Network with WebMD just wiped out my next technical bit explaining some exercise facts. I will try again.
Except weight lifting, and even then it is unnecessary, do not use the slogan "No Pain, No Gain". It rhymes nicely, but it is a blatant lie. Pain is an indicator of injury of some kind, even if you can continue exercising. For the rest of your life, please, no more. Warm-up and cooldown alone will take you 90% of the way so that you will not be even be able to find your anaerobic threshold.
If in muscle tissue, including the heart, it means the affected muscle is not getting enough oxygen. You could just put a plastic bag over your head, and train that way. But that would be crazy right ? You could suffocate. Well, exercising so hard you cause muscle pain is risking KILLING whatever tissue should it ever reach a level of no oxygen at all.
The purpose of exercise should be to strengthen the body, not destroy it. So no more moronic poetry of "No pain, no gain". If someone tells you I am wrong, ask them if you can slam a hammer on one of their toes or fingers. Or anywhere else on their body. Find out if they will accept that pain, and expect a gain from it. Pretty sure they will not. If they did, you would think they were crazy, wouldn't you ? So don't let either a crazy person or an uneducated moron with muscles guide your exercise, and give you long term problems.
Off that soap box.
Track your heart rate during endurance exercise. It should be able to remain stable at different levels or METS. This will vary from person to person. Only YOUR numbers matter to you. Differences are due to age, prior training, individual strength in muscles used. As long as not breathing hard, you can periodically push yourself harder and push the heart rate up a bit more, and a bit more, 5, 10, even 20 beats higher. But find a new level and stay there at that level heart rate. If your heart rate just keeps going up, even though the effort level is stable, then you are pushing too hard and the heart is falling behind on delivering oxygen, to skeletal muscles and to itself. Keep this up, and you will force fatigue on yourself. to fully recover from a fatiguing workout takes 2 - 4 days. So the trick is to only work at levels at which you can keep it level. Your heart will get stronger, as will muscles used. You will get greater and greater endurance, and be able to handle more METS, though their is a maximum.
Playing basketball and rowing are very tough cardio sports. That I can get my heart rate to 180 for extended periods of time, with no pain and no shortness of breath, indicate I am working at the level of a person much younger and healthier. I accomplished this past age 50 by careful training using this attention to uncontrolled heart rate rise, which I have read called by the term "Cardiac Drift". I could not get my heart rate that high always. But in training this way, over time I can handle more and more METS, and a higher and higher heart rate, and never get tired.
I could push to where I do get tired, which is fatigue. But why ? This way, I can train everyday, though varying from easy days to very hard days. And never be tired. I have great fun. Volleyball with people half my age for hours and hours. I lift weights. Joint pain limits me sometimes, as it should.
I had a new personal best this past Friday. For the first time ever, I tried bench step-ups carrying 100 lbs, warming up in a progression from much lower. The last four sets were at 80, 90, 96, and 100 lbs. The reps were 12, 10, 6, and 3 at the weights, listed in order.
Interval training of 1-3 minutes, with 2x-3x times the rest between intervals is good to strengthen the heart as well as other muscles. But with warm-up, first ! This from exercise research journals and exercise physiology text books.
If possible, much less fat and salt in your diet, a lot more fruits, berries and high anti-oxidant foods. For exercise endurance, shift your diet to 80% complex carbs.View Thread
I don't use a machine that gives me METS. I suppose I should try to find one now and then.
In the research I have reviewed, very specific to my case, Chelation has never come up in a search. The reduction of blockage sites has an actual medical term for the gradual removal of oxidized LDL from immune cells attached to the arterial lining: cholesterol effusion. It is a slow process, and requires the presence of paraoxonase in the bloodstream. The only thing to have a significant effect on increasing paraoxonase is pomegranate. So for my money, I would consider "chelation" purely bogus, and not even consider it.
I have not heard of those other meds. They were never suggested for me.
My angina was so severe prior to bypass that I would gauge it 9.5 on a 10 point scale. I would go from 0 to 9.5 in a couple seconds, and if I had been moving at the time, like walking up a steep hill or even just bending my legs to sit, as happened once each, I had to freeze mid motion. To move further drove the pain even higher, thus needing to literally stop motion. All I could do was breathe and wait. It took 3-5 minutes or more before the pain subsided and I could move again.
Please use a heart rate monitor when you exercise, and, please tell me what you are doing when you do these high MET activities. Especially with heart disease, and those without, too, you should do a gradual 6-10 minute warm-up exercise gradually bring up your heart rate. Also, when done, a 4-6 minute gradual cool-down should be mandatory. The first is to ramp up blood flow to the heart so it can support exercise better, and to move blood from torso organs out to involved skeletal muscles. The cooldown does the reverse, assisting to re-distribute blood from the limbs and skeletal muscles back to the torso organs. Skipping either of these can aggravate angina by over working the heart.View Thread
"Studies have shown that with blockages, but not a heart attack, that stents or by-pass do not extend life."
I have to disagree with this. I am the poster boy for that combination. With my good Circumflex at 80% blocked, and the right and left coronary mains 99% blocked, I had emergency bypass surgery the day after the angiogram. 8 months later, two stents. I have followed an optimum diet regimen, and continuous rehab slowly giving me better and better quality of life. I have no restrictions for activity.
The higher LDL is, the more critical it is that a high anti-oxidant diet is maintained. Herbs and spices are extremely anti-oxidant dense. A diet high in niacin and thiamine is also important. No fried foods if at all possible. High niacin foods help boost HDL. High thiamine foods help keep stem cells that keep arteries in good repair in good function and help the body produce more of them.
