Anxiety, stress, depression and your heart attack (or the other way around?)

Anxiety. Depression. Fear. Worry about the future. Don't worry - all these are common when you have a heart condition. Whether it be worrying about every little niggle that you feel (this is normal and due to you becoming extra sensitive to pain after a heart problem) to fear about whether you will be able to do all of the things you love again (tennis, golf, sex...?). Stop and take a breath - not only is it common, it's completely normal. Everyone recovers differently and goes through several different cycles before they feel themselves again (well a different version of themselves but one just as good as the past version!).

• You may go through denial, fear, grief, frustration and sadness (sometimes all at the same time!)
• You may take months to come to terms with the new 'you'
• You may 'bounce back' with a can-do attitude only to hit a brick wall a few months later
• You may have the 'tough guy/funny girl' exterior but be in agony on the inside
• You may have a million more different experiences unique to you

Whilst there is no quick fix, there are a few things that you can do to make sure you are looking after your mental health as well as your physical:

• Talk to someone about how you are feeling. Your partner, friend, children, doctor, nurse, rehab team, Facebook group. By talking about how you feel people will be understanding and helpful. You may be surprised to hear that they may have gone through something similar and can offer a lot of advice and support. Sometimes they don't have to say anything, just being an ear to listen to you may be enough.
• See a psychologist. Often the impartial, stranger's ear may be the best forgetting everything off your chest (literally)
• Use exercise as a source of stress and anxiety relief. Walking can be great for your mental health. Pop on some of your favourite music which can help to get you going. Even 5-10 minutes will do some good.
• Avoid too much alcohol or caffeine. Both are ok in small amounts but caffeine will increase anxiety and feelings of stress and alcohol is a depressent that will make you feel better for a few hours and much much worse afterwards.
• Try mindfulness and meditation - I've put a list together below of good Apps that you can download on your phone for free that can help you to unwind, relax and even help you get to sleep. Simply search on your App store on your phone for the names below. If you don't have a smartphone, you can order meditation CDs from Amazon like this one.

1. Sleep Easily Meditation

This app a 25-minute guided meditation that combines soothing music with talking you through the relaxation process. The female voice is surprisingly calming – I was out for the count within 10 minutes.

2. Calm – meditation and relaxation

This simple to use app presents the 7 Steps of Calm. There are seven guided sessions running from 2-20 minutes with a range of background scenes and sounds to choose from (think beaches, meadows and pouring rain).

Free for iphone and ipad

3. Simply Being Guided Meditation

Good for beginners, this easy-to-use app talks you through the basic skills in sessions ranging from 5-20 minutes. Choose your sound preference –the likes of ocean, rain and stream – and sit back and relax. It comes loaded with meditation tips too.

Available for iPhone, iPad and Android

4. Headspace: Guided Meditation

Headspace co-founder Andy Puddicombe is a former Buddhist monk aiming to make meditation accessible. He delivers the directed 10-minute sessions in his relaxed style - no hippy talk here, he strips it down to basics and throws in the odd joke.

http://www.getsomeheadspace.com

Free (upgrades offered too)

5. Room to Breathe Meditation

Nailing your breathing is key in helping you keep calm and switch off. This app can help anyone who has had problems meditating. There’s a step-by-step-guide to breathing techniques with music options to choose from too.

Available on iPad, iPhone and Android

6. Relax Melodies

Want to learn the art of power napping but can’t switch off? This app can help. Choose from a library of relaxing tracks. There’s a timer and alarm function to stop the nap becoming a deeper sleep.

Motivation is the key to success

This week's post is a guest post, from Holly Barry, who has written a great piece for us all about motivation, especially when sticking to those New Years goals.
 

MOTIVATION IS THE KEY TO SUCCESS

New Year always grants us with new resolutions which primarily focus on shifting that winter weight. But, a healthy lifestyle offers so much more than weight loss. By feeling rejuvenated, you will feel more inclined to persevere with the gym or exercise you have chosen, and stick to eating those colourful foods which will be sure to boost your general health, mental health, appearance and self-esteem. Here are some reasons to adopt healthy habits to help get you motivated for making small, healthy changes.

