We all know that exercise has multiple positive effects on our body and helps to improve our physical, mental and social well-being. There is ample evidence to show that exercise helps to decrease all risk factors for heart and blood vessel diseases, thereby preventing major diseases like heart attack and stroke in healthy individuals and also controlling and reversing the disease in previously diagnosed persons.
In recent years, organ transplantation techniques and outcomes have advanced commendably and one of the major solid organs transplanted today is the heart. In an earlier post, we had discussed about organ donation in general and heart transplantation in particular: http://www.cardiacwellnessinstitute.com/heart-disease-treatment-prevention/uncategorized/the-most-precious-gift-ever/
Let us look at some interesting facts about heart transplantation and the need for cardiac rehabilitation post transplantation.
As heart transplantation is a major surgery it does take a few weeks of intensive medical care for a full recovery. The immediate post transplant period is challenging as the anti-rejection medications lower the defense mechanism of the body which in turn increases the chances of serious infections. So, adequate rest, regular intake of medications and proper infection control steps are of high priority during this time.
Comprehensive cardiac rehabilitation which includes supervised exercise, appropriate nutrition, psycho-social counselling and alternative therapies like yoga and meditation plays a major role in the long term survival of the transplant recipient. Overall body weakness, reduced muscle strength due to prolonged illness prior to surgery, low level of exercise capacity, decreased chest wall movements due to surgical site pain, and restrictions in daily activities to prevent infections are some of the practical problems faced by the rehab team when dealing with a post transplant individual.
While patients and their family members may be worried about exercise making them more tired, aggravating their pain and even putting them at risk for complications, several research studies have shown that cardiac rehabilitation and exercise in particular not only helps individuals recover faster but also greatly improves their quality of life and long term survival.
Here are some exercise guidelines for heart transplant recipients:
- Enroll in a cardiac rehab program at the earliest; start exercising 3-5 days/week, at mild to moderate intensity, for 30-40 minutes each day.
- Aerobic exercises such as brisk walking, stationary cycling, treadmill in comfortable speed and cross trainer can be done. Those who cannot visit the rehab centre on a weekly basis due to distance and other limitations can follow home-based rehab programs as prescribed by their rehab team.
- Once the surgical wound has healed well, strength training can be initiated with moderate intensity twice per week.
- Regular follow up with the transplant team and the rehab team is important; any pain, discomfort, giddiness or palpitation during exercise should be reported immediately.
- All medications should be taken as prescribed and blood levels of specific drugs should be monitored periodically.
- All dietary advice should be followed closely.
- Remember to note down your BP and heart rate prior to, during and post exercise for those following a home-rehab program.
- Try to work out in a healthy environment to avoid infections. Wear face-masks while travelling and avoid crowded places.
- Adequate warm-up and cool-down should be done to avoid exercise related complications.
In conclusion, exercise is an important aspect of the post transplant cardiac rehab program. If performed properly and with adequate education and supervision, it is the best tool to protect, preserve and promote the functioning of the new heart!