Anatomy of a heart attack, Part 4: Stress test and a sweaty gym visit

This is the fourth in a series about experiencing a heart attack and recovering from one.

There are three kinds of heart attacks: bad, really bad and permanent. The first two require immediate intervention such as angioplasty and stents, and then ongoing treatment such as medication and lying awake into the wee hours, worrying. The third kind is not a problem for you to worry about, which is not necessarily a good thing.

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Worrying might be negative, but at least it’s free. After surviving a heart attack, you can’t help but flash back to lying on the operating table, sweating like one of those people you read about who sweat a great deal, shaking uncontrollably like one of those other people who shake, while the doctors work to save your life.

You remember being surrounded by busy people with furrowed brows and scary monitors that beep and “Good grief is that my own heart?”

Yes, that is a radioactive view of my still-beating heart, and there goes the little wire, balloon, stent, camera and investigative news crew, exploring various nooks and crannies as necessary. It’s a unique view, and why they make you lie down for things like this.

It is scary and uncomfortable, and I remember thinking to myself while lying there: “Well, at least I won’t have to go to my dentist this week.” This really happened, but from personal experience, I can tell you that suffering a heart attack is not worth getting out of a teeth-cleaning appointment. It’s a lot of hassle, which brings me to the subject of ongoing treatment, assuming ongoing is what happens to you.

The stress test

The stress test, also known as an exercise electrocardiogram or treadmill test, is a useful diagnostic tool that combines the science of cardiac physiology with heavy sweating in a tiny, unventilated office space. The stress test is made extra-stressy by the presence of a stranger in the room, usually a young, fit, nurse-type stranger who obviously has made several serious career-handling errors that led to her being here with sweaty, gross you.

The point of the stress test is to chart your heart’s electrical activity during exercise, which provides your cardiologist with important data to:

  • Help assess symptoms, such as shortness of breath and chest pain
  • Identify abnormal heart rhythms
  • Determine the precise extent to which you do not look like Brad Pitt with your shirt off.

First, the technician gently clears 10 small areas on your torso in order to attach electrodes and colour-coded cabling that looks pretty much like the tangled mess in back of my stereo system, only less dusty and with fewer dead flies. By “gently clear,” I mean she shaves cellphone-sized squares on random places around your chest, stomach and sides, and then vigorously rubs them with alcohol — but not the good kind of alcohol.

This is to help the cardiologist see what a brown bear might look like after a fight with, say, an enraged mongoose. I’m kidding! It’s to help the stress-test electrodes stick to your body forever and ever and ever.

My last stress test was in July, and I still have little grey remnants of old glue patches here and there, despite repeated treatments with alcohol — and this time I do mean the good kind of alcohol.

The stress test begins with a gentle walk on a treadmill, and gradually progresses to a faster and more difficult run on a steep grade. At regular intervals, your blood pressure will be checked, and you will be asked if you feel any chest or arm discomfort, dizziness, and whether or not your knees normally sound like a bag of pretzels being run over by a shopping cart at a homeless camp.

This process continues until you reach a target heart rate based on your age and fitness level, after which you either a) die and stop, or b) get bored and stop. I’m not making this up. After 13 and a half minutes of running, I got to my target heart rate of eighty billion beats per minute, and then stopped because it was boring and uncomfortable. Not because of my heart, but because — how do I put this delicately? — I am on the largish end of the adult mammal spectrum and not a runner.

I’m more of a pounder, and, as I believe I might have mentioned, a heavy sweater. My point is that just like many other rational people around the world, I really, really, really do not like running.

Exercise your way to happiness — or hysteria

One of my failings as a 21st-century-type person is not getting around to culling the dumber people from my Facebook feed, for example friends who post motivational images of supremely handsome, muscular and bald personality Dwayne “The Rock” Johnson, superimposed with the words: Your only limit is You.

I know what you’re thinking. Hey, you’re thinking, what about gravity? Gravity must be a limit, given how hard it is to get out of the chair after a Thanksgiving meal. What about the speed of light? According to physics, that’s the finite speed limit across the entire universe, including Alberta, where highway signs are mostly just put up for target practice.

What about random automatic weapon fire and cosmic rays and ovarian cancer and land mines and viral meningitis and hungry Burmese pythons and — not to put too fine a point on it — severe heart attacks? No, I’m with you: These things strike me as fairly significant limits.

