Detailed guide after a heart attack

Physical activity
Walking can be commenced the day after discharge from the hospital.
Start with slow walking, 15 minutes in the morning and evening, and gradually increase by 5 minutes each day for a week until you reach 30 minutes twice a day or 60 minutes once a day, at least 5 times a week (starting more strenuous physical activity is dependent on an individual's condition on discharge).
Walking should be done in pleasant weather and after rest. Refrain from physical activity after meals.  If you feel pain during walking or unusual shortness of breath, dizziness or rapid heart beat consult your cardiologist.

Rest and sleep
Sleep is a basic need; its importance is increased especially following heart disease (moderate or severe).
If you find it difficult to fall asleep, you can take relaxants or sleeping pills after consulting with your physician.

Bathing
Refrain from bathing/showering in very hot water as this expands your blood vessels and can lead to lowered blood pressure and a feeling of weakness.  Likewise, refrain from bathing/showering in very cold water as this shrinks your blood vessels. If you feel weak, sit on a chair whilst bathing.

 
Physical Effort
In the first weeks refrain from activity requiring physical effort such as: home repairs, floor washing, hanging washing, lifting heavy objects. Rather keep busy with easy tasks such as: washing dishes, easy cooking, entertaining a few guests.

Back to work
You are entitled to one month's sick leave. Most individuals recuperate and return to work gradually.  Consult your cardiologist / physician regarding how to return to work.

Driving and travel
Refrain from driving 2-3 weeks after discharge from the hospital.  Refrain from driving in heavy traffic or in very hot unpleasant weather. Following a heart attack travel insurance is limited for 6 months (check this out with your insurance agent).

Sexual activity
Sexual activity is dependent on your being able to climb 2 flights of stairs or walk continuously for 30 minutes. If you can do this without shortness of breath or chest pain,  you can return to normal sexual activity 2-3 weeks following your discharge from the hospital. Sexual activity should be carried out after rest and not after heavy meals.

Please note: using a medication such as Viagra is forbidden for 2-3 weeks after a heart attack. Consult with your physician before resuming.

Diet
Healthy dietary habits for a healthy heart..
Four main risk factors for coronary heart disease:
High blood pressure, high blood fats, diabetes and overweight.
There is a direct connection between the food you eat and a healthy heart.

Foods rich in minerals, vitamins, fiber and other nutrients:
Vegetables, fruit, whole fish products, legumes
Source for good fat: -olive oil, canola oil, walnuts, avocado, sesame
Fish containing omega 3 fats should be eaten at least twice a week
Low fat milk products
Turkey and chicken in moderate amounts, and lean beef in small amounts can be eaten.
Approximately 3 eggs a week
Drink lots of water and tea
Broaden your use of herbs

Important:
Refrain from eating foods containing trans and solidified fats
Refrain from drinking sugary drinks and sweetened foods. Reduce your salt intake.

Consult your dietician at the local health fund for advice and explanation.

Managing your medications
The medications listed below will prevent recurrent heart disease. Take the pills according to your cardiologist's/physician's instructions. Ask your physician if you are treated with one of the medications listed below.

Aspirin: drug function: anticoagulant
Instructions for use: Swallow once a day after a meal
Do not take before going to sleep. Take for life

Beta blockers: drug function: reduce pulse, and exertion of heart muscle, balances blood pressure and prevents angina.
Instructions for use: Once a day after breakfast (Dimitone, Lopresor, Novaloc, Normiten, Normalol, Cardiloc etc)

ACE inhibitors: function: reducing exertion on heart muscle, balance blood pressure and treats heart failure
Instructions for use:  Once a day before sleep
(Capotan, Tritace, Inhibace, Oscaar, Losartan, Vascace, Vasodip, etc)

Statins: drug function: reduce cholesterol in blood, helps lower atherosclerosis and frequency of heart episodes. Keep to a less than 70 mg day
Instructions for use: Swallow once a day before sleep.
(Simvacor, Lipidal, Lipitor, Crestor, Pravalip, etc)

Important: Refrain from taking pill with grapefruit juice but you can eat half a grapefruit, or pomela and/or drink a little juice during the morning.

Clopidrogel (PLAVIX) drug function: prevent blood clotting after stent implant. Also given to patients with severe coronary  heart disease who cannot undergo therapeutic catheterization.
Instructions for use: Swallow once a day after a meal
Important:
- continue taking the drug and do not stop without physician's approval.
- Blood count one month after discharge from hospital
- In the event of blood in the urine or stool, rash, or change in blood report refer to your physician
- Report taking this medication when undergoing invasive treatment (dentist, tests etc)

First Aid
Should you feel pain or pressure similar to what you experienced before referring to the hospital, sit or lie down for 5-10 minutes. If the pain does not pass, contact the emergency ambulance service of Magen David 101 or a private service to which you may belong.
Remember: It is recommended not to increase risk by coming to hospital in a private vehicle, but rather by ambulance.

Medical follow up
It is important to be checked by a cardiologist a few weeks after your discharge. You can consult with your family physician. Bring with your discharge letter, catheterization report, echo report and ECG. Make a copy for your family physician, keep a copy for yourself and keep a third copy to present to the cardiologist on your next visit.

Cardiac rehabilitation – a supervised program
Program objective: to help individuals recuperate from a heart episode and to return to normal physical and emotional living.
Balancing the risk factors through healthy living and balanced medication and improved quality of life.  The program is run by a professional team and is included in the basket of services for three months. Individuals with complementary insurance can extend the program. For information on the rehabilitation program contact the cardiology department and/or your health fund.

Understanding your condition – via meetings
It is important to get information from the medical and nursing staff on your treatment, its causes and prevention of the disease. Contact the staff to find out when and how you can get further information.