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You may have had a heart attack, but that doesn't mean your life is over.

Heart attacks happen all too frequently. In Canada, 1992 figures reveal that ischemic heart disease accounted for 38 percent of all deaths, and heart attacks accounted for 53 percent of these deaths. In the United States, heart attacks caused 487,490 deaths in 1994.

However, we should also keep in mind that heart attack patients do survive, and can even thrive. Often, how well heart attack patients recover after an attack is dependent on two important factors: A cardiac rehabilitation program and personal responsibility toward health.

Benefits of Cardiac Rehabilitation

Exercise tolerance: Consistent benefits occur when patients exercise three times a week, 20 to 40 minutes a time, at 75 percent to 80 percent of a baseline test. The exercise program should continue for 12 weeks.

Improved symptoms: Cardiac rehab lessens angina pain and improves heart failure symptoms.

Improved fat levels: The counseling and diet changes found in rehab programs usually result in improved cholesterol levels.

Smoking cessation: Among heart patients who smoke, as many as 25 percent are able to quit after participating in cardiac rehab.

Improved sense of well-being: Working with others, counseling, and education make patients feel better about themselves

Reduction in mortality: Cardiac rehab reduces death rates by 25 percent.

Cardiac Rehabilitation

Heart attack survivors should consider themselves lucky if they have a doctor who steers them toward a cardiac rehabilitation program. Although it seems like common sense—after all, cardiac rehab can cut death rates by 25 percent— in the United States only one-third of heart patients participate in these programs. Elderly women are less likely to be referred to them than men.

Cardiac rehab programs get you on the way to lifestyle changes that will decrease the risk of another heart problem, or death. In a way, these programs are teaching you to do what you should have been doing all along—eating a healthy diet, exercising, and not smoking. They also offer counseling for the psychological effects a major surgery or near-death situation might have had. Because the heart is fragile after surgery, cardiac rehab programs usually take place in a hospital or rehab clinic and under the supervision of health practitioners. Programs are generally tailored to fit individual needs, so they differ in diet and exercise regimens among individuals. They last for eight to 12 weeks.

Personal Responsibility

Being responsible for your health is “follow through.” You have to take what you have learned and practiced in the rehab program and continue to do it without being prodded by a doctor or having a dictated schedule. For many, this means setting up your own schedule and seeing that you stick to it.

Personal responsibility also means remaining upbeat. How you feel about yourself and your future are important factors in life after surgery. There are countless reports on how attitude makes all the difference in the world on health. You must be optimistic, but at the same time realize that you have a chronic, and possibly fatal, problem. If you have trouble remaining upbeat, seek out others to help. This could be a spouse or other family member, a friend, a religious advisor, or a counselor.

Personal responsibility also means asking yourself some tough questions about your life and what you do, and perhaps making some tough decisions. For some, it may mean leaving a job, or cutting back on favorite activities.

Family should be involved. If someone else smokes, for example, it would be best for this person to quit, and if this is not possible, to not smoke around the patient. Look for activities that the family can do together; don’t cut somebody out of an event because she or he can no longer participate. Go along with any dietary changes by joining the patient in his or her diet as much as possible.

Things to Consider

First Things First

Immediately after a heart crisis, consult with a health practitioner for guidelines on physical activity. Generally, you should have complete rest and then increase physical activity gradually. This not only includes exercise, but activities such as housework, gardening, and socializing with others. Talk to a health practitioner about driving and travel. Eventually you should be able to do almost everything you had been doing. Sex is also an “activity”—it stimulates the heart—so if you have concerns with this be sure to consult a health practitioner.

Work

Most patients do return to work. How soon depends on the degree of damage to the heart, the rate of recovery, and the physical requirements of the job. If possible, resume work obligations slowly, beginning by working shorter days and with fewer responsibilities, and gradually taking on longer days and more responsibilities.

Stress

Stress places stress on the heart, so it should be avoided if possible. Don’t stress yourself out worrying about getting back to normal; take it as it comes. Practice stress-relieving activities, such as meditation, yoga, or breathing exercises. Talk to people if you feel “bottled up.” Consult a professional—counselor, doctor, nurse, or religious advisor—if you feel you cannot dispel your stress.

Nutrition helps

As always, diet is important. It is important to eat a low-fat, low- cholesterol diet. A quick look through a bookstore or library will turn up hundreds of “heart healthy” cookbooks.

Equally important, when making changes in diet, is to let a health practitioner know what you are doing. A number of health practitioners recommend specific supplements and foods to those recovering from heart disease or an operation.

Coenzyme Q10 (CoQ10) has long been known in alternative health circles and appears to be going mainstream: a December report on CoQ10 on the ABC World News Tonight supports this. This report noted that scientists had discovered that patients with weakened heart muscles had unusually low levels of CoQ10, and studies have found that when patients take CoQ10 supplements, the majority show significant improvement, including an improved “quality of life” and an improved rating on the New York Heart Association functional scale, which classifies patients with cardiac disease based on clinical severity and prognosis. Studies have also shown that CoQ10 allows patients to reduce the amount of medication they take.

CoQ10 appears to provide more oomph to the heart, allowing you to do more. The ABC World News Tonight quoted Dr. Peter Langsjoen, a cardiologist, as saying, “The most obvious thing a person would notice would be improved stamina. (http://www.abcnews.com/onair/wnt/html_fi les/transcripts/wnt1124.html)

Fish and fish supplements can help lower triglyceride--a type of fat--levels. More recent research is showing that although fish and fish oil supplements do not necessarily limit second heart attacks, they do lower the risk of arrhythmia in subsequent heart attacks, thus lowering the risk of second heart attacks being fatal.

Fiber has long been known to help prevent heart disease—the FDA even allows limited health claims on this. Fiber helps lower cholesterol rates, which are one of the major risk factors for heart disease.

Antioxidants have also been linked to lower incidences of heart disease, especially the antioxidant vitamin E. Antioxidants fight free radicals, which contribute to atherosclerosis.

Tocotrienols, which are just now becoming known to the consumer, function as antioxidants. They have been shown to help maintain healthy cholesterol levels. Green tea has been getting a lot of attention the past few years. Although many of the reports focus on green tea and cancer, there is also evidence that it helps with heart disease risk factors.

Green tea helps maintain healthy cholesterol levels and reduces blood platelet “clumping,” which can lead to blockages. It also may help maintain healthy blood pressure levels.

This bulletin for information only. It has not been evaluated by the Food and Drug Administration. The product is not intended to diagnose, treat, cure or prevent any disease.

The article "Living with It" is reproduced with the permission of AIM International
© 1998, 1999 by AIM International.


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