Being released from the hospital after a heart attack or heart surgery is a big event. You will probably have a lot of questions about how much you can do and when you can do it. Every patient is different, so your doctor and your cardiac rehabilitation team will make specific decisions regarding your case.
It is most important to listen to your body. Take it easy and give it the rest it needs. Getting a full eight hours of rest every night is important. For a few months, you may also want to take an afternoon nap. Resting is important and completely normal — it gives your heart the breaks it needs while it's recovering.
Your doctor may recommend a formal cardiac rehabilitation program after a heart attack or heart surgery. People with other heart problems such as heart failure and angina also may be good candidates for a formal program.
The exercise program is tailored to each patient's needs. Exercise may be very structured, including ECG monitoring, or it may be less structured, without monitoring.
Whether or not you enter a structured program, your activity starts with some light activities such as walking slowly. After a heart attack or heart surgery, this begins in the hospital. As you continue to recover, you may resume additional light to moderate activities, such as walking to the mailbox. Your doctor will allow you to gradually add more activities as the days pass. You can probably do light household chores, such as dusting, after about four weeks. Heavy lifting and moving, sports and many household chores are strenuous activities. Avoid them until your doctor gives you the green light.
Exercise after a heart attack is an essential part of rehabilitation and your life after an attack. But you shouldn't start exercising without going over your plan with your doctor and a physical therapist. Just jumping back into an exercise routine after a heart attack can be difficult and dangerous. A physical therapist will devise an exercise plan that has you gradually increase the amount you work out.
Combining all aspects of cardiovascular rehabilitation improves your functioning, reduces symptoms and may create a sense of well-being and optimism about the future. Here's what your rehab program should include:
- Counseling and education to increase your understanding of the disease process and its management
- An exercise program
- Ways to alter heart risk factors such as high blood pressure, smoking, high blood cholesterol and physical inactivity
- Vocational guidance to enable you to return to work
- Information on physical limitations and sexual relations
- Emotional support.
How quickly your activity level increases will depend upon the seriousness of your heart condition.
Light chores and household duties might be encouraged within a couple weeks.
Bathing is generally a problem only if you've had heart surgery. You should keep your incision as dry as possible. Upon leaving the bath, pat the incision site dry carefully, especially during the first few weeks after the operation.
Even if you haven't had surgery, you may need help getting in and out of the tub and with washing during the first few weeks of your recovery. Avoid either very hot or very cold water. The heart responds to temperature changes by working harder. Remember that the goal in the first few weeks after a heart attack or heart surgery is to rest and rehabilitate your heart.
Ask your doctor when it is safe for you to drive. If you are on a long drive, be sure to stop every hour or so for a brief walk to prevent blood clots in the legs.
Resuming work depends on the type of job you have. It will likely take longer to return to a physically or mentally demanding job. However, some people find it less stressful to be working at their desk than staying at home. You and your doctor can decide what is best for you.
Sex is a major concern for people with heart disease and their partners. If you've had a heart attack, you may be worried about when, or even whether, you should resume your sex life. It is common to be afraid that sex will put too great a strain on the heart. Sexual intercourse exerts about as much strain on the heart as walking briskly up a couple flights of stairs.
There is no strict timetable regarding when you can return to usual lovemaking. Discuss any questions or concerns with your doctor. Take it slow and go at your own pace. Some other recommendations:
- Choose to have sex at a time when you are rested, relaxed and free from stress.
- In the beginning, wait about one to three hours after a meal so digestion is completed.
- If you are scheduled to take a heart medication, do so before sexual activity.
- Choose a spot where you will not be interrupted, preferably a familiar, quiet setting.
- Consider trying new, more comfortable positions.
- Go easy. Work slowly through foreplay so you and your partner can get reacquainted after a long time apart. You may even consider being intimate for the first few times without having an orgasm.
- Often a spouse is nervous about resuming sex. Discuss these fears together and with your doctor.
- Some medications used to treat high blood pressure and angina may interfere with sexual function. Continue to take your medication, but ask your doctor whether there are other alternatives.
- Do not take drugs for erectile dysfunction (such as Viagra, Cialis or Levitra) if you are also taking nitroglycerin.