I R O N K I W IWORKING OUT AFTER A HEART ATTACK (Part I)
March 2020
End of 2019 I had a heart attack. Genetically I'm inclined towards high cholesterol and one of my cholesterol deposits ruptured and entered the blood stream. As I'm sure you know, all blood returns to the heart, which is exactly what my newly-freed cholesterol did and in turn my body created a blood-clot to defend itself against said "foreign" invader. Unfortunately this resulted in a blocked valve and my being rushed to hospital.
On the plus side, from collapse to theatre was less than 30min total for yours truly, by which time I had a stent put in and was being wheeled up to the cardiac recovery ward. I was extremely lucky to have had the event at work surrounded by people/within an institution who had robust systems in place for just such events, as well as medical professionals who cracked into it from ambulance to theatre and got it done.
Two and a half days later I was released home.
THE FIRST THREE WEEKS
I was roundabout 93kg when I went into hospital. Within 3wks of bed rest I was just under 85kg. Why? Mainly because I slept and rested day in, day out, eating very little. What I did eat was not only much less than usual but comprised almost entirely of salads, minimal carbs and chicken or fish. Having had both cardiac rehab nurses and nutritionists hui with me regularly over my hospital stay, I was keenly aware -- and wanted to -- of the need for improved meal plans.
Sure, diet-affected cholesterol is only some 10-20% of your total amount (NOTE: other medical professionals say dietary cholesterol has zero affect on cholesterol levels) but having a heart attack or any near death experience for that matter, tends to make you not give a fuck. You just want to do what's best for your health and recovery very, very quickly. Not that our whanau ate poorly in fact, we've always eaten well but to be honest, I could have eaten less and I could have eaten better regardless. Note to self.
WALK FIRST
Bodywise, I was extremely weak. Walking from one end of the house to the other had me puffing for breath. Not just my strength but my endurance was incredibly low. Most afternoons I'd sleep 2-4 hours easy. I was now on a cocktail of drugs (including statins) which not only slowed my heart down, but decreased the amount of work it needed to perform, thus my blood pressure was -- and still is -- lower than normal. If I stood up too quick I came over all faint.
Regardless, after those initial 3wks of rest I was not only attending cardiac rehab weekly but walking every day with the goal of improving time (not distance) so that ultimately I would be doing a daily half-hour walk as instructed. Whilst I intended to build up 5min extra per week, within a fortnight I was doing 30min a day, probably because I've always tended to do things in extremes and struggle to find a middle-ground.
I didn't go too hard out, just enough to keep my heart-rate up and hold a conversation but to be honest, I still pushed that. Weird as it sounds, after a heart event you need to strengthen the heart aka your entire cardiovascular system, and one of the key ways of doing that is through exercise. Hence why walking is stressed as an absolute pre requisite and not an option. I essentially have to walk/do 30min daily exercise for life now.
All good by me.
I was aware that weather could be a factor so I picked up a cheap x-trainer and began to alternate between that and walking. I was off work for close to 2-months so once back, I switched to doing 30min each morning on the x-trainer. We also started walking our new pup in the evenings so I was essentially doing two "walks" a day, but after two weeks of this I decided no more x-trainer sessions on the weekends as I was doing too much too soon and needed recovery-slash-down time.
BODY-WEIGHT EXERCISES SECOND
I wasn't so naive as to think I could just jump back into strength-training. I knew I'd need to go slow and start small. That meant body-weight exercises to start with which is what I'd recommend to any person wanting to work-out after a heart attack. However, you really do need to go slow and start small. After all, there's no rush. My first week of body-weight exercises occurred 6wks after my event and went as follows...
MONDAY Push-ups x3 Inverted Rows x3 Lunges x3
THURSDAY Push-ups x3 Inverted Rows x3 Lunges x3
When I say "x3" I mean three sets of as many as I could do aka AMRAP (As Many Reps As Possible) only I made damn sure I didn't go balls to the wall. In other words, leave a little in the tank in fact, leave more than a little. Which kind've negates the whole AMRAP thing but you need to base it on your physical conditioning. I didn't try killing myself and I certainly didn't bother tracking how many I did, I just wanted to get used to doing them again and yeah, it wasn't easy. The following week looked like this:
MONDAY Push-ups x3 Inverted Rows x3 Lunges x3
WEDNESDAY Push-ups x3 Inverted Rows x3 Lunges x3
FRIDAY Push-ups x3 Inverted Rows x3 Lunges x3
As you can see, the second week followed the same exercises but three times per week instead of two. Now, a wiser man would probably have stayed on this for another 1-2wks but 'ol mister gung-ho here decided that next week, next week I'd go with the iron. Bloody typical but note the exercises choices: a push, a pull and a squat. A nice, simple go-to for anyone.
LIGHT-WEIGHTS THIRD
My third week of actually working out and at last I was using real weights! Pretty exciting stuff. Again, I kept the program simple, starting with a light warm up i.e. rolling the shoulders, circling the arms, air squats -- basically getting blood into the muscles and hoping like hell my joints wouldn't get too much of a shock here -- before getting into it proper (NOTE: weight is in kg).
Keep in mind two things. Firstly, I'm going with weights that work for me so the above may be too high or too low for you weight-wise. Choose what works; have an experiment and find out where you're at and what you're ready to do. I've been doing this long enough to know what works for me. Secondly, I'm a low rep/heavy weight kind of guy so you won't find me doing endless sets & reps. But would I stay that way in lieu of recent events?
STARTING PROGRAM FOURTH
Feeling good about the week gone -- overly optimistic would probably describe this better -- I opted to start a mixed program for this week. Again, the aim was heavier weights over short sets, just enough to give me a taste of what I could or couldn't do, not looking to do long sets of anything much.
On the Monday squats I couldn't do the 110kg single. On Wednesday I couldn't do the 70kg benchpress single. I press from deficit i.e. off the rack as opposed to unracking the bar overhead, lowering it to the chest then pressing it back up again, and only got it 4-5in up before I folded. I think in both instances ego was whispering! My 90kg single on rows was sketchy to say the least, as was my 50kg single on overhead-press.
I resolved to avoid singles as much as possible.
However, I was wiser in the deadlfit doing a smaller leap up to my single which to be honest, felt really good. I knew I could do another deadlift single at 120kgk the moment I put the bar back down but opted not to (130kg would've been a grind. I wasn't ready for that yet and aren't a fan of grinding anything except coffee beans). I felt it in my upper back the next day though, but I actually like the ache.
NOTE: The Thursday before the above Friday we were walking the dog that evening when I realised something was wrong. Within a hundred feet I was struggling and gave the lead to my wife. It wasn't my heart, it was my energy-levels; it felt as if my energy was draining out of me. Another hundred feet past that and I was walking much slower. Everything was an effort and I realised shit, I'm crashing on my feet. I even wondered if I'd make it home.
In fact, wifey even wondered aloud if she should go on ahead, get the car, and come back to collect me. I did make it home but I was physically exhausted. That Friday I did no x-training in the morning and deferred the overhead press/deadlift session to Sunday of the weekend (though I did walk the dog Saturday but not Sunday, just did the weight session as outlined above).
Take home points? Go slow, start small, the very advice I ignored. The next take home point is recovery times, something else I had conveniently forgotten. I was doing too much too soon. I needed further rest. I also needed greater energy levels which time and diet play a key role in. You forget that people respond differently to heart attacks; likewise, people recover differently too.