After big heart op I want to get fit, not put my feet up

QI HAD a major heart operation eight months ago but am now well again and want to keep my fitness up. I am 70 years old and have normal blood pressure, but medical staff just keep telling me to retire and put my feet up – which seems wrong. Is there more I can do safely without affecting my heart?

AGENERALLY speaking, the advice following a major operation is slow down and take it easy – and for good reason. Heart operations are a serious business and some surgeons advise that it may be up to three months before patients feel themselves again.

However, towards the end of this period – and providing you have checked with your consultant – some gentle exercise that works the heart muscle can be hugely beneficial. After all, any muscle that is not worked will gradually weaken and fade, and the heart is no different. Providing blood pressure, heart rhythm and wound healing is normal, postcardiac advice is to start walking within a couple of weeks, and to up the intensity to moderate exercise such as dancing or gardening after four weeks.

At six to eight weeks, regular, controlled exercise can be resumed, but the key is understanding your own working level and not to overexert yourself.

To establish this, refer to a one-to-ten scale, one being your resting heart rate and ten being the maximum physical exertion. Keep yourself at four to five in the first three weeks via daily walks or leisurely bike rides, for example. In weeks four, five and six, up the intensity to six or seven by introducing runs, or weekly, high-energy dance classes.

Then, by week seven and thereafter – again providing you have the all-clear from surgeons – aim for an eight or nine. This means getting sweaty, pushing the heart rate and exercising vigorously, as often as four times per week. It is possible to push yourself after a major operation providing it feels right, and safe.

QI AM paralysed from the waist down – I have been since childhood – and it’s hard to find exercises suitable for a wheelchair-bound person. I had always maintained a reasonable weight until three years ago when I began to develop fat around my midriff. Even when I watch my food intake, I don’t seem to lose any weight. What upper-body exercises can I do to help me keep the weight off?

AANY physical limitation on the body can be frustrating, especially for those looking to shift excess pounds. But it is possible; it just takes a little more creativity to get the same results.

One way is by using the upper bodily muscles to burn energy. This means engaging the pectoral muscles in the chest, the lats in the back, the biceps and the triceps. Key for burning calories is increasing the pace in order to increase the pressure on the heart and lungs. Keep rest time between sets of exercises short, and alternate between the three different muscle groups.

Alternate between a chest exercise using hand weights (arms out straight with a dumbbell in each hand, bring the arms together and out again), and back exercises such as bending and stretching the upper body forward, at a right angle, while extending the arms out in front of you.

Do 12 to 15 reps, then, with no rest, do 12 to 15 reps of the next exercise. Rest for one minute and repeat that routine four to five times. You can repeat this same process for the biceps and triceps with hand weights The NHS video series on exercising with a disability is a great place to start – visit nhs.uk/video/pages/howto-keep-fit-with-a-disability.

HOW DO I KEEP THE FAT OFF WHEN I’M IN A WHEELCHAIR?