Heart to Hartman

Health Guide for Congenital Heart Disease

This One is for the Ladies

Having trouble maintaining or losing weight as you ages this you? Is this you?  “I used to be able to eat whatever I wanted because I knew I could work it off in a few days, but not anymore!”  Why?  It is so frustrating!  I have heard people say they have given up all sweets and only lost a pound in 2 months.  Others try to drop below 1000 calories a day just to lose a few pounds. What is going on?!

As a consequence of aging, our estrogen levels deplete.  Estrogen is not only essential for our reproductive health, but it also aids in digestion and leveling out blood glucose (aka blood sugar).  Estrogen mitigates the effects of cortisol and insulin, both of which affect our blood glucose levels. Insulin rises when we eat.  If we eat a lot of sugar or starch, our blood glucose will rise higher.  Insulin promotes the clearing of this glucose from the blood by helping it enter the muscles and liver. Estrogen makes our muscles more sensitive to insulin, thus it easier to clear the glucose out of the blood and into the muscle when we have lots of estrogen. Cortisol makes our blood glucose levels rise at a slower rate than insulin to help us “fight” through our stressful days. So, stress can also add to weight gain.  Our blood does not want all that glucose. Thus, when our muscles and liver (the tanks that store the glucose) are full, the glucose will be stored as far, often around our waistlines.  As we approach menopause, we become more sensitive to the effects of carbohydrates (aka, sugar!) and stress. To compound the problem, estrogen also promotes healthy digestion.  With a lack of estrogen, you may notice bloating or constipation. What’s a girl to do? 

First, have a conversation with your physician.  Hormone replacement may be right for you, but it is not for everyone.  In the meantime, the obvious is limit simple sugars, like cakes, pasta, candy, bread etc. But other foods can also increase blood glucose like starchy carbs such as sweet potatoes, brown rice, and oatmeal.  Obviously, we need to eat these foods for the nutrients, but limit them. So, what is a non-starchy vegetable? Here is a list that will help.  Try eating a lot more from this list over the next month and a lot less starchy food and see if you do not start to feel better and lose a few pounds.

Greens

  • Spinach
  • Romain, red or green leaf lettuce,
  • Turnip, mustard, and collard greens
  • Swiss Chard

Cruciferous

  • Arugula
  • Cauliflower
  • Cabbage
  • Radish
  • Bok Choy
  • Brussels Sprouts
  • Kale

Root Vegetables

  • Beets
  • Carrots
  • Turnips
  • Parsnips

Allium Vegetables

  • Onion
  • Chives
  • Shallots
  • Garlic

Other non-starchy vegetables

  • Zucchini
  • Tomatoes
  • Crook Neck squash
  • Butternut Squash (right in the middle)
  • Pumpkin
  • Asparagus
  • Okra
  • Egg Plant

Try experimenting with these.  You can make a butternut squash omelet, add spinach, arugula, sweet potato, or pumpkin to a smoothie. Blend beets or radishes into dips.

Another important reason to eat a lot of vegetables is the nutrient content and inflammation fighting effect of those nutrients. You already have a chronic disease. Protect yourself from getting another one like coronary artery disease, or type II diabetes. Your risk for acquiring these and other diseases increases as you age anyway so you have to do all you can to stay healthy.

As always, exercise! Get your cardio and your strength training in. And manage your stress.

10 Tips to Optimal Wellness

Living your best life is more than just a catch phrase.  Pick a few of these tips to start on your journey to optimal wellness. As you get good at incorporating one tip into your life, pick another one until you have mastered all 10.  Enjoy the benefits as you venture toward optimal wellness.

