Cardiologist Exercise Recommendations

[MistyK0587]

Hi guys!

I was wondering what your cardiologists have recommended as far as exercise. Mine has stated only walking 30 minutes a day with no weights or aerobic exercises. As a 24, almost 25 year old, this is very troublesome to me and I would like to lose weight and be in the best possible shape that I can so being told that all I can do is walk is a bit disheartening. Especially since before I was seen at this congenital clinic (which I might add I've not been overly impressed with due to the lack of communication between all of the physicians and the Coumadin clinic) I was doing classes like Zumba and kickboxing with very minimal breaks. Anyone encountered this issue? How did you handle it? Did you get a second opinion?

 

[Guest]

Hi Misty,

I cannot tell what your cardiac history is from your profile so not sure of your health situation. You should follow your doctors advice and ask lots of questions as to WHY. They should tell you the pros and cons of resuming your Zumba and kick boxing. My cardiologist is very supportive of my staying as active as I want to be. His guidance is "No chest pain, no shortness of breath while exercising, you're ok."

I would seek a second opinion, if your PCP recommended your current cardio, start a thread looking for VR members in Georgia and see who else is in your neighborhood, ask them who they see, maybe they have a good one that you can be happy with.

 

[yotphix]

I listened to an interesting podcast today, of an interview on NPR with a surgeon. He admitted in his recently published book, and in the interview, that sometimes doctors aren't really paying attention to you at all. They can sometimes just go through the motions while they are thinking about another case, or their mortgage, or their kid's hockey game etc. My cardio, despite my having told him that I did hard manual labour for a living, casually said (while I was in the waiting room), 'okay, so, no heavy lifting, see you next year'.
The above advice to push for clarity, and to seek a second opinion if you aren't satisfied with the answers you get, is the best advice out there. I also sought a second opinion when my cardio recommended me for surgery. The other cardio took a look at my stats, asked me a few questions and said 'what do you need me for, he's giving you good advice'. Fair enough, I went back where I started and now wouldn't trade him for anyone!

 

[tprice54]

I would strongly recommend a second opinion....I am totally in agreement with Lucy...no knowing your whole cardiac history, it is hard to give advice. But as a valver and bypass, I am running marathons, so just walking sounds fishy.

 

[johnp]

I guess my doctors know I am the kind of guy to push back at the mention of exercise restrictions, so most of my own guidance was based my my own documented facts.

First I had an exercise stress test about 2 months after surgery. It showed some increased ectopy, which was thought to be the result of the heart healing. So I was very limited in terms of intensity and duration.

Then I went into a cardiac rehab program. This ongoing monitoring showed a dramatic trend down in ectopy over the course of several months, even at higher levels of exercise, so I was thought to be able to take a little more. Restrictions were a bit relaxed, though I could not (nor did I press for) specific parameters. I had to know when I was pushing it a little too hard.

Recently, I had a follow-up stress test and a 24 hour holter, this was reviewed by an Electrophysiologist, Cardiologist, Exercise Physiologist, and one or two other highly specialized doctors. This showed only minor ectopy, even at higher levels of exercise.

So my updated guidance is now "no restrictions" , but I am on some medications that slow my heart rate (that essentially means I physically cannot push myself to higher levels, even if I would like to).

In summary, it took one year to get to the point where I was classified as "no restrictions." And I was told that there are no guidelines, and that doctors mostly have to base thier opinions on their own read of a case.

I am to be re-evaluation in one year's time to see if I can be taken off all meds.

 

[Greg a]

Get thee to a cardiac rehab facility ........they should work with your cardio team to develop a plan tailored just for you ......we are all different so there is not one answer

 

[Bean Counter]

Perhaps for a few weeks after surgery, but after that i dont see that being a sensible restriction. Within 5 weeks, I was walking for an hour each day and started doing some light jogging at the 6 week mark. I ran my first double digt (10) run 4 months after surgery. I did wear a HR monitor and kept an eye on things and was ready to stop if things did not feel right, but fortunately that never happened.

 

[Ovie]

I'm 25 and told basically I'll have no restrictions on workouts. I was told to stay away from the heavy weights until me sternum was fully healed. However I have yet to have my surgery, so I guess we will see how things are after.

When did you have surgery and what kind. You may get some more answers if you clarify your situation.

 

[Superman]

You really have to be your own advocate with your health. As was previously mentioned, sometimes they just go through the motions.

When I had my annual echo in September of 2009, I was told rather casually by the PA reviewing (my cardio was out of town) that my aortic root was 4.3cm, so we'll see you next year. Right away I told her to slow down and asked what it was last year. She had no clue. So I told her to get my records. Turns out it had gone from 3.2 cm the previous year to 4.3 cm (both up from 2.6 in 2006). I told her to get another cardiologist and ask their opinion. They ordered up a CT scan and it turn out it was a 4.9 cm aneurysm that was also bulging further at my bypass connections (if that makes sense) on my aorta from my previous AVR.

Given the rate of growth - I was referred to a surgion and had a graft and valve replacement by mid-October. Had I just taken her "see you next year" comment at face value without question, I might not be here today given the rapid rate of change.

 

[MistyK0587]

Thanks everyone for your replies. I thought I had completed my profile with my history but I suppose not. Anywho, I've had a coarctation and aortic stenosis repair in addition to ASD/VSD closure in '87. In '88 and '89, I had a coarctation and stenosis revision. In '92 at age 4 1/2 I underwent aortic valve replacement surgery with a 19mm St. Jude's mechanical valve. As a consequence of that, I have a right bundle branch block and left side hypertrophy that has never caused me any issues. Each year at my check-up I'm given the "everything looks great" speech but for the past two years I've been told no weights (not even my own body weight) and to just let walking suffice. I'm an active person and that's a hard pill to swallow for me. I know Emory is supposed to be the cream of the crop or whatever but frankly, I'm just not impressed. I'm tired of getting an answer without an explanation. Any advice as to what questions I could ask at my upcoming appointment on the 17th to delve deeper into this issue? Thanks everyone!

 

[yotphix]

How about you say the following to your cardio:

"Each year at my check-up I'm given the "everything looks great" speech but for the past two years I've been told no weights (not even my own body weight) and to just let walking suffice. I'm an active person and that's a hard pill to swallow for me.... I [need an explanation with my] answer..."

I don't mean to be glib, but you've really just hit the nail on the head. You need to speak up and let your doc know your concerns just as you've expressed them here, but with the accusatory tone removed (It's fine here, and comes from an understandable frustration but won't win you much respect from the doc if you try it in the office!). Doc may give you a perfectly good reason, or may not. There's only one way to find out what's on his mind and that's to ask.

Really do consider a second opinion though if you're not satisfied with what's being said and done. It's our own responsibility to see to and advocate for our own health results.