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CHF and Exercise - how much is to much ?
Hi, thank you for taking my question. I had a MI in 1992, ICD for VT 2001- in 2004 I rec'd Mechanical Mitral Valve (rheumatic fever)I have gone from 52m to 63m since my MV surgery. After surgery I went into full heart block and then in 2005 I was Dx with congestive heart failure. I had a CRT done and things improved alittle but then I got edema and my breathing was terrible. I tire very easily.
Q.My EF does not go up upon exertion on my echo stress - is there something I can do or ask for to get it to go up? I take coreg, mexiletine, ace inhibitor, lasix, potassium, coumadin. Coreg has helped me to breath better.
Q.I was runner just a few years ago - I can't even jog anymore. Is it possible to improve my situation to be able to jog again?
I have good days and bad days with CHF. Some days I can't get out of bed. But the next day I might be able to walk for 20 minutes. So I am able to do some walking. But if I start to jog -I can't breath and I get pains in my legs from lack of oxygen. Should I keep trying to jog alittle each day and see if this improves over time or would it enlarge my heart further?
Q.I thought exercise was good for the heart. If I persisted in trying to jog - would it cause my heart to increase in size?
Q.Are there any devices out there on the market that would help me to be able to be more active?
Q. How can I get my EF rate to go up when exercising?
How can I learn more about exercising with CHF ? I don't want to do any further damage. But I want to be more active.
Thank You
K
Q.My EF does not go up upon exertion on my echo stress - is there something I can do or ask for to get it to go up? I take coreg, mexiletine, ace inhibitor, lasix, potassium, coumadin. Coreg has helped me to breath better.
Q.I was runner just a few years ago - I can't even jog anymore. Is it possible to improve my situation to be able to jog again?
I have good days and bad days with CHF. Some days I can't get out of bed. But the next day I might be able to walk for 20 minutes. So I am able to do some walking. But if I start to jog -I can't breath and I get pains in my legs from lack of oxygen. Should I keep trying to jog alittle each day and see if this improves over time or would it enlarge my heart further?
Q.I thought exercise was good for the heart. If I persisted in trying to jog - would it cause my heart to increase in size?
Q.Are there any devices out there on the market that would help me to be able to be more active?
Q. How can I get my EF rate to go up when exercising?
How can I learn more about exercising with CHF ? I don't want to do any further damage. But I want to be more active.
Thank You
K
MEDICAL PROFESSIONAL
Konopka,
Thnanks for the post. I have tried to get people away from this focus on EF over and over. I know that having a concrete number to focus on is nice, but the most important thing is truly how you feel. I have many patients with an EF of 10% who have less symptoms than patients with an EF of 35%. Overall, the less symptoms you have, the better the prognosis is.
Q.My EF does not go up upon exertion on my echo stress - is there something I can do or ask for to get it to go up? I take coreg, mexiletine, ace inhibitor, lasix, potassium, coumadin. Coreg has helped me to breath better.
The only thing I can see that you lack from your regimen is aldactone. Otherwise, the best option is continued maximal medical therapy and perhaps trying to get into some type of cardiac fitness program to increase our overall health.
Q.I was runner just a few years ago - I can't even jog anymore. Is it possible to improve my situation to be able to jog again?
I have good days and bad days with CHF. Some days I can't get out of bed. But the next day I might be able to walk for 20 minutes. So I am able to do some walking. But if I start to jog -I can't breath and I get pains in my legs from lack of oxygen. Should I keep trying to jog alittle each day and see if this improves over time or would it enlarge my heart further?
My best advice would be to get into a cardiac rehabilitation. Often insurance covers this. In this type of program, therapist skilled in taking care of patients with cardiovascular disease can cater a specialized program to get you in better shape. Since youve had a CRT device, and are on pretty good therapy I would strongly emphasize this option.
Q.I thought exercise was good for the heart. If I persisted in trying to jog - would it cause my heart to increase in size?
No, but you should start your exercise program under some type of supervision.
Q.Are there any devices out there on the market that would help me to be able to be more active?
Im sure there are plety of devices, just as there are plenty of exercise equipment and gimmiks that sit around unused after purchase. Instead of spending money and time on this, I again urge you to try out some type of cardiac rehabilitation program.
Q. How can I get my EF rate to go up when exercising?
Again, dont focus on the EF, focus on how you feel and ways of improving that.
good luck
Thnanks for the post. I have tried to get people away from this focus on EF over and over. I know that having a concrete number to focus on is nice, but the most important thing is truly how you feel. I have many patients with an EF of 10% who have less symptoms than patients with an EF of 35%. Overall, the less symptoms you have, the better the prognosis is.
