exercise after a heart attack - a guide to getting started and staying motivated

A Guide to Getting Started and Staying Motivated

Paul Maher

www.heartgeek.com

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Exercise After a Heart Attack A Guide to Getting Started and Staying Motivated

Disclaimer

Copyright © Paul Maher, 2014

All rights reserved. No part of this eBook can be transmitted or reproduced in any form

including print, electronic, photocopying, scanning or mechanical or recording without

prior written permission from the author.

This Guide contains general information about health and exercise. The information is

not advice, and should not be treated as such. If you choose to take actions based on

the contents of this Guide, you do so at your own discretion and are fully responsible for

any risk involved. You must not rely on the information in this Guide as an alternative to

medical advice from your doctor. Consult a qualified doctor or other professional

healthcare provider about specific medical issues and before beginning any exercise

program.

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Table of Contents

Introduction 3

Part 1 – Getting Started 5

Part 2 – Staying Motivated 10

Part 3 – Getting Fit 14

Summary 17

Resources 17

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Introduction

The only thing that may be more stressful than having a heart attack is going home from

the hospital afterwards. One thing's for sure, life's never going to be the same again.

You were likely discharged with a headful of worry, a bag full of medication and a

laundry list of to-dos: change your diet, lose weight,

control your stress and start exercising.

That’s a pretty intimidating list to take on, especially all at

once. So don’t take it on all at once! The secret is to

start with just one to-do: exercise. Exercise is one of the

best things you can do to prevent the progression of heart

disease. It can strengthen your heart, reduce your

weight, lower blood pressure and cholesterol, lessen

stress, improve sleep, and decrease your chances of

another heart attack. What's more, exercise helps you

feel good, look better and enjoy life.

All well and good, but you may be feeling apprehensive

about starting to exercise after your heart attack. After all, shouldn’t you take it easy?

What if exercise leads to another heart attack? Guess what, you are 75% more likely to die from a subsequent cardiac if you DON’T exercise.

So where to begin?

Why Exercise?

• Strengthens your heart • Improves

cardiovascular functioning

• Lowers weight, blood pressure and cholesterol

• Helps manage stress • Improves sleep • Makes you feel and

look good • Minimizes the chance

of another heart attack

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You know you need to exercise, but you don't know how to get started, how to stay

motivated, and what kind of exercise is best. This 3-part Guide helps you answer these

questions and more.

Part 1: Getting Started – lose your excuses, get moving and begin building your

strength and endurance.

Part 2: Staying Motivated – set up long-term healthy habits, including setting

goals and rewarding yourself.

Part 3: Getting Fit – increase your strength and endurance with a mix of cardio,

interval and resistance training.

Let’s get started!

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Part 1 - Getting Started

Even though most of us understand the health benefits of exercising, most of us don’t

exercise regularly. I know I fell into this category prior to my heart attack. What about

you? Common sense tells us we need to get off the couch and start moving, yet we

continue to stay glued to our seats. What's holding us back?

EXCUSES!

Life's busy. All of us are doing our best to balance family, health, work and everything

else life throws at us. We think up all sorts of reasons why we can't exercise. The first

thing to recognize here is that our excuses are usually fiction. The reality is we can

decide to change our behavior. And from that moment, we can look forward to a longer

and healthier life.

Excuse Reality

I don’t have time to exercise Cut down on your TV and social media

addictions.

I’m too tired to exercise Exercise actually increases your energy

levels.

I’m too out of shape to exercise You're out of shape because you're not

exercising. If you have legs, walk.

I’m too old to exercise It’s never too late. Exercise allows you to

keep your independence as you age.

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Excuse Reality

I get bored when I exercise Find the right exercise. Join a group and

make exercise social.

I’m a smoker, not a runner My personal favorite. You are what you

want to be. Change your mindset!

So where do you start? I'm sure a doctor or nurse made you take a few laps around the

cardiac unit before you were discharged. Great news – you've already started!

“Start where you are. Use what you have. Do what you can.” Arthur Ashe

Don’t lose that momentum. Use the following 5 five steps to develop an exercise

program that's right for you.

Step 1: Talk to Your Doctor

You probably didn't have your doctor on speed dial prior to your heart attack. Now that

the heart attack's out of the way, it’s time to start communicating with your doctor.

