happier with a different max. Mine is lower even after going off the the BBs.

 

[GordoAVR]

Age 66; 5'9" 168lbs.
Before AVR: Resting 65; Jogging 140/150
Right after surgery: Resting 89-95; Jogging NA
10wks Cardio Rehab: Resting 70's; Jogging limited to 140-145

I was also was very worried that my HR had increased after AVR. However, now ten (10) weeks post-op, the resting rate is almost normal. The biggest decreases came after about two months.

I was a casual jogger before valve deficiencies began to affect my running. Five years ago, my normal run was a ten minute mile, 15-20 miles per week. I did not run at all the year before surgery.

Starting back, I choose to use a Cardio Rehab. A major concern of cardiologist is the development of an arrhythmic problems caused by stressing the 'handled' heart too soon after surgery. Our first sessions were walking treadmill inclines, limiting HR to under 115 bpm. The next week is was raised to 120, and so on.

I have not shown any abnormal beats in the pulse rate graphs, which is a good sign. My cardiologist pronounced me fixed at our my last appointment, "I'll see you in a year", he said. I liked that; however, I continue to follow the rehab recovery schedule.

In between M-W-F data logged rehab sessions, I run/walk on the beach w/ my HR monitor limited to 140 bpm. Until recently, my breathing was the limiting factor, and I would revert to walking a little before reaching the 140 ceiling.

However, just this week (week 11), the heart rate is now the limiting factor, and if I jog slow enough, I can now begin to extend the time jogging much longer than the walking part. Couldn't do that before w/o gasping!!

I am now beginning to feel more like a runner coming off a long injury, as opposed to a heart valve patient trying to run again. Gotta lose some weight, stretch the hamstrings, etc. etc.

For those wanting to get back into their favorite sport quickly, I would recommend Cardio Rehabs for their graphic monitoring capabilities. My rehab has a ultra-miler who has been very helpful and encouraging. It feels good knowing the stress on my heart when exercising is not causing any post surgery complications. You cannot be sure if you are out there alone trying to self diagnose your recovery.

I think in a week or three; I'll be on my own, and back to running the beach like a kid again. ;-)

Anyhow, I thought I'd post some numbers for folks who might find it useful.