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The heart of heart recovery

April 23rd, 2014

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The heart of heart recovery

There are many myths about exercise and heart diseases. Many people misunderstand that having a heart disease means you are instantly a weak person and your health is in danger. Most will be scared of having a heart disease. My patients with high blood pressure always ask me whether they have a heart disease, and it is a hard question to answer because high blood pressure can often lead to heart disease, and the medicine for high blood pressure can sometimes be the same as heart disease medicine.

Actually, heart diseases are not as scary as everyone thinks. Medical advancement today allows doctors to treat heart problems efficiently (as in curing them, not nurturing them). A problem bigger than treatments is how the patient takes care of his or her health afterward. Exercise and diet are big part of that.

Staying healthy means keeping strong, and as soon as the patient becomes weak, the heart is weaker and the chance of the heart disease recurring is higher as well. Heart disease cannot be cured “permanently” like some diseases. If you have a heart disease (especially myocardial infarction and narrowed artery), you will become weaker and the chance of having that same heart disease is higher than those who have never had it.

To minimize the risk, you have to stay strong, which is not hard at all. Doctors can prescribe extremely effective medicine that is proven to reduce the risk of heart disease from recurring, but at the end of the day, the patient still has to exercise. This is something the doctor cannot help.

Exercising correctly can help reduce the chance of heart disease by 30% and is by far much better than all medicines available today. Surprisingly, most patients would choose medicine over exercise. When the doctor says exercise, the patient thinks of playing sports, excessive sweating and exhaustion. In fact, exercise for the benefit of your heart doesn’t have to be so.

Actually, it can be called “doing activities” so that people are not intimidated by the sound of the word. Anything that gets your heart pumping harder continuously for 20-30 minutes, 4-5 days a week is good enough. It can be shopping (without pausing for purchase!), gardening, sweeping, car washing, vacuuming or dancing. It just has to be 20-30 minutes without pause, and done 4-5 days a week.

No matter how serious or light your heart disease is, you can exercise if you start slowly and work your way up. Very few heart diseases require stopping exercising altogether, but even so, light activities can do no harm.

Experienced doctors will arrange a program for patients to exercise based on their condition. The goal is for the patients to have a strong heart, but after the program ends, it is up to the patient whether the strong heart can be maintained.

Good heart recovery program is designed to match the patient’s physical condition and the right diet will also be recommended. By “right” I mean right for that particular patient, because what’s good for one patient might be dangerous for another. The weight also has to be watched, and risk factors such as smoking have to be avoided.

A patient of mine was about 70 years old. She came to see me because she had felt weak for a year. She had had bypass surgery because she once had narrowed artery. She had a heart failure after the operation, and she had had high cholesterol level before. The doctor therefore recommended that she stay away from fatty and salty foods.

She was quite savvy when it comes to food and nutrition. She had done some research and found that meats are high in cholesterol. She also read that salt could cause heart failure due to water retention, and could be found in any food, not just salty-tasting food. So, she only ate vegetables and steamed fish. Her food was either boiled or steamed, and occasionally microwaved.

She did that strictly, and in one year her weight gradually reduced from 50 kg to 45, 43, 40 and finally 37 kg when she was in her wheelchair and came to see me.

After physical examination, I found that she was malnourished and her muscles were all weak. She had to increase her food intake and did physical therapy to increase muscle strength. After a month or so, she became stronger and could walk for 20-30 minutes. Her weight was back to 47 kg, which was proportionate with her height. At present, she understands that “watching” her food does not mean “avoiding” food.

So, Buddhist believes of “middle path” is also true when it comes to how to look after yourself as a heart patient.

Prof Nithi Mahanonda is consultant cardiologist and interventionist, Perfect Heart Institute.

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