1: Eat better = feel better

Adopting some simple lifestyle changes in terms of what we eat and how much exercise we take can have a really positive impact on our overall health and wellbeing. Our diet and activity levels can affect muscle strength, coordination, stamina and concentration levels, and even simple changes can have a dramatic effect.

Cutting down on sugary snacks and foods that are high in processed fats is a simple way to improve your diet. Going cold turkey is unlikely to be successful over the longer term, so instead, try to replace sweet treats with nuts and fruit, and try to adopt an 80/20 approach to what you eat. If 80% of your food intake is healthy, there’s room in the remaining 20% for the occasional sweet treat or indulgence.

It pays to approach exercise in a gentle way too, gradually building up the length of time you spend exercising and the intensity of the exercise itself. That way, you build your strength up and stay motivated.

2: Looking after your heart health

Making a resolution to lose weight and eat more healthily will have an impact on your overall health, particularly your heart. Maintaining an optimum body weight and taking regular exercise can both help reduce the risks of developing cardiovascular disease.

The British Heart Foundation and the NHS recommend that adults try to achieve 150 active minutes a week, which is less than 25 minutes a day. For time to count as ‘active’, your activity needs to warm you up and make you feel a little out of breath. You don’t have to sign up for a gym membership though, as simple things like brisk walking, dancing or exercising at home can all count towards that target of 150 minutes of activity.

As winter is the busiest time for the NHS, with resources stretched to the limit, there’s even more of an incentive at this time of the year to get fit and stay healthy.

3: Healthier Skin

Our skin is perhaps the most visible sign of Christmas over-indulgence and harsh winter weather. If you want your skin to look fresh and healthy, you need to pay attention to the foods you eat, as healthy eating can provide long-lasting benefits. All that processed food you ate over Christmas means that your skin has been starved of the minerals and nutrients it really needs. Crash diets won’t help restore your skin’s vitality, as they rarely offer a balanced intake of nutrients. Instead, concentrate on eating your five-a-day, making sure you get plenty of food that is rich in vitamins and minerals, such as spinach, sweet potatoes, blueberries and tomatoes.

Healthy skin also needs plenty of moisture, as without it, skin will quickly look dry, pale and taut. Ensure you drink lots of fresh water, and try to avoid sugary, fizzy drinks and alcohol. Keeping a bottle of mineral water with you at all times is a great way to stay hydrated throughout the day.

Healthy eating and regular exercise play such a vital role in keeping us in shape, both mentally and physically. We literally are what we eat, and bad habits can have an effect on our entire bodies inside and out. Trying to eat well and exercise regularly is more than just a New Year’s resolution - it’s a lifestyle change that we should all strive for, and one that will repay us every day for the rest of our lives.

4: Shiny Hair

We all know only too well how much damage the winter months can do to our skin, but we often forget about our hair at this time of year. Hair can suffer just as much during the winter - whether from lack of nutrition caused by poor diets over the festive season, or from cold, wet weather and the effects of constant central heating.

There are plenty of things you can do though, to boost your hair’s health. Healthy eating can play a vital role in helping you achieve great-looking hair, with some foods providing essential nutrients and minerals to really strengthen your hair and make it shine. By identifying which foods can boost hair health, you can easily incorporate them into your healthy eating regime, for visible and long-lasting benefits.

Oranges vs OJ

Good morning and Happy Monday! How was your weekend? Did you manage to fit in some exercise? How was your motivation in the cold temperatures?

Speaking of cold, now that the temperature has dropped a few degrees, it will be important to try to avoid winter colds.  A lot of people reach for orange juice to boost their Vitamin C intake.  However drinking juice is not necessarily the best way of increasing your Vitamin C.
 
Instead, increase your fluid intake, eat more vegetables that are high in Vitamin C (particularly red peppers, kale and broccoli) and sleep more to help prevent colds.
 
Fruit juice is often in debate about whether it is healthy or not, especially for those trying to lose weight.  If you want to lose weight or are struggling to keep consistent weight loss, the best advice I can give you is to avoid fruit juice.  Fruit juices are high-carbohydrate and high-sugar. Even though they’re “good for you” there are better sources of nutrients with much less sugar (or none at all).  Eat fruit and vegetables, don’t drink them.  

But why is orange juice not ideal to be having regularly?
 
