Is this too much after 6 weeks

[RunMartin]

I am finding it difficult to know how much I am allowed to do after nearly six weeks after surgery. At present I am walking every day (1 to 3 miles). Every other day for the past week I have been walking slowly up the local hill, which is about 700 feet of climbing and fairly steep. It gets me to breath much harder and raises the heart rate. I used to do this climb before surgery and climbed much quicker then. The days I do not go up the hill I have been to the local swimming pool and doing 20 minutes legs only with a float. I was very fit before surgery but I am not sure whether this is too much.

 

[Jkm7]

IMO, this is a question for your doctors. Everyone is different and I don't think any of us can know what is best for you.
But the obvious is clearly you are able to do it but should you?
Congratulations on your excellent recovery.

 

[halleyg]

The question is, how do you feel after you do this type of activity? That is the best way (IMO) to know if you are overdoing it or not. And of course you can always ask your dr. In my case my dr. told me I could do a lot more than I was ready to do in the beginning; each of us is different in our recoveries and what length of time it takes us to resume physical activity, and to what degree. Listen to your body, it will let you know. Sounds like you are doing great.

 

[Lynlw]

I am finding it difficult to know how much I am allowed to do after nearly six weeks after surgery. At present I am walking every day (1 to 3 miles). Every other day for the past week I have been walking slowly up the local hill, which is about 700 feet of climbing and fairly steep. It gets me to breath much harder and raises the heart rate. I used to do this climb before surgery and climbed much quicker then. The days I do not go up the hill I have been to the local swimming pool and doing 20 minutes legs only with a float. I was very fit before surgery but I am not sure whether this is too much.

My only thought was did your docs give you any max heart rate you should stay below in the recovery period? If not you might want to call and ask since you are climbing to the point of having to breath harder and raise your heart rate. As for swimming, I don't remember how long Justin had to wait until he was allowed to go in the public pool or ocean, for some reason I keep thinking it was ok at his 8 week check up, but i could be wrong. but I guess if your incision is completely healed it is ok. Since you've been swimming already, I wouldn't bother to ask when it is ok.

 

[Mentu]

I'm with Halley, Martin. How do you feel after being out? If at 6 weeks, exertion leaves you feeling completely exhausted I would say you are pushing too hard. On the other hand, if you only need a little rest afterwards and are ready to go again later then you are probably pacing yourself pretty well. My Cardio's advise was to gradually increase walking distance and stride based on how I felt. At 6 weeks, he said "you aren't fragile but don't be stupid...listen to your body".

A simple way to monitor is to check your own pulse rate. If you ask, your Cardio will give you some basic guidelines as to where you should limit it. This is going to be somewhat different for everyone since it will vary based on overall state of health, complicating factors, etc.

Larry

 

[JeffM]

Halley's and others' guidance to pay close attention to how you feel is great advice. I'd also adivise you get Dr's clearance for a max HR. 130 BPM max for a few months was what I adhered to and it kept me from overdoing it (most of the time, anyway). But everyone's fitness level is different and that max HR should also be based on the levels of intensity you were accustomed to before surgery. Also, if you're on a beta blocker, whatever bpm figure you work with is actually a lot higher than it seems. The level of effort I gave to hit 130 when on a beta blocker was about the same as 145 to 150 normally. Good luck!

 

[kodi]

I agree with the others. I think a lot has to do with your conditioning before surgery which you mentioned you were fit and if you are on medications. My doctor told me I could presume my normal activities after 6 weeks which meant I could start running again. By three weeks I was walking 5 miles a day. After three weeks I started jogging for a minute or so and cut the 5 miles to 3 miles but did it two times a day. Six weeks and two days post surgery I ran a 5K on a very difficult course and only walked a very small part of it. It is too much, it depends on you and your doctor.

 

[RunMartin]

Thanks for your replies. The problem I have is that the doctors (rehab nurses) do not give maximum heart rate etc when I ask them . They just say do not over do it. I generally feel OK after the climbs but sometime the climbs are harder to do than others i.e. more of an effort. I think I will have to phone the rehab nurse up again.

Thanks
Martin

 

[Lynlw]

Thanks for your replies. The problem I have is that the doctors (rehab nurses) do not give maximum heart rate etc when I ask them . They just say do not over do it. I generally feel OK after the climbs but sometime the climbs are harder to do than others i.e. more of an effort. I think I will have to phone the rehab nurse up again.

Thanks
Martin

Can you call or email your surgeon or cardiologist?

 

[Dexter Bob]

I get a similar response from my Cardiac Rehab folks who follow the Perceived Rate of Exertion chart. I see that at lots of health clubs as well. They tell me to keep my exertion between 11 (fairly easy) and 14 (pretty difficult) when walking on the treadmill with varying rates of incline. I am usually at about a 12. I bought a cardio monitor to watch my heart rate but have yet to hook it up.