They can help you determine what types of exercise are safe for you, how often to

exercise, and what your specific goals should be.

• Attend Cardiac Rehab – The hospital or your doctor will likely recommend a

cardiac rehabilitation program. These programs provide a good mix of education

and exercise. They're a great way to get over the initial apprehension you might

be feeling about resuming physical activity. Not only will these professionals get

you moving, they can also assist with quitting smoking, changing your diet and

reducing stress. Most programs last 2-3 months.

• Develop a Personalized Plan - Next, talk to your doctor about a personalized

exercise program that takes into account your condition before the heart attack

and its severity. Your doctor may want you to take a stress test before starting

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your new exercise program. This allows your doctor to get a good baseline of

your abilities in a controlled environment. Also talk to your doctor about

resuming sexual activity.

Step 2: Find a Buddy

The first few times you venture out after your heart attack can be scary, especially if

you're alone. Bringing a friend along on those early walks helps alleviate your

anxiety. Scheduling exercise with a friend is also a great way of holding you

accountable.

• Find a Buddy – Actually, find several. If you have a

primary caretaker at home, leave them at home (they

need a break). Find a few friends that can join you on

your regular walks. If you do walk alone, make sure

someone knows where you're going and bring a cell

phone.

• Walk and Talk – Walking is great exercise and

provides an opportunity to socialize with your friends.

Depression and anxiety are common feelings after a

heart attack. Talk to your walking buddies about what

you're going through. If you get out of breath while

walking and talking, that’s a good sign you need to

slow down the pace.

Step 3: Start Slowly

Step 3 is likely the most important step, especially if you were the stereotypical Type A

personality before your heart attack. Restraint is your friend in these early days.

• Slow 'n Easy – Start on a flat surface. Initially 5-10 minutes at a time is probably

enough. Don’t worry about how fast you go or the distance you cover in these

early days of walking. Also, if it's too hot or cold outside, try the mall. Yes, the

mall!

Sample Walking Schedule

Week Minutes

1 5-15

2 15-20

3 20-30

4 30-40

5-6 40-60

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• Rest ‘n Repeat – Since your walks are short, try several each day. At this stage

in your recovery even these brief walks will tire you out! Make sure you get

enough rest in between. If you feel extremely fatigued, don't walk and consider a

call to your doctor.

Step 4: Build Gradually

After your first week of walking, you should start to feel human again. The body has

started the healing process and is ready to take on a little more. A little more - don’t

start sprinting just yet.

• Add a Few Minutes – As your body regains strength and stamina, add a few

minutes to each walk. By the end of the first month you should be walking for 30

minutes at a time. You still want to walk nearly every day, but multiple daily walks

are no longer necessary. At this point too, your doctor may be discouraging

those daily naps, so pace yourself.

• Add a Few Stairs or Hills – Depending on the severity of your heart attack or

surgery, you should be able to use the stairs shortly after you return home. Take

it slowly on the stairs and rest if you need to, especially if you get short of breath.

At this point, you should also be able to incorporate gentle slopes or hills into

your walking routine.

Step 5: Add Variety

Let’s face it, you're likely bored with your walking by the end of month one. I’m not

encouraging you to leave walking behind, but it may be time to add a little variety to the

mix. Adding variety will work your muscles in new ways and make your workouts more

fun.

• Biking – A stationary bike is a good place to start since you don’t have to deal

with hills, traffic, dogs, rain, etc. The same rules established for walking apply for

biking. Keep it at a moderate pace and build gradually. The focus should be on

time, not distance. Once you have the strength, and the green light from your

doctor, it may be time to hit the open road. Regardless of whether you're on a

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stationary bike or a road bike, your goal is to build cardiovascular strength and

endurance, not ride your first century (100 miles).

• Jogging – Your doctor's guidance and your own common sense are required

here as well. Prior conditioning and the severity of your heart attack play a role in

determining when to start jogging. You may want to start on a treadmill before

venturing outside. Warm up with a 10-minute walk, followed by 10-20 minutes of

moderate jogging. It’s also a good idea to tack on a 10-minute walk to cool down

at the end. Increase intensity and distance with your doctor’s approval.

• Swimming – It may take a little longer before you jump back in the pool. If you

had bypass surgery, you'll likely need to wait at least 6 weeks. Again, check with

your doctor. Swimming conditions the whole body, including the cardiovascular

system. It’s also easy on the joints and can be a part of your exercise routine at

just about any age.

