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Week 3 & 4 of Mike's journey - let's catch up with him!

First - a set back. Last week Mike had a follow up appointment with the Electrophysiologist who performed his ablation. Mike was worried that he was still having several runs of atrial fibrillation (AF). His consultant confirmed from Mike's AliveCor readings (a nifty little gadget you can use at home to measure your heart rate) that he was having several runs of AF every week.

Read more about Mike's journey up until now - Week 1, Week 2.

The good news - this is normal in the weeks after an ablation. Often the heart takes several weeks to settle down and may in fact never stay in sinus rhythm completely. The difficulty with AF is the unpredictability of it - some patients have no symptoms at all, some feel rubbish.

Mike doesn't feel rubbish for our exercise sessions - he's motivated to just 'get on with it'. We start this week with a longer warm up - when you are in AF exercise can feel more difficult and thus a long warm up can help the heart to prepare for exercise much better.  Keeping an eye on Mike's breathing, we were able to complete 9 different exercises - a combination of lower body and upper body. By alternating between an arm and a leg exercise, it means we don't need to rest as much as legs rest whilst the arms are working and vice versa.

This week Mike completed over 40 minutes of exercise without stopping and without feeling breathless. Add this to his homework that he's been sticking to - walking every day and a couple of games of golf last month and he is getting on track to improving his fitness.

Next week we will aim to increase the amount of cardio that Mike completes in one go - our end target is 30 minutes so each week we will add a few minutes until he is able to sustain 30 minutes of continuous cardio work.

Mike thought he couldn't exercise again - he's proven himself wrong week after week. Although it seems like a long road, after 4 weeks he is already doing 40 minutes of exercise in one go - way more than he thought possible!

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Yours in health,

Angela Hartley

Team Leader of the Healthy Hearties!

Read more about our programmes here.



Week 2 with Mike!

His heart approves!

His heart approves!

Welcome to our Week 2 update all about Mike, who has started his new exercise regime and has a new bounce in his step after just one week. That's what more confidence can do for you and I'm so happy that he's feeling much more positive this week.

If you missed week 1 and want to know more about why Mike has started training with me (he has AF) and what the Week 1 assessment looked like, click HERE to read all about it.

Last week's homework for Mike was pretty straightforward, all he had to do was wear a step counter every day for a week and then I would take a look at what his 'everyday' activity levels looked like. This is the step counter I always recommend as it's cheap, the battery lasts for ages and it stores 7 days worth of steps.

The steps that Mike had done over the last week really varied. On sunday when it rained all day, he did 2000 steps, however on Tuesday which was a beautiful day, he hit 11,000! The average over the entire week was 7000, which is a great start and means that Mike is actually much more active than he thought. Mike's target to hit over the coming weeks is a daily average of 10,000. It is different for every person, however I believe that 10,000 is a realistic target based on what he's already doing.

For this week's session, we didn't need to do any big assessments or lots of talking - although there is always lots of questions from me throughout! We did a quick blood pressure and heart rate check and I looked at Mike's AliveCor readings for the last week. AliveCor is a fabulous little machine that you stick to your iphone and it can tell you what your heart rhythm is doing and whether you are in AF. They are a nifty little device and I alway recommend people with rhythm problems, particularly AF, to get one. You can buy them cheaply here.

Unfortunately the AliveCor showed that Mike has still been having regular bouts of AF. He could tell when he was in AF as he felt more tired and had less motivation to do things. This is one of the common complaints of AF - as the heart has to work harder to pump blood around the body, and the heart rate is higher than normal, it makes you feel more tired, like you've been running a marathon all day!For Mike his AF spontaneously came and went. We looked at some common triggers (alcohol, caffeine, stress) however he couldn't say one particular thing set it off.

Mike was in AF during our session. This means that he can still exercise, however the most important thing is we keep an eye out for his energy levels, his breathing and his blood pressure. It is safe to exercise when in AF and in fact, just walking around doing your every day activity is exercise, so don't lose hope that you can do more!

We started out slowly, getting warmed up for 10 minutes before moving on to some great exercises for the lower body. The legs have the biggest muscles in the body, so by building leg muscle, it helps to burn more body fat, supports the whole body, gives you more energy when out walking and makes the body feel stronger and improves your posture.

During the session, if Mike became uncomfortable with his breathing, we slowed things down without stopping. This meant that he could catch his breath, feel more comfortable and then increase again. We aimed to build up to working at an intensity of 6 out of 10, with 10 being the maximum effort he could imagine. A 6 should feel like you are working but comfortable. 

I always encourage people to leave some 'fuel in the tank' and so we never aim to finish a session exhausted. It's important that they can get on with their day and complete their normal every day activities without feeling wiped out.

This week's homework is to replicate the session we did once over the next week, as well as aiming to walk an average of 7500 steps every day. I've reminded Mike that if he feels tired, he should always choose rest over pushing himself and can always do something the following day. 

