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Cardiac Rehab?


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has anyone done this for POTS?

I've been trying pilates/yoga combo classes and I can't manage the position changes and exertion level (yet). I started a water aerobics class which winded me a bit but overall was good and more manageable (although I'm exhausted and symptomatic today).

Is it worth it to ask the doc about a cardio rehab program, or just to keep doing gentle yoga, walking, biking and water aerobics?

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Yes. Yes! Yes!!

I began cardiac rehab last March following a visit to Cleveland Clinic where they strongly recommended it. My local cardiologist here in Clearwater, FL had to write a script for it. At that time I had tried some yoga and exercise bike (but both made me dizzy and I had heart palpitations all over the place.). On my first day of cardiac rehab I could only handle about 5 mins- wore my sunglasses and earplugs but was glad to have the nurses watching for signs of abnormal heart activity. I worked w them for about 6 weeks 3x a week. On good days I would be able to take off my sun glasses and get going pretty hard and strong on both the recumbent bike and rowing machine. On good days the nurses would often tell me to slow down so my HR wouldn't go too high. On bad days I could barely look up and it was downright pitiful. I had pretty bad exercise intolerance and would almost always crash afterward. but starting w cardiac rehab gave me the security I needed to know I wasn't going to die- because on bad days that is what it felt like. (actually, my bad moments still feel that way).

Exercise has been critical for me moving from being bedridden to halfway functional. My muscles are strong and my balance is better directly bc of the exercise.

Since discharge from cardiac rehab I have worked w an exercise therapist. I now only see her once a wk and it is out of pocket- but worth every penny. Today for instance, I did circuit training for nearly an hour. Almost all my exercise w her now is upright. I still do mostly recumbent work without her on the other days of the week. (3-4x a wk). I do have to be careful. I easily grey out, feel dizzy and tach. I have learned techniques like "sit/stands" (squats fast on a chair) that help me restore blood flow to the brain when I'm greying out or dizzy. I monitor my HR like crazy and make sure it comes down to below 120 between each circuit - this is a bit laborious but essential bc my HR will go from 70- 170 in less than a min. And it is important that I don't start my more strenuous exercises when my HR is already high. I often lay down during a sessions and go home and lay in bed to recover after my workouts.

All that said, I am confident to do these more attempts routines which help to manually pump blood bc I know I'm not going to have a life threatening episode.

Exercise has not improved my POTS (I still tach pretty high, pool blood pretty drastically, still have all the symptoms that go along w it) but it has strengthened me to begin living life again outside the confines of my bed/ house.

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I've been going to a cardiac rehab/maintenance program in a hospital 3x per week for almost two years now. Based on my experience I really think it should be a standard thing doctor's send Pots patients to. It certainly hasn't cured my symptoms (not by a long shot) but I know it's been one of the key things that's helped me manage this as best I can.

Before Pots I used to do yoga, but once I got sick I couldn't really do the poses anymore. Even gentle yoga would make me feel awful.

When I first started the cardiac program they had me on the heart monitor and would make me slow way down to a level that seemed absurdly slow- not even like exercise at all. But I learned that was where I needed to be in order to tolerate any level of physical activity. And even though my muscles didn't feel like it was exercise my heart was certainly pumping at a level that qualified as exercise! :) They slowly built my tolerance up. I still go slow, and not very far, but it's better than it used to be- and I'll take any level of progress I can get.

The other thing that's been really wonderful about this type of program is that if I'm in a flare they go back to putting me on a heart monitor for a while and reassess my activity level. At one point my flare was so bad they restricted me to only 5 minutes of seated exercise at a time; and slowly built my tolerance back up, just like they did before. I know I wouldn't have been able to do that on my own.

I also know I would have pushed myself way too hard if were trying to exercise on my own. Which probably would have made me give up on exercise because of how terrible I felt. I've certainly had times where I've pushed myself too hard in CR, then felt awful later. But since the medical staff was there to monitor everything, at the very least I knew nothing super crazy bad was happening. The few times something dangerous actually did happen, I was very glad that the medical staff was there for help.

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