One obvious tip for the day...

[sensei Ade]

All,

In recovery we all appreciate how important it is to build up our cardiovascular ability slowly slowly through walking, running etc. But for those of us working in offices, going up and down in lifts, my tip for you is to use the stairs instead. Something we don't normally get into the habit of doing. I work on the 3rd floor of a bank and the canteen/coffee bar is on -1. By the time you've gone down, got a coffee and trudged back up again, you do feel the ticker working. It really helps and you can track over time how gradually easier it's getting to make the climb. I have a special affinity with staircases ever since I was asked to go up one 3 days after my first operation - wow that was tough! But then it get's easier. By day 5 I was walking up to the top of the building after which I got told off by the nurses!! LOL! I told them it's all in the mind, martial arts training! Seriously though, get yourselves up and down those stairs.

All the best

Sensei

 

[epstns]

Sensei - I got to apply this one as soon as I got home from the hospital. At our house, the "living" spaces are on three different floors, so I had to be able to navigate the stairs or give up my mobility - even at home. I will admit that at first I gathered up reasons to climb the stairs, but after a couple of weeks it was just business as usual, up and down the stairs. I think my knees complained more than my heart. . .

 

[sensei Ade]

Hi Steve,
The fact that within just a couple of weeks you were trotting up and down those stairs shows how good they are for cardiac rehabilitation. Great stuff!! Next challenge: Empire State Building to the top, no lifts...LOL!

Take care

Sensei

 

[epstns]

Ummm. . . not ready for the Empire State yet. My 25 year-old daughter competes as a team member in an annual "Run Up The Hancock." This is a run up the 95 stories of Chicago's John Hancock Building, where the participants are sponsored by donors and the monies collected go to charity. Maybe some day I'll be ready for that. . . but my knees doubt it.

 

[normofthenorth]

My hospital discharge instructions said to MINIMIZE stair climbing for at least several weeks -- use them when you have to but no more. And my Cardiac Rehab people have also said NOT to climb stairs for exercise. Basically, their fave exercises are sustained (30 minutes or more at a constant intensity level) and incremental, gradually adding intensity from one day (or week) to the next. Going up stairs then down stairs is more like "wind sprints", a very different kind of CV workout. All of that is great for fit athletes, but all my info suggests that it's more aggressive than recommended for the first few months post-HVR.

I think one reasonable rule of thumb is to compare your exercise regime to a Cardiologist's stress test. That's supposed to be a pretty extreme workout, while they monitor your heart to find your "red line", and to see how well your heart responds to being pushed to the limit. They all use gradually-increasing treadmills or bicycles, i.e., sustained and incremental. If you do something more "violent" than a Stress Test, you're exploring uncharted waters. It may be fine, it may save you a week or two in your rehab, but it's certainly not what my experts recommend.

At 7 months, the RN who runs my CV Rehab program just said I could probably try some competitive volleyball, provided I wear a heart monitor and stop if I reach my own "red line" -- 145-150, at 66 yrs old, based on a recent Stress Test. That's a big jump from the sustained and incremental stuff I've been doing, maybe bigger than she realizes. . .

 

[JimL]

I was also told not to climb stairs, but I thought that was just one more of those times when they couldn't tell the difference between a valve replacement and a CABG patient who had the leg veins stripped out. Anyway, I took the stairs carefully at first just in case, but soon found myself taking them two at a time as I have for years. Now I do seek out the stairs whenever I can. I recently had a stress test, which was definitely not an extreme workout, since I regularly use the treadmill at faster speeds while reading a book.

 

[epstns]

I guess all of our doctors give patient-specific advice. While I was still in the hospital they wanted to make sure that I could climb at least one full flight of stairs. Of course, don't get me wrong, I was NOT using stairs for a form of exercise. I was using stairs to get from one part of the house to another during normal daily life activities. I just found that over the first month or so it got much easier to climb those stairs to get from place to place. As JimL notes, once the basic healing is complete, it is a good idea to take stairs rather than elevators when possible, as long as you are up to the task.