  1. Be intentional Be intentional with everything wellness.  If you do not intend to exercise, mediate, cook at home etc., you won’t. Decide what you want to add or delete from your life, make a daily plan.  Start small and celebrate each little accomplishment to make your intentions a habit
  2. Be mindful.  What does it mean to be mindful?  According to Merriman- Websters it means to be aware, heedful. This means paying attention to what you are doing and how you are feeling.  Take a minute before starting work and do a simple body scan. When you are eating, do you savor every bite or scarf it down?
  3. Lift “Strength is independence!”, that is one of my favorite sayings.  Walking and other cardio is great! You must add resistance training to get the full benefits of exercise.
  4. Power Add some power to your workouts. A few days a week, stress your body through some power exercises; something simple like a single leg hop, or something complex like a plyo pushup
  5. Think If you are having trouble focusing, if you feel mentally exhausted, take a walk, do some yoga; just move.  Many studies show how your cognitive performance improves after exercise.
  6. Fun Do you remember the last time you had fun?  Have you forgotten what it felt like? Add some fun into each day.  It does not have to be a trip to an amusement park.  It can be something as simple as watching a comedy skit or catching up with an old friend.
  7. Community/ Support We all learned through Covid how important it is to stay connected to each other.  Saint Mother Theresa said, “The problems of this world are because we have forgotten that we belong to each other.”  Find your community.
  8. Fueling We really are what we eat.  If you are not meeting your protein needs, eating too many simple carbs and too much saturated fats, you will not feel well or be well.  Most people do not get 5 servings or fruits and vegetables each day.  Do you?
  9. Boundaries What are you saying “yes” to when you should be saying “no”?  If you are giving all your energy away to your family, your job, you child’s school, your church, your volunteer efforts, what is left for you?  What is most important to you?  Are you giving it your all, or do you not have enough time and energy to devote to it?
  10. Stress management. We all have stress; some of it good and some of it bad.  How are you managing it? Do you ever get a chance to talk a short walk alone, meditate, or simply take some deep breaths?  If not, this should be your priority.

Earth Day Workout!

Earth Day!  Take it Outside.

Since April is Earth Month, let’s take our workouts outside and enjoy nature. This workout is a series of cardio intervals that also focus on legs, hips, core, and shoulders.

I like to warm up, then set my timer for 30-45 seconds for my work intervals and 20-30 seconds for the rest interval.  You can rest longer between rounds.  Do all the exercises one time before starting over again on the second round.  Try to get 2-3 rounds.  Two rounds will take you 12 minutes if you do a 30 sec work/ 30 sec rest interval. Be sure to go at your own pace.  Once you are done working out, be sure to stretch out and do some deep breathing to get you ready for the rest of your day.

Exercise 1 Mountain Climbers works the core, chest, and shoulders, along with your heart and lungs.

Set up Come to a high plank position, hands directly under your shoulders.  Quads, glutes and core are contracted and tight to hold you in position.  “Screw” your hands into the ground like you are opening up a jar.  This will set your shoulder blades against your rib cage which will protect your shoulder joint.

Move When the timer starts pull one knee toward your same side elbow and return it to the start position without letting the foot touch the ground.  Switch legs.  It is like your legs are running with your hands on the ground. If you get tired, hold the plank until the time is up, or move slower.

Exercise 2 Jump Rope works your cardiovascular system, calves and is great for agility and balance. If you have no jump rope, you can use a crack in the sidewalk or a stick. Jump at your own pace

Exercise 3 Plank Shoulder Taps works the core, glutes, adductors, back and abs, and the shoulders.

Set up Come into a high plank with your hands directly under your shoulders.  Keep your feet as wide as you need to keep your hips stable.  Tighten your glutes and abdominals.

Move Press one hand into the ground while bringing the opposite hand up to touch the shoulder of the hand that is on the ground.  Place that hand down and then alternate keeping the hips stable

Exercise 4 Pulsing Squat works the glutes, quads, and hamstring.

Set up Keeping your chest lifted, sink into your heels, and bend your knees like you are sitting back in a chair.

Move Hold in the lowered position and pulse up and down.

Exercise 5 Bicycle Crunches works the core.  The goal of this exercise is to keep the hips stable while moving the arms and legs. Move elbow to opposite knee and then alternate under control.  Go at your own pace!  Faster is not better with this exercise.  In fact, slower is more difficult!

Exercise 6 Squat Jacks This is a cardio exercise and works your quads and glutes. 

Set up Start standing straight up arms overhead.  When I teach this to children, I tell them to make a pencil 😊 Move Then jump or step out to a squat and pull your arms down, elbows toward the rib cage.  Then return to the “pencil” and keep moving between the two poses for the entire interval

If you enjoy this workout, please feel free to help my protein shake fund and allow me to keep doing what I do on this blog

Less than 5% of Adults are in Proper Care for Their CHD

…And now I know why. Let’s be real, shall we? It is not because we were told we were fixed. It is not because we do not care. It is because of the Affordable Care Act. Our choice of providers has been taken from us by hospitals who can gobble up doctors whos own practice can not compete with the hospital providers and the insurance companies any more. Insurance companies won’t cover certain adult cardiologists if they also treat children. This is what happens when administrators and insurance companies and bureaucrats dictate care.

