“Graduation Day”

14 Dec

This week, I “graduated” from Cardiac Rehab – one day past two months after my surgery. Cardiac rehab was a really interesting, and well …  an eyeopening experience. I was pretty much the youngest and most fit person there, and when I started, they said that they would be shortening their normal 13 week program to something less – more like 6-8 weeks in consideration of that and the fact that I had not had a heart attack. Last week they told me “so … how about we graduate you next week. You’re clearly in good shape and handling the exercise well, you’re working out well, you’re losing weight and you’re well motivated.” Have to say, yup, that sounds great.

The Cardiac Rehab program in the North Shore health system here in the Chicago area marries up programs at Highland Park Hospital, Evanston Hospital and Northwestern Hospital downtown. Clearly, the program is designed more for folks who have lived completely sedentary lifestyles, have rarely if ever exercised, eat badly, are elderly, etc. As both the youngest and most fit person in the room during all this, I had more than a few folks ask me “So … why are you here?” And I had to tell them pretty simply – because I have heart disease and the repaired a problem with a stent back in October.

That said,  being the youngest, most fit person in that crowd is like being the best behaved kid in after-school detention. You may be at the top of the heap, but you’re still there, aren’t you? I didn’t lose sight of that every day – every morning that I went to this was a slap in the face that I have coronary artery disease and that I cannot live life “as usual” any more. And I think that’s good. Honestly, the people that were there were also a reminder to me, and while this sounds terribly harsh, the thought through my head across the board was “if you don’t change, this is going to be you.”

The goal of Cardiac Rehab is simple – put you on the path to better heart health. That obviously means different things to different people.  But overall, it’s a combination of exercise and education.  The exercise has two goals – get you moving, and see how you respond.  The education is on healthy habits.  Since I “aced” their intake exam on healthy habits, they said I didn’t need to attend the once-weekly education session.  The program is pretty simple – three days a week, we did a monitored workout, wearing a wireless, 3-lead EKG unit in a pouch on our chests, while two nurses guided and monitored us. For those starting out, they are REALLY careful. The first week was pretty humorous. The Friday before, I went there to find the place, check in and get registered, talk to them about the program, etc. Then on day 1, I dutifully showed up, togged up in my exercise gear, water bottle along. First thing I noticed: Most of the people are in their street clothes. Most are well above 60 years old. There’s only one guy there that looks to be in his 50s and in decent shape. There are several that are in profoundly delicate shape – one guy is 350 lbs or more, and can barely walk without getting winded. Ooh boy.  This is not fitness bootcamp.

They directed me to a treadmill with the admonition “start slow” … and followed me there and set up the treadmill for me. 1% grade, 2 mph. It was so slow, I was tripping over my own feet. Before she could leave, I said “you’re joking, right? My WARM UP pace is 3.5 mph.” … and she said “until we know how your heart responds, you follow our lead.” Ookay, boss, OK. Well after 4 minutes of plodding along so slowly I had to work at going slow, she came back and said “well, your heart rate moved only 5 beats above your resting rate, guess we can crank it up a little.” And a “little” it was – still not above 3.0 – five more minutes of that and she said “Ok, put it up where you want it … so to 4.0 mph and 3% grade it went.” Finally, I’m trucking along enough where I’m going to break a sweat! They let me go 30 minutes at that pace, and then moved me to a bike – when I started to pedal at my normal 80-90 RPM pace, they kept telling me “slow down!” – and I’d answer back, “why, do you see anything wrong?” and they’d say “no, but …” and I’d not slow down.

Finally after three days of these struggles – them trying to keep me slowed down, me trying to push, at the end of the first Friday’s workout, Robin, the lead nurse (and not my wife), said “Ok, we talked to your cardiologist and he gave us an authorization to take the chains off you. However, on Monday, we’re going to test you and push you to see how you respond. You up for that?” Yes! PLEASE!

So, the following Monday, they put me on the elliptical machine and proceeded to roundly kick my ass as hard as they could. Their goal? Push my heart to 160 beats per minute and see how it responded, and then watch how fast I could recover. First of all, I was amazed at how high we had to go in terms of resistance and incline on that machine to get me to that point – between the BP meds and the fact that I was already in a bit of physical shape, I really had to push hard. I was sweating from places I didn’t know would sweat! After 30 minutes of this, wow – I had had a workout! They put me on a bike then and let me cool down with an easy ride, and this time, I took their advice and slowed down. But, the EKG and recovery rate and all looked OK. Still some abnormalities in my EKG which they said they’d send to my cardiologist, but overall, I was green light to “self-manage” my workouts.

The rest of the seven weeks of rehab were basically me going for monitored workouts. In week three, they let me start my “couch to 5k” running program – and that felt like such an achievement. I did the first run with them monitoring me, and it felt great. If you’re not familiar with “Couch to 5K”, it’s basically a program designed to take some who is sedentary and in poor condition and turn them into a 5K runner in about 8-10 weeks. It is a programmed series of walk/run interval steps that you follow, three runs a week, until you’re able to run for 30 minutes straight. This idea has been around for quite a while, but with the advent of smartphones and apps, it has taken off.

