Exercise for Dilated Cardiomyopathy Patient

The best exercise

Once I had attended a recovery program in the hospital after view weeks lying down the bed for another edema and catheterization process.  View things that I have to remember before doing an exercise are:

1. My cardiac muscle is very weak (26% fraction of ejection)
2. My blood sugar level need to be stabilized. 
3. My medication is slowing down my heart beat rate and also lowers the blood pressure.

Those 3 things collide to each other, because I can't rise up my physic to be strong enough to do exercise due to my medication.  If I try too hard, pushing myself to do a bit long exercise, it may cause another damage to my heart muscle.  And in the other hand, if I don't do any exercise, it will increase my blood sugar level. So that, my therapist had to carefully monitor my physical sign and condition while I was exercising. In general there are 3 kind of soft exercises I did: 

1. Warming Up: by walking in 5 minutes. Speed of walking is not a mandatory target. Please do not run or having any movement that could shake your body recklessly even for a shorter time. For newly recovered patients, shaking up your body might result bumps to your Heart and far more can disturb  your heart beat rhythm. I quite dangerous to patient that also has cardiac arrhythmia.  
2. Slow and Soft Aerobic: do a steady movement with your body from arm to your leg using most of your muscle.  A continuous stretching and riding a static bike are adequate to this stage. The main point is to exercise your lung and cardiac to absorb oxygen more efficiently.
3. Strengthened the muscle: is the advance level after several repetition of stage 1 and 2, and has to approved by your therapist or doctor after reviewing your latest condition.  The main idea of this stage is to gradually rise up your muscle contraction until it gets tired.  Please remember that each patient of Dilated Cardiomyopathy has to do this very carefully, since overloading your body muscle with excessive load and exercising time, will surely cause another dilation or heart remodeling.  A "hard" defecation can also cause severe damage to your heart muscle as well.

There are also non-medical exercises that i am sure will be good to try at home: 

• Respiratory and mind meditation
• Tai Chi or Chi Kong if you know the movement
• Light Yoga

In common, to reach an optimum results from the exercise, you have to do it gradually from point to point. Start from 5 minutes per day, 5 days a week, double it in the second week, become 20 minutes in the next week, and then keep it in total 30 minutes per day in two weeks. And don't you forget to monitor your heart once a month until it is gradually recovered.

After two or three months of a consistent basic exercise, and also with the permission of your physicist, you can add up your exercising time up to 45 minutes.  Warming up and cooling down time could be set in 5 minutes each, while the rest of it will be the calories burning time.  But still, please don't shake up your body or pushing its limit too much. 

It is cheap, but most effective (walk, walk, walk)

Guidelines for your routine exercise

I feel so lazy doing exercise like aerobic, tai chi, meditation, etc. My biggest enemy is myself.  I would rather playing badminton, basketball, table tennis, tennis or any of game sports, which I should not.  It is not fun anymore, is it ?  So that the objectives of doing such exercises will have to start by defeating yourself first.  You must enjoy yourself for accepting your own condition.  Think like this: "How can I play badminton and teaching my son, if I have not full recovered yet ?". Resolve this first, because the next guidelines will be so bored and stressful if you fail the first step.

1. Eat before you do the exercise and give it at least 2 hours space in between.  Empty stomach will give you no power and even gastric inflammation sometimes.
2. Remember: to have fun fun fun.  Do it with your full interest and happiness. It will stimulate your endorphin instead of cortisol and norepinephrine, the two "bad" hormones that cause you depression and hypertension.
3. Never forget to start your aerobic with warming up and ended with cooling down for 5 minutes each. These 2 sessions will avoid you from any muscle cramps or shocks. 
4. Dress up properly and adapt the climate.  A body with a Congestive Heart Failure might have a narrow tolerance to the temperature change.  Don't let your body tremble because of the cold weather or too sweaty because it is too hot and humid. And certainly don't be wet in the rain.  Wearing a wet and cold cloth will lead your body into a shock condition.
5. Be careful not to drink too much after the exercise, because you will still be in drinking restriction.  Usually patients will feel so thirsty and pardon him/her self to drink more than it should be. I did it too. But it is not a good decision to make. I would estimate that a light aerobic perhaps only results 150 - 250 cc of sweat which is the additional water I will take to avoid dehydration. It is only a glass of water.  My point is to give you an illustration about how much water you may take as an additional drink.
6. Try to find some creativity when you do the aerobic to avoid boredom, and always start at same time, for example: at 08.00 in the morning. 
7. The seventh stage will be making it your habit and lifestyle, so that no burden is on your shoulder anymore, because it has become your daily need. And the last one but not the least, keep recording your activity and progress. You might need it to consult with your doctor regularly.