Recovery Stage 2 – outpatient rehab

Hospital based rehabilitation programmes in NZ

In New Zealand we are very fortunate to have a fantastic hospital based rehabilitation programme. These are publicly funded and available to anyone who has had a cardiac “episode”. For more information about cardiac rehabilitation as well as contact details have a look at the Heart Foundation’s webpage on rehab.

For me this part of my rehab started at about 4 weeks after my surgery. The programme is 6 weeks and is made up of a 1 hour exercise class followed immediately with a 1 hour information session on various aspects of heart health -nutrition, exercise, stress management, medication – were among the topics. Patients attending the classes ranged in age and degree of severity of illness. All classes were supervised by cardiac nurses, hospital physiotherapists and students from Massey University’s Exercise Science programme.

This programme really gave me the confidence to start exercising again. Up until that point it was a little scary going for my regular walks on my own, wondering what would happen if I keeled over in the street. I found being surrounded by a bunch of highly competent health professionals very reassuring and it meant I could push myself physically again.

The first session was quite slow and easy. I was still getting used to how far I could push my body, given my bones were still knitting back together again and there had been a lot of muscle damage to my chest wall from harvesting arteries, and of course the grafts. My lungs were still getting back to capacity to, so I was out of breath quite quickly. After a 2 or 3 weeks I was starting to feel stronger and exercising harder. It felt like I’d be back on my mountain bike in no time!

Over the 6 week programme I lost about 10kg (22lb) – a combination of the exercise, eating ridiculously healthily and not drinking any alcohol. I never thought I had that much to lose – but there it was (or wasn’t!). Having a record of my “vital stats” at the beginning of this programme was hugely motivating and kept me on track for sometime afterward. And now that I think about it, it has taught me a heap about the importance of benchmarking, setting goals and monitoring progress. It’s not rocket science, just discipline 🙂

If you’re reading this and have the option of attending one of these classes, I highly recommend doing and sticking at it for the full 6 weeks. You won’t only benefit from the exercise, the information sessions will give you a good understanding of how to better manage your heart disease. You may also hook up with others in your area that can help keep you motivated when if things get tough further sown the track.

Recovering: Stage 1 – the early days

In hospital

I can’t speak highly enough of the staff that looked after me in hospital – before, during and after my surgery. Friends and family who visited me before my operation often commented how well I was taking the whole ordeal . My response – “my choices are pretty limited and these guys know what they are doing”.

Now I’m not saying I never flipped out. There were tears and “I’m too young” and “it’s not fair, I’ve looked after myself”. However I was where was and at some point I accepted that I needed bypass surgery.

I have always felt very fortunate I didn’t have a heart attack. At worst my wife would have been without a husband and left to raise 3 children on her own, and my kids would grow up without their dad. At best I’d be taking a lot more drugs and having to manage the side effects of those. Thankfully things worked out differently for me.

Immediately after my surgery the best thing is to get moving (so they told me when I woke up from my surgery!). I was very surprised at how weak I was – barely able to stand up. This improved over the next few days but it took some determination to keep up with all the exercises at hourly intervals. Personally I found I was very focussed and resolved to recover as soon as I could. So I didn’t find it too hard to keep moving.

Dealing the the wounds and dressings was unpleasant but not painful. I hadn’t thought about that aspect of my surgery so when a nurse announced she was going to remove the chest drain tubes and the wires that had been stitched to my heart, I got a little anxious. Once again though, my choices were limited and I trusted the medical team implicitly. Yes there is some discomfort and it takes a while to get used to moving without hurting (coughing, sneezing and hiccoughing were the worst!), but it’s all absolutely bearable.

Mentally I felt great. I was alive, I had survived the surgery and my recovery (at this very early stage) was going well. I had great support from people who visited me hospital. I looked forward to company every day and probably didn’t get quite as much rest as I should have. A few truly great friends would stay on even while I was asleep so I had someone there when I woke up. I’m very grateful to those people.

On the not so great side, I have always had this little voice in some dark recess of my mind saying “but how do they know the surgery worked?” other than the usual vital stats – blood pressure and whatnot – they don’t do a before and after angiogram just to make sure they plumbed everything correctly and everything is working as it should. The fact that I was walking, talking and breathing didn’t carry much weight. After all I was walking, talking and breathing with 90% block! This continued to be a source of anxiety for me until much later in my recovery, when I had a second angiogram. This showed that only 3 of the 4 grafts were still working, but the 3 remaining grafts were working perfectly and my bloodflow was fine.

Back home

This early stage of recovery continued at home and it was increasingly difficult to stay upbeat. The gaps between visitors got longer and my wife having to continue on with the daily routine with the kids. Keeping up with the exercise regime was also difficult. It was the middle of winter which made getting out for walks challenging and mildly unpleasant.

I had periods where my levels of pain were quite high. They were usually associated with times when I had overdone things – too many visitors in a day, too much exercise and not enough rest. This is difficult to manage because people want to see you, more so than in hospital. Perhaps they think that because you are home, you’re on the mend. I remember seeing the look of deep concern on a friends face when he dropped in unannounced. I was having a bad day and had made it half way up our hall. I had to stop and lean against the wall I was so sore and out of breath. I don’t think he realised how big an operation a CABG is. At times like that the best thing I could do was rest. Shut myself in a dark bedroom and sleep for a few hours. Inevitably I’d wake up feeling much better.

Despite all this I remained focussed on recovering as quickly as possible. I had no trouble at all eating well, in fact you couldn’t have paid me to eat anything “bad”. I had no desire to eat anything that might have a negative impact on my health. I started researching the best cooking oils to use, which fruits and vegetables had the greatest benefits for people with heart disease, in short – I was obsessing! This didn’t last long and it has resulted in some long term changes to my diet

I guess, in hindsight, this is a time of extremes. Extreme highs and lows, overwhelming joy and absolute despair. The best you can do is enjoy the highs and be courageous through the lows (with a little help from your friends and family).

Feed me

My eating habits were never that terrible. Sure I ate pub food occasionally or sausage rolls at kid’s parties. But in recent years I was never into really terrible food. However, life has changed and what eat is more than just about taste. It has to be good food – good heart food.

Well, this was my thinking from day one after my surgery until about 6 months post op. I’d lost quite a bit of weight – around 10kgs (22lbs), mostly through diet. I just refused to put anything in my mouth that I thought was “bad” for my heart. Like I say this lasted about 6 months, more recently my resolve has begun to dissolve! I’m looking for motivation (as if I need to look very far for that!!!) to keep on with the healthy eating.

I’ll let you know how it goes.

Welcome to theheartcoach

Hi there. This is the first post for theheartcoach. This is an idea that has been bubbling away since my heart surgery nearly a year ago. I’ve finally decided to just start writing and see what happens! I hope you find some useful info here to help you on the road to recovery – or to just plain get your head around what has just happend to you and what it means from here on in.

I’m writing this based on my own experience with heart surgery and heart disease, which is quite recent. You can read more about about it here