Getting back to fitness after an ICD implant.

This is my story on how I got back to fitness after having a Sudden Cardiac Arrest, you will find some tips and guidelines but remember we’re all different.
You will also come across many barriers as you come to terms with your new life.
After implantation of an ICD (Implantable Cardioverter Defibrillator), you can be usually discharged from the hospital the next day.
Depending on your situation this can be a relief, for some, it feels a little too quick.
Usual recovery time for this procedure is between 4 to 6 weeks, there are two different types of ICD.
The recovery time is generally the same for these but ‘cause of the placement you may counter different difficulties.
Subcutaneous ICD is less invasive than Transvenous ICD, the generator is usually bigger than a  transvenous ICD.

Your cardiologist will decide what sort of ICD is suitable for your needs if you require pacing the transvenous will most likely be opted.
I think subcutaneous is becoming more popular due to the fact that it is less invasive and is believed the placement is better suited to patients needs.
A subcutaneous pocket for the generator is created on the left side of the chest next to the rib cage and the lead is implanted just under the skin above the breastbone.
The subcutaneous ICD electrode is placed under the skin and the system delivers therapy without the need for wires implanted in the heart.
The subcutaneous ICD leaves the heart and blood vessels untouched and intact.
Personally, I have a transvenous ICD so unable to comment on the recovery of the Subcutaneous.

A transvenous ICD device is typically implanted in the left shoulder area, near the collarbone, a pocket is made in the muscle. Using X-ray imaging, the leads are fed through a vein into the heart and across the heart valve.
Depending on your heart condition, one or two leads will be placed in the heart.
Once the leads are put in place, they are attached to the heart wall for optimal connectivity.

A couple of hours after having my ICD implanted I woke up in my room full of friends, I think I came around full of emotion that first thing I did was throw up.
I had been in the hospital for 3 weeks at this point, I felt bruised, beat up and now that I had ICD they were telling me that I’m going to be released the next day.
I had been ready weeks ago to go home but having my ICD implanted I was scared to go home, but also relieved to be going home.
The cardiac nurse felt that I wouldn’t benefit by going to cardiac rehabilitation, I think that was my mistake.
Yes, I was 26 at the time, but I didn’t know what I could do anymore, they said I could exercise but never gave me a true indication of what I could do.
So my first tip is to make sure you take up any rehabilitation offered to you, even if you’re really fit, I think cardiac rehabilitation is a good tool to help you adjust to your ICD.

So after being released from the hospital I only had to return 3-5 days later to get my stitches removed, I was then left to my own to adjust to my new life.
I had an early setback, whilst in hospital, I made friends with someone online and they said they wanted to look after me after I got released from the hospital.
So I did go and stay with this person for a few days, I had a sexual encounter with this person, afterwards, I collapsed/ passed out in their bathroom.
That was a week after being released from the hospital, maybe that was too much too soon.

I was back to work within 2 weeks from ICD implantation, I worked in retail management ‘cause I will still healing I wouldn’t do any lifting or reach overhead.
I was pretty much back to normal within 6 weeks and regained natural movement in my left arm.
I wanted to get back to exercise, I wanted to go running, but I was too scared, finally, I had my first pacing test 3 months after being released from the hospital.
I relayed my fears to the technician at the pacing clinic, they put it in my notes and through them, I got my fitness test at the hospital.
So they got me on a treadmill, wired me up and this helped me discover that I could get back to fitness.
In my mind I still didn’t know what level of fitness I could attain too, I still wanted to run.
Running had been my escape, if I was down I would run and I felt I could no longer do that anymore.

Joining a GYM was my next move, all gym will ask you to fill out a PARQ form (Physical Activity Readiness Questionnaire).
Working in gym myself now I appreciate the importance of a PARQ form and I feel it is best to be honest when filling one out.
I joined the Gym Group and they didn’t contact me to ask me any questions or to check that it was safe for me to exercise.
A good gym will ask you questions and some might want a doctor’s note or a cardiologist letter to say that you are good to participate in exercise.
Which can be a pain to obtain but if the gym showing an interest in your welfare and not just your money that is a good sign.
Also by filling out the PARQ form honestly if something was to happen whilst you were exercising the staff in the facility will be able to help or pass on your PARQ form to medical professionals.
Most gyms will offer you an induction with a Personal Trainer/ Fitness Instructor and hopefully, they will put you with someone that got cardiac experience or with the doctor referral qualification.
Do take an induction up it is good opportunity to relay your fears, but also they will be with you whilst you workout and they can be the reassurance you need to get you through your first workout.

Being aware of what I was capable of doing, I would jump on the cardiovascular machines and go hell for leather trying to get my heart rate as high as I could.
Probably not the best practice but it was my way in finding out how hard I could push myself.
There may be a fear of doing overhead exercises, it is safe to do overhead exercises.
Start with light weights to get used to the movement and with time and confidence increase your weights.
Over the years I have now pushed my body harder than ever but at the same time, I listen to my body.
If I have cold/ illness I take a break from my training, I let my body fully recover.
When you think have recovered from a cold it can still takes up to 5 days for your body to be fully recovered.

In 2010 I finally braved it to go out and run on my own again, it took me 2 years.
In 2012 I started work in a gym called Alive Fitness & Natural Health, I have completed my qualification as Fitness Instructor & Personal Training.
In 2014 I completed Spartan Race, I had to get my cardiologist to sign a consent form, I think if he knew what the Spartan Race entailed I would have given him a heart attack.
In 2015 I completed the Brighton Marathon and I completed it 20 minutes faster than my London time in 2007
I even set myself crazy challenges like how many press ups I can do in an hour, the most I have completed in an hour is 1033.