After years of advocating that adults be seen by adult congenital heart specialists, I have now become one who no longer has access to my doctor unless I want to pay 600.00 just for a resting EKG. Come on. Really? That does not even include the interpretation fee. Even if I had that kind of money, its the principle of the matter. I literally train college kids in 5 minutes to do a resting EKG. But hospitals can charge that, and we are all ok with that? Must be. In my Facebook group of other adult CHDers, they all have the exact same experience fighting with the insurance company. I have two friends being bounced around by doctors and insurers right now to try to schedule a surgery for a heart valve.

The CHD fight is hard enough on some days and now we are adding the stress of insurance to just trying to be seen. I’m out. I am one who will no longer give my money to Florida Blue or Baptist just so they can tell me where I can and cannot go for care. I’ll pay the penalty tax and die. That’s what the authors of the affordable care wanted anyway.

Full Body Workout

Get ready for some fun!  Combining these 5 exercises makes for one amazing full body workout that will promote your overall strength and balance. You can do this workout anywhere!

Time: This workout can take as much time as you have! If you have 15 minutes, maybe do 2 rounds of 30 seconds of work and 30 seconds of rest. You can also count reps, if you prefer. Eight to twelve reps of exercise per set. Be sure to warm up and stretch after you have completed your sets. If you have more time, add more rounds.

Go through all the exercises 1 time before starting over with your second, third, or fourth set.

Equipment: (Links are affiliate links that help me keep doing what I do on this site)

Don’t have the equipment? No problem! You can do all these exercises except Exercise 3 with no equipment at all.

This is a 1 minute video of the work out

Exercise 1

Lateral lunge to curtsy squat with a medicine ball 30-45 secs of work or 8-12 reps

Works: Quads, Glutes, Hamstrings, Core, Arms

Be sure to keep your abs tight throughout the movement. The medicine ball is just a way to add resistance to make the exercise more challenging. You can use a dumbbell or no weight at all.

To begin, step out to one side shifting your weight through your lead leg (the one that is stepping out) heel. Keeping your trail leg straight, lower your body from the hips, making sure your knee stays in line with your forward facing toes. Push the weight out in front of you, keeping your core tight and your shoulder blade stable against the rib cage. Next, push back from the lead leg and bring it behind and across the body like a curtsy, and lower down with your body weight on your front leg. So your weight is being transferred to the stationary leg . Do not let the back leg take a lot of weight. It is for balance at this point. Bend your arms completing a bicep curl as your curtsy. Do all reps on one side before changing sides.

Be sure to use a light weight because your arms are getting double the work of the legs with this exercise.

Exercise 2

Single Leg Cobra 30-45 Secs of Work or 8-12 Reps on Each Leg

Works: Mid-back, Backs of Arms, Hips

It also is good for balance and ankle stability. You can do this exercise with dumbbells or no weights at all.

To set up, place all your weight on one foot. The foot should be “screwed into ” the ground. The other leg is slightly behind, like a kick stand. Palms are facing each other. Perform a slight hip hinge on the stationary leg, leaning slightly forward from the hip. As you bring your arms straight back so your palms end up at hip height, lift your “kick stand” leg slightly off the ground. Keep your core tight. Move your arms as if you have no elbows. They stay straight and try to pull the shoulder blades together behind you. You can also do this exercise with the “kick stand” leg staying on the ground.

Exercise 3

Stability Ball Stir the Pot 4-5 Reps in Each Direction

Works: Core

This is by far the most difficult exercise of the workout and you do need a stability ball. 

To “stir the pot”, Place your elbows and fore arms on the ball and come into a plank position, supporting your weight on the ball. The closer your chest is to the ball, the easier the movement is. Be sure to contract your glutes, abs and quads. Slowly rotate your elbows while pressing down on the ball as if you are stirring a pot with elbows. The smaller the circles, the easier it is to control the movement. Stir 4-5 times in each direction. You will probably notice one way is harder than the other. This exercise takes practice!

Exercise 4

Goblet Squat with a Band Tap Out 30-45 Secs of Work or 8-12 Reps

Works: Glutes, Quads

Place the resistance band above your knees or around the arch of your foot. To set up, hold the weight in both hands against your chest. Put your feet a comfortable distance apart and “screw your feet to the floor” Doing so will activate your hips and protect your knees. Hold your chest up and slide your shoulder blades down toward your back pockets. In the squat position, keep your chest lifted and shoulder blades slid down. Tap one foot out and bring it back to the start position. Stay in your squat and tap the other foot out. Come out of your squat and repeat.