The key issue is a lack of fibre. When we eat fruit, the fibre forms a protective layer that acts as a barrier to the intestine, slowing down the absorption of sugar. The high sugar content obtained from the digestion of fruit juice can elevate your blood sugar levels, which in turn stimulate your pancreas to produce insulin. The more carbohydrates you eat at once, the higher your insulin levels are likely to increase. For example, your insulin levels will increase more after having a large banana and orange juice compared to after eating an egg and glass of milk, which is much lower in carbohydrate. Having other carbohydrates at the same time, such as a  a slice of bread or cereal, can also further increase your insulin levels.  If this blood sugar is not used for activity/body function, it may get stored as fat to use 'later'.  If you are very active or not trying to lose weight, this is not generally a problem as you are using the energy that you are consuming.

Oranges themselves are an excellent source of vitamin C, just one large orange contains a full day’s dose. Vitamin C is critical for producing white blood cells and antibodies that fight off infections; it’s also a powerful antioxidant that helps protect cells from free-radical damage and plays a key role in producing skin-firming collagen.

Oranges are also high in fiber and folate.  They contain on average:

60 calories for one, 12.5g of sugar, 3.1g fibre
116% of your recommended intake of Vitamin C.

Compare this to orange juice:
 
250ml: 125 calories, 25g of sugar, 0.6g of fibre
200% of your daily recommendation of Vitamin C.
 
Compare this to 1 slice of wholemeal bread (which people often cut out to try to reduce carbs):
 
80 calories, 15g of carbohydrates, 1.5g sugar, 2g of fibre

Please do ask me any questions at all if you want to know more.

Have a 

Just how important is diet and exercise to improve your heart?

Good morning and Happy Wednesday! I hope you've had a great week so far. We've had a busy week here at Clinical Exercise - lots of new enquiries, lots of fab chat over on our Healthy Hearties Facebook group, a HUGE batch cooking session on Monday (fish pie, fish chowder and fish cakes - yes a lot of fish this week!) and an old client has returned from overseas and is getting restarted on his exercise programme.

This week I'm talking all about Heart Health - obviously I'm always talking about heart health but I wanted to really focus on what you can do to ensure you are reducing your risk of having future heart problems.  This is particularly relevant if you have a history of heart problems in the family or if you are recovering from a heart event or currently have a heart condition.

There are so many do's and don'ts to look after your heart - below are the top 5 things you should be doing to ensure your heart is in tip top condition.

Also, this week I have a simple exercise that you can do any time of day to tone up the back of your arms - easy!

Looking after your heart

Cardiovascular disease (heart disease) is the world’s biggest killer, causing over 17 million deaths a year and many of these deaths are preventable through lifestyle changes.

Most people know someone or have themselves been directly affected by heart disease and a lot of times it is avoidable by changing lifestyle habits. If you've had heart problems in the past it's never to late to make improvements to improve your health for the future.

Simple changes in diet by reducing your salt intake and eliminating processed foods from your diet and trying to get a couple of hours of exercise a day can make a huge difference.
 
A healthy diet reduces the risk of coronary heart disease and prevents weight gain which puts pressure on your heart, the introduction of a healthy diet also helps to prevent further worsening of existing heart disease and it’s not too late to start eating healthily.
 
To help prevent heart disease here are five ways to change your lifestyle and take better care of your heart.

1. Follow the Mediterranean diet

A 2013 study showed the Mediterranean diet reduces the risk of coronary heart disease by 30% and prevents weight gain which puts pressure on your heart, the diet also helps to prevent further worsening of existing heart disease and it’s NEVER too late to start eating healthily. Recent attention has been drawn to the benefits of the Mediterranean diet by cardiologist Aseem Malhotra who has recently filmed the ‘Cereal Killers Movie’ about his quest to find out the secret to a long life in the Mediterranean. Check it out here.

2.  Reduce salt
 
Too much salt can cause high blood pressure, which increases the risk of developing coronary heart disease. Reduce your consumption of crisps, take aways, packaged snack foods and processed sauces. As a cardiac nurse this is one of the biggest misconceptions people have – they think if they don’t add salt to their food then their diet is low in salt.  However salt is hidden in so many things you wouldn’t even think – cans of tuna, ham, tomato paste and roasted peanuts.  Always check the label – if a serving size contains more than 10% of your daily recommended intake, avoid or reduce the amount you have.

