Rehab - Do or Not?

[dcc617]

Sorry I haven't been around but work has been UGLY and there's not much time for anything.

I started rehab last week and have to admit, I'm wondering why I'm there. The exercise is extremely light and they don't want me to do anything more than what they say. To be honest, I'm walking faster on my own than what the treadmill is set at. My cardiologist warned me that I'd probably be bored.

So here's the question - what is anyone else's thoughts and/or experience?

 

[Madsometimes]

Can you speak to the exercise instructors and ask them to differentiate the class for you?

They are quite good at doing this where I go. I do a circuit class, and the fitter people are urged to do more, whereas others exercise in chairs. They ask where you are on the Borg scale, and check your heart rate to see if it corresponds. I find the exercise bikes work me out best because I'm free to fiddle with the resistance.

 

[2003miata]

I had my AVR last November and rehab was one of the best decisions I made. For me, it wasn't so much about the exercises that the rehab team had me doing, it much more about developing the confidence that I could exercise again after OHS. Looking back, my experience with intensity of exercise was similar to yours - I always felt I could do more, but I think that's what gave me the confidence to continue to maintain my recovery.

 

[ESF]

When I asked my cardiologist about rehab at my three-week checkup, he said that I could do it on my own. He highly recommends rehab for people who are out of shape, need the nutrition and exercise education, or are afraid of exercising post-op. I was in good shape pre-op and highly motivated, so he felt it was fine for me to do it solo.

The first couple of weeks, I walked twice a day, extending distance and speed every couple of days, and at five weeks, I added a once-a-week gym workout using light dumbells. I also saw my surgeon at five weeks, who told me to listen to my body and use common sense (which I did). I'm now comfortably at the gym twice a week doing my just-about-regular kettlebell workout and have had no issues at all. When I saw my cardiologist in early May, he was very impressed with how I'm doing----it was way beyond his expectations for me at that point, so I think I did this right.

The one cardiac rehab center in my area (lots of great hospitals around for the initial surgery, but way limited rehab afterwards!) was definitely geared towards heart attack survivors and heavily emphasized lifestyle education, and I felt that I'd be wading through a lot of unnecessary (for me) stuff.

 

[dwhist]

I had my AVR end of Oct last year and started rehab mid December. Before surgery I had been working out biking or on other stuff 6 times a week. Two weeks after surgery I was going to local indoor workout place and walking the track and doing some light stationary biking. I had a heart monitor of my own and watched heart rate keeping it under 110. After the first 5 rehab visits, I talked to my cardiologist and told him what I was doing at the indoor workout place and he told me I could quit the rehab as I was doing more there than in rehab. We did check with the rehab people and they said they saw no issues with my heart during the 5 sessions. They also told me I was in better shape when I started than most people are when they have completed rehab.

I think from past reading that there are 2 good items about rehab. One, it is good for heart and two, you are in with others in same position and give each other support. I was getting workout and knew others at workout facility I was going to who I talked to alot while working out.

I do see you have a pacemaker, which I did not have and it may be better for you to continue the rehab a bit more to be sure all is ok and then talk to your doc about whether or not you need to continue.

Hope this helps a bit.

 

[epstns]

I still think rehab was one of the better decisions I've made. Although I was in pretty good (age adjusted) shape prior to surgery, the complications of my surgery and recovery took a lot out of me. I was not ready for rehab until 3 months post-op. Since I was a gym rat before surgery, my cardio said that rehab was my choice. He thought I could do well enough on my own, but he also recommended rehab because it not only gets you back onto a regular program, but the program he recommended for me is one that adjusts the work level for the condition of each patient. I started out walking about 2.5 MPH on a flat treadmill. By the end of 12 weeks, I was cleared for jogging at about an 11:30/mile pace. Not my pre-surgery pace, but not shabby for my age. Rehab also had me on an exercise bike, doing free weights and stretches. The comeraderie was good to have as I progressed, but the effort and attitude of the clinical staff made all the difference. They watched our BP and heart rate as we exercised, and when they saw that we were having an easy time of it, they increased the pace or workload. It really helped me not only to get back on track, but also to realize that my heart won't break if I work it hard.

