Exercise RX

Heartbeat Exercise RX

By Cindy Baldhoff

There’s no magic pill for heart disease, but doctors say physical activity is the next best thing.

As a child, Susie Sullivan was prohibited from doing most types of physical activity. Born with congenital aortic stenosis, she was mostly sidelined from things like physical education and sports. At age 15, Sullivan had her first open-heart surgery; afterwards, she got the green light for exercise-related activities — but with certain caveats and limits.

“My high school required participation in sports year-round, but I wasn’t allowed to do team sports or anything that involved running,” says Sullivan, who is a member of Mended Hearts Chapter 106 in Chicago, Illinois. “So, I either managed a team or was a cheerleader.”

She craved activity, so once she started college, she rebelled. Sullivan started running and taking a lot of aerobics classes. Rather than leaving her weak and tired, she discovered exercise was energizing, bolstering both her mental health and physical strength.

“I found that exercise kept my heart and entire body strong and better able to deal with surgeries,” says Sullivan, now 60. “And it really gets my endorphins flowing and lifts my mood. It also gives me a sense that I am able to do things I want to do.”

While exercise is often touted as being beneficial for physical health, it does, as Sullivan found, also have mental and emotional benefits. Today, more and more doctors are prescribing it to provide relief from some of the most common maladies on the planet, including heart disease, depression, Type 2 diabetes and autoimmune disorders, while also eyeing its benefits in treating mood disorders.

“I believe that if physical activity was a drug it would be classified as a wonder drug,” writes Dame Sue Bailey, chair of the U.K.’s Academy of Royal Medicine Colleges, in the 2015 report “Exercise: The Miracle Cure and the Role of the Doctor in Promoting It.”

The report provides a thorough review of studies supporting the belief that exercise can be as effective as — and in some cases, more effective than — medications in treating individual conditions. The report found that regular, consistent exercise can reduce the risk of dementia, Type 2 diabetes, some forms of cancer, depression and heart disease by at least 30%. The researchers noted that such improve- ment is better than many drugs offer.

“People who exercise regularly tend to have better vascular health,” says cardiol- ogist David Huneycutt, M.D., of TriStar Centennial Heart in Nashville. “Those that do routine exercising have a healthy lining of their arteries, and that creates a resilience to things like heart attack and plaque buildup.”

He says exercise often improves blood pressure, but diet plays a key role as well. And once someone begins exercising, they may become more aware of their choices. That can create a positive cycle of good habits.

“People who exercise regularly tend to be a little healthier in general, they tend to be more health conscious and they also tend to have lower weight. All of those are independent variables that affect their overall health and vascular condition.”

Getting Your Head in the Game

While doctors have long been prescrib- ing exercise as a way to lower the risk of heart disease, stroke and diabetes, studies now make a strong link to its role in mental health as well. A study published in The Lancet Psychiatry journal showed that when done in moderation, exercise boosted mental health and led to less stress, depression or difficulty managing emotions. Regular exercisers reported 43% fewer days of poor mental health compared to those who did not exercise at all.

The study found that 45 minutes of exercise, done three to five times a week, appeared to be the most beneficial for mental health. Interestingly, doubling the amount of activity didn’t double the results; researchers could not find a noticeable difference between exercising for 45 minutes a session and exercising for 90 minutes.

Their findings also showed that exercise in group settings showed slightly more benefits for mental health than exercising alone, but even completing housework that required a significant amount of physical activity provided a positive mental boost.

One important element in the success of any exercise program is the mental attitude with which it is approached. Too often, people view it as a task or a chore that must be completed. For Sullivan, the ability to participate in any form or exercise is something she views as a gift.

“Because I wasn’t able to exercise or be active for large chunks of my life, it was and is something I don’t take for granted. Exercise really is a privilege.”

At the age of 50, she had her third surgery to repair an aneurysm to replace a valve. She resumed running as part of her cardiac rehab, and eight years later, she laced up to run the Chicago Marathon for the first time.

“At first, I was totally shocked that my cardiologist cleared me to actually do the marathon, since I had been told ‘no’ my entire life. She ordered an exercise echocardiogram to help her make the decision. Getting the OK was like being unchained,” Sullivan says. Initially she wasn’t sure she would be able to work up to running 26 miles, but she followed the training schedule, stayed aware of how she was feeling as she added distance and remained consistent with her running. At age 58, she completed the marathon — then ran it again the following year.

“Crossing the start line on the first marathon brought me to tears, as did crossing the finish line on both marathons,” she says. “I’m amazed and a little proud to say that I did the marathons, because that was something I thought I’d never actually be able to do.”

Although her marathon days are now behind her, she still runs three or four miles a few days a week. She also enjoys doing yoga or taking online at-home fitness classes.

“Exercise, especially running, has opened up my world, cleared my mind, brought me joy and a sense of accomplishment and shown me I can do so much more than I ever thought I could,” she says. “On days when I feel lazy or have a bad attitude about it, I remind myself that there will be a time in the probably near future when I’m told to put on the exercise brakes in anticipation of another valve replacement, so I’d better take advantage of it now.”

Slow and Easy Wins the Race

For those who are ready to start a new exercise program, or resume one they previously abandoned, Dr. Huneycutt says there are two key factors to make it successful: It needs to be something you’ll be able to do, and it needs to be something you enjoy.

“For my older patients, who might also have problems like arthritis, we try to get them walking and doing things like water aerobics and swimming,” he says. “Younger patients are able to do a little more vigorous activity. But I usually start the conversation by asking them what they like to do, because if it’s something they enjoy in terms of physical activity, they’re more likely to stick with it.

“If they don’t like it, the first time they hit a speed bump like a time constraint or an injury, that will be the first thing to go out the window.” While you want to be challenged, it shouldn’t be frustrating.

“Especially for those who are new to exercise, I have them start with kind of low levels of activity and work their way up slowly over time. We start with a pretty low expectation of starting physical activity in people who are deconditioned and haven’t been doing any kind of exercise regularly.”

For example, the American Heart Association recommends walking on a flat surface, whether that means strolling down a sidewalk or walking on a treadmill, for up to eight weeks before attempting to walk at an incline or breaking into a jog. (And of course, if there’s any sign of chest pressure or pain, lightheadedness or shortness of breath, it’s important to stop immediately and contact your doctor.)

Combining different types of exercise — such as strength training a couple of times a week and cardio or interval training on other days of the week — can help keep an exercise routine from feeling stale, which adds to the likelihood of sticking with it.

“Folks can mix it up if they want to. Or they can combine them and do a little bit of both each day; whatever works best for them and keeps them exercising.”

Sullivan adds that if someone isn’t comfortable with going to a gym or doing something alone, there are many online programs and workout plans to follow. Her biggest advice is just to start slowly and be consistent.

“It can be daunting, but take it step by step. Get your doctor’s clearance. Walk, bike, whatever and do something almost daily. It becomes a habit quickly and you’ll immediately feel good about yourself — even before you start seeing physical results.”