With exercise, long duration moderate exercise helps bring down LDL; high intensity exercise hitting bursts at a pace of 540 calories an hour is good for HDL. Rowing uses all the major muscles, so it is an ideal exercise for intervals since you can control the pace easily.
It seems like no one but me writes about LDL/HDL ratio. Mine at time of severe angina was 144/36, 4:1 . Very high. With angina now rare and minor, my LDL/HDL ration has been between 1.2 and 1.7 for 8 years. I have been unable to get my heart rate over 183, but it should max out at 158 and leave me collapsed in a heap. Last time it was 183, I was playing full court basketball for 40 minutes, and it was at 183 for 30 minutes continuous. That indicates I would seem to have the healthy heart of someone under 30 years old. Not a man of 62 with severe coronary heart disease.
So, depending on what you have to live for, yoy mught want to revert to that extremely healthy diet and exercise program you had a few years ago.
Read or review with your doctor the conditions with which EECP is normally the suggested treatment. I believe it needs to be daily for one or two months. My doctor suggested it for me, without reviewing the conditions. I found them from a hospital, posted on the internet. There are four stages of symptoms for which it is the recommended treatment. My symptoms were more mild than any that EECP was recommended for, and I was responding well to the protocol of graduated cardio work that I was doing, and have continued to do.
The goal of EECP was to get to where I already was in terms of reduced angina, which is only induced by a poor meal choice, not exercise intolerance. It might have been of some benefit, but at great inconvenience to me, so I chose not to do it. Playing volleyball, I can play longer and just as hard as pretty much all the people in the group. I am not jumping quite as much as some, but I move a lot, and many find me impressive considering I am 15 to 35 years older than most of them.
From what you have written, you have larger and better collateralization than I do, or did at the time when I reviewed the standards for EECP. Your heart rate may not get as high as mine does, 183, but tolerating 10 METS is very, very good. In terms of where I am now, it might be 10 METS. I get my heart up to 159 or more for 10 to 15 minutes rowing. A few times each outing, twice a week, and also very high playing volleyball sometimes. The volleyball is mostly less strenuous, unless I am playing a major part in a long rally, which can leave me breathing a bit hard after a long rally. But that is rare.
You have not stated if you made major changes in your diet, and stressors. Me, diet is very low salt, very low fat, very high in anti-oxidants via cooking herbs, spices, and fruits. Information gleaned from NIH website, pubmed, regarding all this.
One opinion I will give, based on what I have learned of the anti-oxidant content of herbs and spices, is that they are the real key of the Mediteranean diet. Anti-oxidants prevent oxidation of LDL, and that ox-LDL is what increases blockages. Oregano and Parsley the highest content. Pomegranate and dark chocolate of special benefit, and pistachios to improve number and function of stem cells that repair arterial damage. High intensity Interval training helps boost HDL, as do some foods. I do try to get those foods in my diet, too. I think those are high niacin foods. All this was posted on a WEBMD forum, with links to the NIH website, but not updated in a couple years. So WebMD, archived it and removed it.
But they also did a short feature article in the Web MD magazine about my "amazing" cardiac recovery, but leaving out all details. Search on "cardiac recovery", looking for "My Story". It is in the 2012 September issue. I was not just a reader. I was a major contributor to quite a few WebMD forums, and providing verifiable links to all information I posted, unless they were of my personal actions. I am also among a select group of knowledgeable webMD contributors with a few special website rights, and title of Health Ambassador.
I suppose to have recovered to where I can play volleyball for hours at a time, a few days a week if I choose is pretty amazing considering my heart disease. Methodical rehab, extremely beneficial diet.View Thread
Based on over 20 years of comprehensive study of research on heart disease, by Dr. Richard Flanigan of Denver Colorado, a practicing cardiologist, a genetic factor of heart disease only occurs in about 1 in 500 patients. The other 499 are diet, stress and lifestyle issues. Self inflicted.
You should not be doing exercise that tires you. Three weeks after my bypass surgery, I could barely walk 100 feet. Through gradual rehab, and a very strict diet, I can walk briskly a few miles, or play volleyball for hours and hours. Volleyball is way more fun.
Use a heart rate monitor. Everywhere if necessary. Your rate rate will stay in a normal range over most things. Before fatigue strikes, your heart rate will start climbing higher and higher, and is indicative to SLOW DOWN and REST a bit.
The best rehab is gradual, but can progress higher and higher if done methodically.View Thread
100% clogged. You have been going without it, using collaterals for an indeterminate time.
Why did you have an angio ? This procedure is not done without good reason.
I had 99%, 99%, and 80% in the three cardiac mains. When this was found, bypass surgery the next day. I had a full secondary collateral capillary network I was living on. But the angiogram was done for sudden onset severe unstable angina.
After bypass, the two worst arteries went totally blocked, and I could have lost 70% of my heart without 1) the extra capillaries, and 2) the bypasses.
Nine years later, with careful strict diet and careful exercise rehab, I have no issues, and am able to exercise like a 40 year old, if not better.View Thread
No one can predict the future. If my cardiologist were right about me, I would have died 6 years ago. I defied the odds by being extremely pro-active to learn everything I could about our disease, beneficial foods, careful methodical exercise rehab. And by doing everything he told me to do. He suggested four supplements, besides a few prescribed medications, and I am a near ideal patient to rarely ever miss a dose of any of them. Most people are not so good about their meds. Be one who does.
We are not all cookie-cutter critters. That is one reason it is called "practicing medicine". Doctors learn and do their best for us, but it is nearly impossible to keep up with all continuing research. And they don't. They can't. But they give us the best information they can from their years of education and medical practice.