In the right kind of program, go for it. If the program cannot adjust to your abilities and needs, it may not be worth the time.

P.S. I really wasn't that worried about my valve, but I did not expect to retain much exercise tolerance with a pacemaker on board. We sure put that rumor to rest. . .

 

[Noyolk]

Mine started out slow the first week as well. I kept saying "nice warm up" after stepping off the treadmill. They would get a laugh from this, but soon let me push myself. I am now really pushing the limit and feel secure doing it. Keep in mind they see mainly low activity level patients and not high performers.

 

[epstns]

Noyolk - It is true that they are used to seeing patients who can barely walk, etc. The crew at my rehab center seemed to really enjoy those of us who wanted to push things harder. They would ask "Do you think you can do XXX?" My response was usually something like "Bring it on!"

 

[Rachel]

I think that if you think/feel that you have better results without the rehab, than go for it! I too was also told by both my surgeon and my cardiologist that rehab was not necessary for me. I did rehab anyway and liked hearing the stories from other participants who although were very different from me, I admired them and they really gave me another perspective.

For me, rehab was also a confidence booster, having someone watch me and monitor my heart really helped me to run by the end of the program.

Rachel

 

[Bean Counter]

I did not go through rehab, but it seems the people that have gone through it have not regretted it. Prior to surgery, I was a pretty active runner and the doctor interpreted that as I know my body and my limits and told me I would be bored at rehab, so i did not go through it. It also helped that my wife is a RN and was there to put pull back the reigns when I was doing too much.

 

[Mentu]

I think most of us with a good cardiac rehab experience would agree that the exercise portion is something that we could do at home. BUT, there is more to recovery than exercise in the CR Gym. At my rehab gym, everyone was encouraged to continue walking on their own and reminded that the experience in the gym was only part of recovery. The big difference between the Rehab Gym and home is that at the Gym one is monitored during exercise and there are people there following your progress and to speak with about your concerns or problems. I think most had issues arise during recovery along with the question "...is this normal?" Cardiac Rehab provides a wonderful source of information and a standard against which to compare yourself. I also found it very comforting to be working with a group of people who each shared many of my experiences of recovering from surgery. At home, you will not have that kind of support. The regular exercise in a safe environment, monitoring, documented improvement, and commaraderie all helped to restore my sense of confidence in my body.

Larry

 

[marc_kowal]

My rehab was very good. They let me go at my own pace and encouraged me to keep increasing my times, provided I wasn't in any discomfort. The other thing was that mine was a monitored rehab, so everytime I was there I was working out EKG leads on me and the staff would monitor your vitals. This was really helpful to make sure your heart wasn't doing any funky things while working out or during the cool down phase. All in all, I'm glad I did it.

 

[Superbob]

I loved cardiac rehab! That sounds strange, I know, but it did a lot for me, physically and emotionally. The nurses were great about individualizing the program after monitoring. If you mention your level being too light, maybe they would crank up your program.

I loved the camaraderie as much as anything. If we hadn't moved from Virginia, I would still be in that group paying for maintenance sessions on my own. (My insurance covered 36 sessions.)

 

[dcc617]

Thanks for the input everyone. I'm going to give it a few more sessions before I call my doctor. Quite honestly, I'm walking faster on my own than on the treadmill. When I pumped up the speed to get it at a comfortable speed, I got some 'tude' from the nurse. Hopefully I can get a little more challenging stuff soon.

 

[TheGymGuy]

I did not go through rehab, but it seems the people that have gone through it have not regretted it. Prior to surgery, I was a pretty active runner and the doctor interpreted that as I know my body and my limits and told me I would be bored at rehab, so i did not go through it. It also helped that my wife is a RN and was there to put pull back the reigns when I was doing too much.

Same here. My doctors agreed that I can train myself and listen to my body. Since I was a gym rat for 2 hours daily right up intill the surgery they let me get away without it. I would also say that reading on here, seems everyone who went really benefited from it. If it is too easy, ask them to make it harder or more applicable to your skills and abilities.