That said, it was my desire to do “C25K” that flushed my heart problem into the open. Back in June, around my birthday, I downloaded “5K Runner” onto my iPhone and gave it a try. I could not run more than 45 seconds without chest pain coming on, and after the third interval, I decided I shouldn’t do it. Again, then, I thought I was chasing a back problem, but it was that feeling during running, and when I tried to bike this summer, that got me into the Cardiologist to have a stress test. So, thank you, C25K! You probably saved my life.

At rehab, they released me to do my C25K and that first run was so triumphant feeling that I was fist pumping! No chest pain at all, I felt great, energized after doing it. I was back!  Now that said, it was interesting when I started running – the dynamic in the room changed.  At any time, there were about 10-12 people at each day, and that first day that they had me up and running, the other folks in the class were amazed.  Again, this is a group of folks where the average age was probably about 64, and most of them were very sedentary people.  After the third day of running, one gent got to talking to me in the locker room and said “I’ve never exercised before – or at least not since I was a kid.”  He was amazed that I had taken on an diet and exercise program on my own and well, was impressed.  Again, best behaved kid in detention – that’s me.

My fitness level in just 8 weeks has really soared. In addition to the 3X weekly workouts at rehab, I’ve been getting at least two additional workouts in a week, sometimes three or even four.  My goal each week is to exercise at least five of the 7 days and I’m definitely doing it.  I feel so much stronger, lighter, better, it is simply amazing.  I can dash up the stairs without getting winded.  I’m finding I’m having to push my exercise level up to break a sweat now, etc. etc.  All exactly where I wanted to be.

So, where am I after all this? Well on my C25K program, I’m still only at week three – mostly because I’m repeating each day’s program at least three times – both out of an abundance of caution and out of a desire to just progress very slowly and take it at my own pace. My first major fitness goal is to participate in the Bank of America Shamrock Shuffle here in Chicago on April 7th – going running with 25,000 of my closest friends! I have a few friends that are going to do it with me, and it should be both fun and a huge feeling of victory. Then, at the end of April, is a 5K in Champaign that I’m going to do with Joel, my oldest son. That should be fun – it finishes at the 50 yard line of Memorial Stadium, where the Illini play.

In terms of weight, I’m down about 15 lbs. since the summer.  Honestly, my goal isn’t weight loss – it is health.  The weightloss will follow along with the fitness.  I am looking at the scale every few days, but it is not ruling me.  My eating habits are dictated more by “what’s healthy to eat” versus “what’s on my diet.”  I still snack too much although I’m getting better with my food choices.  I could cut down more on drinks, but I sure do like my wine with dinner, and that’s good for my sanity.  So again, the focus is on health and fitness. The weight will find its own level.

What’s next?  Well in addition to the 5K runs planned for spring (and more to come in the summer, I think – and I want to be able to do a 10K by end of summer), I intend to buy a road bike sometime this winter and start riding in the spring. I love bicycling – always have – and there is a huge community of cyclists in Buffalo Grove to go ride with and huge networks of roads, trails, etc. to go ride on. Maybe I’ll go on RAGBRAI again in the next year or two … who knows?

All I know is this – this IS my new life. I work out 5-6 days a week. I eat healthy stuff now – my “snack drawer” in my desk is stocked with kale chips, sun-dried tomatoes, almonds, etc. Instead of getting a breakfast sandwich if I don’t eat at home, it is a Clif Bar on the train. Me, Mr. Bacon, Mr. Meat and Potatoes, a guy that never met a burger or steak he didn’t like, is experimenting with Vegan dishes and cooking. It’s all amazing to me.

Of course, my mortality is never too far out of my mind. As I said in another post, I spend a lot of time visualizing the insides of my coronary arteries. I sincerely hope I’m starting to turn back the tide – the reality is that I have heart disease – have – in the present tense. Having a stent placed doesn’t remove the disease, it just unclogs the pipe. It’s like anything – treat the symptom and you feel better. Treat the disease and you get better. The cardiologist’s job was to treat the symptom, and with the meds, the diet, and most importantly, the exercise, it’s up to me to treat my disease. And get better.  And I do feel like I’ve made a great start.

Onwards and upwards. Bottom line: I feel great, and I’m making progress. It’s incremental, and at times feels like a snail’s pace, but I’m in this for the long haul. We will keep bailing the ocean, one teacup at a time. And I hope to be doing this for decades to come.

As you were,

Stew

Finally, a PS to anyone facing this – GO TO THE REHAB PROGRAM. It is good for you. It can change your life for the very positive.

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One Response to ““Graduation Day””

  1. rehabilitateyourheart December 14, 2012 at 6:01 pm #

    Great description of the overly cautious cardiac rehabilitation. Some programs wouldn’t give you that kind of freedom ever. You had a good program.

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