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Friday, March 25, 2011

Cardiac Rehab Session #26

Today the PVC's were not that bad. I totally ignored the monitor & talked a lot during my workout. I did not look at the monitor and only took a peak when I was to fill in my pulse rate at the end of each workout machine. Today I did:

5 minute warm up
15 minutes on the Treadmill
15 minute weight training
8 minutes on the row machine
6 minutes in the stationary bike with arms
5 minute warm down

I also had a chance to discuss my remaining schedule for rehab once I get back to work & coaching. Will go from 8 AM rehab to 4 PM rehab & work out a schedule for coaching track after school.

Thursday, March 24, 2011

PVC Discussions from the Cleveland Clinic

The discussion that I found today on PVC's was very interesting. If you wish to have a look just click on the link at: Cleveland Clinic - Exercise & PVC's.

I was in my cardiac rehab today (session 24 of 36), and again had PVC's pop up on the heart monitor. Right now the game plan is just ignore them and continue to exercise. In the discussion groups, it is interesting that many of the runners that suffer from the PVC's have them in the beginning of a race at a time when they are excited. Also, they disappear at times when the heart rate rises in the race and come back as the runner is cooling down and the heart rate comes down.

Also in the discussions, stress is discussed. Again, for me, just the fact that I still have the PVC's, going back to work, coaching, and other commitments may be adding to the PVC's.

The one quote that I found I thought was very interesting and will need to take more research. Here is is:

I believe the reason your and my PVC's stop at a certain HR is that offending renegade cells don't have enough time to discharge their stored chemical energy(?). Of course this changes when you stop exercising and your HR gets close to normal. This may be something you want to monitor yourself.

The phrase, "renegade cells" and "discharge their stored chemical energy" demand more research & questions for my cardiologist.

My goal is to 1 - continue to monitor, 2 - try to relax, 3 - cut back on commitments, and 4 - stay focused on diet & exercise.

Wednesday, March 23, 2011

Cardiac Rehab Locker Room Talk

Today after rehab I had a chance to talk to a bunch of my cardiac rehab buddies. I am always amazed to hear the stories. Here are just a few:

Story 1
This fellow rehab buddy had a brand new procedure performed by my surgeon group - Cardiothoracic Surgeons of Lancaster. This procedure was for open heart bypass surgery using the new robotic procedure. Take a look at the procedure at the Cleveland Clinic & view the video.
This procedure is less invasive, no need to open the chest cavity - you only need a small incision to insert the robotic arms! (I missed this one because of the location & number of bypasses - lucky me!). The scar is just about 3 inches under the left chest plate.

Story 2
A navy vet, has had a bad valve replaced with a mechanical valve. He had this problem from birth, but did not realize it and he is now 61 years old! He said during midget sports, he was always sent for a special physical to get permission and the doctors always said he could play, but did not know way he had irregular heart beats. He joined the Navy and had issues, but they said he was allowed to serve. Finally, with todays medical advances, they noticed the issue - bad heart valve! He had it replaced and is good to go!

Story 3
After the surgery of this patient, the doctor noticed a eagle tatoo, that the patient had across his chest from his time in the service. After the surgery, the doctor took and extra hour to sew the incision back very carefully do the eagle was lined up on both sides of the chest! That is what you call great service!

Story 4
While in Jamaica, the patient had a heart attack, in fact he had several! He did not want to go to the Jamaican hospital, so he flew home to Lancaster, PA! He did not want to risk heart surgery in Jamaica! It seems Jamaica is great for vacations by the beach, but the heart surgery in Jamaica is not what is is here in the good old USA! Maybe after OBAMACARE for a few years we will be flying to Jamaica for vacations and heart surgery!

Great stories! The locker room is where I have learned a lot over the years!

Tuesday, March 22, 2011

Stressssssssssss! Busy Schedule?

I do not know if stress helped to clog my arteries, but stress probably caused me to be to busy, not eat the right foods and not exercise on a regular schedule. One of my bad habits (I guess it depends on your definition of bad) was to be a very busy person! As I pointed out in yesterdays blog, getting back to my "normal" routine may not be very wise for me, although I really only have 2-3 months of that routine.

For the past 30 some years I have kept a very busy schedule, with teaching & coaching at the "heart" of my time management. When I started in education I was coaching 2 sports, football & track, while teaching. And, I am also an earlier riser - ask my wife Sue. So a normal day would be:

5:30 AM - wake up, shower, & get to school
6:30 AM - get to school about an hour before the kids to get my work done - grading tests, preparing lessons, and any other paperwork.
6:30 AM - 3:00 PM at school
3:00 PM - 6:30 PM - coaching. In the early years I was running & working out with the kids. In my twenties, I would run up front & lead the athletes. In my thirties, I would run in the middle and keep an eye on the front & back of the pack. And in my forties, I would run in the back to make sure no one would get lost! And in my fifties, well you know, I would tell the kids where to run.
6:30 - 11:00 - this changed through the years - meetings at church, at school, midget sports, helping with midget sports, taking courses for my masters, and many other activities.

Even in the summer I was busy (the public does not always see this part of teachers) To supplement my income I spent many years painting homes & rentals (and falling off ladders). Taking summer courses, helping with the boys and their midget sports (many a weekend at the ball field for baseball tournaments), and even a little time for vacations!

