Tag: emotional support

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Obesity and Heart Health

Obesity or overweight, a state of excess accumulation of fat in the body, may lead to various diseases. When an individual is obese, their excess body fat can have detrimental effects on overall health as well as on heart health.

The heart has to work harder to pump blood in obese individuals, and this extra strain on the heart can lead to hypertension, heart muscle disease, heart rhythm abnormalities, enlarged heart and heart failure. It has recently come to limelight that a condition called “Obesity cardiomyopathy” accounts for a significant proportion of heart failure and can only be managed by experienced cardiologists.

A recent study by the Indian Council of Medical Research has shown that our country now has 101 million diabetics, with a further 136 million pre-diabetic individuals in need of prevention as shown in the statistics in the Metabolic non-communicable disease health report of India, ICMR.

The study also looked at the number of people with hypertension, central obesity and generalized obesity.

The vicious cycle

There is strong scientific evidence to show that obesity plays a key role in the causation of diabetes, hypertension and cholesterol abnormalities and together they contribute to the condition called Metabolic Syndrome. The vicious cycle of obesity worsening your blood sugar, blood pressure and cholesterol levels which in turn leads to deterioration in lifestyle and pushes one into further obesity, has to be halted right in the beginning. In fact, these are the most sinister precursors of killer diseases like heart attack and stroke. If you are wondering how being obese predisposes an individual to deadly ailments, the excess fat that builds up inside the arteries supplying the heart and brain – a condition known as atherosclerosis – is the culprit.

Timely detection and an early intervention are very important in addressing the obesity burden that the world is facing today. While maintaining an ideal body weight should be high priority right from the age of adolescence, the warning signs that warrant immediate medical attention in obese people are:

  • Fatigue or excessive tiredness
  • Shortness of breath
  • Inability to do their routine activities
  • Excessive snoring and daytime sleepiness
  • Swelling of feet, frequent coughs and colds
  • Chest pain
  • Palpitations

People with obesity not only face many physical challenges but significant emotional challenges too. Obese individuals may develop depression, anxiety, mood swings and eating disorders; hence it is vital to keep your loved ones on a routine medical follow-up and provide them adequate emotional support.

The causes for obesity are many

Lack of exercise, unhealthy food choices, chronic mental stress, long work hours, lack of sleep are some of the modifiable causes of obesity and the Metabolic Syndrome. It is important to identify and treat any underlying medical conditions like thyroid hormonal insufficiency and polycystic ovarian syndrome while correcting the lifestyle factors.

But the solution is simple

Overcoming obesity can be simple with the right knowledge, awareness, help and guidance.

Changes in lifestyle such as making healthier food choices, exercising regularly for at least 30 minutes daily, practicing good sleep hygiene, adopting stress management strategies and keeping a track of the silent killers namely BP, blood sugar and blood cholesterol are the cornerstones of beating obesity.

A simple measure of your waist and knowing your body mass index can reveal a lot about your heart health, talk to your healthcare provider about it. Please refer to our earlier article on this topic: http://www.cardiacwellnessinstitute.com/heart-disease-treatment-prevention/uncategorized/metabolic-syndrome-a-threat-to-heart-health/

Below are a few tips that are rather simple to follow and easy on the pocket too:

  • Restrict use of processed and packaged foods
  • Stock your refrigerator / pantry with fresh fruits and veggies
  • Reach out to a variety of nuts and seeds like almonds, walnuts, sunflower seeds etc. as a snack instead of cookies and biscuits
  • Eat whole grains and pulses, limit use of refined grains and flours like maida, polished rice, sugars, and artificial sweeteners.
  • Learn to manage food portions well; use a smaller plate during meal times
  • Our humble buttermilk and lime juice are far better and healthier alternatives to soft drinks and packaged juices
  • Practice a good sleep routine; avoid the use of gadgets and bright screens prior to sleep
  • Ensure adequate water intake
  • Incorporate physical activity in your daily routine – use steps instead of elevators, park your vehicle a bit far away and walk to your office or the supermarket, try a walking break for 5-10 minutes every 1-2 hours while at work and learn; incorporate regular brisk aerobic exercise along with muscle strengthening exercises on a regular basis

In summary, obesity is a universal problem that significantly increases the risk of heart disease and several other chronic ailments. Taking proactive measures to address obesity through lifestyle changes is vital in promoting heart health and avoiding other comorbid conditions.

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Pain and its implications in a heart patient

As a cardiac rehab expert working with and helping individuals in their recovery from heart ailments, the commonest complaint that is brought to my attention is ‘pain’.

Cardiac rehab, the only proven path to complete recovery from cardiac conditions, is comprehensive in nature, medically supervised, and addresses all your lifestyle choices, risk factors and symptoms including pain. The most common sites where pain may be felt while recovering from cardiac surgery or procedure are the chest, upper back, upper abdomen, access sites like wrist or groin and vein removal sites like legs. Let me walk you through some real-life scenarios where we worked closely with our cardiac rehab participants to understand and address pain.

Scenario 1

A 70-year old Businessman who was under treatment for hypertension for over 40 years was diagnosed with severe coronary artery blocks and underwent open-heart bypass surgery.

Being a very active and fit person, he enrolled in our cardiac rehab program within a few weeks of the bypass surgery with an aim to recover completely and to get back to his gym-based exercises and swimming at the earliest. We were glad to see his enthusiasm to walk long distances and engage in strengthening exercises taught by us but we had to advise him to hold back and not perform over-zealously as he was just recovering from a major surgery.