3.  Say no to processed foods
 
There are lots of hidden saturated fats, sugars and salts in processed food, fast food and ready meals.  Even foods that may appear ‘healthy’ traditional meals such as lasagne are usually made with cheap ingredients and are laden with salt. I would strongly advise people to check the content of the ingredients of any food they buy and start cooking from scratch together – it’s more fun too!

4.  Quit smoking
 
Smokers are twice as likely as non-smokers to have heart disease with all the health issues it causes it is the most important thing you can do for your heart. Try a nicotine replacement to reduce your cravings – electronic cigarettes, patches, gum or lozenges are a great help when you’re quitting.

5.  Exercise more

The heart is the most important muscle and just a small amount of exercise will keep it functioning properly. Exercising for as little as ten minutes a day can make a huge difference. If you haven’t exercised for some time start out with gentle walking and build up – we should be aiming for a minimum of 30 minutes of exercise 5 days per week.

Aim to improve in one of the above areas each week and you’ll soon be on your way to a healthy heart.

Let me know if you have any specific questions at all!

Exercise of the week - Tricep Dips

1.  Sit up straight on the long edge of a stable, heavy chair or a bench. Your legs should be slightly extended, with your feet flat on the floor.
2. Place your hands on both sides of the bench just outside your thighs. Your palms should be down, fingertips pointing towards the floor.
3. Without moving your legs, bring your bottom forward off the bench.
4. Steadily lower yourself. Beginners: Bend your elbows 1-2 inches and push yourself back up. Advanced: When your elbows form 90˚ angles, push yourself back up to starting position.
5. Repeat up to 10 reps, rest and then repeat up to 2-3 times.

Some people find that this exercise is too much on their wrist joints. If so, you may need to change the exercise to triceps kickbacks, which we will cover in the next couple of weeks.

Do let me know if you have any questions at all!

Exercising safely with a heart condition

I can't believe it's the end of January already. How did the first month go for you? Did you have a look at setting some goals (not NY resolutions, but long term goals for the whole year)? Even if it feels like your goals are so far away from where you are right now, you'll be surprised how much you will achieve over the course of a year.

Some ideas for goals are:

• Double the distance that I can currently walk in 3 months eg if you can walk 5000 steps per day without feeling too tired, aim to be doing 10000 in 3 months time.
• Go down 1-2 belt notches in 2 months time.
• Do my 15 minute exercise routine at home every day.
• Stop using technology in bed so that my sleep improves.
• Eat more vegetables with every meal.
• Say no to sugary desserts 9 times out of 10 (you're allowed some treats every now and then!).

What are your goals?

Don't forget to join my Health Hearties Facebook group here - we now have over 160 members who give helpful tips and advice about all things heart related including exercise, medications, diet and more. Come join us!

Heart tip of the week

There is almost no disease that exercise doesn't benefit from regular exercise. As such, if you've had a heart attack, have heart failure, an arrhythmia or other heart disease, doesn't mean that you can't do regular exercise (even if you don't feel like it right now!). In fact, with regular exercise (greater than 150 minutes a week), you can improve your recovery, improve heart function and even get off of some of the medications you're on.

Cardiovascular benefits of exercise include:

• Strengthening your heart and cardiovascular system
• Improving your circulation and helping your body use oxygen better
• Improving heart failure symptoms
• Lowering blood pressure
• Improving cholesterol levels

Make sure that you get the "OK" and some guidelines from your doctor before you start.

Important things to know about exercising with a heart condition

• Avoid isometric exercises such as pushups and sit-ups. Isometric exercises involve straining muscles against other muscles or an immovable object and often causes you to hold your breath, which increases your blood pressure.
• Avoid exercises that involve pushing heavy weights above your heard eg shoulder press. This causes an increase in thoracic pressure and can increase your blood pressure.

• Don't exercise outdoors when it is extremely cold, hot or humid without checking with your doctor first. High humidity may cause you to tire more quickly and become dehydrated. Extreme temperatures can interfere with circulation, make breathing difficult and cause chest pain. Better choices are indoor activities such as a circuit or using a treadmill.

• Make sure you stay hydrated. It is important to drink water even before you feel thirsty, aiming for around 500ml per hour of exercise. But, be careful not to drink too much water if you have heart failure - check with your doctor if you should be limiting the amount you drink.

