Rehab exercise - safe sustainable heart rate post op

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Luckyguy17

Luckyguy17

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Joined
May 3, 2010
Messages
513
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Montreal, Canada
For the folks doing rehab post op, is there a recommended maximum sustainable heart rate target that is recommended or is it individually set?

Am now 2 months post OHS and it is time to firm up that OHS recovery flab. Have had no weight gain...but there is a definite loss of heavier muscle, especially in upper body.
Have now had my 1st echo post surgery and murmur gone and all is working as it should according to cardiologist.....have yet to see the numbers of latest ultrasound, but cardiologist says it's ok to notch up the physical.

Will be joining the gym and doing a few sessions with personal trainer to get me started on a program. Curious to know what the new tuned up heart can safely do?

Thx
Gil
 
Here's what the cardio rehab folks told me yesterday (at my 'graduation' ceremony). Take 220, subtract your age, and that's your target for a maximum HR. In my case (49) that's 171. They said it's ok to get close to that maxium breifly, but don't sustain it very long. As far as a sustained target for cardio activity (i.e. 1/2 hr sustained), they said to take 80%-85% of the max #. So in my case the target for sustained activity is 137-145 or so.
 
Nope

Nope

Nope, the 220 minus your age to determine maximum heart rate is useless.

If you want to be careful, visit with your cardiologist about what your maximum heart rate should be as you deal with the recovery-rehab stuff. Your cardio doc may give you a range to start with which may increase as you get yourself back into shape. Sustainable heart rate should put you into an aerobic heart zone which will feel comfortable as you do your workouts.

Keep in mind, even at eight week post-op, there's healing going on inside your chest.

The scientists who developed the 220 minus your age to determine maximum heart rate never intended it to be used as the standard it became. There are too many individual factors which affect what maximum heart rate can be.

There are a number of ways to get a decent, fairly accurate maximum heart rate number, but why try to go there until you're healed up completely.

-Philip
 
Thanks Gil, I cleaned out my inbox. They don't give ya a very big inbox here lol. Phillip is right, that formula is only a guideline. The rehab folks also told me to get a more accurate number by going to my cardiologist. Sounds like they'll do a stress test to figure out a more accurate number. I'll do that at my next appt, but am using the formula for now. Both the max and sustained rates feel safe to me so far so I must be one of the ones that the formula works for.
 
Luckyguy17 said:
For the folks doing rehab post op, is there a recommended maximum sustainable heart rate target that is recommended or is it individually set?

Am now 2 months post OHS and it is time to firm up that OHS recovery flab. Have had no weight gain...but there is a definite loss of heavier muscle, especially in upper body.
Have now had my 1st echo post surgery and murmur gone and all is working as it should according to cardiologist.....have yet to see the numbers of latest ultrasound, but cardiologist says it's ok to notch up the physical.

Will be joining the gym and doing a few sessions with personal trainer to get me started on a program. Curious to know what the new tuned up heart can safely do?

Thx
Gil
Click to expand...

Good for you, Gill, about joining the gym and taking control of your own well-being. I spent 6 weeks riding in the back seat of my car before I was allowed to drive. Then 5 weeks in Cardio rehab. and was really disappointed with the low pulse rate that the crew insisted, after my stress test. However, I kept to the plan, using the Borg RPE (rate of perceived exersion, staying at about 13-14) and now, 4.5 months later, I see the wisdom. I'm seeing my cardiologist in a week and will be asking about running, which will raise my pulse rate much more. I've been cautious because I'm obese and have an enlarged left ventricle. The experts should know what is best for you but don't be afraid to push it a bit.

George
 
Definitely get a number from your cardiologist. Everyone has different health and conditioning issues. Also, remember that if you're on any meds that lower your heart rate (i.e., beta blocker), then you need to account for the fact that you could be working really hard at a lower heart rate. I practiced a self-imposed limit of 130ish my first few months after surgery, but that exertion was probably equal to 145 - 150 (without beta blocker). I went to my cardio and presented my plan to keep my HR max at 130 until I went off the beta blocker at 5 mths post op. She was fine with that and with my plan to go all out after that.....for me. Better to get YOUR Doc's OK on what's right for you.
 
Philip B said:
Nope, the 220 minus your age to determine maximum heart rate is useless.

If you want to be careful, visit with your cardiologist about what your maximum heart rate should be as you deal with the recovery-rehab stuff. Your cardio doc may give you a range to start with which may increase as you get yourself back into shape. Sustainable heart rate should put you into an aerobic heart zone which will feel comfortable as you do your workouts.

Keep in mind, even at eight week post-op, there's healing going on inside your chest.

The scientists who developed the 220 minus your age to determine maximum heart rate never intended it to be used as the standard it became. There are too many individual factors which affect what maximum heart rate can be.

There are a number of ways to get a decent, fairly accurate maximum heart rate number, but why try to go there until you're healed up completely.

-Philip
Click to expand...

x2

Just starting out, I would suggest exercising at a "conversational pace", easy enough where you could still carry on a conversation without huffing and puffing too much. As Philip recommends, don't push yourself too hard at first and give your body time to heal.
Mark
 
Conversational Pace?

Conversational Pace?