And yes, Norm, my rehab advisors take the same approach as yours - sustained aerobic exercise with increasing intensity over the days or weeks. I'm now at the point where we can't increase my treadmill speed any more without jogging, so we are increasing the incline rate. Once I hit around the half-way point in the program I plan to have my rehab advisor contact my cardio to see if it is OK for me to jog instead of walking on the treadmill.

 

[normofthenorth]

I was also told not to climb stairs, but I thought that was just one more of those times when they couldn't tell the difference between a valve replacement and a CABG patient who had the leg veins stripped out. Anyway, I took the stairs carefully at first just in case, but soon found myself taking them two at a time as I have for years. Now I do seek out the stairs whenever I can. I recently had a stress test, which was definitely not an extreme workout, since I regularly use the treadmill at faster speeds while reading a book.

Jim, something "doesn't compute". Your stress test is supposed to be. . . a STRESS TEST! See, e.g., Wikipedia: "Stress testing . . . involves testing beyond normal operational capacity, often to a breaking point, in order to observe the results."

In my experience with cardiac stress tests, the treadmill or bicycle keeps getting harder and harder, until the test stops because your heart has reached its stress-test limit (beyond normal operational capacity) -- either you've hit your predetermined max "just safe enough" "red line" HR, or your heart rhythm has gone wonky enough that it's scary. (I've done both.)

If you're going past that routinely while reading a book, then either your recent stress test was a waste of time, or your routine exercise is going into uncharted scary waters. Neither one sounds good. If there's a third option, please share!

 

[normofthenorth]

I guess all of our doctors give patient-specific advice. . .

Steve, in my extensive experience (first-hand and second-hand) with Orthopedic Surgeons treating Achilles Tendon Ruptures, most patients assume that what you say is true, and it almost never is. Treatment and rehab protocols vary all over the map (literally and figuratively), and the variation hardly EVER has anything to do with the specific injury or repair or leg, and almost ALWAYS has everything to do with the specific doctor, hospital, and health insurer -- or the Attending Surgeon who showed the OS what to do, back when the OS was an Intern! I'm sure we all hope that your statement is true in the Cardio/OHS/HVR field, but it's sobering to remember that a recent study found that Orthopedic Surgeons were the highest-paid discipline in medicine, earning more than Cardiologists. (The short summary I saw on "theheart.org - heartwire" didn't mention Cardiac Surgeons.)

When we act as our own patient advocates, I think it's smart to assume that unwanted variations in our own treatment may NOT be patient-specific, but more doctor-specific. If the assumption is wrong, little harm is done by correcting us.

 

[JimL]

All I can say was that I was nervous about the stress test ahead of time, and it turned out to be nothing. Years ago, long before surgery, I had a stress test in which they made me run, which wore me out immediately. This time they let me walk for the whole thing, and took the speed all the way up to a wopping 2.5 mph; the only unfamiliar part was the elevation, which I don't usually use; they elevated to perhaps 5 degrees. I normally walk and read and 3.0 mph, and then bump it up to 4.0 or 4.5 at the end. The guy very clearly said that he only needed to get my heart to a certain point, which he got to his satisfaction, and then he shut the treadmill down.

 

[Duffey]

All I can say was that I was nervous about the stress test ahead of time, and it turned out to be nothing. Years ago, long before surgery, I had a stress test in which they made me run, which wore me out immediately. This time they let me walk for the whole thing, and took the speed all the way up to a wopping 2.5 mph; the only unfamiliar part was the elevation, which I don't usually use; they elevated to perhaps 5 degrees. I normally walk and read and 3.0 mph, and then bump it up to 4.0 or 4.5 at the end. The guy very clearly said that he only needed to get my heart to a certain point, which he got to his satisfaction, and then he shut the treadmill down.

Same experience for me, Jim. Years ago I had a stress test, where I had to run, and it lasted until I could go no further.
Two years ago, after after having AVR in 06, I had a walking stress test, with an incline they increased a few times, and when my target heartrate was reached, they said I could stop. I don't remember if there was a minimum time I had to stay on the treadmill--maybe so.