Tag Archives: heart rate

I Graduated…

…from Cardiac Rehab!!!

After 36 sessions of Cardiac Rehab over the past 4 months, I finally graduated!  Here is my “graduation” photo, which they will hang up along with all of the other photos of graduates, on their bulletin board.

photo 1

For my last session,  I did my workouts as normal, but the nurses and exercise physiologists talked to me quite a bit about my Individual Treatment Plan (what I can do at home) and answered any questions I asked.  On the first day of Cardiac Rehab they took measurements, and they took measurements on the last day to compare.  I did not really lose any weight or body fat percentage, but I am extremely happy about the 3 inches lost from my waist!  I can tell a difference in my body even if the other measurements don’t show it.

They gave me a packet of information to take home that included my Individual Treatment Plan (listing the things I was doing – speed, duration, weights, etc – in Cardiac Rehab). Within this packet, they wrote down my maximum heart rate, so I know what not to go over when working out, as well as heart rate range I should be in while working out.  They suggested that I take my blood pressure before and after working out and keep a log in case my cardiologist needs it.  I also received a certificate and, most importantly, a Tshirt!

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I have the option of moving into Phase 3 with Cardiac Rehab if I ever want to, but I don’t think I will need to do this. This would consist of going into Cardiac Rehab to work out, but without the heart monitor and constant supervision of the nurses.  It’s kind of like going to a gym where someone checks your blood pressure for you before and after your work out, you wear a heart rate watch during the work out, and you work out on your own (based on your Individual Treatment Plan).  This is not covered by insurance and costs $4 per visit, but you have the comfort of nurses around you in case something happens.  Since I already have a gym membership, and my focus is jogging/walking, I will continue my Phase 3 at home and at the gym.  But I can definitely go back to Cardiac Rehab to continue Phase 3 if I change my mind at any time.

I’ve had such an amazing team assisting me throughout Cardiac Rehab.  It helped me gain confidence and decreased some of my anxiety about working out.  Now, I’m on my own, and it’s up to me to continue to workout 150 minutes per week.   Let’s do this!!

Nuclear Exercise Stress Test and Results

I was very nervous preparing for my first stress test and unsure of what to expect.  Luckily, my facility provided me with a one-sheet of information that eased my mind.

I could not consume any caffeine, decaffeinated beverages, or chocolate for 24 hours prior to my appointment, and I could not have any food or drink (unless water to take medication) 4 hours prior to my appointment.  They were very strict on this.  They also suggested that I wear comfortable clothing and sneakers (or shoes you’d go walking/jogging in) and to plan on being there for up to 4 hours.

A nuclear exercise stress test is used to see how blood flows through the heart during exercise and at rest by using radioactive tracers.  Images are then taken of the heart to show the coronary artery circulation and which parts of the heart are receiving blood (marked by the radioactive tracers).

When I got to the facility, I checked in, made my co-pay, and was immediately called in by the Technologist.  They first took me into a room where I had to sign some forms and was asked a few general questions about my meds.  I made sure that he knew I had a stent.    Then the Tech inserted an IV into my arm (inside elbow) and the radioactive tracer which needs some time to circulate before they can begin taking images.  I was then escorted to a small waiting room and told to relax and drink 3 cups of water from the water cooler.  I probably waited about 15-20 mins and made conversation with a nice man in his 80s who must have been there for a similar test.  He told me how he used to be in the military, worked as an engineer, retired from NASA, and his grand daughter was going to Auburn University (the conversation began because I was wearing an Auburn shirt).  It helped the time go by quickly because the TV channel was boring.

The Technologist came in to get me and took me into the imaging room where I had to lie down on a narrow table with my arms above my head.  To the left of my chest was a large scanner that rotated over my chest so the Tech could position it accurately.  Once it was in the right position, he told me to hold still and breathe normal and that the scanner would take about 15 mins to take its images.  The computer monitor was in my line of sight, but it didn’t really show me anything that I could comprehend.  My arms got a little tingly from being over my head for so long, but I stayed as still as I could so they could get good images.  When the machine was done, the scanner rested to the left of my chest, and the Tech escorted me to the room with the treadmill.

