I’d heard good things about cardiac rehab and was actually looking forward to it. In most cases people said it was the thing that got them back on track after a heart attack and they loved it. Reports suggested that for the most part people were hooked up to an ECG where they would be monitored whilst undergoing exercise. The rehab team would then prescribe individually tailored exercise programs for them to do. It allowed people to regain confidence in their abilities and gave them new aims and targets.
This sounded perfect for me. It would be like having a personal training coach again, but one with my heart health forefront in their concerns. I don’t consider myself the ‘normal’ cardiac patient so I was looking forward to getting some personalised testing carried out. I was also secretly hoping to impress on the exercise tests even with a damaged heart.
I was therefore a little disappointed with the first session which consisted of little more than some mobility exercises whilst stood next to a chair. There was no monitoring of our heart rates let alone an ECG. There was no individualisation and for me no effort was involved. They did ask us to rate our RPE on the BORG scale at the end of it. I hoped that rating it at the lowest level would mean that they would step things up a notch for me in the next session.
Unfortunately that wasn’t the case as the format and ‘exercise’ prescriptions were the same as week one. Once again it was a series of mobility exercises whilst stood next to a chair. There was no monitoring, no measurement and no personalisation. They did at one point tell me I could go a little harder if I felt OK. However, there’s only so much you can do whilst taking a few steps backwards and forwards or doing bicep curls without any weights!
I can see how such a class is useful for an 85 year old ‘little old lady’ who has never done any exercise in her life, but it’s not a lot of use to me. I don’t need to be taught how to warm up and cool down. I don’t need to be taught how to do exercises and I don’t need any encouragement or persuasion to exercise either. What I need is to push myself a little whilst hooked up to an ECG so that I can be given precise training targets. Now that I have a damaged heart I need to know how hard I can go before starting to cause any further damage. I need to set myself some limits and hopefully regain some confidence by knowing what is safe to do.
Standing next to a chair without any monitoring isn’t going to help. Especially when a trip to the toilet with it’s associated squatting and squeezing is more effort than the exercises we’re being asked to do!! It seems as though elsewhere people are monitored on an ECG and are running on treadmills, cycling on stationary bikes and lifting weights or pulling resistance bands. Cardiac rehab here is so far a very different story.
I did put in a little more effort where I could this week so as to make the most of it (I have paid upfront for all 10 sessions so I may as well). This does at least mean that I could see a heart rate response to the ‘cardio’ exercises. I wore my own heart rate monitor seeing as the rehab team don’t seem interested in it. The heart rate trace looks OK until you look at the scale and see that it barely got above 90bpm so it wasn’t exactly taxing.
I did tell them it wasn’t doing much for me and they said they’d ask what my heart rate targets should be. That’s a start I guess but as they aren’t measuring such things those figures will at best be based on an age related algorithm which certainly isn’t a personalised prescription based on my own individual physiology.
I am still pushing for some proper exercise testing and I am pursuing other avenues outside of the cardiac rehab provision.
Going it Alone
In the meantime, I’m going it alone to a certain extent by adding in some easy turbo trainer sessions and starting some walk/jog sessions. They are all easy and I’m keeping them that way until I have more of an idea of what is safe to do, but here’s the heart rate trace from a recent walk/jog.
Such data doesn’t substitute for a proper exercise ECG test but at least my heart is responding as it should for short efforts and more importantly is recovering properly afterwards too. Hopefully over the coming weeks those periods of higher intensity will become longer and the recoveries will become shorter.