Is It Safe for a Heart Failure Patient to Lift Even a Finger to Exercise?

Does it seem illogical that I should exercise when I have a heart that doesn’t pump blood properly?  I think back to the period of months where I had two blackouts while exercising in a fitness room.  At that time, I stopped any exercise routine until we figured out what was wrong with me. 

Despite my precaution, I would get dizzy just walking to and from the subway or performing any normal walking activity at work.  People would say to me – If you want to get better why are you still exercising??!!??!  I would have to explain to them that it wasn’t exercise that was causing my issues anymore, but just normal activities that we all do.  
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Getting the pacemaker made me physically stronger because it was helping my heart.  I thought that I might be able to return to a workout routine with a device assisting my heart.  But I have to admit, some people had a visceral reaction to my commitment to get back to exercising after my pacemaker implantation.  It made me wonder if they were right and that I needed to curb my activity.

You can imagine how my questions about exercise increased when I was diagnosed with heart failure.  Did having a weakened heart mean that the doctors were going to tell me that I could no longer exercise?  Fortunately, in the time that I have been seeing heart doctors they have never ever told me that I needed to stop exercising.  In fact, they have encouraged me to be as active as possible. 

It helps that my doctors know that I am prudent and will come to them whenever I take on a new form of exercise to make sure that I am not taxing my heart.  I should also add that websites devoted to matters of the heart also confirm that exercise is good because it may improve the functioning of the heart, and just make you feel better overall. 

​Here is what the Heart Failure Society of America says about heart failure and exercise:  “One of most important ways that people with heart failure can maintain their sense of well-being is to keep active. In the past people with heart failure were advised to rest and give up many of their usual activities. But recent research has shown that activity including exercise, work, and sex is healthy and safe for most people with heart failure. Activity can help you feel better, may decrease your symptoms, and may improve your heart’s function. By keeping active, you may be able to do more of the things that you enjoy.”

What a relief!  I have already gone cold turkey on my favorite thing – salt!  I think it would have killed me if I had to stop exercising because of my weak heart. 

So rest assured that if you want to keep up an exercise routine it is not only possible but probable as long as you keep in mind the most important rule of exercising with heart failure:  When you go into the gym you have to make sure that you bring more than just your exercise outfit, your shoes and your activity tracker.  You must bring your common sense.

Yes, I know I have talked in past blog posts about the importance of common sense in managing your heart failure.  But I don’t think it can be discussed too many times.  In fact, I wish we had something to measure our common sense function just like we can measure blood pressure.  Because in my case, as I will discuss shortly, I have on occasion forgot to factor in common sense and ended up overextending myself.   

I do give myself credit for approaching exercise cautiously, especially when I am recovering from some type of medical procedure.  There have been 3 times in the last four years when I had hospital procedures related to my heart.  The first was my pacemaker implantation in March 2013, the second was my upgrade to a device with a defibrillator in July 2014, and the third was my cardiac catheterization in September 2014. 
 
I was under anesthesia of some type during each procedure.  During the implantation procedures, I also was under the knife to insert or upgrade the device in my collarbone area, and I was in the hospital overnight.  So it occurred to me that I should have some time to recover before getting back to exercise activity.  The implantation procedures obviously required more down time.

When I decided to exercise again, I knew it had to be a gradual entry into the arena.  In other words, going down to the fitness room and jumping on a piece of cardio equipment was not a good idea.  Instead, I started out with simple walking routine around my apartment, and later on walking around my building.  Then I worked my way up to walking outside in good weather, gradually introducing inclines and steps to my walk. After I felt comfortable with this routine, I returned to the fitness room but spending less time on the equipment until I felt I was up to speed.

After a while, I got tired of just doing cardio exercise.  In one of my therapy sessions, my therapist mentioned something that she had heard of called the plank challenge.  The goal was to increase the amount of time that you could stay in a plank position.  This sounded interesting, so I immediately googled the term “plank challenge’ when I got home.  

I found that the plank is an exercise to improve core strength.  It involves maintaining a position similar to a push-up for the maximum possible time, and there are a number of variations including side planks.  I checked with one of my nurses and found that it was okay for me to do this exercise.  I got quite good at it, getting to the point that I could do a number of different variations over a period of 15 minutes or so.

But there came a day when my common sense was in demand but apparently had gone on vacation.  I started to feel some aches in my chest and shoulder area.  Of course, I exercised during the period where the term “no pain, no gain” was coined.  So I just assumed that the muscles were building in these areas and causing some aching.  But it did not go away. 

So I googled various terms on the web to see what might be the cause of this ache.  Of course, the most common cause I kept coming across was a heart episode.  Given that no one in the Heart Monitoring Center was calling to notify me that my device was registering disturbing readings, I figured I was not having a cardiac issue.  But I did figure it was time to check in with the office of my primary care physician.

I was able to get an appointment right away to see a nurse practitioner.  It appeared that I had severely strained some muscles in the chest and shoulder area.  The nurse practitioner told that me to lay off planking and other upper body exercises for a week to 10 days, and I followed those instructions.  Should I have figured this out on my own before I ended up at the doctor’s office?  Yes, and it was a lesson that I needed to remember.

When I was on the cruise this past summer, some of my companions wanted to visit the spa.  But I saw that you could arrange a personal training session.  That was much more appealing to me because I still wanted to get more strength and toning.  So I ended up with two sessions before the cruise ended.  The personal trainer thought that I already had a strong core.  Maybe I did, but I still felt I could improve.  So she gave me about four additional exercises that I do in addition to planking, and I immediately started to see a difference. 

In early January, I came down with a really bad cold.  I decided that since heart failure involves some shortness of breath, it would not be a good idea to exercise when the cold was already compromising my breathing.  So I took a little vacation from exercising.  I did have some issues getting back up to speed, finding that I had to stop for quick breaks for a breath or two before continuing on.  I eventually figured out that I needed to change my routine, which I do right after getting up in the morning. 

Normally I would eat something light before I exercised so that I could take the heart medications that require food on my stomach.  But I also figured out that perhaps I was getting some indigestion from that plan.  So I just drink some water and take my allergy medications and then go exercise.  Once I have finished, I immediately eat something and take the heart medications.  At this point, my exercise routine is almost back to where it was pre-cold.  But I have learned another lesson of being flexibility and learning to modify exercise when I’m having a bad day or a stretch of bad of bad days. 

One day at the church about a few months ago, a woman who is not a member approached out minister’s wife about teaching yoga at the church on Saturdays.  She did not want to be paid, as she felt this was a way she could serve the community.  She started teaching classes on Saturday mornings at our church, and participants have been giving donations to a local charity.   I have been a faithful attendee, and it is again helping to mix up my exercise routine to include more toning and calming/restorative exercises.

Having checked with my doctor’s offices a number of times about exercise, I can tell you that there is encouragement to exercise as much as I can – cardio, core, yoga, Pilates, etc.  I can even do some work with very light hand held weights.  So yes, this heart failure patient can lift a finger to exercise and long as there is NO POWER LIFTING!!!!!!!  But every heart patient should always check with her doctors before beginning or increasing an exercise program.