Exercise again--- being overweight versus exercising.

[sandylevitt]

Based on an answer given at the annual meeting, those with HCM are not suppose to get their heart rates over around 110. also weight lifting is pretty much a no-no for muscle building. This pretty much says that light walking (probably not over 3.5 mph) and other casual exercise, such as leasure bike riding, is the only "official" forms of exercise.

The issue of losing weight usually involves both diet and exercise. Those that are most successful in the non HCM world, usually do so with a regular exercise routine. To lose weight with just walking and eating
healthier is not as easy.

Now, being overweight is not healthly for any heart. I would assume that extra weight is pretty bad for an HCM heart as well.

So the question becomes, which is worse, being pretty overweight, or increasing your exercise (as long as you can tolerate it), to a point where maybe its a bit over the guidelines.


Being a spouse of a HCM'er, in the last few years I had lost 25lbs. I attribute that to both low carbing and also getting in shape and even doing some running. This also helps me to attempt to maintain as best
I can. I could not imagine having to lose weight by just reducing my intake and walking. Since felix has been diagnosed with HCM I have seen his weight go up 20-30lbs. After his myectomy he pretty much stopped eating, so he lost weight then, but even when he has healthier eating habits he cannot seem to lose weight. He is frustrated that HCM
has not allowed him to get back into the exercise routines that he did before diagnosis. Even with walking being allowed, there are days when he doesnt feel good enough to do so. I can see how this is affecting him both physically and emotionally.

sandy

[shirleymahoney]

Sandy

I can relate a hundred percent with Felix, my myectomy did do something for me it took the obstruction away and it made me quit smoking and that has alot to do with my weight gain but my heart is still very stiff and that in itself makes me Short of Breath, The group in Mn says if i sweat when i walk or if i can't cope when i walk upstairs then i shouldn't be exercising and i swell so bad when i walk, so i'm at a catch 22 here, I try to do as much as i can but my family hears me breathing and they say sit down, but tell Felix i feel for him

Shirley

[mtlieb]

Sandy,

I'm glad this issue has been raised again and I look forward to hearing the responses. I have to tell you this has been a real struggle for me of late and it is frustrating to say the least. Coming from an archaeology background, I'm accustomed to ten-hour days of pretty rugged hiking, digging and heavy lifting, at which time I could eat just about anything I wanted and stayed in good shape. The abrupt change from that to my current lifestyle has not been going at all well.

I've got a large endomorphic frame that was more or less built for strength not endurance. There are runner's-builds, swimmer's-builds... and then there is me. Strength-training was always how I kept this body in shape... the walking and diet alone aren't cutting it right now. I'm just not built for thin and lean... I'm built for muscle. I know with some determination, drastic reduction in caloric intake, and lots and lots of walking I should be able to do it, but it ain't gonna be pretty.

I do exceed my doctor's orders at times, but mostly out of necessity. I'm not supposed to lift more than ten pounds, but just yesterday I was pushing my heavy ol' rusty mower around the lawn and it greatly exceeds ten pounds. I swear that thing weighs almost as much as my car. It was hot and humid here, and I thought I was going to die. LoL. Being able to mow my own lawn is not something I'm ready to give up yet though.

I'm looking for ways to incorporate strength training back into my new HCM lifestyle. Has anyone found safe alternatives that yield the same results?

Jim

[Pam Alexson]

I agree , this is an area I think most of us can relate well to in terms of frustration. I am planning for gastric by- pass surgery and I need to lose 20 lbs before the surgery . The reason for the loss is not to show motivation but to help shrink the liver and get it to shed some fatty deposits so in essence I am healthier. Not so easy. I thought I had lost about 8 pounds according to my scale it was on 2.5 on theirs. I have tried to increase my activity and it is a snails level of functioning that I tolerate , I swear. I tried the treadmil, and have not given up yet. I can only tolerate 5- 8 minutes at the lowest setting and , I have to stop as my heart rate goes up to 120+ in that short time and begins to get irregular. I am exhausted all the time and , SOB more then in the cool weather and dizzy. The groups I attend are geared to individuals with normal functioning hearts but with individuals who weigh 50 - 300 more pounds then me. They want to impress x- husbands soon to be x- husbands, lovers , get into bikinis fit in normal chairs, go on vacation, run after granchildren, etc , etc. Help!!! I want to scream , just get the surgery done and hope that it relieves some of my symptoms or gets me to a lower med dosing and have a successful colon removal/ hernia repair.

I am losing this emotional mind twisting battle and I am a super misfit among wanna be glams. Why must we( HCMers) struggle so for a piece of any betterment/ desired normalcy?