Exercise 5

Squat to a bear – knee tap 30-45 Secs of Work or 8-12 Reps

Works: Hips, Core, and Shoulder Stability

To set up, keep your feet a comfortable distance apart, “screwed into the floor” like always. Raise your arms to shoulders height, shoulder blades down. Move into your squat and then hip hinge forward to place your hands on the floor, keeping the knees bent, hovering above the floor. Contract your hips and core and life one arm off the floor to touch the opposite knee. Switch arms, push back to the squat and then stand up.

Support

If you enjoyed this work out please consider contributing to my Protein Shake Fund.

Wellness Journal

Ever get discouraged that there is so much information on how to be healthy that it is too overwhelming? Where do you start? What is best for you? How do you know what to eat? How much exercise do you need? What is the best way to manage your stress? You are the expert on you, but this is where the heart to Hartman motto of “Intentional Intuitive and Mindful “plays into your health plan.

Be intentional about where you want to start. Maybe your goal is to lose weight or “feel better” or have more energy. No matter what the goal is, the process is managing your time. You only have so much time in the day. Manage your time and your stress by being intentional with which aspect of your health you want to focus on first; nutrition, activity, meditation, socializing, praying etc and go from there. Ideally you choose one of these areas to start with; just changing one thing at a time. Track your progress and see how that change is working. It is hard to know what is working and what isn’t, if you try to change your whole life at once. It is also a recipe for failure. Take your time. Changing is a process and a journey.

Next, be intuitive. Learn to listen to your body. This is where you can use the Heart to Hartman Wellness Journal. Track your progress using this resource so you know what is working for you and what is not. This is the first edition, and you can download it for free.

Being mindful about what you are you doing, how it is feeling to you and how it is effecting you is the way you know how and where to start. Notice not only how it feels to you, but what you think about it. For each change you try to make, notice the thought, feeling and emotion that comes up with each success and failure. You will have failures; that is how you learn.

I hope you find this journal helpful as you take your first step toward better health. Please share it and share my website. Please comment on your success and failures as well! If you like this post and want to Buy me a Protein Shake click on the link and thank you!

Meet the Jijo Client of the Month

October’s client of the month is Stephanie Wolf.

Stephanie has been training with me on Jijo since we launched in April. She has attended over 32 live classes and many recorded sessions! She is a 5:15 AM regular, and when she does not have work meetings, she can join an evening class like, Mindful Movement

 “I love Melissa’s early morning classes for getting me up and moving with a good combination of strength and cardio.  It’s a great way to jump-start my day.”

When asked what she likes about training on Jijo, she said, “I like Jijo because of the convenience accessing recorded classes anytime.  It’s perfect when traveling or when other things interrupt my usual routine.”

“Melissa’s a great coach – motivating without being too pushy. She helps me build strength in my weak areas and can easily modify a routine to accommodate my limitations. “

The Jijo client of the month gets paid to workout! He/she is awarded a 20.00 Amazon gift card.

Join us on Jijo

World Heart Day!

Today is World Heart Day!  Hmmmm what could you do that would benefit your heart and help others around the world with their hearts?  Sign up for the first annual Hearts with Running Legs Anniversary 5k Run/Walk.  This walk is hosted by Estrellita de Belen and is a benefit for children in Venezuela who need life saving heart surgeries.

The walk/ run will be a fun event taking place in beautiful Jacksonville Beach Florida on November 6th starting at 09:00. The event is a result of the tireless work of the founder of Estrellita de Belen, a Venezuelan born women with a CHD.  Each year 2000 children in Venezuela die waiting for heart surgery.  Her mission is to help those children get the lifesaving surgeries they need, and all the funds raised at her events support that mission.

This walk will be a way for your benefit your own heart health in three ways.  One: the obvious, exercise is medicine.  Walking and running are forms of cardiovascular exercise that your heart, lungs and blood vessels crave no matter what your disease state. Two: being on the beach and with a community of likeminded people, improves stress levels, and stress damages your heart and blood vessels.  And three:  the walk provides a means for you to be altruistic.  Altruism also improves heart health.  Giving to others makes us feel good ourselves.

So, mark your calendars and get out walking to prepare for the event.  I cannot wait to see everyone there.  Heart to Hartman is sponsoring this great event and may even lead a warmup….