Understanding your limitations and frequent communication with your doctor are very

important as you start your exercise program. If you experience chest pain, dizziness or

nausea during exercise, STOP! If the symptoms don’t disappear quickly seek medical

attention.

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Part 2: Staying Motivated

Congratulations on getting started! Believe it or not, the hard part is over. Most people

never achieve their goals for a healthier lifestyle because they just can’t get started.

With that hurdle out of the way, how are you going stick with it and stay motivated to

achieve your goals?

Most people think having a heart attack is motivation enough to change your old ways

and begin a new healthy lifestyle. After all, you have a second chance at life, so how

could you not be motivated? I get that. I also get how hard it is to break old habits and

pick up new ones.

“Motivation is what gets you started. Habit is what keeps you

going.” Jim Ryun

Let’s start with the old unhealthy habits. Even if you've started exercising and eating

better, you may still be clinging to some old habits. Here are some tips for breaking

them.

Unhealthy Habits Tips for Breaking Old Habits

Smoking Don’t be shy about asking a doctor or

support group for help with this one.

Watching TV You don’t have to quit TV altogether, just

don’t settle in for hours of channel surfing.

Instead, set aside a small amount of time

to indulge in your favorite shows.

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Unhealthy Habits Tips for Breaking Old Habits

Overeating Only eat if you're hungry and learn what a

proper portion or serving size is. Be

mindful of eating because you're bored or

stressed.

Eating junk food Learn how to cook. Healthy food can also

be tasty and convenient.

Drinking excessively

Excessive or binge drinking is stressful for

your heart (and liver). Limit yourself to no

more than 2 drinks per day.

Ignoring Sleep

Sleep is incredibly important for your

overall health. Go to bed and get up at a

regular time each day. 7 to 8 hours are

appropriate for most adults.

Stressing Exercise is a great way to relieve stress.

Be aware of your stress and look for

healthy ways to manage it such as deep

breathing or meditation.

Even if you're dealing with all these unhealthy habits, the easiest way to get rid of them

is to form healthy habits to replace them.

Healthy habits are the key to long-term motivation. They help you to envision yourself

as a healthy person. Healthy people do healthy things. Doing healthy things leads to

healthy habits. Before you know it, you enjoy doing healthy things, and you are a

healthy person.

Here are 5 steps to help you develop healthy habits:


Step 1: Set Goals

Goals need to be measurable and obtainable. For example, 'I'm gonna lose 2

pounds a month' is much more realistic goal than 'I want 6-pack abs'.

Step 2: Make a Plan

How are you going to achieve your goals? Put your

morning workouts on a calendar. Or, build exercise into

activities you're already doing. Can you walk or ride

your bike to work? Whatever your plan is, make sure

you tell other people. Accountability is likely to help with

your motivation.

Step 3: Track Performance

Take before and after pictures. They're very motivating! www.myfitnesspal.com is

one of many sites that help you keep track of your diet and activity. There's also a

lot of cool wearable technology and watches available that help track your fitness

goals.

Step 4: Provide Rewards

Recognize when you achieve goals. If all goes as planned, you may need some

new clothes. My own favorite rewards are the technology gadgets just mentioned.

Invest in a good heart rate monitor. If you don’t want to hassle with the chest strap,

there are a few new watches out there that can track your heart rate in real-time.

Step 5: Enjoy Yourself

Make sure you're doing something you enjoy. If running's not your thing, try biking

or swimming. Look into sites such as www.fitocracy.com to provide motivation and

make working out fun.

Don’t worry if you have setbacks along the way. This is hard stuff and setbacks are

inevitable. Just don’t throw in the towel when they happen. Acknowledge, them, try

Motivation Tips

• Communicate your goals to family and friends

• Take before and after pictures

• Measure and track yourself against goals

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and determine why they happened, and start over. Any habit takes time to develop and

the healthy ones are well worth the effort.



Part 3: Getting Fit

You followed your doctor’s orders, completed cardiac rehab, and gradually built up to

lengthy walks each day. You might even have mixed in a little bit of biking or swimming.

You're feeling stronger, starting to believe in the benefits of exercise, and you want

more. You're motivated all right - you want to be better, stronger, faster!

