Posts Tagged ‘Walk’

The Long Walk

June 16, 2010

“Improvise, adapt, and overcome.” – Heartbreak Ridge (1986)

Heart parents are understandably worried about their Cardiac Kid’s activity level. It’s a balancing act – we know that exercise and activity can help strengthen a weak heart, but how much is too much? And couldn’t something bad happen if he pushed him/herself too hard?

A 1997 research report concluded that parents worry about their children who have a Congenital Heart Defect (CHD). The study identified seven specific concerns but was unable to determine if these were specific to parents of CHD kids. The study was very limited – only eight parents participated – and drew no conclusions.

Sort of leaves you wondering. One of the major questions on my parents mind was my activity level, and what I could do physically. I think they were finally convinced by a Pediatrician who told them that he really had no idea what my limits were. “But I do know that when he gets tired, he’ll stop and rest,” he said. “I’ve seen thousands of children do that.” And…. he was right. No matter how much fun I was having, when I got tired, I’d quit and rest, and rejoin the game later. It all happened naturally, no one had to teach me how to do that.

One problem CHD kids can have is a lack of self-efficacy (in other words, we sometimes don’t believe we can accomplish a goal.) And honestly, sometimes we can’t – not in the normal, accepted way. This is where we have to convince ourselves that “there’s more than one way to skin a cat!” As a fellow Heart Warrior said in an interview published on this blog:

“…its about having the self-confidence to find another way when you reach a roadblock.”

And we all get a case of  “I don’t want to!” at one time or another. I know that walking is good for me, but I also know that walking in cold weather is going to cause my joints to hurt. I’ve got on thermals, coats, gloves, a scarf, and a heavy sweater; I’ve tried hand warmers and foot warmers (both thermal and electric) but it still happens – probably because of my cyanosis and/or my bloodthinners. My hands are going to ache; the joints of my fingers are going to hurt so much that they feel like dead weights until I get back inside and warm them. So in the winter months you can’t pry me out of the house and I wonder how the CHDers I know who live in cold areas survive.

This report outlines some exercise and physical activity guidelines for CHDers.  Even though those of us with a univentricular heart (a cool phrase for someone with one working ventricle, like my Tricuspid Atresia) have a reduced exercise tolerance, physical activity can help us, too. We just need to make sure that we don’t overdo it. And recent studies show that physical activity usually doesn’t trigger an ICD shock.

So the bottom line, Mom and Dad, is don’t become Helicopter parents and “hover” all the time. And for us CHDers, it’s probably OK to get out and exercise or play. Naturally, check with your doctor first.

And for me, to get up the enthusiasm to get out in the cold!

Work It!

June 4, 2009

There really shouldn’t be any doubt about it – if you have a chronic illness such as a heart defect, you have got to take care of yourself. Obtaining health insurance is difficult if not impossible – yet we are the ones who need it, as we’ll need doctor’s appointments and prescription medication more often than most people. Public assistance (Medicare or Medicaid here in the United States) is available, but both programs make you jump through bureaucratic hoops and limit the amount of pay you can earn. Most CHDers I know have bum hearts but sharp brains, and we’d rather not go that route.

One of the best things you can do for yourself is exercise: you’ll feel better, and hopefully you’ll be able to hold the doctor at bay for a little longer. You usually can’t weight – lift yourself off of your medicines, but improve your health and the doctor might not need to see you nearly as often. After I went into heart failure and then had a stroke, my cardiologist wanted to see me once a month for eight months – That’s the cost of gas to from my home to Atlanta and back (about 500 miles one way), meals, and a hotel room every 30 days. It adds up.

So do what you can to take care of yourself. First of all, discuss your exercise options with your doctor. If you propose to start walking, he’ll probably be cool with that. If you want to climb Mount Everest… I doubt he’ll agree!

As you may know, I walk. I would have loved to have walked the Bolder Boulder, but my cardiologist had said “No.” because of the altitude, and I followed his advice.  A good brisk walk that gets your heart rate up is a great thing. It gives you time to sort through your problems and make important decisions. It also gives you a natural high, a sense of feeling good and actually doing something to help yourself. And recent research has shown that feeling lasts a lot longer than you might think – even though you don’t “feel” it, your body is supercharged! Obesity and Diabetes make a case of heart failure worse, so it stands to reason that if you are susceptible to heart failure, avoid the other two. Exercise can reduce your risk of both conditions.