There, I met a nurse (or maybe she was also a technologist) who began hooking me up to a 12-lead EKG whose pack was strapped to my stomach and had a long cord connected to the computer.  I was able to lie down on the bed to connect everything.  She had to enter lots of info into the computer and verified info with me and was also pleasantly conversational.  The room had lots of windows, so I had a great view of downtown while I was in there.  Finally, the first Tech came back in along with a doctor, and they helped me with my cords (so I didn’t trip) onto the treadmill.  It didn’t look like a normal treadmill.  It was basically a belt and bars.  No buttons or displays, which I thought was odd, but helped me focus.  They determined that they needed to get my heart rate to 153 to get the images they needed.  I let the nurse know that I had not gotten over 137 in cardiac rehab.  They turned on the treadmill, and let me start walking.  The EKG monitor was right next to me, so I could easily see my heart rate and the timer.  I told them that in cardiac rehab I normally walk for 15 mins at 3.0 and 3%.  They began this treadmill walk at about 1.6/1.7 and 10% (the max).  They needed to quickly get my heart rate up to its max.  I could completely tell a difference between this treadmill and cardiac rehab.  Within 1 or 2 mins, I could already tell I was getting winded.  They kept me talking the entire time (not sure if that was on purpose or if we were all just chatty), but I started to get out of breath pretty fast.  I told them that this was EXACTLY what I had been explaining to my doctor about how I feel when trying to walk up stairs or briskly walking through a parking lot, but I had never experienced this in cardiac rehab.  When I started to get really winded, the doctor asked the nurse to administer the second radioactive tracer so they could get it in there before they needed to stop me.  I had to continue on for about 2 or 3 more mins (I think).  I was hot and very winded and my heart rate was only 147.  Finally, the doctor told them to stop the test as he didn’t want me to overwork or push my heart too much and he got what he needed for the images without going up to 153.

Wow!  What a workout!!  I sat back down on the bed and the nurse took the leads off of me.  She then brought me a juice box (all natural, no added sugar) and a pack of peanut butter crackers, and had me wait back in the small waiting room for about 15 mins.  It was so great to finally eat and drink something!

The Tech came back in to get me to take me back to the imaging room where I got back onto the narrow table and let the scanner take pictures of my heart.  This lasted for about 15 mins again.  Then the IV line was taken out, I got a bandaid, and was released to go home.

So, the stress test was not as bad as I thought it would be.  I was afraid I would be running for a long time and not able to keep up.  But now, I feel like I want to conquer a treadmill at 10% incline!  But I’m sure my doctor won’t approve of that anytime soon.

The doctor overseeing the test said he would read the results the next morning and call me (even though it would be a Saturday).  He never did.  I went by his office after cardiac rehab that Monday to get my results.  A nurse called him on the phone and let me speak to him.  He said he was surprised at my results and had mostly good news for me.  The scar tissue is at the apex of my heart and estimated to be about 20% (originally estimated at 50%). My ejection fraction was a couple percentage points better than my echo, but that doesn’t mean it had improved in 2 weeks, it’s just that this is a different test measuring that. They are not sure how much of the 20% is permanent damage.  It will take 6 months to a year to better determine that. But I am still cleared to continue working out and to start jogging.  I will probably continue to have shortness of breath for a while (or even the rest of my life), but it could get better as I continue to work out and my body finds ways to compensate for the damage to my heart. This encourages me to want to work so much harder.  It is really disappointing when you’re told that you may never be the same again and may be limited in activities and quality of life.

Cardiac Rehab.

I finally began Cardiac Rehab, which will help me determine my limitations.  The past few times I’ve gone walking in my neighborhood, I’ve had some pain in my chest and back when breathing.  Cardiac Rehab will allow my heart to get stronger and will hopefully increase my stamina.  I will start off with 18 sessions, and then they will reassess to see if I need an additional 18.  My insurance covers it, but my copay is $40 per session, which is way more than I can really afford, but it’s something I have to do.  I can do 2 or 3 1-hour sessions per week, so I’ve agreed to start out with 3, and then I’ll drop down to 2 per week for financial reasons.

My first session was over 2 hours long because the nurse wanted to go over my file with me, discuss my prescriptions, and review my cholesterol numbers.  Then, I got to try out some of the machines.  I wear a heart monitor and there are nurses and exercise physiologists in the room that monitor your heart rate and check your blood pressure.  I started out walking on the treadmill for 5 minutes at a pace of about 2.1.  I had no problems!  Then, I tried 5 minutes on an elliptical-type machine where you are sitting down.  Finally, I tried 5 minutes on a stationery bike.  Even though everything was done at a slow pace, I still worked up a sweat.  It really is a great feeling to know that if something happens, I’m surrounded by a team of medical professionals.

During my second session, they increased my time on the 3 machines to 7 minutes and increased the pace.  I had no pain and worked up more of a sweat.  My heart rate and blood pressure exactly what they should be for someone my age.  In fact, I even went back on the treadmill a 2nd time for 6 more minutes and felt fine.

My goals from Cardiac Rehab are to ensure my heart heals, build up my stamina, and eventually get to the point where I’m healthy to run again.  Years ago, I was a runner and would run 3-5 miles a day.  I competed in 5Ks, 10Ks, and even completed a half marathon.  I believe that running for so many years is the reason that my heart bounced back so quickly after the heart attack.  The doctors are still amazed that my heart went from 15% EF to 40-44% EF in a matter of a few days.  I attribute this to running for so many years.