Q.My EF does not go up upon exertion on my echo stress - is there something I can do or ask for to get it to go up? I take coreg, mexiletine, ace inhibitor, lasix, potassium, coumadin. Coreg has helped me to breath better.
The only thing I can see that you lack from your regimen is aldactone. Otherwise, the best option is continued maximal medical therapy and perhaps trying to get into some type of cardiac fitness program to increase our overall health.
Q.I was runner just a few years ago - I can't even jog anymore. Is it possible to improve my situation to be able to jog again?
I have good days and bad days with CHF. Some days I can't get out of bed. But the next day I might be able to walk for 20 minutes. So I am able to do some walking. But if I start to jog -I can't breath and I get pains in my legs from lack of oxygen. Should I keep trying to jog alittle each day and see if this improves over time or would it enlarge my heart further?
My best advice would be to get into a cardiac rehabilitation. Often insurance covers this. In this type of program, therapist skilled in taking care of patients with cardiovascular disease can cater a specialized program to get you in better shape. Since youve had a CRT device, and are on pretty good therapy I would strongly emphasize this option.
Q.I thought exercise was good for the heart. If I persisted in trying to jog - would it cause my heart to increase in size?
No, but you should start your exercise program under some type of supervision.
Q.Are there any devices out there on the market that would help me to be able to be more active?
Im sure there are plety of devices, just as there are plenty of exercise equipment and gimmiks that sit around unused after purchase. Instead of spending money and time on this, I again urge you to try out some type of cardiac rehabilitation program.
Q. How can I get my EF rate to go up when exercising?
Again, dont focus on the EF, focus on how you feel and ways of improving that.
good luck
Thanks for asking those questions, and thanks, Doctor, for the answers that you offered, and obviously believe very strongly. This forum is wonderful... when words like CHF are mentioned by a Cardiologist regarding one's condition, most of us who hear those words are simply floored and can't think of the right questions to ask.
I went to class as you suggested, and continue to work out every day, centering more on aerobics than weights, a reversal for me. I was trying to be a 64 year old Tarzan, didn't work!!! I now lift light weights with multiple reps, do 40 minutes of easy cardio every day and seem to be getting stronger. I'm also trying not to dwell on the diagnosis but take things a day at a time. This weekend I celebrate Easter with my wife, children and grandchildren plus a brother and several friends, life is good.
I went to class as you suggested, and continue to work out every day, centering more on aerobics than weights, a reversal for me. I was trying to be a 64 year old Tarzan, didn't work!!! I now lift light weights with multiple reps, do 40 minutes of easy cardio every day and seem to be getting stronger. I'm also trying not to dwell on the diagnosis but take things a day at a time. This weekend I celebrate Easter with my wife, children and grandchildren plus a brother and several friends, life is good.
Thanks for answering my questions. :-) I normally don't pay much attention to it. But, since I haven't been able to exert myself well for some time - I thought maybe some meds would make me able to exercise more. Last week I had talked to my CHF doc about cardiac rehab - but I don't think he thought that was a good idea. But he did say I could try to mow my lawn - just go easy and don't overdo it as I would feel bad the next day. I got so excited and went out the next morning and proceeded to mow my front yard. It felt awesome at first - but then the lawnmower kicked and sputtered and so I checked the gas and I filled it up and then I checked the oil and I saw that there was 'no' oil - so I went to the hardware store and bought some and filled her up.
I told my husband when he got home and he was so excited to see me so happy when I told him I had mowed the front lawn. After I told him all about my exciting day he proceeded to explain about some dip stick in the oil compartment of the lawnmower and how your only suppose to fill it up to a certain point where it indicates (full) otherwise the engine can cease !!! Ooops - maybe we could tip it upside down and get some of the oil 'out'. Anyways, besides a beautiful looking front yard - I got my first lesson on the mechanics of lawnmowers. I can't wait for my grass to grow and to be able to mow it again. :-) It looks so nice and I think I'll try mowing the side lawn next week. :-)
Thanks and I hope everyone has a very Happy Easter :-)
Konopka
I told my husband when he got home and he was so excited to see me so happy when I told him I had mowed the front lawn. After I told him all about my exciting day he proceeded to explain about some dip stick in the oil compartment of the lawnmower and how your only suppose to fill it up to a certain point where it indicates (full) otherwise the engine can cease !!! Ooops - maybe we could tip it upside down and get some of the oil 'out'. Anyways, besides a beautiful looking front yard - I got my first lesson on the mechanics of lawnmowers. I can't wait for my grass to grow and to be able to mow it again. :-) It looks so nice and I think I'll try mowing the side lawn next week. :-)
Thanks and I hope everyone has a very Happy Easter :-)
Konopka
Oh, Marilyn, I am so sorry to read your post! I have not been on so much, and I had no idea life was starting to get very rough again in the cardiac dep't. I'm surprised your chf doc didn't think rehab was such a good idea. Perhaps he was thinking of the strain on your heart... but s/he said pushing a lawn mower was okay? Well, rehab at least is supervised, but s/he is right about being outdoors -- that counts for a lot, I think. Have you read An Arrow through the Heart by Deborah Daw Heffernan (available Amazon -- or it was)? Just wondering -- it is a small book by a woman who was very active and totally unexpectedly suffered a major MI at 43 and wound up with an EF of 14. It's really interesting -- her whole passage and how she contends with it. Well, she and I are different, but I appreciate her account very much. I think I am doing okay on Coreg, Sotalol, Coumadin, a dual chamber pacer... still a lot of arrhythmia at times, which I try to ignore and just go about my life. I am loving taking walks in the evening light now, and much warmer! Stay upbeat! It's the best!