• If your exercise program has been interrupted for more than a few days (for example, due to illness, holiday or bad weather), make sure you ease back into the routine. Start with a reduced level of activity, and gradually increase it until you are back where you started.

Precautions

• Do not exercise if you are not feeling well or were very recently ill. You should wait a few days after all symptoms disappear before restarting the exercise program. If uncertain, check with your doctor first.
• Don't exercise if you have very high blood pressure - it needs to be under control/treated first.
• Don't exercise if you have unstable angina or are waiting for test results or treatment.
• Reduce the intensity of the exercise, slow down or stop and rest if you become overly fatigued or short of breath. Discuss the symptoms with your doctor if they have become worse than previously.
• If you have persistent shortness of breath, rest and call your doctor. The doctor may make changes in medications, diet or fluid restrictions.
• Slow down or stop the exercise if you develop a rapid or irregular heartbeat. Check your pulse after you have rested for 15 minutes. If it remains above 120 beats per minute at rest, call your doctor. If you have an arrhythmia, it is safe to exercise however aim to work at an intensity just below where you start to feel breathless.
• If you experience pain, don't ignore it. If you have chest pain or pain anywhere else in the body, slow down and then stop the exercise. If you have a GTN spray, use it and wait 5 mins. If the pain subsides, you can resume the exercise if you feel able. If the chest pain continues, take up to 3 doses of GTN spray and if chest pain persists call an ambulance.

Exercises to include

• Walking - build it up gradually. Get a step counter/activity tracker to keep track of how much you are doing so that you can see an improvement. Aim to add around 10% extra each week. E.g if you currently can do 2500 steps per day, aim for 2750 per day next week. Here is an easy step counter you can use, or use the free app on your iphone, or if you want something more high tech, the new Fitbit looks good: check it out here.
• Create an indoor circuit. Aim to do each exercise for 30 seconds. To make things easier, start by doing the exercises seated. To make them harder, add in hand weights (use food cans to begin with and then you could buy a set of small weights, these ones are good). Choose from:
  • Marching on the spot
  • Heel raises
  • Sit to stand or squat
  • Bicep curl
  • Arm raises out to the side
  • High knees
  • Wall press up
  • Tricep kickbacks
• See if there is a phase 4 cardiac rehab class in your area that you can join in. Search for one here: http://phase-4.cardiac-rehabilitation.net/

Let me know if you have any questions at all!

Travelling with a heart condition

As Christmas gets closer, a question I'm often asked is about travelling with a heart condition. Is it safe? Is there anywhere I shouldn't go? Any foods I should avoid? Can I get travel insurance? What do I do if I don't feel well? Will I be allowed to take all of my medications on the plane?

Travel can bring out all sorts of questions, concerns and anxieties and of course every person is different so often my answer is 'it depends'.

Can you answer 'yes' to all of the following:

• Is your condition currently stable and you aren't awaiting any test results or treatment?
• Has your doctor told you that you are safe to travel?
• Have you been taking the same medications for a while and any side effects have reduced or stabilised?
• Does the place you are going to have a hospital or good medical facility close to it?
• Can you email/phone your doctor or health team if you have any questions?
• Do you know what to do if you are going to an extreme temperature? eg hydration, keeping out of the sun etc
• Have you told your travel insurance and will they cover you for heart related problems whilst you are away?

Here are some insurance companies that seem to cover for heart conditions - you will need to talk to them to find out more about what is included:

• https://www.staysure.co.uk/travel-insurance/medical/heart-conditions/
• https://www.freedominsure.co.uk/Heart-Condition-Travel-Insurance
• https://www.goodtogoinsurance.com/medical-travel-insurance/travel-insurance-heart-condition
• There are a few more if you search for them or ask your current provider.

