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Heart Disease in Women
|You Are A Survivor
Have you had a heart attack? Or have you been diagnosed with heart disease or just undergone surgery to treat symptoms of coronary heart disease (CHD)? If so, you already know how very frightening the experience can be. You know how it feels to be told that your body is no longer working in the way it should and you have been plunged into the unfamiliar territory of a hospital and all its high-tech procedures. Yet, the main thing is – you are alive - and hopefully will be for many more years to come. Thanks to the huge advancements in technology and coronary heart disease treatment millions of more women are now living with heart disease rather than dying from it. In fact, many go on to experience a full recovery and even eventually feel healthier than they did before. The recovery process however may be a bit of a physical and emotional roller coaster, particularly after a heart attack. Some women resign themselves to a more sedentary and dependent lifestyle and suffer depression as a consequence. However with the right support and commitment from the patient themselves, their family and their healthcare team, most women can return to a fulfilling and active life. No matter what your age or personal circumstances there is a lot you can do to improve your health and prevent future complications. Remember, there is no cure for heart disease. You can control it with CHD prevention techniques but you cannot make it go away. So if you have been diagnosed with a cardiac problem, or survived a heart attack, use it as a wake up call. Turn it into a positive by starting to manage your own health. You are alive. That's something to celebrate!
When you first arrive home from hospital try to rest as much as possible, eat a healthy diet and get plenty of sleep. For the first week at least avoid any house cleaning or other tasks that require much energy. Know the signs of a heart attack and do not hesitate to call 911 or your doctor if you experience them. In the ensuing weeks and months you will recover much faster if you avoid extreme temperatures and stress and activities that place a load on the heart. Do be sure to report any of the following to your doctor instantly:
• Angina attacks which occur when resting or with less activity.
• Angina which wakes you up at night.
• The need to increase your dosage of nitrate drugs to control angina symptoms.
• Unexplained shortness of breath.
• Swelling in the ankles or legs.
• Light headiness, fainting or pounding heart.
• Gain 5 pounds (3 kg) or more in a week.
• Nausea or vomiting.
• Bloating or feeling full all the time.
• Cough or cold symptoms which last for 2 weeks or more.
• Extreme fatigue or tiredness.
When you are discharged from hospital your doctor may recommend joining a cardiac rehabilitation (rehab) program. This is a medically supervised program which gives patients a personalized cardiac rehab exercise program, counseling, advice and education. Research shows that patients who actively participate in cardiac rehab are 50 percent more likely to be alive 3 years after a heart attack than those who do not. Yet despite this, only a fraction of the people eligible for rehab take up the program (women even less so than men). Nearly everyone with heart disease will benefit from this program, young and old, male and female. It is also useful for people living with heart failure. If you have not been told about it, be sure to inform your doctor or nurse that you are interested in joining a program. You may experience some form of rehab in hospital before leaving, and once you leave you can continue it on an outpatient basis. This next phase lasts between 2 to 6 months and affords the individual the chance to learn about their personal risk factors for heart disease. You will receive a personalized heart healthy diet from a dietician, be given weight loss goals (if necessary) and exercise targets. You will also learn how to manage the stress in your life. Do be sure to stick to the program until the end.
Returning To Normal
How fast you recover will depend on how severe the heart attack was and what kind of treatment you received. Or if you received surgery, it will depend on how major it was – coronary angioplasty is far less invasive than heart bypass surgery or heart transplant surgery. Other factors include your age and how physically active you were beforehand. Here are some guidelines as to what you can expect:
Driving involves sitting straight, it may require sudden movement, tensing or stressful situations. For this reason, after a heart attack you will be told to avoid driving for at least 1 week and 4 to 6 weeks after bypass surgery. People who have chest pain or angina attacks should not drive until their symptoms have been stable for a few weeks. Each state has different laws regulating driving after serious illness, so do be sure to check that you are compliant.
Only travel when your doctor indicates it is safe to do so. Always keep your medications easily accessible in your purse or carry-on luggage. Try to pack lightly so you do not have to lift anything too heavy. While traveling walk around every 2 hours or flex your feet regularly to help prevent blood clots. Do check with your doctor before traveling at altitudes higher than 6,000 feet or to locations which are particularly cold. On arrival, always rest for at least an hour.
How soon you return to work will depend on what kind of job you do and its physical and emotional demands. Many women with office based jobs return to work within 4 weeks of a heart attack and 8 weeks after bypass surgery. If the job involves any heavy lifting you may need 3 months to recover before returning. While some people continue in their previous role, some choose to lighten the load on their heart by working shorter days or switching jobs.
Sexual intercourse is a physical activity which increases heart rate and blood pressure. So, many of the rules that apply to exercise will also apply to sex. Most people wait for 3 to 6 weeks after a heart attack or surgical procedure before resuming sexual activity. Your doctor may need to perform an exercise stress test before giving you the go-ahead. Some positions are less stressful on the heart than others, for example side by side or where your partner is on top are better. If you develop any new symptoms while having sex, inform your doctor.
Coping With Depression
It is almost impossible to experience any major illness without experiencing a wide fluctuation of feelings. You may feel some relief at surviving but also worried, anxious or depressed. This is very common and be reassured that the worse can pass after the first few weeks. However your cardiac rehab team will offer psychotherapy counseling which may help you overcome the initial period of depression. This is important because depression can slow down recovery as well as cause physical problems such as chest pain in women (particularly), palpitations, fatigue and reduced ability to exercise - read more about the effects of depression. It can also affect your loved ones and keep you from returning to work. If you are not in rehab, do seek help and share your concerns. Talk to your family or join a support group for heart patients.
To find a support group in your area, go to:
Dial: 1-888-HEART99 or 1-888-432-7899
Mended Hearts partners with hundreds of hospitals and rehabilitation clinics and offers visiting programs, support group meetings and educational forums for heart patients.
British Heart Foundation
Dial The Heart Helpline: 0300 330 3311
Irish Heart Foundation
Dial: 01 6685001
Why To Take Extra Care in Cold Climates
Patients who live in states with extreme weather patterns should take extra care in winter - particularly those that need to shovel snow in sub-zero temperatures. Studies show that people who die shoveling snow or as a result of some other physical activity carried out in low temperatures, die because plaque (atherosclerosis) in their arteries ruptures and travels to the heart causing a heart attack. If you do live in a cold climate and need to perform outdoor tasks then follow these guidelines:
• Take a few minutes to warm up as this prepares your heart for activity (see Home Cardiac Exercise Program for ideas).
• Build frequent breaks into any activity so you do not tire.
• Wear warm clothing and drink plenty of fluids.
• Plan ahead, watch the weather forecast and try to pick a better day for outdoor activities.
• Ask neighbors or family to clear snow in particularly cold weather.
• Always stop instantly if you start to feel any chest pain, shortness of breath, dizziness or nausea. Alert your doctor immediately.
• Know the location of your nearest chest pain clinic in case of emergency.