So go for a walk. Play in the neighborhood. Put some music on the stereo and dance around the house – I promise I won’t laugh, I can’t dance either! Just do something. Just get up and start taking care of yourself!

Do yourself a favor and move those muscles;

Defeatin’ evil!

May 23, 2009

I was worried that I would not be able to function properly while in Boulder because of the higher altitude, but I am doing a lot better than I expected. I went out and saw some of the city – I didn’t pack my pedometer so I can’t tell you how far I walked, but I wouldn’t be surprised if it was two miles or more. My pulse ox is about 77% ( down from the 80% I usually have at home.)

At home, I set my watch for a certain amount of time and walk a fast pace until the time runs out, or I get too tired to continue. Here, it was city walking: Stop and start, walk into the store, wait for the light to change, etc. I have no idea how I would do on one of my timed walks and really have no desire to find out! I’m just very happy that things are going so well.

It’s also a balancing act – I’ve been told by the Denver ACHA chapter and my cardiologist to stay hydrated… BUT my cardiologist has also said to be careful because of my Congestive Heart Failure restrictions (2000 milliliters of liquid per day). Because I am feeling good, I am assuming that I am doing it right. (Famous last words….)

There are certain things that someone with a heart defect should NOT do; we should avoid caffeine overload. Here’s an article about a young man who ran into problems after consuming energy drinks. Thankfully he survived. And since he didn’t know he had a heart defect, you can’t really “blame” him for ignoring his doctor’s advice.

Walking, having supplemental oxygen, drinking enough without drinking too much (and drinking things that won’t freak my heart out) may seem like a sacrifice, but I’ll do it. Because while I have a heart defect, it does not own me.

I do what I do to defeat the evil that lives within me.

The Bolder Boulder is getting closer!

The Funky Heart

(My fancy signature is on my home computer)

Heart Failure, Salt, and Exercise

May 8, 2009

The two rules of the Congestive Heart Failure (CHF) diet are 1) keep your liquid intake below 2000 milliliters of liquid per day; and 2) reduce your daily salt intake to below 2000 milligrams of sodium per day. Keeping your salt intake down is crucial: less sodium means less liquid trapped in your body, which makes it easier for your weak heart to do its job.

Lowering your salt intake is also the hardest goal to accomplish. Putting down the salt shaker usually isn’t enough – processed foods are notorious for having high salt content.  Sandwich meats are among the worst, and those “heart healthy” soups are low in fat… but the sodium is so high, you can see it from below!

A new study shows that even people who were trying to keep their salt intake below 2000 mg overshot the mark. Ouch! And this just isn’t a suggestion – for a Heart Failure patient it is a critical lifestyle change. So if you are on the CHF diet, keep a close eye on your sodium intake. It may be higher than you think!

There is also a report out on something you can do to actively combat Heart Failure: exercise! Obviously, we are all different, so you should discuss an exercise program with your doctor  before you start. What works for me may not be good for you, so check first. But CHF patients who are able to add moderate exercise to their diet and medication have a higher quality of life.

So what is considered “moderate exercise”? Walking! 100 steps per minute for 30 minutes daily, (3000 steps in 30 minutes, if you are using a pedometer) five days a week is a good exercise program. That’s a pretty fast pace, so start slow and work up to it. After all, Rome wasn’t built in a day, and you don’t have to turn yourself into a treadmill trackstar overnight.

While you are walking, why not use the new FiTrainer? FiTrainer is a pair of  headphones that also includes an ear clip with a built in heart rate monitor. It is pre-programmed with several workouts (with music!) or you can plug in your own MP3 player. An electronic voice reports your heart rate through the earphones, so you never have to check a display!

Back to the beginning

April 8, 2009

“I get knocked down, but I get up again. You’re never going to keep me down!” — Tubthumping, Chumbawamba (1997) (My British readers are going to chuckle at my musical selection, and I do know that a Tubthumper is slang for a politician. But the song is very upbeat, and I love that verse! It says to me that no matter what, you keep fighting back!)

Some good news, my hernia is better. It is not fixed, of course, but things are better. It’s co-operating, or I am learning to live with it. Or perhaps a little of both.

But this thing has had me in its grip for months… December was the last time I walked with any regularity. My weight is creeping up and my stamina is gone. As I mentioned, a friend’s father is in the hospital recovering from a car accident; I went to see him last Friday. There is construction at the hospital, so you have to enter the Children’s Hospital and walk over to the main building. And by the time I got to his room, I was worn out.

