Controlling weight with heart problems.
February 21, 2008 4:38 PM   Subscribe

How does one keep their weight down when to exercise is to risk sudden heart stoppage?

Two years ago I lost about 70 pounds through diet and exercise. I did a good job of keeping it off until a couple of months ago when I was stricken with cardiovascular problems and have since been in and out of the hospital with a BP of 70/50 and a week erratic heartbeat with no diagnosis on the doctors part. Today I'm quite a bit better but even light walking will send my heart rate to around 145. Yesterday, after being recruited to help push a car. After 20 seconds of moderate effort my HR approached 200 and my knees buckled. Cutting calories isn't really an option as I only take in about 1200 a day. Is there any sort of exercise I can do that keeps off the pounds but won't send my heart into a death spiral?
posted by bunnytricks to Health & Fitness (16 answers total)
For what it is worth, I wouldn't really worry about exercise right now. In fact, if your symptoms are as you describe, I would really focus on finding a good cardiologist and getting a clear diagnosis as soon as possible. Really. Seriously. And don't push any more cars.
posted by scblackman at 4:43 PM on February 21, 2008 [1 favorite]

We're completely the wrong people to be asking this question. Talk to your doctor about it.
posted by seanyboy at 4:46 PM on February 21, 2008 [2 favorites]

Boy this is a tough question. The first thing you really need to do before you even think about exercising is to find a good cardiologist. I don't want to alarm you, but the condition you are describing may be quite life threatening and suspicious for possible cardiomyopathy and/or serious arrhythmias. This NEEDS to be sorted out as soon as possible. Once it is, I would suggest discussing the possibility of cardiac rehab, which is essentially a closely monitored exercise program.
posted by drpynchon at 4:50 PM on February 21, 2008

Response by poster: Err. I should've said "for the past three weeks I've been a lot better." Slightly low BP, but chest pain and arrhythmia only when laying down. The cardiologist didn't see anything wrong with my heart in the echo and sent me home with a heart monitor for a month.
posted by bunnytricks at 4:54 PM on February 21, 2008

Best answer: This is completely anecdotal and should no way replace the good advice other people have already mentioned, but I just thought I'd let you know that there's a contestant on the current season of Australian Biggest Loser with severe heart issues. He'd basically had a non-diagnosed heart attack not long before entering the show. He was told by his trainer in one of the first episodes that his exercise was going to be extremely limited: only walking (with his heart rate to remain under - IIRC - 100bpm), no lifting of any kind, no running, no punching, nothing*. He can't even help out in the challenges. So for several weeks now, while everybody else strains in the gym, he's just been walking. Walking and walking and walking. And you know what? So far he's one of the biggest losers on the show. He's lost, like, forty pounds. And while he's kind of a dick, I nevertheless find it really inspirational that he's showing lots of people with serious health issues that you can still make a change.

* Interestingly, he was also told by the trainer that he was no longer in the running for the cash prize for winning the show. There must be some rule that they can't allow the contestants to actually try to kill themselves for money.

Anyway, yeah, silly reality TV show nonsense, but still, I think it shows that you've probably got more options than you realize...
posted by web-goddess at 5:01 PM on February 21, 2008

Chest pain when laying down still sounds pretty bad. Even if your heart is hunky-dory something is making you hurt. Get help from a doctor.
posted by uandt at 5:05 PM on February 21, 2008

I'm going to reiterate this: if what you say is true, the medical evaluation you have had thus far is unsatisfactory. If my blood pressure was 70/50 and someone told me my echo was normal, the first thing I'd want is another echo done somewhere else, followed by a slew of other potential tests from tilt-tables to stress tests to electrophysiological testing. Have you ever caught one of these episodes of your heart rate going to 200 with minimal exertion on the cardiac monitor? This needs to be done. If you are unable to get an adequate second opinion in Memphis, I would suggest strongly considering a trip to Vanderbilt for further care.
posted by drpynchon at 5:15 PM on February 21, 2008 [3 favorites]

The only thing I can recommend is to have your RMR (resting metabolic rate aka metabolism) measured. This test is super easy and not strenuous in any way. Basically you just take a nap. This way you can know exactly how many calories you burn at rest. Knowing that you can eat about 500 calories less than that and this will really help control your weight. Granted 1200 calories is what is considered average, but it isn't the same for everyone and you may have a lower RMR than 1200 or even right under 1200 and therefore you would be eating too many calories if you continue to take in 1200 everyday.
posted by peperoxors at 5:38 PM on February 21, 2008

As someone who has heart problems which sound very similar to what you're describing, let me jump in on the side of everyone telling you to find another, better doctor. My diagnosis was delayed for several months because doctors kept missing the obvious signs, and as a result my heart is permanently weakened. You should at the very least ask for a BNP test to rule out heart failure -- any doctor can order it, it's a simple blood test and it's very cheap -- but you should really get to someone who can diagnose you properly, even if it means going to the Mayo Clinic. The sooner you get to the root of the problem, the better it can be treated. And, to get back to your actual question, keeping weight off only gets harder the longer you let a heart condition go untreated. You need to deal with your heart's death spiral first, then worry about your weight.
posted by katemonster at 6:36 PM on February 21, 2008

70/50 with erratic pulse (irregularly irregular?) and a stress test over after 20 seconds? With no diagnosis? At your age, I would be seeing if I could get into clinic at an academic medical center. I'd go to Nashville or Dallas if I had to. Exercise beyond walking I wouldn't dream of. An HR of 145 is not good.
posted by a robot made out of meat at 7:01 PM on February 21, 2008

Nth go to a good cardiologist!

I have health issues (unrelated to yours) and exercise is out of the question for me too. I am very very sedentary.

I don't know how much I eat but it's probably a lot less than 1200 calories a day. Dietary guidelines are just that, guidelines. Your 1200 calories/day might be fine for you or you might need less. As I'm either sitting or lying down most of the day I don't have the caloric needs of active, healthy people. I was overweight for a while so I lost about 40 pounds by diet alone, and my weight is fine and has been stable for three years. It's possible to maintain through diet, you just have to choose nutritious food and pay attention to when you're full and hungry.

A friend of mine has similar problems and starting doing weight watchers to maintain. It took some trial and error. I tried weight watchers and hated it but it works for her. So that's another option, you can also keep a food diary.

Good luck!
posted by red_lotus at 7:36 PM on February 21, 2008

I second drpynchon's cautions. I do not like your story at all. The next chapter needs to involve a new cardiologist.
posted by ikkyu2 at 8:25 PM on February 21, 2008

I would listen to the doctors in the thread and go find a new cardiologist. ASAP. And stop pushing cars.
posted by bedhead at 8:42 PM on February 21, 2008

I hate to be such an echo, but please do be sure to talk to your cardiologist about this. What was true for someone on a TV show may very well not be true for you. Heart problems are probably not one of those things you want to mess around with. You can probably just call and talk to your cardiologist on the phone (I would think, anyway), since he's already seen you.
posted by !Jim at 9:24 PM on February 21, 2008

There must be some rule that they can't allow the contestants to actually try to kill themselves for money.

We haven't quite reached The Running Man yet - wasn't one of the other game shows in the book/movie about "run on a treadmill, have a heart attack for dollars!"?
posted by mrbill at 10:02 PM on February 21, 2008

I would be concerned if I was gaining weight at 1200 calories a day. That seems like such a low amount of calories to be fueling your regular day-to-day activities. Maybe your diet is affecting your heart? I don't know. Get thee to a doctor and a nutritionist (maybe?). Good luck and congratulations on the 70 lbs, that is great work!
posted by collocation at 6:35 AM on February 22, 2008

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