Good evening gents,

I'm looking for some insight/advice for a heart condition that my dad has suffered from for years.  My dad has small vessel coronary disease, a.k.a. Cardiac Syndrome X, which is a narrowing of the small arteries in the heart.  When my dad exerts himself physically, his already-undersized arteries either do not dilate properly, or they become even more narrow, causing severe chest pain.  He ends up in the hospital at least four times a year and has been placed on disability.  He's not even fifty yet, and he had to give up his barbershop.

As far as I can read on WebMD, the Mayo Clinic, and hearing from his doctor, losing weight and regular exercise is needed to relieve the symptoms, but such physical exertion is what lands him in the hospital in the first place.  He's on a cardiac rehab program following his last hospital visit.  Now he want's to join me in my Taekwondo classes.  My instructor and our other black belts are sure that they can modify the workload to accomodate his needs until he gets stronger, but I'm very apprehensive about it.  It doesn't take much to set off his chest pains.  I've tried to talk him out of it, but he's a bit stubborn.  He's already done three classes, surprisingly without incident.

Does anyone else out there have any experience with this sort of thing?

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First sorry to hear this about your dad; It seems to me he is going to an extreme here. He needs to walk before he can run and I literally mean WALK, WALK and Walk some more while eating right.

I’m primal and Mark’s Daily Apple is a great site for reading about it, but most doctors’ would have a shit fit over it.

 

Good Luck,

Arthur 

From everything I've read, the keys are diet and exercise.

You might try Dr. Andrew Weil's "Eight weeks to Optimum Health" program.  Once you get past the  slightly "hippy-dippy" tone and the usual "diet/fitness testimonials", it's a nicely paced plan to get your motor running, without over revvng yourself into a hospital. The exercise plan is essentially walking, and is geared towards someone who is extremely sedentary.  The diet plan is a it more involved, but involves what fats to eat, and makes sure you get some fish and veggies into your diet.

The book should be available at your local library.

Arthur is right about the walking.  It works, and it's quite low key.

How far is it from your dojo to the closest hospital with an ED? How close is it to the nearest ambulance station? Any Paramedics/nurses/MDs in your classes? Do you have an AED there?

And further along JonEdanger's reply, what medical, specifically cardiology, training do the instructor and "other black belts" have?  My children took Taekwondo classes, and I don't think a good portion of the trainin I saw would really fit into a carediac rehabilitation program, especially for someone who gets admitted four times annually for a heart condition.

Our program strongly emphasizes cardio, and the workouts are very intense.  The most common workouts we do are two-minute drills punching and kicking the bags, with a one-minute interval doing jumping-jacks, push-ups, core work, etc.  Usually five rounds.  We also have ladder-running drills that also last for two minutes per round.  My instructor is letting Dad take it easy.  He's had some pretty hopeless cases in the past who have earned their black belts.  So far nothing's happened in the first week of class, but I'm still anxious about it.

One thing I wish would happen is the dojang would bring back Tai Chi.  The doctors did authorize Dad to take up that program, but unfortunately, there weren't enough students interested, so it was dropped in favor of yoga.

I guess I should have clarified, the chest pains usually start out mild, but Dad tends to ignore it while it gets worse over a couple days, and then when he can't take any more, he'll go to ER when he should really see a doctor early on to get the pain alleviated and avoid hospitalization altogether.  Since Mom passed away, he's even gotten up at night and driven himself without me or my sister knowing, and then calling after he's admitted.  I'm constantly watching him and making him slow down when I see he's doing too much.

At the dojang, we have one physical therapist and a VA nurse, and the instructors are required by our organization to get certified in CPR.  Dad's never had a heart attack, but he's had this problem since he was 16.

CPR outside a hospital is rarely effective (other than making you feel like you've done all you could).

That being said, it's his life. If he is comfortable taking that chance then good luck to him.

I'm CPR certified.

During one of my recertification classes, the instructor, a very experienced EMT, pointed out that what unequipped, partially trained people in the field are doing is trying to keep the victim from completely dying.  No breathing, no pulse, that's pretty much dead...but if the brain's still alive (and you've no way to tell without equipment), you might be able to keep things from completely shutting down until the equipped pros get there.

Your father sounds like the stoics that used to be all too typical of the US population.  (One of my grandafathers amputated one of his fingers using a pocket knife, and my grandmother (his wife, a LVN) was 'famous' in the family for saying "Use a little Christian Science--" for a lot of minor medical things.) 

It's often a problem for those of a stoic disposition to distinguish between something minor (like a touch of bronchial pain brought on by cold temperatures) and something major (like the beginning of a heart attack).  That's because they don't want to bother with (or in the case of some guys, rack up a hefty ER bill dealing with) something minor.

Also, the stoic can get very upset when he thinks someone is "babying him" or being overly solicitous.

 

Yep, that's exactly what I'm dealing with...and since Mom died, it's been on my shoulders to try to make sure he doesn't kill himself.

He sometimes tells a story - almost braggingly - about a time when he was a kid, one of his brothers shot him in the stomach with a BB gun, and he used his pocketknife to cut an H to remove the BB.

Just a quick follow-up...I finally talked Dad into asking his doctor about Taekwondo.  His doctor and cardio therapist both gave him the OK, which I was a bit surprised at.  He did his fourth class today, and still without incident.

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