Which brings me to why I am here at the gym, sweating at what is probably the professional level. I, too, would like to justify my own lack of making any sense by cultivating supreme handsomeness, muscles and male-pattern baldness. I have an advantage over many in that I have already achieved one of the three, and I also have a motivational quote, which is: “Does anyone here know how much sweat is too much sweat?”

I am told that being physically active and sweaty is an important part of my recovery. Too much sitting around, eating bonbons and/or pounding back scotch is no good for anyone, but exercise is particularly important for heart-attack survivors. According to the Heart and Stroke Foundation of Canada, exercise reduces the risk of dying from heart disease by 50 per cent.

If that isn’t enough motivation, exercise helps you feel better physically and emotionally, and reduces the risk of having more heart problems, because exercise:

  • lowers blood pressure
  • improves cholesterol levels
  • lowers blood sugar
  • strengthens bones and muscles
  • reduces stress and improves your mood, except when that guy hogs the gym machines.

I try not to think about the fact that I was probably in the best shape of my life when I suffered my heart attack. I’m not so much angry about that as I am furious. Nevertheless, what is important is that I am now back on the horse. Fortunately, my gym does not allow any actual horses.

The hardest part about a gym workout is actually going to the gym. As soon as you arrive, it will be apparent that the gym is not as comfortable as, say, your La-Z-Boy recliner at home.

The gym is also uncomfortably full of beautiful people with skin-tight exercise outfits that might or might not be body paint, aerodynamic drink bottles probably not full of scotch — certainly not single malt — and muscles so big they can barely contain all the tattoos.

They might say confusing things such as: “Cotton kills, dude,” and other bro-science such as: “I hold my pee after drinking protein shakes so I can absorb more.”

Even if you are already comfortable with the gym, it is a little scary going back after heart trouble. You have to change your expectations about what you can safely do, and reset all the weights to roughly that of an empty aerodynamic drink bottle. Again, what’s important is that you are at the gym, and the horses are not.

Before starting an exercise regime, it’s important to check in with your doctor. Ha ha, I’m kidding again! Nobody has their own doctor any more. But there is a ton of good information online. My recommendation is, after first stretching for 45 minutes, Google “FITT” — a helpful exercise acronym that stands for Frequency (how often?), Intensity (how hard?), Time (how long, O Lord, how long?) and Type (what kind?). We don’t have time to go into the details of FITT right now, because I forgot to stretch before writing this.

Safety tip: Always listen to your body. Chest pain is a good indication that something bad is going on, and it could be heart-related. Either way, the take-home message here is: Take it easy.

If you’re completely new to exercise, you’ll be happy to hear that walking counts as exercise. You’ll be even more happy to hear that sex also counts as exercise, but not while walking because that is prohibited by several municipal bylaws.

There are five basic kinds of exercise: stretching, belching, resistance, aerobic and vacuuming. They are all very important for your recovery and ongoing health, and you can combine them in any order you like as long as they do not involve horses in the gym.

Aerobic exercise is sometimes called endurance activity, and refers to the continuous movement of large muscle groups, such as the legs or, in some unfortunate people, the ears. Aerobic exercise increases breathing and heart rate, which strengthens the heart, lungs and circulatory system.

Almost anything counts as aerobic, so long as you are breathing air. Examples of aerobic exercise that you can begin today include:

  • Walking
  • Cycling
  • Bench-pressing kitchen appliances
  • Swimming
  • Yoga
  • Yogurt
  • Competitive Indian leg-wrestling
  • Filling out short-term disability insurance forms for your HR department

A warmup is essential before starting aerobic exercise. This allows the blood vessels to relax, open up and increase blood flow to the heart, lungs and muscles.

Warm up for at least five minutes, wearing appropriate clothing, such as a wool tuque, warm mittens and an Eddie Bauer 100 per cent goose down parka. You might wish to build a fire, which is also very good exercise.

To safely end your exercise session, cool down for at least five minutes, gradually slowing your rate of activity until you fall gently into a light sleep.

When you rouse, if you do, complete your exercise with more stretching while your muscles and joints are warm and pliable, and thus easier to bend and twist into a more handsome, muscular and bald version of you.

The series

Part 1: 'Every part of me felt really awful'

Part 2: 'Exceptional medical talent' at Royal Jubilee hospital

Part 3: Risk factors and the French Paradox

Part 4: Stress test and a sweaty gym visit

Part 5: Grow up and eat your vegetables

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