I’m pretty much a wreck right now. The Funky Heart is planning to travel in late May, and if the trip was this week, I couldn’t do it. And this adventure is pretty important to me; I plan to see a couple of friends, meet some new ones, see a part of the country I’ve never visited before and (most importantly) help spread the word about Heart Defect Survivors. So as we say in the South, I’m chompin’ the bit to go!

When you are out of shape, you have to exercise. Everyone knows that. But when you have a bum heart, it is much more important. I want to get those few extra pounds off, because it causes my heart to work harder, and wears it down faster. And you want your body to be as healthy as possible, just in case you have to fight off a major illness. You have to have the physical reserves to do that, and CHDer’s are starting from a disadvantage.

So send your Cardiac Kid out to play. A lot of us spent our childhood curled up on the couch with a good book – great for school, but we’re awkward and clumsy as a result. So get outside. Toss a ball, play HORSE. It’ll also help develop social skills when they  hang out with the neighborhood children.

As for me, I’ve gone all the way back to the beginning with my walking program. After I recovered from my stroke in 2002, my Cardiologist told me to start walking. Fifteen minutes a day, just around my driveway. That’s all. But I was so out of shape that I couldn’t do it.

And I couldn’t do it yesterday. Nor could I do it today, but I got a few more steps in before I was too tired to continue. But  I’ll keep going. Every day, just a little bit further… and further… and come May, I’ll be ready.

Four Million!

October 18, 2008

I walked my Four Millionth step today!

I feel a little bit guilty bragging about it… the weather was cold, it had been raining, and I didn’t really want to be outside. So instead of walking the long path we have through the woods, I circled the driveway for about twenty minutes, decided it was a bit too chilly for me, and came in. When I entered how much I had walked into my spreadsheet, the all time total read 4,000,002.

A milestone! But because I feel like I basically “gave up” for the day, I’ll just nod and smile. Don’t open the Champagne just yet, save it for a truly Important Event.

I really don’t add up the miles. I set my watch for a certain length of time and walk as fast as I can, using my Pedometer to keep track of how many steps I’ve covered. If I walk the same amount of time several days in a row, the number of steps should go up as my body gets used to the amount of exercise. If it doesn’t (and you have to allow for slight variations from day to day) there may be a problem. Defective hearts usually develop problems over time – sometimes so slowly that it isn’t noticeable. Monitoring your level of exercise could tip you off to any deterioration in your health before it becomes too big to handle.

Occasionally, you should reset your Pedometer. Mechanical Pedometers figured a pre-set distance every time you took a step. It was usually set to advance the distance of an “average” person’s stride, but the newer electronic Pedometers can take into account the length of your stride, not the average. Before you use it, the manufacturer recommends that you stand with your bare feet in a pan of water, step out, and then walk ten steps at your normal pace and stride. Now quickly – before your footprints evaporate – measure the distance covered by your footprints and divide by ten. The answer is your stride measurement. Enter this information into the Pedometer, and you are ready to go!

Cardiovascular exercise keeps your heart strong and functioning. If your heart ever has a crisis, it may need whatever reserves it can find to keep the system going. Living with a Congenital Heart Defect means that I don’t have much reserve. So I need to do what I can to build them up – and walking does that for you. My doc in Atlanta was quite pleased; he once told me that I had probably added 10 to 15 years to my life just by walking.

You don’t have to run a mile the first day you start – doing that would almost certainly lead to an injury; and I’ve never ran a step – but grab your sneakers and enjoy a nice brisk walk!

They ARE out to get you!

September 29, 2008

“Paranoia strikes deep,” read the lyrics to the song For What its Worth. “Into your heart it will creep…” And goodness knows, I am a worrier. I probably worry too much, but when those eleven guys stand in a small circle on the football field, I just know they are talking about me!

You have to have one ear tuned to your body, ready to detect any subtle change. When I walked this morning, I had a rough time: I was puffing and wheezing 10 minutes into a planned 40 minute walk, bad enough that I had to call it off. I’m pretty certain that it’s nothing – I usually have a Kool-Aid type drink in the refrigerator that i drink along with breakfast, but I was out and forgot to make a fresh batch last night. So I had a muffin and a grape soda. Carbonation + stomach + exercise = Steve is not a happy camper! It’s happened before. But with a heart defect, you never assume anything. So I’ve been sensitive to weird beats and unusual pains all day. So far, nothing, so it is looking more and more like the soda.