Marilyn,
I am so sorry to hear you are having difficulty. I agree with the Doc. Forget about the EF. It matters more how you feel and how you function. Exercise is extremely important. I remember when I was diagnosed. My cardiologist said to me very sternly (he had never talked to me like that before) if you do nothing else, you must exercise each and every day. I had gone through two cardiac rehab programs with my two heart surgeries and knew what I had to do. To this day (it is about a year and a half) I have exercised a minimum of 30 minutes per day. I do a cross trainer for 15 minutes at a low level though and then I do some weights for about 15 minutes and then a stationary bicycle for 15 minutes. It is only very recently that I am able to use my legs and arms to exercise at the same day like using the cross trainer or the airdyne bike. So, it takes time and persistence. I also find that keeping the fluid off with diuretics and making sure I take supplements of KCl, and Mg etc. I am able to exercise quite well. my CRT (bi-v pacer) has been wonderful. My EF and function have improved significantly. I still am bothered a lot by ectopic rhythms but I am protected with an ICD so feel confident moving forward. Good luck with your rehab. I would suggest not running but walking instead and then gradually building up your stamina. I could never run now. I can hardly walk fast but I walk as fast as I can tolerate...when I get short of breath I pull back and try again the next day.
I am so sorry to hear you are having difficulty. I agree with the Doc. Forget about the EF. It matters more how you feel and how you function. Exercise is extremely important. I remember when I was diagnosed. My cardiologist said to me very sternly (he had never talked to me like that before) if you do nothing else, you must exercise each and every day. I had gone through two cardiac rehab programs with my two heart surgeries and knew what I had to do. To this day (it is about a year and a half) I have exercised a minimum of 30 minutes per day. I do a cross trainer for 15 minutes at a low level though and then I do some weights for about 15 minutes and then a stationary bicycle for 15 minutes. It is only very recently that I am able to use my legs and arms to exercise at the same day like using the cross trainer or the airdyne bike. So, it takes time and persistence. I also find that keeping the fluid off with diuretics and making sure I take supplements of KCl, and Mg etc. I am able to exercise quite well. my CRT (bi-v pacer) has been wonderful. My EF and function have improved significantly. I still am bothered a lot by ectopic rhythms but I am protected with an ICD so feel confident moving forward. Good luck with your rehab. I would suggest not running but walking instead and then gradually building up your stamina. I could never run now. I can hardly walk fast but I walk as fast as I can tolerate...when I get short of breath I pull back and try again the next day.
Thank You emmaj for your caring post. :-) The book you mentioned I have not read - but does sound very interesting and I will ask my book store if they can get me a copy. I hope to sit out in my yard this summer and get some rays and reading a book would be nice. Maybe my doc didn't recommend rehab because he probably thinks I would overdo it knowing I'm in a safe environment where I might be tempted to push things. I think he knows me well. :-)
He did schedule me for an echo on Monday !!! Which I'm rather nervous as I hope my 'valve' is functioning well. Some nights I don't hear it 'clicking' and that's not normal for my valve. Usually its very loud and 'crisp' sounding. But all is quiet lately. He had mentioned doing an echo this August - as that would be two years out from my mitral valve replacement - but I guess someone called and cancelled their appt and so they called me to come on in. In the past several mos - I can't drive for more than 10-15 minutes as I almost fall asleep at the wheel. But what I do is pull over at various exits and I get out and stretch and move around I'm able to drive further after. It takes me almost 2 hours (one way) to get to my appt. But at least I can do it on my own - without someone having to drive me. :-)
I'm glad to hear your doing okay on your meds. I have a home kit that I'm able to do my own INR testing on my coumadin.