Some tips while you are away:

• Pack a copy of your latest medical report with a summary of your health conditions and medications.
• Ask your doctor if there's anything you should be aware of (or any activities you should avoid).
• Take all of your medications in your carry-on luggage with your medical letter/list (just in case your luggage gets lost!).
• If you are travelling to a hot country, take a few days to adjust to the warmer weather - spend the first few days in the shade and avoiding the peak of the sun (10-4pm) so that your body can adjust.
• Keep an eye on your weight /fluid retention by looking at your ankles for any swelling, how your clothes are fitting (or your weight if there is scales).
• If your weight seems to be increasing, you may need to take an extra diuretic or adjust the fluid you are drinking (ask your doctor before you go what you should do).
• Increase your fluid intake based on how much you are sweating, how hot it is and how much activity you are doing - probably lots more than usual if you are out exploring!
• Avoid too much alcohol - it's dehydrating and can affect your medications. It's easy to over-indulge on holidays but try to stick to your usual routine and don't overdo it.
• Call your nurse/doctor if you have concerns while you are away - they are more than happy to give you some advice over the phone about what to do.
• Relax and enjoy! It may be hard at first but the risk of any heart problems occurring while you are away is low. Try to enjoy yourself!
• Don't forget your exercise - if you can, choose a room which has a comfortable temperature - if it is very hot, you may need to do some simple exercises in your air conditioned hotel room. Or go swimming! If you are going to a very cold country, the same principle applies - the room shouldn't be too hot/cold.

Let me know if you'd like me to put together a 'travel circuit' for you to do while you are away!

Until next time....

How much sugar are you really eating?

This week is all about sugar - we've been through the reasons why it's bad for you (leads to insulin resistance, fat gain inflammation and can damage the arteries), so this week I wanted you to take a little test for me. Download the app My Fitness Pal  on your phone (or you can use it on your computer)- https://www.myfitnesspal.com/.

Once you've got a profile (it's free to use), fill in your daily food and drink intake for a few days. Include sauces, condiments etc.

Here's a sample of what it looks like:

Next, take a look at the breakdown - go into the 'nutrition' section and have a look at the breakdown. Click on 'nutrients' and it will give you a breakdown of how much protein, carbohydrate, sugar and fat you are consuming. 

For the purpose of today just look at the sugar - what does it say? Your profile will set a target range of sugar for you to be having each day. Are you close to your target or way over? Have a look at the foods that may be the culprit - it's not always as obvious as avoiding sugar in your tea and not eating chocolate. Here is a list of products which are high in sugar which you may have thought were 'healthy':

• Muesli or granola (aim for one that has less than 15g of sugar per 100g)
• Yoghurt (aim for less than 5g of sugar per 100g)
• Juice (can contain up to 25g of sugar in a small glass)
• Sauces especially sweet chilli and tomato sauce
• Dressings - particularly ones that are fat free
• Baked beans - the second ingredient is often sugar!
• Pre made meals - even the 'healthy' ones can contain a lot of added sugar

So you see how easy it is to add up. Have a look at the ingredients on the foods you buy - check out if sugar is on the ingredients list. The higher up the list (i.e. if it's in the top 5 ingredients) then it is usually high in sugar.

Try to avoid as much added sugar as you can. There's nothing good to say about it! Stick to foods that are unprocessed and still in their 'natural' form. Vegetables, fruit, nuts, seeds, lean proteins and some good fats like avocado, olive oil etc. If you are worried about your food lacking flavour then try adding chilli, herbs, pepper, pesto etc to liven things up.

Check out this website for more ideas on how to reduce sugar:
https://iquitsugar.com/recipe/

Until next time....

Running with a heart condition

Good morning and happy Wednesday! I can't believe we are more than half way through November already. Oh and apparently there are only 5 Mondays until Christmas. Who's counting! There are a few problems with this:

A) I haven't bought any presents yet
B) I have no idea what to buy
C) When I did attempt to go shopping the other day I wandered aimlessly not having any inspiration at all.

There must be something to be said about last minute shopping panic mode - it forces you to get your act together! Anyway I'm off tonight for a special 20% off sale at a big department store nearby - let's hope there's hardly anyone there and I don't end up simply buying things for myself.....Fat chance of either happening?!

I digress. This week I want to talk all about running. As you may know, I love running. Having done a few marathons, a lot of trots down the river and back and a few ParkRuns(check it out if you haven't heard of it - BRILLIANT free run every Saturday morning all around the world!).

Running when you have a heart condition can be scary, overwhelming and something that you may think can never happen again. However this isn't the case. If you have been given the ok from your consultant to exercise again, there is no reason that you can't safely build up your fitness (both body and heart) to be able to jog/run again. So you may not be the fastest anymore (who needs to be) but if it's what you enjoy, then let's try to get back out there!