“Exercise should be regarded as tribute to the heart.” Gene

Tunney

All right, all right, settle down. It may be time to say goodbye to your walking buddies at

the mall, but you still need to be sensible. Work with your doctor to develop a more

advanced fitness program that's still safe. Your new program may include a

combination of regular cardio, interval training, and resistance or strength training.

Steady-State Cardio Training

Walking, jogging, biking, or swimming improve cardiovascular functioning and

endurance and help maintain your weight and conditioning. These forms of exercise

are known as steady-state cardio. Steady-state cardio is necessary to build the

aerobic conditioning necessary for more advanced exercise programs. It’s also

good for relieving stress. Note the following, however:

• Low-Moderate Intensity – You're not competing for Gold. No matter which

activity you focus on, training should be done at a low to moderate pace. Sprints

don’t relieve stress.

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• Mix it Up – There's no reason you can’t pick more than one activity for your

steady-state cardio exercise. Alternating between jogging, biking and swimming

keeps things interesting and protects your body from injuries caused by the

repetition of a single activity.

Interval Training

Interval or HITT (high-intensity interval training) is all the rage these days. However,

be careful - this is serious stuff and shouldn't be attempted until you've obtained

proper conditioning. You must speak to a doctor before starting any kind of interval

training.

Interval training is usually defined by short burst of intense activity (think sprinting up

a hill) followed by a short recovery and then a repeat. Benefits include a more

efficient cardio workout and increased weight loss due to faster calorie burn.

• Duration – Interval programs range from 4-30 minutes. Typically, you

sprint/exercise for about 30 seconds followed by a 15-second rest, and then

repeat. I have an 8-minute routine on the stationary bike that's a serious

workout.

• Intensity – Intensity is the key to interval workouts but so is the fact that you

recently had a heart attack. Instead of sprinting, you may want to start out with

30 seconds of moderate running (treadmill or outside), followed by 15 seconds of

light jogging. As you build strength and endurance, you can speak to your doctor

about increasing the intensity.

Resistance Training

Resistance training is traditionally a taboo topic for cardiac rehabilitation, and for

good reason. Lifting too much too soon can put undue stress on your heart or

surgical incisions. If you've had open-heart surgery you need to wait at least 6-8

weeks before beginning resistance training.


Today, there's growing support for adding resistance training - at the right time - to

cardiac rehab programs. After all, your heart is a muscle and could probably use a

little strengthening.

Resistance training can help you regain your strength and endurance (not to

mention your self-esteem). Start with bands or very light weights and go easy on the

repetitions.

• Free Weights – Go light, very light. This shouldn’t be a problem as you're likely

struggling to lift a gallon of milk after your heart attack! Bands or 1-2 pound

weights for a few reps will get the job done in the beginning. As your strength

comes back and you regain confidence, add 1-2 pounds per week. Your focus

should be on regaining strength, not getting HUGE!

• Bodyweight – Bodyweight training is great because you can do it anywhere

anytime, and you don’t need equipment. Make sure you've regained your basic

strength before graduating to these exercises. Bodyweight training works the

whole body and typically includes lunges, squats, push-ups and pull ups.

Just as with your cardio program, a weight-training program should be tailored to your

personal situation. Resistance training can enhance the benefits of your cardio program

while also increasing muscle strength and bone density. Be careful, getting ripped is a

potential side effect!

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Where To Go From Here

If you follow the steps outlined in this book, you will begin your journey to physical

fitness and a heart healthy lifestyle. Success doesn’t happen overnight and you should

expect a few stumbles along the way. Don’t get discouraged. Even a few small

changes in your physical activity can make a difference. Keep at it and don’t go it

alone. Share your experiences and get useful tips from others in the HeartGeek

community.

Join our community by signing up for email updates.

You can also be a fan of HeartGeek on Facebook or follow me on Twitter.

Resources

www.myfitnesspal.com

http://www.fitocracy.com

About Me: My name is Paul Maher. I'm a heart attack, cardiac

arrest, and bypass survivor and author of the blog HeartGeek. I

started HeartGeek to share my cardiac experience, recovery, and

road to wellness. My hope is that by sharing these experiences, I can

help you have a more positive recovery, enjoy a heart healthy

lifestyle, and hopefully have a little fun along the way.

exercise after a heart attack - a guide to getting started and staying motivated

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