Tuesday, March 27, 2012

Heart Rehabilitation Programs are for Life


About a month after my heart attacks, it was suggested to me that I join the rehabilitation program at the Ottawa Heart Institute (http://www.ottawaheart.ca ). This free program consists of 16 one-hour sessions, 2 a week.

During these sessions, each participant warmed up by walking around the indoor track. 

I was surprised that only about 35% of people who are offered this opportunity at this facility actually do it. There are 15 people in each class. It was my impression that many of this group did not work out seriously. They would go out on the track for a short time and then intersperse the exercise with talking with their friends, getting a drink of water or going to the bathroom. On the other hand, there were some who arrived early to get warmed up, exercised diligently and cooled down afterward.   It wasn't hard to guess who might be candidates for repeat attacks. 

Before I joined the program, I could only walk about one block before I got chest pains and had to rest. This I could do only twice a week. 

At  my first rehab session, they wired me up and sent me onto the track. There was a nurse and a physio watching monitors of my progress. They said to come to them when the pains developed. In five minutes I was back. 

They saw nothing ontoward on the monitors and suggested I raise my arms over my head. "Do the pains feel different with your arms up ?". "Yes". "Then those pains aren’t cardio but likely musculoskeletal".  With that reassurance, I went back to the track and walked for an hour. First time I had been able to walk since the attacks. 

I now walk over an hour a day, every day.  My weekly target is more than 400 minutes a week.

Takeaway:
1.    Use everything offered to you to improve
2.    Continue to push to get answers to your unanswered questions
3.    Be adamant about your exercise. Your life depends on it
4.    Search for local programs to help you with your recovery
5.    Your life has changed. Work with it to have many more years

Action Steps:
1.    Find a program today
2.    Sign up
3.    Follow the program diligently

Monday, March 5, 2012

Why Heart Attacks Kill Women

It is now not unusual for a woman (of any age), with no family history of heart disease, to suffer a heart attack and not even know it.

We have been inundated, and rightly so, with messages of what the symptoms are of an impending heart attack.  These are often for the heart attacks that men suffer, but women’s symptoms, and their response to these symptoms, may be far different.

The clutching chest pain and discomfort that we see in the movies may not be the signs for either gender.  Many people, especially women, even when they ‘allow’ themselves to acknowledge the symptoms,  end up in the hospital without ever having felt that telltale symptom (chest pain).  Telltale symptoms are different for men and women.  Women who have heart attacks are more likely than men to present with "atypical" symptoms.  Women also have much busier lives, often involving other family members, than ever before and even busier than many men so they don’t take the time to listen to their body’s complaints.

They have higher rates of mortality in the hospital as well.  This can be a combination of reasons:
  1. they get to the hospital too late (on average, an hour later than men) because:
  • they don’t recognize that they are having a heart attack, because of their symptoms;
  • they don’t think they should take the time from their daily ‘duties’ to others;
  • they don’t want to inconvenient others and so, they try to ignore the symptoms;
  • they have other symptoms from their body, at various times in their lives, that tend to mask , or divert attention from, the real cause this time;
      2.  at the hospital:
  • they don’t present with the expected symptoms (this was also most pronounced in younger heart attack patients);
  • they often experience a delay in diagnosis because they have different symptoms than men and so, their heart attack isn't recognized as such.

Chest pains and/or discomfort are still the expected symptoms but 35% of all patients don’t have them (42% of women; 31% of men). Why hasn’t this new scientific evidence overridden the historical anecdotal evidence ?

Both genders must pay attention to other signs of a heart attack such as pain or discomfort in one or both arms, as well as the back, neck or jaw. Shortness of breath and nausea or vomiting are other possible symptoms.(2)

References:
1.    Journal of the American Medical Association (JAMA)
   http://jama.ama-assn.org/content/307/8/813.short
2.    American Heart Association
   http://www.goredforwomen.org/about_heart_disease_and_stroke.aspx
3.    Thomas Jefferson University Hospital
4.    Corrigan Women's Heart Health Program at the Massachusetts General Hospital Heart Center