While on the cardiac rehab program, he started to experience upper back pain that was aggravated in the lying position due to which he was unable to sleep well and felt tired in the daytime. After a thorough assessment, we explained to him that the pain is due to a combination of abnormal body posture which is quite common after an open chest surgery and over-exertion due to long brisk walks while the body is still recovering. We guided him with some postural correction techniques, advised him to do short bouts of brisk exercise instead of long sessions and suggested a few tips to relieve the muscular spasm. He felt a lot better within a couple of weeks and was able to sleep well and do a variety of exercises within 6 weeks of surgery.

Scenario 2

A 51-year old Architect had suffered a heart attack in the year 2019 for which he underwent a coronary stent procedure and had another attack and stenting in 2020 and presented to us for cardiac rehab during the pandemic. He complained of angina (chest pain) while exercising.

After going through his medical records and interrogating him, we understood that his angina was not new but persisted for quite some time. We first reassured him that his coronary blocks had been treated appropriately with stents. We then provided him closely supervised exercise training sessions with adequate guidance on what to do to relieve the pain. As he had lost his job during the early days of the pandemic, we ensured to counsel him on the psychosocial aspects as well along with nutritional guidance to modify his dietary behaviour. These measures along with some minor modifications to his prescription helped relieve him of his angina and he went on to complete the cardiac rehab program successfully. He also got placed in another firm and was looking forward to a fresh start when he completed the program with us.

Scenario 3

A 47-year old Marine Engineer, who underwent a combination of stent procedure plus minimally invasive bypass surgery, complained of shoulder pain that affected his daily activities and hindered his sleep. The cardiac diagnosis had come as a complete shock to him and his wife as he had just come back home after a long voyage and had a heart attack the very next day.

We noticed that he had discomfort in the keyhole access site on the left side of his chest due to which he was avoiding using the left arm and was overusing his right arm instead. We offered him simple solutions like hot pack applications and gentle shoulder exercises, which helped him to adhere to the rehab program better.

He has been on the rehab program for over 8 weeks now and has been following our guidance strictly. He is glad that he is able to perform all his routine activities comfortably and that he is able to build his fitness levels with professional help. He used to smoke in the past and has been counselled on the importance of complete avoidance of all tobacco products.

Scenario 4

A 62-year old retired Airforce personnel with diabetes complained of pain at the surgical site 6 weeks after undergoing open-heart bypass surgery.

Being a fit person with regular exercise habits he was disappointed and emotionally shaken after being diagnosed with a cardiac condition. Residing far away from our rehab centre, he made use of the home-based rehab program option and showed a lot of dedication and willpower to improve his health.

We guided him on strategies to resume exercises without aggravating his pain and worked closely with him to alleviate his anxiety and sleep issues. While his overall wellbeing, his blood sugar control and his lifestyle choices improved significantly within a few weeks, we redirected him back to his surgical team to examine him and search for any local cause for lingering pain in the surgical site.

We hope that our readers have gained some valuable insights into how we work together with our patients to understand the root cause of pain and address them appropriately. It is a gratifying experience every time we see a smile on their face, be it with more awareness, improved symptoms, or the sheer joy of gaining a clear idea about their condition and the ways to manage their health better.

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Is it okay to feel the way I feel?

If you are feeling anxiety, fear, guilt, confusion, anger, depression or just drained of energy after you have been diagnosed with a heart problem – you’re not alone. It is extremely common for individuals to experience emotional disturbances when their routine life gets shaken up by a cardiac problem.

Questions often arise in our minds when a sudden health calamity strikes. While some of them have straightforward answers, some questions can only be answered with passage of time and especially after tiding over the acute phase.

Worries are to be expected. It is only natural that you are worried about your health and the thought about what is in store for you.

Your needs will vary depending on your health condition, your age, your social support and other factors, but everyone has needs that must be addressed by the healthcare team.

Let us see what emotions two of our patients felt.

As seen in the picture above, Mr. Arun (name changed) was rushed to the emergency department directly from his office within 30 minutes of the start of acute chest pain. He was 44 years old, married and had 2 young children. He was working in a multinational IT company as a project lead. He had never had a health check before this episode and was paranoid about what the doctors are going to say. He was diagnosed with a heart attack due to a severe block in an important coronary artery and advised angioplasty immediately.

Why me? Is this the end of my career? Will I live to see my daughters grow up? Can my block be reversed? …. These are just a few questions running through his mind prior to angioplasty.

Another individual, Mrs. Neela (name changed) was in her 70s and taking treatment for diabetes and hypertension when one day she suddenly collapsed to the ground while climbing stairs at home. Her maid who was at home at that time did not know what to do, panicked and called the family doctor’s phone. He promptly alerted the ambulance and instructed the patient to be admitted to the emergency department. The first aid crew in the ambulance provided CPR and successfully revived the lady. She was diagnosed with severe heart failure (Ejection Fraction 22%) and was initiated on multiple medications. Mrs. Neela was better within a week but she had several questions, concerns and unaddressed needs.

How do I prevent a future collapse? What should my caretakers do if I collapse? How can I improve the function of my heart? How often should I see the doctor? Can I carry out my daily duties?

This is where a cardiac rehab team comes into the picture. By providing answers to health-related questions, alleviating worries and offering evidence-based guidance and advice, our team of healthcare professionals work side by side with the doctors and nurses in the hospital, to establish a rapport with the patients and their family members. They provide ongoing emotional support during the hospital stay, the recovery period and most importantly during the intensive rehabilitation period of 3-6 months after the disease sets in.