Good point, Mark.

Remember conversational pace means you can carry on a conversation or talk easily. It's not speaking a word or short phrase followed by gasping for air. If speaking while exercising doesn't feel comfortable, you've exceeded conversational pace.

-Philip
 
Anyone notice that once your heart rate goes up it does not go all the way back down for a day? I get mine to the 140s for a while and then the next 24hrs I am at 100.
 
My workout rate was set only AFTER the results of an intake stress test and then adjusted by staff as I progressed and a final recommendation was made AFTER a outtake stress test

Everything is a factor , height, weight, BMI. age, meds ..........
 
HR Drop after Exercise

HR Drop after Exercise

No James, I've not noticed my heart rate staying-up after exercise. Here's an example: I did 2.5 hours on my road bike this morning. My heart rate during the ride peaked at 171; my average was 154. As I sit here writing this my resting heart rate is 55.

I suspect you'll see improvement with your resting rate as you continue to exercise. Typically, as cardiovascular fitness improves, recovery rate times tend to drop.

-Philip
 
I believe that the Pacemaker Nurse at the Cardiologist's office told me that my pacemaker had a top end number that my heart will not Beat above. I think it was somewhere around 170, so if i were to do anything so strenuous to need my heart to beat faster than that, it just can't because the pacemaker wont tell it to. I beat on my own 98% of the time in the top of my heart, but I am 99.9% pacemaker dependent in the bottom part of my heart. I know when she tested me for pacemaker dependence and lowered my pacemaker to 30 beats per minute, my stomach sunk and I started to see the black spots as i felt myself feeling the beginnings of passing out. That's when she told me how dependent I am on the pacemaker. She then returned it to the 65 beats per minute setting that it has been at. She also told me that on June 29th ( 20 days after surgery) that I was in A- Fib for 4 1/2 hours as it was recorded in memory in the pacemaker. I had no clue I was in A-fib and i remember exactly where i was during the time the pacemaker recorded the incident. I guess my long winded point is that the 220 minus age formula would definitely not work for me and that as has been stated each person's own situation is unique and has to be tailored to. Take care all......Michael
 
I just had an appointment with my cardiologist and got an OK to stress myself more in exercising. So I'm going to start running. He told me to not worry about achieving a target heart rate since I am on Beta-blockers and probably won't achieve the HR. The heart is still going to go strong.

The treadmill that I use takes into account not only the 220-age but my weight as well. So, to do cardio training, my HR goal would be 220-63 = 157 but with my excessive weight of 265, the goal drops to 130. I'm fine with this as it challenged me in the past 2 times that I worked to get fit and it will probably help this time.

George
 
heartman77 said:
I believe that the Pacemaker Nurse at the Cardiologist's office told me that my pacemaker had a top end number that my heart will not Beat above. I think it was somewhere around 170, so if i were to do anything so strenuous to need my heart to beat faster than that, it just can't because the pacemaker wont tell it to. I beat on my own 98% of the time in the top of my heart, but I am 99.9% pacemaker dependent in the bottom part of my heart. I know when she tested me for pacemaker dependence and lowered my pacemaker to 30 beats per minute, my stomach sunk and I started to see the black spots as i felt myself feeling the beginnings of passing out. That's when she told me how dependent I am on the pacemaker. She then returned it to the 65 beats per minute setting that it has been at. She also told me that on June 29th ( 20 days after surgery) that I was in A- Fib for 4 1/2 hours as it was recorded in memory in the pacemaker. I had no clue I was in A-fib and i remember exactly where i was during the time the pacemaker recorded the incident. I guess my long winded point is that the 220 minus age formula would definitely not ..
Click to expand...


do you have a pacemaker or an ICD
 
When my resting heart rate was at 90 bpm my cardio told me 120 bpm. Now I'm on Sotalol with a resting bpm of 60 and tomorrow I'll have to ask her again. I'm pretty sure 120 is too high now that I'm on Sotalol.
 
heart rate

heart rate

My resting rate is around 70 bpm my cardio rehab instructor gave me a target of 105 to 130 for exercise, no more than 140 or damage would be done. The heart is a muscle and improves with exercise but muscles do get pulled so be careful and don't aim too high. You will know when you are overdoing it. Regular aerobic exercise is best, warm up too and build up slowly.
 
I did not go through a formal cardiac rehab program, but a friend of mine, that runs a program, suggested that I keep my level at whatever my resting heart rate is that day + 30 beats. After about 5 weeks, I started taking it up to RHR + 40 beats.
 
my 2 cents:

(1) get a professional to advise you, no point doing self-experiments
(2) recommended HR depends on whether you take medicine
(3) post surgery GO SLOW, there is no point rushing anything for the sake of short term gaining 2-3 weeks...
(4) personally - i went with formula similar to bean-counter, ie start with RH + 20 beats (whilst on beta blocker). After about 5 weeks (beta blocker gone), I started taking it up to RHR + 40 beats, then continued to further increase.
(5) Five years post op: I (age 45, warfarin and BMI slightly <25), exercise around 130 bpm average and I try my best not to keep it above 145 for too long. I dont think I have ever gone > 150 (as per my cardio's advise)

hope this helps
well2allofu
 
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