 

[acr]

Yea beware those heart monitors, I got one and it scared me to death. Like cycling up a little hill and you glance the monitor and you like "...omg how fast!!!!!".

Martin - are you going to be doing cardio rehab ? You can get some good advice from there. I really didn't push myself until after rehab, at your stage I was walking the dog on the flat, maybe 2 miles max.

But everyone is different.

 

[Jeanie]

I am in an organized, hospital-administered cardiac rehab program, which if such a thing is available, is way safer, IMO, than exercising that much on your own. As another person mentioned, it makes a big difference whether you are on a Beta Blocker or not. Also, if you had any left ventricle hypertrophy secondary to the valve problem, (as I did and do), both my surgeon and cardiologist made a point of saying that in order to allow the ventricle to improve its contractility - assuming it can - the way to ensure that is not push the heart too hard too soon. Since your signature mentions you had both severe stenosis and regurgitation, I would be willing to bet money (if I had any, LOL) that you are really, really overdoing it.

Does your medical facility, where you had your surgery, have any organized exercise program? Even though you mentioned being fit before, do not assume such a program is only for couch potatoes and wimps. Because such programs (at least in this country) include issues such as target heart rate or RPE if on Beta Blockers, EKG leads to monitor HR, Resp rate and periodic blood pressure checks, it is the safest way to make sure the heart is being gradually strengthened, not overworked. That actually was kind of hard for me to understand at first, as I felt so much better with the new valve in place that I had not realized that there is a lot more involved in the heart's recovery than just valve function. I hope that helps!

Regarding the RPE (perceived exertion scale) I was instructed that with my having had same problem you had, stenosis and regurg, and now being on a Beta Blocker, that they want my exertion rate to not go beyond a 13. Thus my target range is 11 - 13 during exericse at this time. Today I found my treadmill setting to be too easy, so they told me just to bump up the speed until I felt as if I was in the target range. I did and do find it very helpful to have that method of gauging exertion.

 

[RunMartin]

It is getting a bit frustrating now. I have been to see my local doctor, phoned the rehab nurse and phoned the surgeons office.

The local doctor was not sure what I should do and just reduced my dosage of Bisoprolol (Beta blocker) to 1.25 mg from 2.5 mg. The day I saw him my resting heart rate was 44 bpm (48 when driving). A few days before it was 52 bpm. Also my heart rate walking uphill was 115 bpm.

The rehab nurse was still not sure but said I should be able to hold a conversation whilst exercising. She has booked me into a rehab class on 12th April (2 months after surgery). People on this forum seem to go after only a few weeks. She also said I was not to go in the swimming pool even though I was only using my legs. This seems strange as I generally feel really good after 20 minutes of this. I have been consciously holding back to make sure I am not overdoing it. I have not yet met the rehab nurse as everything is done over the telephone.

I was supposed to see the surgeon or one of his registrars 6 weeks after surgery and I still have not got an appointment (it is now nearly 7 weeks). I phoned them up again and an appointment still has not been made yet. I was told the office had not yet received a surgeons report of my operation so they could not give me a date.

I seem to learn more from this forum about what to do than from the medical professionals.


Sorry for the moan but I am getting a bit frustrated with the lack of help from the doctors etc.

 

[Nicholas288]

Martin,
I am at 7 weeks post op. Regarding swimming, my surgeon had told be to wait until after 8 weeks. The reason was the healing of the breast plate. He didn't want it to loosen that would lead to arthritis etc. This was the same reason he restricted other activities until 8 weeks. There were pretty much about the healing of the sternum and not really the heart per se.

Regarding activitiy, I had a check up at 3 weeks and was told I didn't need rehab because I was already doing more by myself that I would in rehab. Yesterday I biked 25 miles on a road bike, inside on a magnetic trainer.

Back to what everyone says, it is all about how you feel.

Nick

 

[Dexter Bob]

Don't know what type of cardiac rehab you have over there "across the pond". The one I am attending here in the colonies pushes me pretty good. Also included in the program is an education component; weekly classes for an hour for eight weeks. The education piece covers a wide range of topics including diet, exercise, risk factors, cardiac meds and their affects, and others. It's a good program and I would recommend it to you. Keep pushing yourself but don't try to go too fast too soon or you may find one of those famous "SPEED BUMPS"!

Bob

 

[halleyg]

I seem to learn more from this forum about what to do than from the medical professionals.

I think many of us have felt this way at some point, which is why having this board is such a great thing. Glad to see you are being proactive in order to receive the answers you are looking for. I didn't start rehab until almost 3 months post-op b/c I wasn't ready, but in a very short time I was out of there and back at the gym. Rehab was helpful in getting me motivated and being monitored increased my confidence that I wasn't overdoing it. I'm surprised they don't want you swimming even with the board but you're not far from 8 weeks now anyways. Good luck.