Sorry for the vent. Pam

[NoCrash]

Sandy,
I’ve been in exactly the predicament you’re asking about. It is possible for an HCM’er to lose weight through diet and only very limited exercise (such as walking), but it takes some doing, some knowledge and (most likely) some help to do it. In my case the help came from Weight Watchers and from my wife, who also joined-in with the program (I’m not employed by Weight Watchers, nor is anyone in my family!). Between the two of us we’ve lost an embarrassingly large amount of weight. My wife met her goal weight and earned a “lifetime membership” and I’ve gone back to “losing mode” to take off a few more pounds after being in “maintenance” for over a year. This time, however, my diet is complicated by an edict to limit fluid and sodium intake in order to avoid complications of CHF (I had a 20-pound swing in my weight from fluid retention due to CHF—I’m a big guy to start with, but that was ridiculous!)

I got asked “Have you lost weight? How?” a whole lot after I had been dieting for about 8 weeks (and it takes a lot weight loss for another guy to notice!) It was my experience that “guys” do NOT want to hear of another guy losing weight primarily by diet—the typical response was “I’d rather burn it off by taking another couple of laps” and there was just no talking to those guys!

The problems with that approach, as you hit upon in your post, are that (1) it really doesn’t work unless accompanied by at least some diet changes, and (2) HCM’ers can’t/shouldn’t indulge in exercise that burns large numbers of calories per hour. (My own days of 30 mile bicycle rides are long over, at least until a new heart comes along. I’m now burning-up-the-sidewalks having worked-up-to a scorching 40-minute mile. Age seems to factor into it, too, but it seems some of the weight I took off at age fifty must have gotten on me when I was 25—just how does that happen anyway?)

One of the things I learned that was revolutionary for me is that in order to have a sustained weight loss you need to control your metabolism by keeping your calorie intake within a range of values—you can’t just drastically reduce your food intake and expect to lose weight. Too many calories per day and your body says “better store some of this energy for bad times ahead” and too few calories per day your body says “bad times are here, better slow down to avoid starvation.”

A dieter HAS to know what they’re eating and keep the caloric intake in the range you need to lose weight. It also helps to get SOME exercise to help keep the metabolism going. I was pretty successful when I was only capable of a slow walk for 15-20 minutes per day.

Weight Watchers helped with diet tricks and food/ingredient substitutions, too. I'm still carniverous (medium rare, please) and we still manage to have meals where I just have to say "nothing wrong with that meal!"

I’ll stop proselytizing for Weight Watchers and say that I found another thread here on the subject of weight frustration and Weight Watchers (it seems I'm not alone in my views). If you have questions about their program I’m sure somebody here can take a stab at answering them.

http://forum.4hcm.org/viewtopic.php?t=3655

Hang-in there guys, we’ve all been there!

Regards,
Rob Thomas

[michael obrien]

hi everyone.this such a difficult area for me I have always struggled with weight,and now with the activity restrictions,and 200mg dose of toprol.my metabolism is as slow as a snail.I have discovered a way to strengthen my flabby frame.I asked my dr.if I could punch a heavy bag he said go ahead just dont overdue it.(he had told me not to lift more than 20lbs so hes not a quack).I went and bought a stationary bag with a base you fill with water.I watch the clock on my computer,put on some music and I begin by slowly punching(with gloves).I have a resting heart rate of about 55.yeah you guessed it toprol.I hit the bag for 3 min.and then break for a min.I go slow and develop a little rhythm,and I get my heart rate to about 90 or 100.I can work up a sweat and dont have much in the way of symptoms.I cannot tell you how good I feel after this.I am much happier since I have been doing this little workout.the next day my arms ,shoulders and lats are all slightly more toned.my endurance has increased,and I can walk further.I try to walk everyday,but Im still not losing much weight,but I definitely feel better.please respond if any one has any other ideas or feedback on what im doing thanks everyone,and feel good mike

[Laoshur]

Mike,

I don't have any insights into the bag punching, but I am having a similar experience with exercise. I started doing a work-out video that is very mild before I was told "No exercise" last spring before I got the ICD. At that point I quit. I tried it once or twice last semester and found that I had chest pain and weakness after doing it. A few weeks ago I decided that I was sick and tired of being overweight and out of shape so I pulled it out and persisted. What I am doing is doing as much as I can without feeling like I am really straining or getting too short of breath. I feel so much better and better about myself as a result. However, I do think that it increases my fluid retention problems, so I am unsure if it is a good idea or not. I am generally doing this every two days, but if there is a day that I have a lot of stressful activity (such as yesterday when I had to give a technical seminar in an unAC's 4th floor room), I do not do it. I have also been trying to watch the food and have lost about 6 pounds and can feel my muscle strength returning.

Maybe someone can also comment on what I am doing.

Rhoda

[mtlieb]

Rhoda and Mike,

It sounds like you both have found activities that you enjoy and make you feel good, with a minimum of discomfort to boot. I'm no medical professional but it sure sounds allright to me! You guys are doing great.

Since I last posted, my exercise of choice has now become my mountain bike. I got the old Rockhopper out, fixed it up, and I've been riding the heck out of it ever since. I know my doc would prefer me walking, but it just wasn't doing anything for me whereas the cycling seems to be doing wonders. I ride my bike to school, to the grocery store, doctor's appointments across town... everywhere. Heck, I haven't had to use my car in over a week... which is rather convenient since it's broke down. LOL.

