|
Recovering Well: Life After a Heart Attack
|
|
Excerpted from the National Heart, Lung and Blood Institute
|
|
|
|
 |
Having a heart attack or a heart procedure can be a frightening and upsetting experience. It is difficult to discover—often suddenly—that your body isn’t working the way it should, and to be plunged into an unfamiliar world of hospitals and high-tech procedures. But it’s important to know that millions of people have survived a heart attack, recovered fully, and gone on to resume active, normal lives. Likewise, most people who undergo heart surgery recover well and return to their usual activities. Many surgery patients eventually feel healthier than they did before their procedure.
The time it takes to get back to normal will depend on many factors, including your age and general health. If you have had a heart attack, the pace of recovery will also depend on the severity of the attack.
If you have undergone surgery, recovery time will depend partly on the type of procedure you had. But whatever your situation, there is much you can do to improve your health and prevent complications following a heart attack or major heart procedure.
The first step: Give yourself permission to recover. You and your body have been through a lot, and it will take some time to feel like yourself again . Expect to feel quite tired at first, and to gradually regain your strength and energy. While individual needs vary, following are some overall tips for recovering well from a heart attack or heart surgery.
When you first arrive home from the hospital, you’ll need to get a lot of rest so that your heart can begin to heal. It is very important to eat healthfully and to get enough sleep. Take the medications your doctor has prescribed for you. (See “Heart-Healing Medicines” below.) Avoid heavy yard work, house cleaning, or other projects that require a lot of energy. Also refrain from physical activity in very hot or cold weather. Ask family and friends to help out with chores, childcare, and other activities that may be difficult to take care of during your first weeks at home.
At the same time, it is important to get up and move around as you begin to recover. Your heart is a muscle that needs be exercised—though very gently at first. Pace yourself. Allow plenty of time for each thing you do during the day, from getting out of bed to taking a shower to preparing a simple breakfast. Rest between activities, and whenever you feel tired. Ask your doctor for a list of guidelines for activity during your first few weeks at home.
Your doctor will want to check your progress 1 to 4 weeks after you leave the hospital. During your first followup visit, your doctor will check your weight and blood pressure, make any needed changes in your medicines, perform necessary tests, and check how your recovery is progressing overall. Use this opportunity to ask any questions you may have about safe or unsafe activities, medicines, lifestyle changes, or any other issues that concern you. You may want to write down your questions beforehand.
For some situations and questions, it is best to call your doctor right away rather than wait for your next appointment. Call promptly if:
- You have symptoms related to your original heart disease, such
as trouble breathing, chest pain, weakness, or an irregular heartbeat.
- You notice side effects after starting a new heart medicine.
- You’ve
been given a prescription for a condition other than heart disease. It
is important to find out whether it’s safe to take other medicines
along with your heart drugs.
- You’ve recently had heart surgery
or another kind of medical treatment and you notice symptoms that your
doctor has warned you about.
- You feel down or “have the blues” for more than a few days.
Heart - Healing Medicines
Following a heart attack, your doctor will probably prescribe one or
more drugs to improve your heart functioning and help prevent
another heart attack. If your doctor doesn’t mention medicine, ask
whether you should take one of the following medications.
- ACE inhibitors
- Aspirin
- Beta blockers
- LDL cholesterol-lowering and triglyceride-lowering drugs
|
If you have symptoms of a possible heart attack, call 9–1–1 right away.
Your doctor may recommend cardiac rehabilitation (rehab) to help you recover from a heart attack or heart surgery. This is a total program for heart health that includes exercise training, education on heart healthy living, and counseling to reduce stress and help you return to an active life.
Getting involved in a cardiac rehab program is an excellent idea. A recent study showed that people who participated in cardiac rehab were 50 percent more likely to survive 3 years after a heart attack than those who didn’t participate. Cardiac rehab can help to strengthen your heart, reduce the risks of a future heart attack, and return you as quickly as possible to your normal daily activities. Almost everyone with heart disease can benefit from some kind of cardiac rehabilitation. No one is too old or too young to benefit. Women are helped by cardiac rehab as much as men are.