Next week: we aim to build up to 35 minutes of exercise and will add in some upper body exercises that he can do without any equipment at home.

Making exercise realistic is all part of the fun, there's no point having fancy equipment if you hate using it!

Making exercise realistic is all part of the fun, there's no point having fancy equipment if you hate using it!



An easy morning detox; what is AF?

Good morning and happy Monday! Wow this must be the first time I've been organised enough to get an email out on Monday morning - must be the fact that I'm on holidays! All is well in the sun, we are keeping active (I've joined the gym for 2 weeks), walking lots and swam in the surf a few times.

I've added a new section to my weekly emails - Heart Fact of the Week. As my interest is all things cardiac and heart related, I'm going to put more info up for you about how to keep your heart healthy, signs and symptoms to be aware of, and how to keep your blood pressure and cholesterol at healthy levels. Let me know if you have any ideas or requests.

Food of the week
Apple cider vinegar

For years my friend has been taking apple cider vinegar regularly and as I was visiting this week I noticed it again in her kitchen.  She swears it has helped improve her skin as well as reduced her knee pain so this week I have been looking into how and why it may help.
Apple cider vinegar contains several minerals including magnesiumphosphorus,calcium and potassium.  

It has been found that mineral deficiency can worsen joint pain, so a diet rich in essential minerals is an important step to relieving the pain of arthritis. The potassium in cider vinegar may be especially beneficial because it works to prevent acid build-up in the joints, which is linked to joint stiffness.
Apple cider vinegar is also rich in beneficial enzymes and acids that improve digestive health. Taking a tablespoon of apple cider vinegar before a meal will encourage proper digestion of food and absorption of nutrients. This is vitally important for those with arthritis or any digestion issues, as poor digestion can lead to deficiencies in minerals and other nutrients. These nutrients are crucial for joint health, so it is imperative that the body be capable of absorbing and using them. With apple cider vinegar, this is made possible even if you have arthritis.
Studies suggest that joint pain and arthritis may be linked to toxins accumulating in the joints, since metabolic waste is often stored in connective tissues. At the same time, people with joint pain tend to shun activities that might trigger more pain, and the lack of movement may cause toxins to build-up even more. The pectin in apple cider vinegar helps absorb toxins and move them out of the system, while the acids in cider vinegar work to purify and detoxify the entire body.
Unfortunately there has been no concrete scientific research that proves apple cider vinegar helps with joint pain however most doctors conclude that it will not cause any harm and may have a placebo effect. So why not!

How to Use Apple Cider

All of the benefits of apple cider vinegar can only be achieved with vinegar that is organic, raw, unfiltered and unprocessed. Your apple cider vinegar should be ruddy-colored with a noticeable amount of residue floating around in the bottle. This is the natural accumulation of beneficial enzymes and nutrients.
The simplest way to incorporate apple cider vinegar into your diet is to mix 1-3 teaspoons in a glass of water three times per day, preferably just before meals. You can sweeten the drink with a small amount of honey if you like. 

I'll be honest, the taste isn't amazing, but it tastes....healthy!


Interactions to be aware of

Apple cider vinegar interacts with the following medications in large doses so be cautious if you take the following:
Digoxin, insulin, diuretics.


Normally, your heart contracts and relaxes to a regular beat. Certain cells in your heart make electric signals that cause the heart to contract and pump blood. These electrical signals show up on an electrocardiogram (ECG) recording. Your doctor or cardiac specialist nurse can read your ECG to find out if the electric signals are normal.

In atrial fibrillation (AFib or AF), the heart’s two small upper chambers (atria) don’t beat the way they should. Instead of beating in a normal pattern, the atria beat irregularly and too fast, quivering like a bowl of jelly.  The heart will still pump blood around the body, but it won't be as effective.  You may also experience symptoms such as fatigue, breathlessness, or feel dizzy.

Your heart has a natural pacemaker, called the “sinus node,” that makes electrical signals. These signals cause the heart to contract and pump blood. With atrial fibrillation, random electrical activity interrupts the normal conduction rhythm. This prevents the atria from properly contracting.

It’s important for the heart to pump properly so your body gets the oxygen and fuel it needs. 

How do I test for AF?

If you have any symptoms such as fatigue, breathlessness, palpitations (feeling your heart pounding in your chest), dizziness or faint, have your doctor perform a full cardiac check including an ECG. You can perform a simple pulse check on your wrist to feel if your heart is regular (normal) or irregular (possible AF).  Watch this video here to see how it's done. 

What happens if I have AF?

There are many different treatment options for AF, including a range of medications, cardioversion and catheter ablation. The treatment recommended to each individual is based on their symptoms, length of time they have been in AF and response to medication. You may need to take anticoagulation to prevent stroke.

To find out more, read here or ask me for more information.