 

[normofthenorth]

For me, the key was the monitoring.

I'm glad I did the rehab, though I was extremely active before the AVR, and at or near the top of the class in fitness during the rehab. I was occasionally bored and/or frustrated, and the solution was monitoring. My rehab clinic administered its own cardiac stress tests -- either bicycling or treadmilling, with a "breathing tube" to monitor CO2 output as well as cardiac monitoring. My initial, relatively wimpy, exercise prescription was based on my on-admission stress test, when I was still on a BB (metoprolol). About a month or two later, I thought I could do lots more, so I requested a repeat test, and got it, with the help of a second rehab nurse (who was filling in for my regular one, one session). Based on that test, they loosened up and raised my exercise prescription significantly.

Soon after that, I also changed my rehab day -- and therefore my class and my rehab nurse -- to suit my personal schedule.

The new rehab nurse was a volleyball player (like me), and also quickly discovered that I love bicycling and don't really love walking or jogging. So she designed a program for me that was like "wind sprints" or "interval training" on one of the stationary bicycles. I'd bicycle gently for 5 minutes, then semi-gently until my HR was in the 120s, then push hard (faster and with more resistance) until I got near my "red line" (143, at 66 yrs old), then back to semi-gently until my HR was back in the 120s, and over and over for 45 minutes, then cool down for 5 minutes. It was a nice tough workout, and I was always dripping sweat when I finished. And my transition back to competitive volleyball -- including 2-on-2 beach -- was uneventful and reasonably easy.

I don't think I would have done as well without the rehab. But I also wouldn't have done as well if I hadn't agitated for some extra monitoring.

 

[yotphix]

I had a great conversation on the track at rehab with another man, relatively young, like me (under 40 at the time), and relatively fit. (We're both casual runners before and after.) We both had the same experience of thinking that rehab was a waste of time, of arguing with the staff about the too light exercise, and about not letting us push ourselves. We both did push ourselves outside of rehab. Predictably, we both plateaued, then suffered setbacks, and came back to rehab with new eyes. We are all individuals, and each program is to some extent unique. What's almost certainly true though, is that the staff have your best interests in mind, and have seen a lot more recovering cardiac patients than you have!
My two cents? Go to rehab, do what they say, do extra if you can, report that to them. Respectfully show them that you are exceptional and they'll likely help you to recover at your faster rate.
What it comes down to is that there are people who need rehab because they wouldn't do the work otherwise, and people (like you and I, and a number of others here) who need rehab to keep from damaging ourselves in recovery. Incidentally, it was my cardiologist's opinion that my exemplary return from Ventricular Hypertrophy may not have been quite so exemplary if I had gone ahead on my own.

 

[Noyolk]

Epstns- My wife is an Occupational Therapist in the same building as cardiac rehab, but no nurses in her rehab office. No therapists in the cardiac rehab, but my wife and her coworkers tell me they enjoy the patients that they can help make a measureable or visible change in. I figure this is similar with the rehab nurses.

I have only been to rehab for 2.5 weeks at 3 sessions per week. I am warming up at 120 bpm on treadmill for 25 min. Then on to a ellipitical where I hold 140 to 150 bpm for 20min. Sweat dripping off my head, and that is how I worked out prior to surgery. If they are comfortable sitting behind the desk watching my stats on the monitor, then I am comfortable when I exercise alone at the same intensity.

 

[Ovie]

Yes it's slow, yes it's boring and you can probably do more on your own. However I think it's a confidence booster and recommend it.

 

[Mom2izzy]

My nurses held back a little at first (like I was the typical rehab patient), but caught on pretty quickly.

For me it was about the confidence and getting into the routine (I didn't exercise much pre-surg).

I also learned how to handle some dizziness due to my LOW blood pressure...no more anxiety over it.

Met some pretty cool people there too. One actually had a full heart transplant at the Cleveland Clinic. It was amazing to see how "normal" he was.

For me it was also a free (insurance paid) "membership" at the most expensive, nicest gym in the area.

It was good for me.