Men's health: Cardiac care
Congrats, you survived a heart attack. Now what? Maybe you'll have to stop eating a 16-ounce steak and downing a six-pack daily, but you won't be an invalid either. Here are tips about exercise, diet and mental health. And yes, you can have sex again.
Photo copyright 2011 Crestock.
Each year, more than 565,000 American men will have a heart attack and, on average, it will occur in men 10 years earlier than in women. According to the American Heart Association, about 489,000 of those men will survive.
Experts say men can return to a healthy and happy life following a heart attack. Although it may feel strange, it’s something thousands of men adjust to each year.
“A heart attack is not insurmountable,” says Cindy Baker, an interventional cardiologist with Heart Specialists of Ohio. “Most patients will get back to a normal state of health or even better after appropriate treatment.”
Dr. Thomas Ryan, director of the Ohio State University Medical Center’s Heart and Vascular Center, says modern medicine makes a difference. “With the treatments that are currently available and appropriate lifestyle changes, most patients will survive a heart attack and be able to live a normal life,” he says.
Ryan says since a heart attack is most typically the result of a blocked artery, angioplasty and the insertion of stents to keep the artery open are common treatments. Sometimes, bypass surgery is necessary, and so patients generally will need to recover from some sort of surgical procedure. They also will have to adopt some new habits. “Medication and lifestyle changes are almost always a part of therapy,” he says.
Baker says adhering to a regimen makes a big difference in a successful recovery. “Most patients will continue on medications long-term to prevent future heart attacks,” she says. Medication is just part of the new regimen men may undergo. Rebuilding strength and getting healthy are other essential components, and getting back to full health may take a while.
“Recovery is a gradual process and depends in part on how extensive the heart muscle damage is,” Ryan says. “Most patients are able to go back to normal activity after several weeks. A cardiac rehabilitation program is an important part of the recovery phase for most patients.”
Until four to six weeks after the incident, Baker says patients will have to limit themselves to basic daily activities only, including walking. No helping a friend move and no training for a half marathon. Until the heart has grown strong again, patients will have to err on the side of taking it easy.
She says this recovery period is also a good time to get into a heart-healthy frame of mind and make some lifestyle modifications. What we eat is a strong barometer of future heart health. “We recommend the American Heart Association diet, which includes a diet of low fat, low cholesterol and low salt,” Baker says.
Does this mean no fun foods ever again: no pizza, beer or spicy chili on Super Bowl Sunday? “No, we suggest prudent dietary changes made by limiting intake of total fats,” she says. “I suggest that patients plan their meals. If they know that they will be eating a large meal out, we suggest that they limit their meals early in the day.”
Potentially fatty meats such as beef and pork are not completely out of the question, but Baker says she recommends eating it no more than twice per week, and even then, choosing the leanest cuts.
“A heart-healthy diet is an important way to help prevent more problems in the future,” Ryan says. In addition to recommending limited fats and cholesterol, he urges patients to make fruits, fresh vegetables and whole grains part of their diets.
Moderation and common sense are the keys to good health, he says.
“Diet is part of the way we control blood pressure and lipid levels, so it’s a major part of secondary prevention,” Ryan says. “But in combination with medications and exercise, for most patients, the diet can be very tolerable.”
Karen Miller-Kovach, chief scientific officer for Weight Watchers International, says the company’s newest regimen leads participants to a healthier way of looking at food, and it is grounded in just the kind of research experts cite as effective for heart patients.
“Our new PointsPlus program is based on the latest scientific research and is designed to guide people to foods that are nutrient dense and highly satisfying, ensuring they will make healthful decisions,” she says. Weight Watchers has been testing the program in the U.S. for the past year. Testers report feeling healthier and more satisfied after shifting their food choices away from energy dense, processed foods and toward fruits, vegetables, whole grains and lean proteins.
Alcohol consumption isn’t off the table for recovering cardiac patients, either. “But again,” Ryan says, “moderation and common sense prevail. Alcohol in small quantities may actually be beneficial, but more than one or two drinks per day is usually harmful. And I would never encourage someone to start drinking just for the protective effects.”