Ending the Confusion about how Cardiovascular Exercise affects the Body

For whatever reason, you decide you want to start exercising. Maybe you need to “get healthier” or you are looking for a way to manage your stress, anxiety or depression. Perhaps you want to lose a little weight or build some muscles. The benefits of regular exercise are endless and priceless! But some of you may be apprehensive about starting an exercise program if you have never exercised or its been awhile. If you have a heart defect or any other chronic disease, you may be even more nervous about exercising. Once you understand what exercise does to your body, you will feel more confident to begin and maintain an exercise program that works for you!

Acute effects of exercise– Once you begin some cardiovascular exercise like walking, running, or cycling, your heart rate will immediately increase due to a down regulation of vagus nerve activity to the heart. Be decreasing this vagal tone, your heart rate can quickly increase to approximately 100 beats per minute. The amount of blood returning to the heart will increase and that will mean more blood will be able to exit the heart with each beat. The vagus nerve is part of the parasympathetic nervous system. When you begin to exercise, the sympathetic nervous system up regulates and causes the release of catecholamines which will also help to increase your heart rate to deliver oxygen to your working muscles. Those hormones will also cause some blood vessels to constrict and others to dilate to direct blood to the working muscles. The byproducts of metabolism will help to increase your breathing rate and more surface area of your lungs will be used to get oxygen out of the inspired air and into the blood.

Maybe you would rather perform some resistance exercise. What kinds of effects will that have your body? Resistance exercise causes many of the same demands on the cardiovascular system. However, the increase in heart rate is due not only to decreased vagal tone and increase in catecholamines. When the heart has to push against the resistance of the muscles lifting heavy weights, it decreases the volume of blood the heart can push out with each beat (stroke volume). Thus, when the stroke volume goes down, heart rate must go up to meet the demand of the exercise. All these responses are not only normal, but necessary and your body loves it! So embrace it!

Chronic effects of exercise With consistent exercise the cardiovascular system adapts. The heart muscle becomes stronger and stroke volume goes up and heart rate goes down for any given submaximal intensity, and at rest! Blood vessels become more compliant and healthier. Blood volume increases via increases in plasma volume and hemoglobin content. More capillaries will grow in the working muscle to help extract more oxygen from the blood. The muscles will take up more glucose out of the blood stream, and your body will become more efficient at using fat for fuel.

Should you be afraid to start exercising? The American College of Sports Medicine recommends that if you are having symptoms of a chronic disease, you should get a medical exam before starting exercise. If you are not active, have a disease and have no symptoms, it is safe to start exercising at a light to moderate intensity as long as you have seen your physician in the last six months and gotten the “all clear” for your disease status. If you are unclear if your exercise intensity if light or moderate see the post, How to get the right heart rate for you. The risk of sudden cardiac death with exercise is low, especially if you start at a low intensity. Data from the Physician’s Health Study and the Nurses’ Health Study show that a “sudden cardiac death occurs every 1.5 million episodes of vigorous exertion in men and every 36.5 million hours of moderate to vigorous exertion in women.” (American College of Sports Medicine’s Guidelines for Exercise Testing and Prescription 11e. p14) If you do plan to see a physician first, you can use this form to help get the exercise prescription that is right for you.

The bottom line? You should not be afraid or anxious about starting an exercise program. You should be more afraid of staying sedentary! Besides, it’s fun!

Creating Balance

Part of any good exercise program includes some functional exercises. A functional exercise would help you be able to perform a primary movement activity – like walking or picking something up. There are 6 so called primary movement patterns, squat, bend, single leg, push, pull and rotate. A key component to a lower body functional movement is balance.

Balance can be trained on its own or in conjunction with other exercises. For example, if you wanted to simply train your balance, try to stand on one foot and see how long you can hold it. Add closed eyes to make the exercise more difficult. You can step up onto a step with one leg and hold it. To make the balance integrate into your workout, simply choose any single leg exercise or a lunge.

While training balance you can also include various types of balance training devices. A common one is an airex balance pad or a Bosu, which stands for both sides up. Once you can balance on one leg you may increase your challenge by adding one of these, the airex first and then bosu. Most gyms will have one or both of these items. If you are working out at home, you can purchase either of these items. They are a little pricey for your home so be sure you plan to use them. I bought mine used, which is a great way to get fitness equipment.

Once you have a Bosu you may want to do some exercises with it. Check out my video on Youtube to get some ideas!

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Heart to Hartman

Health Guide for Congenital Heart Disease


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