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Pilates Instructor
First and foremost, you must have clearance from your treating doctor as to when you can start exercising. Once you have clearance, you may commence. Pilates is a versatile form of exercise. Gentle warm up and warm downs give your heart an opportunity to get ready for exercise and to wind down after exercise. As you get stronger and fitter, the exercises intensity will change accordingly. Remember to always listen to your body. If you feel any chest discomfort or dizziness, you should stop the activity immediately and contact your doctor. Definitely I would recommend being in a studio environment, because it's closer supervision.
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Exercise Physiologist
Like above, however it also depends on the type of heart surgery. Have you have had CABGS, PCA or Stent? If you have had a CABGS, the sternum has been affected and there are guidelines in terms of exercise. Most important thing is to consult your GP in regards to attending a Cardiac Rehab program for at least 6-8 weeks, from there the Physiotherapists or Exercise Physiologists will guide you on the amount and the mode of exercise you can complete or most importantly how long you must wait until you can return to your regular routine ie Pilates.
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Cardiologist (Heart Specialist)
I generally advise 2 weeks after a coronary stent that has been placed for angina.
4 weeks for a stent placed in the setting of an acute heart attack.
6 weeks after CABG or a permanent pacemaker implantation.
After CABG the sternum needs plenty of time to heal.
Attending a cardiac rehabilitation program at your local hospital is a free service and an excellent way to get into physical activity.
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Cardiothoracic Surgeon
Assuming you mean after "open-heart" surgery, then the answer is almost immediately.
Walking is the best form of exercise after heart surgery. Another assumption is that you have had a sternotomy for the surgery. In this case it is crucial to 'protect' the sternal healing by avoiding exercises that disrupt or 'pull' apart the sternotomy wound closure. Weight-bearing exercises are generally limited to after your postoperative review by the heart surgeon.
For example, in my practice, I routinely review my patients 6-weeks following surgery. I would expect patients to be engaged in daily walking exercises after their hospital discharge. If the sternum is healing well at the postop review then I encourage patients to transition slowly to weight-bearing exercises/activities as tolerated by the level of comfort.
Outpatient cardiac rehabilitation is offered some weeks after the surgery and is a great resource to guide you through the recovery phase.
It is critical that patients are given the correct level of expectation for what to feel depending on what they do, and at what point in time. For example, as you progress back into your usual levels of activity in the months after surgery, it is not uncommon to have fluctuating levels of discomfort during this period. Overall, the trend should improve week by week.
Good luck.
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