I agree staying upbeat is the key to a happier and healthier life. :-) Thank you for your support and words of wisdom. I hope you and your family have a very Happy Easter :-)
Take Care and Best Wishes
Konopka
Dear DottyCece,
My cardio has told me the same thing - exercise 'every' day as it is extremely important. I couldn't when I worked as I didn't have the energy - but I'm finding that I can do more when I can rest inbetween periods of the day. I should try some cross training. I just bought a stationary bike and I'm able to do 15 minutes on it. So that's good. I have also learned to cook from scratch and use virtually no sodium and I enjoy doing it and I love the the food. Its amazing how much sodium is in the breads and even milk !!! So, I'm doing well on this and I have some great recipe books if your interested. But my lasix has been extremely helpful even with a low sodium diet.
Working took alot out of me. So now my energy is better served on everyday things and exercise. I think I'm getting more strength as time goes on without working. I think 'resting' when I need to rest has helped me to have more stamina. My meds are very expensive. In total they add up to over $800.00 a month !!! But they have helped me to stay out of the hospital and I'm able to 'breath' and so for that alone they are worth the expense.
Take Care and Thanks for your response
Hope you and all your loved ones have a Happy Easter
Konopka
He did schedule me for an echo on Monday !!! Which I'm rather nervous as I hope my 'valve' is functioning well. Some nights I don't hear it 'clicking' and that's not normal for my valve. Usually its very loud and 'crisp' sounding. But all is quiet lately. He had mentioned doing an echo this August - as that would be two years out from my mitral valve replacement - but I guess someone called and cancelled their appt and so they called me to come on in. In the past several mos - I can't drive for more than 10-15 minutes as I almost fall asleep at the wheel. But what I do is pull over at various exits and I get out and stretch and move around I'm able to drive further after. It takes me almost 2 hours (one way) to get to my appt. But at least I can do it on my own - without someone having to drive me. :-)
I'm glad to hear your doing okay on your meds. I have a home kit that I'm able to do my own INR testing on my coumadin.
I agree staying upbeat is the key to a happier and healthier life. :-) Thank you for your support and words of wisdom. I hope you and your family have a very Happy Easter :-)
Take Care and Best Wishes
Konopka
Dear DottyCece,
My cardio has told me the same thing - exercise 'every' day as it is extremely important. I couldn't when I worked as I didn't have the energy - but I'm finding that I can do more when I can rest inbetween periods of the day. I should try some cross training. I just bought a stationary bike and I'm able to do 15 minutes on it. So that's good. I have also learned to cook from scratch and use virtually no sodium and I enjoy doing it and I love the the food. Its amazing how much sodium is in the breads and even milk !!! So, I'm doing well on this and I have some great recipe books if your interested. But my lasix has been extremely helpful even with a low sodium diet.
Working took alot out of me. So now my energy is better served on everyday things and exercise. I think I'm getting more strength as time goes on without working. I think 'resting' when I need to rest has helped me to have more stamina. My meds are very expensive. In total they add up to over $800.00 a month !!! But they have helped me to stay out of the hospital and I'm able to 'breath' and so for that alone they are worth the expense.
Take Care and Thanks for your response
Hope you and all your loved ones have a Happy Easter
Konopka
My mom, age 82, had a St Jude's mechanical mitral valve put in 11 years ago. I used to be able to hear it tick when she was riding in the car with me, watching TV, etc. She had a heart attack which left her with 45% function of her heart along with a mild stroke two months ago. I just noticed a few days ago while riding in the car with her that I hadn't noticed her valve ticking and she said she hasn't noticed it while lying in bed at night or any other time also. Does this mean the valve is about to stop working or is wearing out? Do we need to contact her cardiologist? Thanks for your help.
http://health.groups.yahoo.com/group/Heartfailuresurvivors/
You are an important part of Heart Failure and Heart Disease's C ardiomyopathy Support Group, Whether you have heart problems or are looking to prevent them, it's a good idea to learn as much information as you can. If you or someone you love has been diagnosed with heart failure, it can be frightening. This is a serious condition that has no cure, but you can live a full and enjoyable life with the right treatment and active attention to your lifestyle. Here we will discuss life style, excerise, nutrition and give one another needed support.
You are an important part of Heart Failure and Heart Disease's C ardiomyopathy Support Group, Whether you have heart problems or are looking to prevent them, it's a good idea to learn as much information as you can. If you or someone you love has been diagnosed with heart failure, it can be frightening. This is a serious condition that has no cure, but you can live a full and enjoyable life with the right treatment and active attention to your lifestyle. Here we will discuss life style, excerise, nutrition and give one another needed support.
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