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After the first few weeks at home

Over the last 6–8 weeks you should have been gradually increasing your activity.

For most people now is the time to begin regular exercise. The cardiac rehabilitation programme aims to help you with this and other aspects of your recovery and you are encouraged to attend. If you have not been given a date to start, please contact your cardiac rehabilitation nurse.

What sort of exercise is best?

Your exercise should be Aerobic. Good examples of aerobic exercise include walking,cycling, swimming and dancing.

What is enough exercise?

Research shows that you need a minimum of 20 minutes of moderate aerobicexercise, five times a week to obtain the best benefits. We recommend daily exercise whenever possible. The 20 minutes does not include the warm up and cool down.Pace yourself and gradually work up to the 20 minutes. It may take some weeks before you reach this level.

Warming up and cooling down

Warm up

This should last at least 20 minutes and should consist of gentle exercises or slow walking, gradually increasing in intensity. The warm up will prepare you for exercise by:

  • Gradually increasing your pulse and breathing rates
  • Enabling you to do more exercise before you feel tired
  • Reducing your risk of having angina. If you are prone to angina, you should find with a proper warm up that you are able to do a lot more before the angina starts

Cool down

This should last 10- 15 minutes and consist of gentle exercises or slow walking gradually decreasing in intensity. The cool down will:

  • Allow your pulse and breathing rates to gradually slow down and return to normal
  • Reduce the chances of you feeling stiff or aching after you exercise

If you have been exercising and stop suddenly without cooling down you may feel dizzy and faint.

Thoughts and Feelings

The way we think is important in determining how we feel. Feeling anxious or miserable is often accompanied by negative thoughts. Challenging these thoughts is an important first step in managing negative feelings.

Feeling fed up

Feeling fed up or sad is common after a cardiac event. These feelings usually go as time passes. They can range from the occasional feeling of sadness or tearfulness to absolute despair. All these symptoms are common: -

  • Loss of interest in things that were once enjoyable
  • Tearfulness
  • Poor appetite
  • Sadness
  • Early waking
  • Loss of interest in appearance

Sleep problems

These symptoms are unpleasant, not dangerous. However, if they interfere with, or take over your life, they are called depression. Depression affects the way you think and you can only see the bad side of things; previously enjoyable things can seem flat and dull. It is all too easy to imagine the worst when you are depressed. For example: -

“I’ll probably have another cardiac event.”

“I’ll never work again.”

“This will last forever.”

The chances are that none of these things will happen. If you are feeling depressed, the slightest setback or difficulty may lead to thoughts of complete disaster.

What can I do about these feelings?

Try and get them in perspective: sudden feelings of sadness happen to most people, they almost always fade over time. If they only happen occasionally, and most of the time you feel OK, it is best to accept them as part of getting better. It is a stage that most people have to go through. Remember that although feeling low or sad is unpleasant, there is a lot that you can do to help yourself, so don’t suffer in silence.

Try to stay active as exercise is a great mood lifter and make sure that you talk to people to let them know how you are feeling. If you (or your family) are concerned about your mood discuss this with your GP or Cardiac Rehabilitation Team.

Feeling Anxious

The next time you feel anxious or upset, note what youare thinking. Write down the thoughts.

  • Look at your thoughts and try to identify whether any action can be taken to sort them out. For example, worrying about whether your car is going to break down could be reduced by getting the car serviced and joining a breakdown service.
  • Next, try to substitute more reasonable objective thoughts, e.g. tell yourself you are unlikely to break down as you have just had your car serviced, and if you did, the breakdown service would get you to your destination, and provide you with a hire car until the problem is solved.
  • It may help to imagine what someone else might say or think, someone reassuring.

The aim of this exercise is not to stop having negative thoughts, but to be less worried by them and to find ways of reducing their power by challenging them with alternative ways of viewing the situation.

Think positively: don’t let negative thoughts stop you appreciating the positive things in your life.

Partners / Family Members

It is common for you to feel fed up, anxious and overwhelmed at times. It is also understandable for you to feel anxious or apprehensive about letting your partner resume activities. This can cause tension between you and increase the level of stress on you both. All of the strategies listed here can be useful to you too.