Cardiac rehab often begins in the hospital after a heart attack or heart surgery, with very gentle physical activity and counseling on adjusting to life at home. Once you leave the hospital, you can continue to participate in cardiac rehab on an outpatient basis. Outpatient programs may be located at your hospital, in a medical center, or in a community facility such as a YMCA. Some people continue cardiac rehabilitation at home. Regardless of the location, your cardiac rehab team—which may include doctors, nurses, exercise specialists, dietitians and counselors—will help you to create a safe exercise plan, as well as provide information and encouragement to control your risk factors.
You will need your doctor’s approval to get started in cardiac rehab. But not all doctors bring up the topic with their heart patients, especially women. Research indicates that women are only about half as likely as men to participate in cardiac rehab programs. This is worrisome, because nonparticipation increases the risk of having second and often fatal heart attacks. So be sure to tell your doctor or nurse that you’re interested in cardiac rehabilitation. Talk with them about your specific needs and preferences, and ask for a referral that is a good fit for you.
Cardiac rehab programs vary in the types of services they offer and emphasize. Choose one that makes exercise training a priority. Studies show that people who participate in an exercise-based program are less likely to have a future heart attack or major heart surgery, and are less apt to die of any heart-related cause than those who don’t join a program that emphasizes exercise. When choosing a cardiac rehab program, also look for one that:
- Offers a wide range of services, including education and counseling.
- Offers services at a time and place that are convenient for you.
- Offers services that meet your specific needs and preferences. For example, if you’re overweight, look for a plan that provides help for weight loss.
- Is supervised by a team of health care professionals.
- Is affordable. Your insurance may cover the cost of some cardiac rehab services, but not others. Find out what will be covered and for how long, so you’ll know from the start what your out-of-pocket costs will be.
Get moving. Exercise training will help you learn to safely participate in physical activity, strengthen your muscles, and improve your stamina. If you’ve recently gotten out of the hospital, you may be worried that exercise will bring on another heart attack or other heart crisis. In fact, physical activity can help prevent future heart problems. Your rehab team will help you develop a program that is safe and effective for you.
Some programs make use of equipment such as a treadmill for walking, stationary bikes, and light weights, and you’ll be shown how to use this equipment to get the most benefit. Other programs offer low-impact aerobics classes and other group exercise activities. In most programs, your heart rate and blood pressure will be monitored while you move. As your heart and body become stronger, you will gradually increase your physical activity. Eventually, after you become familiar with the program, you can continue it at a fitness center or at home.
Learn new heart healthy habits. In your cardiac rehab program, you’ll also learn about controlling your personal risk factors for heart attack and other heart complications, and how to create new, healthier habits. Controlling risk factors is a very important part of your recovery process. Depending on your personal needs, you may learn to:
- Quit smoking if you’re a smoker.
- Manage related health conditions such as diabetes and high blood pressure.
- Eat a healthy, low-saturated fat, low-cholesterol diet.
- Control your weight.
- Manage stress.
Get counseling and support. A good cardiac rehab program will help you learn to cope with the challenges of adjusting to a new lifestyle, as well as address any concerns you may have about the future. You’ll also be offered help in dealing with the emotional ups and downs that many people experience following a heart attack or heart surgery. Many programs offer classes in stress management, as well individual counseling, group support, or both.
Getting the Most Out of Cardiac Rehab
You’ll benefit most from your cardiac rehab program by becoming as actively involved in it as possible. Think of yourself as the most important member of your recovery team—because you are . Join with health care professionals in designing or adjusting services to best meet your needs. Show up for exercise, education, and support sessions. Ask questions. Report any changes in your feelings or symptoms.
Finally, be sure to complete the program. Even if you feel that you already “have a handle” on how to recover, keep in mind that your needs will continue to change throughout the recovery process. Your cardiac rehab team can help you respond to those changing needs, and thereby continue to help you improve your heart health. So stick with the program!
As you begin to recover from a heart attack or heart procedure, you may naturally wonder when you can return to your usual activities, including work, sexual activity, driving, and travel. Most people can safely return to most of their normal activities within a few weeks, as long as they do not have chest pain or other complications. While you should ask your doctor when you can return to each of your usual activities, here are some general guidelines:
Work. Most people are able to return to their usual work within several weeks. Your doctor may ask you to take tests to find out if you can do the kind of job you did before. While most individuals can continue their customary work with no problems, some people choose to change jobs or reduce their hours to lighten the load on their heart. Counselors at cardiac rehab programs may be able to provide support and resources for those considering a job change.
