Importance of physical activity after heart surgery
Dr Ravinder Chadha

Open-heart surgery has become one of the most commonly performed surgical procedures over the last few years. After undergoing surgery probably due to the lack of counselling, people generally feel that their daily activities would be restricted. They cut down on their physical and social activities and thereby step into depression. They do not realise that after undergoing angioplasty or bypass surgery their blood circulation is back to normal and is even better than an individual suffering from high blood pressure, diabetes or cardiovascular diseases with a high cholesterol level, etc.

Here comes into play the vital role of cardiac rehabilitation. This implies to a post-operative programme of physical activity which is of critical importance, as it stimulates the release of morphine-like chemicals which increase the sense of well-being.

It is a well-known fact that the lack of physical activity is one of the major factors leading to heart disease. Undergoing heart surgery does not mean that one is free from heart disease forever. Therefore, physical activity after surgery is very important.

After surgery a mandatory two-to-three weeks of rest is required before starting with normal activities. The usual complaints are poor appetite, constipation, generalised weakness, excessive sweating, depression, etc. Daily walking and exercise regimens not only help in overcoming these problems but also prevent heart blood vessels to be blocked again. The main objective of physical activity after surgery is to reduce the stiffness due to prolonged bed rest, to enhance muscle strength and improve overall well-being.

Smoking has to be stopped immediately as it increases the risk of heart attack due to nicotine. Heart gets less oxygen and plaque builds up in blood vessels

The following precautions should be taken before starting the exercises:

*Start doing exercises for 10 minutes and increase it gradually to 30 minutes, five-six days a week.

*For the first three months after surgery, one can start doing light house work but should avoid pushing heavy objects, lifting objects more than 5 to 10 pounds in weight — carrying children, pets, suitcases, etc.

*Do not exercise outdoor when it is too cold, hot or humid.

*Climbing stairs or uphill should be restricted initially and can gradually be increased.

Stop exercises immediately in case one experiences chest pain or tightness, palpitation, breathlessness, light-headedness or dizziness, sweating more than usual, etc. These symptoms act as a red alert to stop, take rest and consult a doctor.

Walking: Walking is the most important exercise after heart surgery. It improves circulation, muscle tone and strength. On the first day after discharge, one should walk the same distance as in the hospital. Everyday walking time can be increased from one to two minutes. In case one feels dizzy, short of breath and tired, walking should be cut down by one or two minutes during the next day. Once one can safely walk for a mile, then gradually speed can be increased. However, running or jogging initially should be avoided. Do not increase the distance and speed simultaneously. It is important to walk at a speed where one can simultaneously talk.

In winter, walking during afternoons and in summer during the cool part of the day is recommended. In very humid and cold weather, it is advised to walk in-doors.

Calf stretch: It should be done before and after walk. Stand with right foot forward, feet pointing straight ahead. Lean forward and bend the front knee without bending the back knee. Both heels should be on the floor. Hold this position for 10-15 seconds. Repeat two or three times.

1. Sitting on a chair, cross your arms in front of the chest. Breathe in as you lift arms up and out to the sides. Breathe out as you lower the arms.

2. Sitting on a chair, place hands in the lap. Sit up straight and lean slowly to one side. Straighten up and lean to the other side.

3. Circle your shoulders backward and forward.

4. Sitting on a chair, place your feet flat on the floor. Straighten one knee all the way. Relax. Repeat with the other leg.

5. Sitting on a chair, raise one knee as high as possible as if you are marching in place. Return to the original position and repeat with the opposite leg.

6. Sitting on a chair, lift one leg so that your foot is lightly off the floor. Move the foot up and down in a pumping motion. Then circle the ankle in each direction. Repeat with the opposite foot.

A patient undergoing coronary surgery requires a minimum level of muscular strength to perform the activities of daily living but he often lacks the confidence or strength. The resistance exercises are similar to the exercises for healthy adults except the fact that the intensity and progression of the training volume is reduced. Resistance stretch bands should be used and repetitions can be increased with the passage of time under the guidance of a sports medicine specialist.

Physical activity after heart surgery can make life comfortable. Otherwise incurring huge expenses on surgery would be a total waste.

New Delhi: Snoring is a disease and a treatable one at that, say doctors.

"Those who snore are at a high risk of developing blood pressure problems as snoring interferes with the cardiovascular system. In fact, several researches have associated snoring with increased risk of heart attacks, paralysis and even motor accidents," said Dr K.K. Aggarwal of the Heart Care Foundation.

Snoring by definition is to breathe with a rough hoarse noise while sleeping and, according to Dr J.C. Suri, Head of Department of the Respiratory and Sleep Medicine Unit at Safdurjung Hospital, it is caused when the air passage gets narrowed down and the muscles holding the tongue relax pushing it backwards.

"Those with anatomically small air passages are the ones to suffer from this disease and on an average 45 to 55 per cent adults snore", he said talking to UNI.

According to Dr Suri, 6 per cent of these adults face a bigger danger in the form of Sleep Apnoea, which occurs when the air passage is totally blocked and the patient stops breathing for more than 10 seconds.

"This means sure death, unless the body wakes itself up. The characteristic trait of Apnoea is that the person who is snoring falls silent for a while and then suddenly wakes up with a start, gasping for breath," explained Dr Suri.

"Apnoea can be mild, moderate or severe and accordingly treatment is given.

"At our hospital we get an average of three to four patients a day who suffer from such spells and they are from all age groups. However, the incidence of it increases with every decade.
Therefore, generally speaking, the senior citizens are at more risk," he added. — UNI