The below also applies if you haven't exercised for a while and would like to ease back into running.

By the way, don't forget to join my brand new group - Healthy Hearties! It has tips/advice/feedback from others who have a heart or health condition. We've almost got 100 members already in just 2 weeks! 

Below I've put the key things to focus on when getting back into running with a heart condition. Remember to always check with your doctor to find out what level of exercise is safe for you.

The following tips are relevant to anyone who would like to improve their running, for those who do and don't have a heart condition. After all, training smarter can definitely help us all!

The below focuses on an aerobic workout. This means that you body is able to use oxygen as it's fuel source. This allows enough oxygen to get to your muscles without reducing the oxygen available to the heart (our main priority).

If you feel out of breath, have any sensation of pain or feel uncomfortable, please slow down, rest and either try another time or see your doctor for more advice.

1.  Always perform a warm up - this applies to walking as an exercise as well as running. To do a proper warm up:

• Allow at least 10-15 minutes at the beginning of your workout.

• Start out at a slow walking pace - slower than your normal walking speed (or start by marching on the spot).

• After about 5 minutes, bring the speed up to your normal (comfortable) walking speed.

• After 10 minutes, begin to walk at a faster pace, slighter faster than before.

• After 15 minutes, walk at a faster speed and swing your arms in exaggerated movements by your sides.  You are now ready to begin the jogging section (or stick with the faster walking speed until you feel ready to add some jogging in).

2.  Watch your intensity. You can do this in a few ways:

• Do the talk test - at the beginning of your warm up you should be able to talk in full sentences.

• By the end of your warm up, you should still be able to have a conversation and be able to say 7-8 words at a time without pausing for breath.

• For the jogging component you should be able to say at least 5-6 words without pausing for breath (we are focusing on aerobic exercise so will not be pushing it any harder than this). If you are alone try singing to make sure you aren't working too hard!

• Get a heart rate monitor. These can act as a great tool to monitor the intensity of your workout. Your individual heart rate is based on your age, medications and genetics so I can't give you the exact heart rate to target. As a rough guide, your heart rate at the end of your warm up, when you are feeling like you are working fairly hard but can still say at least 5-6 words, is about 60% (6/10 effort) of your maximum heart rate zone. Ideally you wouldn't go above 70% (7/10 effort) when you are working aerobically as this starts to reduce the oxygen available. Here is the one that I use with all of my one to one clients: Polar FT7 or Polar FT4. If you want one that does the distance travelled it will need to have a GPS and thus becomes more expensive. Here is a Garmin one that is highly rated.

3.   Build up the jogging gradually. If you haven't run for a while, you will need to start with a walk/jog/walk method. Here's how:

• Complete your 15 minute warm up.

• When you feel ready, start your first jog. It doesn't matter how fast it is, just pick the feet up and move a bit quicker than your walk. It is better to start out slow than to sprint and run out of energy. You are aiming to work at about 6-7/10 (10 being an all out sprint).

• Aim for 20-30 seconds of jogging.

• Slow back down to a walk and recover until you feel ready to jog again. This may take a few minutes, so take as long as you need.

• Repeat. For your first few jogs, you may want to stick with 2 or 3 jogging sets. Build it up gradually over the weeks.

• Eventually, you will feel more comfortable to increase the amount of time jogging and reduce the amount of time walking in between. There is no rush to do this, only when you feel ready.

• Your goal is to complete slightly more each week, unless you are feeling unwell, tired etc. In which case it is better to complete the exercise walking and get some rest, coming back out when you feel better.

• For some their goal may be to be able to jog for 5 minutes without stopping. Others may want to build up to running 5km, 10km etc. It is all dependent on your personal goals and how able your heart is to cope with the increased demands. For some their fitness will increase very gradually, other may see an improvement quite quickly.

4.  Stay close to home. This means that if you get tired you are never too far away. Also, tell someone what your plans are and what route you plan to go.

5.  Always cool down. Take at least 10-15 minutes to reverse the warm up - start by walking briskly at the end of your jogging, gradually slowing the pace until you are walking very slowly by the time you finish. This is a crucial step that is often overlooked. It is essential to ensure that blood in the muscles is returned to the circulation, waste products created from the muscles are moved into the lymph to be cleared and to return the heart rate towards its resting rate gradually, helping to prevent arrhythmias. 

