Tackling exercise after a heart attack or being diagnosed with a heart condition is possible with guidance from a physiotherapist, like WHHC's own Cammy Tsai.
People are often afraid of embarking on exercise straight away after a heart attack or being diagnosed with a heart condition, as they feel weak and are unsure how to exercise and what is ‘safe'.
However, exercise is important. Once doctors feel that patients have recovered sufficiently and are on ‘optimal' medication, they will recommend patients to start a graded or progressive exercise regime, to slowly build their fitness. That's where the physiotherapist comes in.
Physiotherapy is a branch of treatment that uses physical means to relieve pain, regain range of movement, restore muscle strength and return patients to the normal activities of daily living. It is a healthcare profession, which sees human movement as central to the health and wellbeing of individuals.
Physiotherapists identify and maximise the patient's potential through health promotion, preventive healthcare, treatment and rehabilitation. The core skills used by physiotherapists include manual therapy and exercise therapy. Physiotherapists also have an appreciation of psychological, cultural and social factors that guide and influence their interaction with their patients.
A physiotherapist‘s role in the care of patients with heart conditions includes education and counselling on the importance of physical fitness and how to achieve and maintain it. The physiotherapist is also responsible for the prescription of individualised exercise regimes to improve the patient's heart condition and fitness level to help prevent further heart complications.
Patients should always check with their cardiologist and physiotherapist before embarking on exercise programmes.
Many cardiac patients are prescribed medication and it is important for them to take them according to the doctor's instructions. Some medications may cause unwanted side effects but these usually only last a short time and should stop once the body gets used to them. Please check with your cardiologist if you experience unwanted side effects from medication, in particular if you feel the side effects are affecting your daily activities.
Some patients are prescribed medication for angina which is discomfort or pain in the chest when heart muscles don't get enough oxygen, which may occur during exercising. It is important to know how to take this type of medication properly and to always bring it along when exercising. Always check with your cardiologist or physiotherapist regarding its use.
Exercising After Cardiac Surgery
When you are feeling weak and are in pain after cardiac surgery, it might seem strange to be embarking on a course of physiotherapy instead of just resting. However, but that is just what is recommended, according to WHHC’s physiotherapist, Cammy Tsai.
If a patient has cardiac surgery and then does nothing to regain strength, that patient will soon get progressively weaker . Physiotherapy offers a means to restore functional mobility and strength. It supplements the benefits of cardiac surgery by making the patient much healthier than before the surgery took place.
Physiotherapy usually begins as early as the day after a cardiac operation such as a bypass. The physiotherapist will see the patient in the ward and assess her functional mobility and strength, prescribe and help her perform exercises, including breathing exercises to prevent chest complications, and other forms of exercises to help her regain her strength.
After patients are discharged, they are often encouraged to join an outpatient cardiac programme, where they will learn how to exercise safely under the supervision of the physiotherapist. This way, the professionals will be alerted if a patient has troublesome symptoms. The exercise routines usually concentrate on improving cardiovascular performance and mobility.
After the initial period of monitoring and once they have completed the programme, patients would be encouraged to exercise at home. By then, they would have been taught proper warm-up and stretching exercises, and know how to monitor themselves. Generally, patients are advised to exercise three to five times a week unless they are having problems.
The physiotherapist will also instruct the patient on acceptable activities in the weeks and months after surgery. During the first six weeks, only a few activities are allowed, for example, lightchores at home. From then until the third month, more activities will be added gradually.
How our Modern Lifestyle and Stress Affects Heart Health in Women
Everyone needs an optimum level of stress to be at our optimal productive level. However, too much stress coupled with the inability to cope will cause one’s health to suffer, according to Ngooi Bi Xia, the WHHC occupational therapist.
So how does a woman know if the ‘stress’ that she’s facing is unhealthy and will have a dangerous impact on her health? The key is learning to recognise your loved one’s or even your own symptoms of stress, especially the early symptoms, so as to intervene before it gets serious.
Physical symptoms of stress include migraine and tension headaches, neck and shoulder aches, insomnia, drastic weight change, chest pain, dry mouth, rapid heartbeat without exercising, sudden, suffocating pain, constipation, increased sensitivity to light and sound.
Mental and behavioural symptoms of stress include anxiety and depression, increased anger and irritability, problems concentrating and making decisions, forgetfulness, constant tiredness and strained communication.
There are two types of stress responses that may typically occur:
- Fight or Flight: This is our body's automatic response that prepares the body to confront (fight) or run away (flight) from perceived stressors. Both responses create big amounts of muscle movement and exertion, which effectively breaks down the stress hormones. Once the stressor has been overcome, our body and mind return to a state of calm. When stressed for a prolonged time, we start to experience physical symptoms, for instance tense muscles, headache, upset stomach, racing heartbeat, deep sighing or shallow breathing. Others may experience emotional or psychological symptoms such as anxiety, poor concentration, depression, hopelessness, frustration, anger, sadness or fear.
- Tend and Befriend: This stress response pattern is unique to women, in which stresses lead to nurturing and bonding behaviour. It is a result of the activation of the hormone, oxytocin, which promotes care-giving behaviour. It is believed that tending and befriending behaviours happen after the fight and flight response.
Tending behaviour poses certain risks. For example, the woman’s own needs may be neglected, she faces the risk of possible burnout or accumulated unhappiness in the end, or experiences difficulty being objective with problems associated with care giving. All these may lead to anger outbursts or the development of depressive symptoms.
Befriending behaviour can help alleviate stress. So keep your girlfriends close! Women need other women. Keep ties warm with old friends, socialise and make new friends and make bonding sessions like spa parties, shopping outings and gossip sessions regular features in your life.