I think maybe the key with HCM is finding an activity we really enjoy and then just doing it as often as we can. We can't hit any one type of exercise really hard, so what we lack in quality we have to make up for in quantity. And with our meds putting a cap on our metabolisms, we may have to do any activity twice as long as our non-HCM counterparts just to burn the same number of calories. The double-whammy. Not fair, but that's what we've been given to work with.

Jim

[Darren1]

HCM are not suppose to get their heart rates over around 110

Really? Hrmm.. I can't even walk fast w/o reaching 110. When I bike or run, it's about 150-160. I agree with the comments on this thread that it's better to be active with HCM than sedentary.

[mtlieb]

Re: HCM are not suppose to get their heart rates over around

Really? Hrmm.. I can't even walk fast w/o reaching 110. When I bike or run, it's about 150-160.

It's a med thing. With the beta blocker I'm on (as with many other folks here), I can't get my heartrate over 100 no matter how hard I try. During rehab, I think the highest it ever got was 98, and that was at peak intensity on the treadmill. The result is that we don't burn the same number of calories as another person doing the exact same exercise.

It's kind of a catch-22 really. The meds we take to control our symptoms and manage arrhythmias are the same meds that prevent us from getting a good workout. That's why I'm thinking the only way to get around it is by increasing duration.

Jim

[Cynaburst]

Jim - Is that a confirmed fact, i.e. has any professional ever told you or have you ever read somewhere (and if so, where) that if you can only get your heartrate up to 100, that you aren't burning as many calories as someone who has a higher heart rate? I ask because I have never been able to get a straight answer on this issue. I also can't get my HR over 100 because of the beta blockers (although maybe I should try my monitor again since I have reduced BB). Anyway, I also struggle w/ my weight and exercise, so I do wonder if this is true. Please share any info. you have, and where you have gleaned it, oh wise one....

[mtlieb]

Hiya Cyn,

Previously I had always thought that it just kind of makes sense, so I didn't bother to look much further:

Increased Heartrate = Increased Metabolism = Greater Weight Loss

However, I have a family member who has recently lost a great deal of weight through the Weight Watchers program... which she highly recommends. Being open-minded (and desperate) about getting this thing under control I decided to peruse the online Weight Watchers materials and found many references to heartrate and weight loss. One such article is this one which pretty much confirmed what I had thought. Here's an excerpt:

Heart Rate's Impact

A person's heart rate has an impact on metabolism – the higher the heart rate, the more calories burned. Stimulants, whether from a prescribed medication, dietary supplement, or a caffeine-containing beverage, all work to increase the heart rate and fire up the nervous system.

In a controlled study that looked at giving stimulants, including amphetamines or a placebo, weight loss was greater with the stimulant because heart rate and blood pressure were raised and food intake was decreased as a side effect of being "hyper."

I've also discussed this issue with my various docs, and the advice I've received has been exactly what you would expect. With my reduced heartrate and metabolism because of the Atenolol, I will simply have to do 'more' to achieve the same results as my non-HCM counterparts.

In response to your question, I also just did a quick Google search for the keywords "heartrate, metabolism, weightloss" and came up with plenty of references to suggest the link between heartrate and weight loss. When I get time later on, I'll do an academic search for peer-reviewed journal articles and post the links, but I feel confident that they will all say the same thing.

Hope this helps,

Jim

[Cynaburst]

I will tell you that what you say is definitely my experience. I lost about 15 lbs. last year with Weight Watchers, but it was SLOW and I could never seem to get the same results as others. I could still lose another 10, and I try to stay on target, but it is easy to get discouraged, esp. when progress is so doggonned slow.

If I could confirm this thing about decreased heartrate, I would have it as a convenient excuse!

[mtlieb]

LoL Cyn...

God I wish that were the case, but I'm afraid we just don't get to use HCM as an excuse my dear. Using myself as an example... the people I come in contact with pretty much don't give a rat's behind whether I'm on beta-blockers or not. All they see is that I'm overweight right now, and think that this is the reason I have heart problems. They just don't realize that the HCM diagnosis came first, and the weight gain came later. But I'm still plugging along, and one way or another I'm going to get back to where I was before all these restrictions.

Take care,

Jim

[Linda]

Jim,

I have listed a site below that explains the "Borg Rating of Perceived Exertion Scale" This is an alternate means of measuring physical activity in those people who for some reason, consistently do not seem to have the expected heart rate response to the level of exercise they are engaged in. This scale is commonly used in CardioPulmonary Rehab Programs as a means of evaluation and is taught to patients as a means of evaluating their own performance. There are quite a few papers written on this, just search under "Borg Scale".

Your heart rate doesn't have to be at the suggested target level for you to really be working, but you still have to deal with the issue of decreased metabolism. However, you are strenghtening the muscles and increasing endurance.

Linda

"The Borg Rating of Perceived Exertion is also the preferred method to assess intensity among those individuals who take medications that affect heart rate or pulse."

http://www.cdc.gov/nccdphp/dnpa/phys...d_exertion.htm