When I was working in cardiac rehabilitation, there is one heart transplant patient I will NEVER forget.
She was a mom of young children, waiting for a new heart. It was October and she was hoping to go trick-or-treating with her children. She came in the week after Halloween completely discouraged. She just did not have the stamina to walk even a couple of houses with her kids.
In the year that followed, she walked on the treadmill, a little every day, slowly and steadily, still waiting for a new heart. The next year came around and it was Halloween again. No heart transplant yet, but exercise had worked its magic to unleash her design to thrive.
The next October she came in and joyfully reported that she was able to go trick-or-treating with her children throughout the whole neighborhood!
I still smile when I think of that day.
I share this as a reminder that every system in your body is designed to thrive. When one part is not working well, other parts will work harder to make up for it. This is just how your cells are hardwired. They want you to survive so you thrive!
The focus on oxygen in cardiac rehab exercise for heart disease patients
Cardiovascular exercise, or “cardio”, is any exercise where the body is moving continuously so the system is challenged a bit beyond normal everyday physical activity levels. Some examples are walking, swimming, dancing, and biking.
When we think of cardio, we might think of getting the heart rate and blood pressure up and strengthening the heart muscle. In actuality, what is important about cardio is how it strengthens all three parts of this system that work together to take in oxygen, send it where it needs to go, and put it to use to create energy.
Taking in oxygen is up to the lungs. Healthy lungs do not limit cardio - although it seems like it when we are short of breath. Shortness of breath during exercise is actually triggered by the body trying to rid itself of carbon dioxide. An issue with the lungs such as asthma or emphysema can limit the body's ability to take in oxygen. However, even when the lungs are compromised, the other two other parts of this system can take over to improve stamina.
The transport of oxygen is the job of the heart (the pump) and the blood vessels. When we perform cardiovascular exercise on a regular basis, the body does all it can to make this system efficient. The heart becomes a stronger pump, the blood becomes a bit thinner to allow for ease of blood flow. Also, new small vessels grow like roots in a tree to send blood to more areas of working muscles, including the heart muscle. All this makes oxygen more available for working muscles.
The muscles’ ability to use oxygen is key. With consistent exercise, the muscles adapt by increasing the system that turns oxygen into energy. Specific enzymes as well as energy-producing parts of each cell (mitochondria) increase to make this happen. This area adapts within a few weeks of cardiovascular training. With a bit of consistency, you will notice everyday activities becoming easier.
The mom waiting for a heart transplant was able to increase her oxygen delivery and use systems to improve stamina, even when her heart could not get stronger.
Putting together an exercise plan for heart disease patients
When shortness of breath, leg fatigue, or pain occurs with only a short distance of walking, it seems like getting these benefits of regular exercise is impossible.
Often, myths and misconceptions prevent many from gaining the life-enhancing benefits of regular cardiac rehab exercises:
Myth #1: It has to be hard. For improving stamina, your breathing should feel moderate to comfortably challenging. If it is uncomfortable, your body is not using oxygen for energy as well and your brain learns this type of exercise is something to avoid!
Myth #2: I have to get my heart rate up. If this were true, we all could sit around and drink coffee to get a good workout. The heart rate is only one way to measure and it is not perfect. The heart rate ranges based on your age are just estimates - and the error in those equations could be about 10-15 beats inaccurate - higher or lower, so this is not a perfect tool by any means. Your breathing is a much more reliable gauge when it comes to health benefits.
Myth #3: I have to sweat. Sweat rate has to do with the environment, genetics, hydration, etc. Sweating does not mean you are burning more calories or getting a good workout - it is simply a way your body regulates temperature. Please don't make yourself sweat to burn more calories or fat.
Myth #4: I can't exercise, it is too painful. There are many ways to challenge the cardiovascular system. If you have pain with walking, we can find a way for you to exercise and improve stamina. I have met very, very few people who truly can't exercise.
Myth #5: I don't have time. It takes only three 30-minute sessions of cardio a week to improve stamina. Can't do 30 minutes altogether? If you are just starting out you will notice an improvement in stamina with several shorter bouts (i.e. 5 or 10 minutes) that add up to 30 minutes on most days of the week. The key is to do intentional movement, so you can listen to your body to know how much is enough. Something is way better than nothing! An hour and a half a week for amazing health and well-being benefits - what a bargain!
Consistency is key to enjoying these benefits! That is why we need motivation science and mindfulness, in addition to exercise science. The synergy of these three sciences is The Be Well Now Method. It is designed to simplify exercising to unleash your design to thrive!
Bottom line: Your cardiovascular system is designed to thrive. When the three parts of the cardiovascular system are challenged in the right way consistently, they work their best. The best part is you have more stamina to enjoy life.