Sexual activity. Most people can have sexual relations again about 3–6 weeks after a heart attack or heart procedure, as long they have no chest pain or other complications. But since everyone recovers at his or her own pace, your doctor may give you a stress test to determine when you can safely resume sexual activity. When you’re ready for sex again, choose a time when you feel relaxed and rested. Wait at least an hour after eating a full meal to allow time for digestion. Take your time. If you have chest pain or other heart symptoms during sexual activity, have lost interest, or are worried about having sex, talk with your doctor.
A special note: Couples who use medication to enhance sex should know that these drugs can cause irregular heartbeats. If you’ve been using one of these medicines or are considering taking one, ask your doctor whether it is safe to do so.
Driving can usually begin within a week for most patients, if allowed by State law. Each State has its own regulations for driving a motor vehicle following a serious illness, so contact your State’s Department of Motor Vehicles for guidelines. People with complications or chest pain should not drive until their symptoms have been stable for a few weeks.
Travel. Once your doctor tells you it’s safe for you to travel, keep these tips in mind:
- Keep your medications in your purse or carry-on luggage so they will be easily available when you need them.
- Pack light so that you can lift your luggage without strain. At the airport, train, or bus station, use a pull-cart to cut down on lifting. If possible, get help from a porter.
- Allow more time than usual to catch your flight, train, or bus. Who needs the extra stress?
- Walk around at least every 2 hours during trips. While sitting, flex your feet frequently and do other simple exercises to increase blood flow in your legs and prevent blood clots.
- Check with your doctor before traveling to locations at high altitudes (greater than 6,000 feet) or places where the temperature will be either very hot or very cold. When you first arrive, give yourself a chance to rest.
Remember, each person’s recovery process is different. Don’t try to guess when you can return to normal activities. Always ask your doctor first.
Anyone who has had a heart attack or has undergone heart surgery knows that it can be an upsetting experience. You’ve just come through a major health crisis, and your usual life has been disrupted. Afterward, it’s normal to experience a wide range of feelings. You may feel some relief. But you may also feel worried, angry, or depressed. It may be reassuring to know that these reactions are very common, and that most difficult feelings pass within a few weeks. Here are some things to remember:
Take 1 day at a time. Try not to think too much about next week or next month. Do what you can do today. Enjoy small pleasures: a walk in your neighborhood, a conversation with a loved one, a snuggle with a pet, or a good meal.
Share your concerns. Talk with family members and friends about your feelings and concerns, and ask for support. Be sure to ask for the kind of support you need. (For example, if you want a sympathetic ear rather than advice, gently let your loved ones know.) Be sure to give family members time to say what they feel and need, too. Supportive relationships may actually help to lengthen life after a heart attack.
Get support from “veterans.” Whether you’ve had a heart attack or gone through heart surgery, consider joining a support group for people who have shared your experience. Groups for heart patients can provide emotional support as well as help you develop new ways of handling everyday challenges. For a list of support groups in your local area, contact The Mended Hearts at www.mended.hearts.org or at 1–888–432–7899. Your local American Heart Association chapter may also offer support groups.
Keep moving. Regular physical activity not only helps to reduce the risk of future heart problems, but also helps to relieve anxiety, depression, and other difficult feelings. Any regular physical activity—even gentle walking—can help to lift your mood.
Seek help for depression. Up to 20 percent of heart disease patients battle serious depression, and many more suffer milder cases of the “blues.” If you find yourself feeling very sad or discouraged for more than a week or so, be sure to let your doctor know. Counseling and/or medication can often be very helpful. Seeking help is very important, not only because you deserve to enjoy life as fully as possible, but also because heart patients who are successfully treated for depression are less likely to have future serious heart problems.
Excerpted from Your Guide to Living Well With Heart Disease by the National Heart, Lung and Blood Institute of the National Institutes of Health. NIH Publication No. 06-5270, November 2005.
|
|
|
|
|
|