So, staying maybe too busy, and not focusing on my own health, may have something to do with my clogged arteries. My first blood test, when I was about 48-50, showed my cholesterol at 300! Not good. With meds, exercise, and diet, I controlled the cholesterol over the last ten years, but how much of my arteries were clogged in the days of McDonals 1/4 ponders, pizza with extra cheese, and Tastycakes for breakfast?

So, for the next 30 years, one of my goals will be to "smell the roses"! That means saying NO to things that will continue bad habits - eating & exercise. Dedicate time each day to exercise & diet control!

Great Stress Website:
American Institute for Stress

Monday, March 21, 2011

14 Weeks After Open Heart Bypass Surgery

Fourteen weeks after surgery I am at the point where sometimes I forget I had the surgery! That is good & bad. Here are a few of the issues at this time in recovery.

Physical Issues
I am increasing my lifting at cardiac rehab. In the use of free weights, I have progressed to using dumbbells for side stretch, curls, bent rowing, and other exercises. Wall pushups(I can hardly wait to try a regular push up!), squats, leg extensions & leg curls are also part of the routine. So, we are increasing weights and making progress. All my incisions - leg, arm, chest are healing well & the only discomfort I feel is in my chest incision. I still have some numbness & soreness about inch on either side of the incision. I also feel some discomfort when I try to sleep on my side. When I roll over, the area around the incision is sore.

The cardiac rehab with the machines is progressing. I can do more time on each machine, but I feel the PVC's at around 95-105. I push through the PVC's and try to keep my heart rate below 110, so I do not have any runs & scare the nurses. Walking outside I go for 15-20 minutes and the only issue is with hills, again I feel a "flutter" sensation in my heart & when I do I back off the pace.

Medicines
I seem to be OK with the meds I am taking & have no noticeable side affects. Here is my current list:
Heart Meds:
1 - 81 mg aspirin daily
1 - 40 mg tablet of lipitor daily
1 - 5 mg tablet of Amlodipine daily
1 - 75 mg tablet of Plavix daily
1 - 50 mg tablet of Metoprolol daily
Other Meds
1 - 20 mg tablet of Aciphex
1 - 10 mg tablet of Singulair

Diet
I am behaving myself - I think! Although my weight is still around 185 (my goal is 170). I am avoiding trans fats & cholesterol. The only time I have had red meat (usually once per week) I have the lean hamburger. Eating oatmeal every morning & apples & bananas. Sometimes I will have cereal - usually Cheerioes! If I have a sandwich for lunch it is turkey or tuna on wheat bread. I eat fish about twice a week & salads when we go out to eat. As a snack I have tried Angel Food cake with fruit. No chocolate, candy bars, or ice cream! (This is brutal!) I probably will try cutting back on portions in the next few weeks. Also, have given up caffeine!

Stress
This is something I will research more. One of my problems before the operation I'm sure was schedule & too many activities. I have cut back, but starting back to work & other obligations may push me a bit till retirement.
Work - usually wake up at 5:30 AM and to work by 6:30 AM & work to 3 PM.
Coaching - coach tarck and field from 3 - 6 PM
Church - President of Council & meetings 2-3 times a month
Family - boys & helping - Jared & moving & help with logistics of the Army life. And Josh, with his busy life with working & his music.
Home - maintaining the home - yard work, painting, repair, remodeling, etc. And taking care of our two grand dogs - Otis & Lyla!
Retirement - getting ready for retirement & the financial concerns of retirement.

So, one of my main focuses the next two-three months will be stress management! I retire in June & will attempt to be aware of my recovery & how it relates to not trying to do too much!

Sunday, March 20, 2011

Target Heart Rates

What is your target heart rate for your age? Here is a Heart Rate Calculator at the Mayo Clinic.
According to this calculator, for my age of 57, I should be at 114-139.

This is a brief synopsis from the Mayor Clinic:

For vigorous exercise, aim for a target heart rate of 70 to 85 percent of your maximum heart rate (MHR). Your MHR (roughly calculated as 220 minus your age) is the upper limit of what your cardiovascular system can handle during physical activity.

These numbers are estimates that provide an average value. Many people have a higher or lower MHR, sometimes by as much as 15 to 20 beats per minute. Disagreement exists on how to most accurately estimate your MHR and what percentage range to target.

If you're looking for more than an estimate, consider discussing your target range with an exercise physiologist or personal trainer.

Note: Several types of medications can lower your maximum heart rate and, therefore, lower your target heart rate zone. Beta blockers, most anti-arrhythmic medications, some calcium blockers and digoxin are among the most common. In some people, H-2 blockers prescribed for acid reflux also reduce maximum heart rate. If you're taking any of these medications, ask your doctor if you need to use a lower target heart rate.


Notice the last paragraph in red! I am on beta blockers & medicine for acid reflux - Aciphex. Therefore, should I be pushing my heart rate to the suggested 114-139 range suggested in the calculation for my age? My PVC's are occurring at the 105-110 range. Should I be there in exercise? Another question for my nurses & doctors!!!

Today's readings were 113/75 for Blood Pressure and 65 for resting heart rate.