Baker says one glass of wine or one ounce of alcohol a day is generally an acceptable limit, but it depends on the individual patient’s medication regimen. As with any other factor when it comes to recovering from a heart attack, a patient should consult his doctor.
If you’re feeling like you’ve been given a new lease on life, you may decide to hit the gym to make your physique match your new, indestructible attitude. This is an especially important time to involve your doctor in decisions. He may recommend not just your regular gym, but a supervised program designed especially for cardiac patients.
“Activity limitations during the recovery phase may be recommended, and this is where a cardiac rehab program can be very useful,” Ryan says.
A rehabilitation program can provide support for those who have recently suffered a heart attack, assisting in the physical, emotional and social recovery.
Baker says she likes the structure and guidance aspect of rehab programs. “Patients are closely monitored for their heart rate and blood pressure, and it allows them to build their duration and improve their lifestyle,” she says.
Such programs can get patients started on the right road and help them find greater health and vitality than they experienced before. “In the long term, regular exercise is often beneficial in helping to lower risk factors and lower the risk of subsequent problems,” Ryan says. “Heart attack survivors have run marathons and even completed the Ironman.”
Ryan says doctors don’t generally recommend that sort of exertion for recovering cardiac patients, but it is altogether possible.
Matthew Hickey, owner of Core Fitness Studio, says that with a doctor’s approval, cardiac patients can begin working on a combination of strength training and cardiovascular conditioning.
“What they can do will vary depending on the severity of the condition and where they are in their recovery, but even something as simple as riding a recumbent bike at a comfortable pace can be beneficial,” he says.
When it comes to weight training, there will be some moves a cardiac patient won’t be able to do at first, Hickey says. “But there are plenty of ways to build strength and build cardiovascular endurance to get people to a level where they can do more,” he says.
Patients may find themselves doing less than they think they should be—Hickey says a 20-minute walk would be recommended, increasing the time by 10 minutes each session up to 40 to 45 minutes, as long as the exertion level remains comfortable.
A little cardiovascular exercise is the place to begin, and strength training can be built in gradually in 10- to 15-minute increments, he says.
The physical and mental state can be closely related, and this is especially true when it comes to sex. Whether a man feels invincible, or whether he feels a need for close human contact, he may need to put the brakes on for a while after the heart attack.
“To the heart, sexual activity is another form of physical exercise,” Ryan says. “Early after a heart attack, physical activity may be limited, but this is usually temporary. In the long term, normal sexual activity is possible for most.”
Baker says many patients know they’re ready to resume normal sexual activity when they’re able to walk up a flight of stairs.
Ryan notes that some medications used after a heart attack can adversely affect both sexual desire and function. He recommends that men discuss this with their doctors so they know what to expect.
For reasons both mental and physical, men may experience symptoms of depression following a heart attack. Ryan says such symptoms aren’t uncommon, but should be dealt with since depression can have an adverse effect on long-term recovery.
“For most patients, the depressive symptoms will resolve, although for some, specific therapy may be needed,” he says. “We are now recognizing this as an increasingly important part of management in heart attack survivors and certainly something that shouldn’t be ignored.”
Baker says there are medications that can help a patient deal with early depressive symptoms following a heart attack. She says the need for these medications may lessen with time. Depression following a heart attack is not uncommon in her experience, either.
“There will always be some changes in how individuals feel after a heart attack, as many individuals feel that their body let them down,” she says. “Some individuals may interpret the changes as good and use this as an opportunity to make their lives better, while others will look at this as a life-limiting change.”
She says this is another benefit of participating in cardiac rehab. “It can give patients a sense of control as they learn how to manage their symptoms and disease,” she says. “It helps to put the patient in control of their life and cope with life’s unexpected turns and daily frustrations.”
“You can’t change life,” she says. “You can only change the way you respond to it.”
Kristin Campbell is a freelance writer.