6.  Stretch!!!  Often forgotten, never should be. Stretching helps to release the muscle fibres that have tightened whilst you were exercising. This helps to reduce muscle soreness and prevent injury the next time you exercise.

Don't exercise if you:

1. Feel unwell

2. Have a fever

3. Have very high blood pressure - it needs to be under control/treated first

4. Have unstable angina

5. Are waiting for test results or treatment

All of the above is based on an average. Please do get in touch if you'd like more information specific to you. Don't forget to ask your doctor for clearance before starting any new exercise programme.

Kind regards,

Angela Hartley

Cardiac Specialist Nurse, Exercise Coach

Please note that the information provided is a guide only and does not take into account your individual circumstances. Please seek advice from a medical professional before commencing any exercise programme or new diet.

Can Trump at least fix the obesity crisis?

What a night/morning - big news across the world today and what an interesting few years ahead for all of us. 

One thing I was interested in was what Trump's policy on health and the obesity crisis in the US and what he proposes to help turn the problem around.

Hmmm... it's not looking good for this side of things. At the moment, the US spends almost $322 billion every year on treating Type 2 diabetes. And that’s for a single disease that’s almost entirely preventable through a healthier diet and lifestyle (http://www.diabetes.org/diabetes-basics/statistics/infographics/adv-staggering-cost-of-diabetes.html).

Trump does not have a policy or plan on tackling the obesity or diabetes problem, in fact, he doesn't really have a plan on improving the health of the US at all. In questions that he's been asked about health, Trump has stated he supports mass meat production regardless of the treatment/health of the animals, doesn't mind GMO food and believes global warming is a made up phenomenon - he tweeted 'The concept of global warming was created by and for the Chinese in order to make U.S. manufacturing non-competitive.'  Also, he doesn't know much about obesity, blaming poor genetics and lack of exercise(rather than the poor diet that a lot of Americans eat). 

Let's hope that we can spread the message about how to improve health so that people can take control of their own, as it doesn't look like much will change for the better in this department for a while!

It's not easy, but the key message we need to be teaching the world is: eat mostly fresh, natural foods that having been altered by processing. Limit meat to a few servings per week, drink plenty of water, avoid foods with artificial colours/flavours/sweeteners and exercise regularly. Sounds simple but can be a big challenge when our habits have been one way for so long. 

What do you think?

Food of the week

This week's 'Fruit of the Week' is the Clementine.

A clementine is often just thought of as a small orange, but they are a fruitlike no other!  The small fruit's size makes it a comfortable fit inside a handbag or a packed lunch, there are no seeds and they are easy to peel.  Out of the refrigerator, a clementine lasts for two to three days, so you can leave a few in your office or on your table and they are less messy than an orange, making it an easy snack. 

They are also packed full of nutritional benefits such as….

• A Clementine contains a good amount vitamin C, which is necessary for the production of collagen, a structural compound throughout the body, from the skin to the bones.  Vitamin C helps to transport fat to cells to convert it to energy and even helps convert cholesterol into bile, which can play a role in protecting one from heart disease and gall stones.  Since humans cannot produce their own vitamin C within the body, we need to consume it from an outside source.
•  Clementines also contain calcium, which is necessary for muscle contraction and bone growth
• Clementines are also a source of potassium, but contain much less sugar than a banana
• They also contain only 35 calories each so make a great snack.  Try having one with a handful of cashews for full healthy snack status

HEART FACT OF THE WEEK
WHAT IS YOUR HEART AGE?

Here is a handy calculator to assess your 'heart age' - it adds up your risk factors for developing heart disease or stroke and gives you an age based on your health.

Let me know if it says you are much younger or older than your 'real' age - if it's older than we can look at ways of bringing your heart age down.

Click HERE to take the test.  Let me know your score!

Have a great week! Please let me know if you have any questions at all.

Kind regards,

Angela Hartley

Cardiac Specialist Nurse, Nutritionist, Exercise Coach

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!

Follow/Like us on Facebook to get regular updates on Mike's progress! 

Yours in health,

Angela Hartley

Team Leader of the Healthy Hearties!

Read more about our programmes here.