I hurt my right index finger in Baltimore; it’s swollen a little and bruised. That was the stupidest thing — you know the little curved piece of metal on a hotel door that is part of the privacy loop? I put my hand there when I was pushing the door open and it tried to “bite” my finger off! I thought for a bit that it was broken, but it’s not. (I learned this trick when I kept statistics for the football team in college: To determine of a finger, wrist, toe or ankle is broken, fill a container with the coldest water available. Add ice if possible, and give it a few moments to chill. Then plunge the hand or foot into the water.  If you have the “That’s cold!” reaction, it’s fine. But if that body part hurts – and I mean really, really hurts – then it is most likely broken.)

There are always little aches and pains, but folks who have had surgery seem to have more of them. It’s not normal to have your body sliced into! So we have to learn what’s “normal” (normal for us, that is) and what is a cause for alarm. I had just graduated high school and was hanging out with a few friends at a Captain D’s restaurant, and right in the middle of the meal my heart started racing. That’s not normal, not by a long shot, so I let my friend know I was having a problem and he got me home. (I have a hand signal that only a few trusted friends know; if I ever flash that sign it quietly tells them “I need help.”) To make a long story short, it turned out that I was drinking too many sodas and I needed to cut back on the caffeine. But for all I knew, it could have turned into a Fibrillation, and that’s trouble. (“Gotcha!” The reader says. “You said that you had to cut back on the caffeine, but earlier you said you drank a grape soda at breakfast! Bad boy!” True, but Grapette Soda has no caffeine!)

As always, it’s a balancing act. Live life and do your thing… BUT stayed tuned to your body. If it is sending you a warning signal, pay attention!

Song of the Open Road

August 8, 2008

Afoot and light-hearted I take to the open road,
Healthy, free, the world before me,
The long brown path before me leading wherever I choose. — Walt Whitman

Grab your shoes, we’re going for a walk. This is not going to be a casual stroll, we’re walking for our health.

I never was much for running, and tend to avoid it if at all possible. When I run, it is not very long at all before my heart and lungs start protesting. It’s almost funny to imagine my heart sitting there in the middle of my chest, pumping away and thinking “Now just hold on! You know I don’t like… stop that right now!” Whenever I run, it isn’t long before I’m standing with my hands on my knees with my breathing sounding like a worn calliope. So running is not for me, but walking is.

Your Cardiologist will tell you that exercise is good for you, as long as you don’t overdo it. By definition, a defective heart has weaknesses. Given the fact that your heart will weaken even more as you age, it only stands to reason that strengthening it as much as possible would be a good idea. Some people swim, others run. I walk.

You have to start small and, for a while at least, think small. Don’t try to do everything on the first day. When my Cardiologist told me that walking would be good for me, he told me to start with a fifteen minute walk around my driveway. I lasted seven.

Walking can allow you to clear your mind and work out your problems, but since nothing is really bothering me, I grab my radio. I also get my watch and my pedometer. I measure my walking in steps, not miles (You’ll understand why in a moment) so I make sure the step counter is reads 0, set the timer on my watch to 40 minutes, and off we go.

The trick, of course, is to make your heart work harder than it is used to working. I walk pretty often, so my heart is fairly resilient. But I’ve figured out a good way to get a workout without overworking — and perhaps damaging — my body. I began by setting the timer on my watch to 15 minutes and walking until the time ran out. I did that for about a week, until walking 15 minutes didn’t bother me at all. Then I increased the time by 5 minutes. When you’re used to that, add five more minutes.

I had been up to 65 minutes, but then my hernia flared up, which curtailed my walking. (The hernia is better right now, thankfully) Life in general got in my way on a couple of days, so it has been about a week since I walked. Just to be safe I went back down to 40 minutes today. After i finished, I did a little math: Steps taken divided by minutes walked equals Steps Per Minute. The higher my steps per minute, the better I think I am doing. The Steps Per Minute is pretty high and I don’t feel too tired at all, so I’ll go up to 45 minutes tomorrow.

CHDer or heart-healthy, exercise is good for you. And it doesn’t have to be complicated. So talk to your doctor — I’m not a doctor, so I can’t (and won’t) give you advice — about an exercise program and get moving.

I’ll see you on the Open Road.

NOTE: Sorry for the late post, a thunderstorm knocked out my electricity for a while last night.