Things to remember:
There are so many different heart conditions out there, meaning you could also be on medication.
If your medication makes you dizzy or feels sick best not to workout directly after taking said medication.
We are all different and we shouldn’t put a timescale on recovery, there will be other obstacles.
The greatest obstacle is in our mind and the fear of what will happen when we receive a shock.

There is no answer to this, other than it’s not worth worrying about because it may never happen.

Look after your body:
You have a foreign object in your body, the muscles have to adapt to this object.
Your muscles have been pulled and stretched and this will affect other areas of your body.
I suffer from a really tight back and my left shoulder is always knotted, after doing a little research and talking to other people with ICD I learned they suffered too.
Even if you don’t exercise you may find that you have a tight back, there is a couple of ways to break these knots you will need a friend/ partner.
Get them to put apply pressure on the knot with their elbow and this will slowly breakdown the knot.
Another option is to purchase a handheld massage ball like the one below priced between £5-£10.
You will need your partner to roll over the knotted area but my god it feels good.

Please do not attempt this until you have fully recovered from your surgery, give your body at least 12 weeks.
I hope that you find this information useful, don’t forget there is support out there, we’re here to support each other.

The Gym

The gym can be a scary place for some people and stepping foot into a gym can be a big step.
We all have images in our mind of people with big muscles, posing, making grunting noises whilst they push out that last rep.

Some of that does exist, we like to stereotype people.
First thing is we shouldn’t worry what other people are doing, you’ve made a decision to better yourself.
People that go to the gym weren’t born with a dumbbell coming out of the womb, they were once like you.
We all have to start somewhere, maybe one day you will grunt, pose, and make the gym a scary intimidating place for others.

I’ve worked in a gym now for over 7 years, when selling a membership I always say to the prospect you should consider a couple of things.

  • Is it close to where you live or work? Us humans are good at making excuses not to go if you pick a gym that far away. Be serious are you going to leave your house on a cold wet day?
  • Atmosphere… Can you see yourself working out in this environment? This could be various things from music to lighting and energy of the place.

To get a feel for the place, ask the gym if they do a free trial, most gyms will happily let you try out their facilities in the hope of getting your sale.
If the gym doesn’t do a free trial there are many platforms out there that get you access to venues in your area like MoveGB, Hussle, when joining these platforms do read the small print.

Once you have picked your gym and brought your membership don’t be afraid to ask for help.
All gyms should offer you an induction and some will offer you regular program reviews, make sure you are asking these questions when signing up.
An induction with gyms will vary, some gym will just show you how to use the equipment and then leave you to your own devices.
Other gyms will write you a program to follow, and explain what a repetition, what a set is and how this will help you on your fitness journey.

I finish this post with my first experience in a gym, I hadn’t a clue what I was doing, I didn’t ask for help.
I watched people and learned from watching people exercise.
To make people think I was lifting heavier on the resistance machines after I finished my sets, I would move the pin a couple of stacks down.
I didn’t want people to think that I was weak and a part of me liked seeing the next person go on the machine having to move the pin back up ‘cause they couldn’t lift my weight. 🙂

Working up to a Press Up

NO exercise is easy, and the Press UP is one of those exercises that people can find very difficult.
The idea of pushing up your whole bodyweight is a scary notion for so many people.
If you are one of those people that can push up their whole bodyweight, well done you, this post is not for you!

There are Personal Trainers out there that will ask you to attempt a press up on your first session with them, a press up is a good indication of your strength.
Personally, I wouldn’t ask someone to do something they aren’t comfortable with, though I would see it as a challenge to build your strength and confidence to attempt a Press Up in the future.

To start from the beginning I would suggest starting with a Standing Press up.

Standing at arm’s length from the wall and doing leaning pushups is a good way to start.
As you continue the exercise, move your feet farther away from the wall.
The weight transfer works your arms, shoulder and chest harder, building added strength and better muscle definition.
Aim for 10 repetitions, once completed your 10, rest for 15- 30 seconds and attempt another 10, rest 1 last time and attempt your final set.
If you are able to complete all 30 you may be ready to attempt the next level of press up.

Knee Press Ups

Your upper body should shift slightly forward as you descend.
Your arm will form a 90-degree angle as you lower down from plank position.
Do: Move your shoulders beyond your wrists as you lower down.
Your hands should end up next to your ribs (chest area) and your forearms should be perpendicular to the ground.

Then push yourself back up to your starting position, aim to do 10 repetitions, once completed your 10 repetitions rest.
Don’t worry if you can’t manage all 10, go back to standing press ups to finish your 10, try to complete 3 sets.
When you are able to complete all 3 sets it will be time to attempt a full press up.

Press Up

With your arms straight, your shoulders should be over your wrists and your hips should be over your knees.
Bend your elbows and lower your upper body slowly to the ground.

When your nose reaches the floor (this is a good indication that you are going low enough), press up with your arms and return to the starting position, if you manage to return to starting position you have achieved a press up.
Now you have to attempt another 9 to complete your set, go to your knees if you find it tough.
What we want to achieve is a progression, give yourself a goal, follow it through.

Now that you can complete a Press up look at all different variations of the press up, challenge yourself. I pushed myself to see how many I could complete in an hour, starting at 536, I managed to get to 1056