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Getting Back into Your Life After a Heart Attack

Article provided by American Family Physician Journal

How soon can I get back into my regular activities?
Most people can go back to work and the activities they enjoy within a few months of having a heart attack. Others may have to limit their activity if their heart muscle is too weak. The amount of activity you can do will be based on the condition of your heart. Your doctor will work with you to develop a recovery plan.
You will need to start slowly. For the first few days after your heart attack, you may need to rest and let your heart heal. As your heart heals, you will be ready to start moving around again. A few days after your heart attack, your doctor may want you to move around more. You may do stretching exercises and get up and walk. You will then slowly become more active, based on advice from your doctor.
After you have gotten through the early weeks after a heart attack, your doctor may talk to you about how to be active within your limits. Your doctor probably will want you to do an exercise test, also called a stress test. During this test, you will exercise (usually by walking on a treadmill) while your doctor monitors your heart. Based on the results, your doctor will develop an exercise plan for you.
Your doctor also may recommend that you get involved in a heart rehabilitation program. Rehabilitation programs are supervised by exercise specialists. Many hospitals sponsor programs to get people started with a safe level of exercise after a heart attack. After a while, you probably will be able to exercise on your own. But if you have any of the symptoms listed in the box below, call your doctor. You might be exercising or working too hard.
Why is exercise so important?
Exercise strengthens your heart muscle. It can help you feel more energetic, help you feel more in control of your health, and help you lose weight and keep it off. Exercise also may lower your blood pressure and reduce your cholesterol level.
What kind of exercise is good?
The best kinds of exercise are those that involve your whole body, such as walking, cycling, jogging, rowing, cross-country skiing, or swimming. Your doctor or rehabilitation therapists also may prescribe activities to increase your strength and flexibility.
Exercise alert!
Call your doctor right away if you have any of the following symptoms during exercise:
• Shortness of breath for more than about 10 minutes
• Chest pain or pain in your arms, neck, jaw, or stomach
• Dizzy spells
• Pale or splotchy skin  
• Very fast heartbeat or irregular heartbeat
• Cold sweats
• Nausea and vomiting
• Weakness, swelling, or pain in your legs

How often should I exercise?
This depends on your exercise plan. You probably will start slowly, and gradually increase how much exercise you do. Your doctor may want you to exercise three or four times a week for about 10 to 30 minutes at a time. Be sure to warm up and stretch before exercising.
What is a "MET"?
You may hear your doctor talk about METs when he or she discusses your activity level. METs stands for metabolic equivalents. Different activities are given different MET levels, depending on how much energy they take to do (see the list below). The higher the MET level, the more energy the activity takes. Your doctor may ask you not to do things that take more than 3 or 3.5 METs right after your heart attack.
MET Activities
Sitting in a chair 1.0 
Golfing 4.5
Sweeping the floor 1.5 
Gardening 4.5
Driving a car2.0 
Playing tennis 6.0
Ironing 3.5 
Mowing lawn by pushing 6.5
Showering 3.5 
Shoveling 7.0
Bowling 3.5 
Skiing 8.0
Sex 3.5 to 3.7   

What can I do to speed my recovery and stay healthy?
Your doctor probably will recommend that you make some changes in your diet, such as cutting back on fat and lowering your cholesterol level, and watching how much salt you eat. If you smoke, you will have to quit. Your doctor also may suggest that you learn better ways to deal with stress, such as relaxation training and deep breathing.


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