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Tuesday, July 19, 2016

Swimming Helped Me Survive, KAATSU Enabled Me To Thrive

Courtesy of WOWSA, Huntington Beach, California.

On May 12th, Steven Munatones had a heart attack (read his first-hand account here). This is a follow-up story on his ongoing recovery:

It was quite an ordeal in which I was rescued by my son, saved by paramedics, treated by emergency room staff, operated on by cardiologist Dr. Lee Carter, and made hypothermic and revived by the Critical Care Unit staff at Hoag Hospital in Newport Beach, California.

I knew it was a miracle that I lived. Everything - the timing, the location, the circumstances - went just right for me to live. Everyone involved did an outstanding job in an extremely timely manner to enable me to recover from a heart not beating and lungs not moving.

Every morning since coming out of the hypothermic coma, I profoundly appreciate that I have at least another day on this Earth. I look at my wife, think about my son, smile at my daughters, and am forever grateful for the talents of the paramedics, nurses and doctors who treated me.

Even before being released from the hospital and returning home, I was intent to getting back to normal as soon as possible. I knew my stress levels and heavy travel schedule had to be significantly reduced to return to a more healthful lifestyle. But I also instinctively knew that swimming and KAATSU was a big part of my recovery. Swimming is what I have done all my life, whether in a pool or the open water, and KAATSU is something that I had done for the last 15 years.

I saw no reason to stop now.

But the learned words of the medical professionals reminded me - and other cardiac patients warned me - about swimming and pushing myself too soon and too hard. "Take it easy." "Not for a few more months." "Focus on the cardiac rehab at the hospital." "Don't get your heart rate too high." "You need to rest and take it day by day."

I understood the much-appreciated advice of people who had heart attacks and those who treat them. Since they have the experience and were among the medical professionals who saved me, I listened. But I still craved rehabilitating through swimming and blood flow moderation training.

While cardiac rehabilitation traditionally involves pharmaceuticals of various kinds, rest, and walking on treadmills under medical supervision, I wanted to swim. I wanted to take off my shoes and get in the water; I did not want to put my shoes on and hop on a stationary bike. I wanted to get wet; I did not want to perspire in a rehabilitation clinic. I wanted to swim with my buddies; I did not want to make new friends, all with cardiac issues.

I also wanted to do KAATSU to augment my swimming; I knew that inducing blood pooling in my limb with pneumatic bands would be helpful.

But I followed directions and impatiently waited.

Finally, the day came when I could swim. It was great to wake up before the sun rose and drive to the swimming pool in the dark. I could see the lights shining over the pool deck from a distance, a familiar sight. I knew my swimming buddies would park in the same spaces, walk slowly to the pool, and hop in the same lanes...as they have for years. I knew the warm-up would be the same and the main set would be varied as usual.

I was under strict directions to keep my heart rate low and swim cautiously. That was not to be a problem.

I knew that I can control my swimming pace and heart rate by the speed of my kick, my stroke rate (arm turnover), my breathing pattern, the length and intensity of my breakouts, or the length or duration of the main set. That is, if I shifted from a 2-beat kick to a 6-beat kick, my heart rate would increase. If I increased my arm turnover or if I breathed less frequently or if I performed longer or faster breakouts, my heart rate would increase.

So control over my swimming pace and heart rate was easy to manage.

But I wanted definitive information about my heart rate so I downloaded Cardiio, the free mobile app created by the MIT Media Lab, to my iPhone. I placed my iPhone next to the pool so I could easily grab it when I stopped to rest at the poolside. I checked my heart rate throughout the workout, but made notes during the main set when I would swim faster.

Initially during Week 1, I swam very slowly, barely kicking with a purposefully slow arm turnover. I only did open turns rather than flip turns and I stopped frequently. I kept my swimming distance to 2,000 - 2,500 yards (1828m - 2286m) in a short-course pool and was careful to never get out of breath.

During the first five swimming sessions, I kept my heart rate or beats per minute (bpm) to under 110 bpm [see below]. It felt easy and comfortable, but I really enjoyed just being back in the water with my swimming buddies.

Data from Cardiio, taken at poolside

Then I increased my controlled heart rate to a maximum of 130 bpm during Week 2 and increased it yet again to a maximum of 150 bpm during Week 3 - where the maximum will be maintained for the next six months. I checked my swimming pace after a 2-3 50-, 75- or 100-yard swims, depending on our main set. Sometimes, the group would do fast 50-yard or 75-yard USRPT (Ultra-Short Race-Pace Training) sets or I would just do a pace 100-yard swim for time at the end of the workout.

As soon as I finished a swim set, I would stand up on the shallow end of the pool and quickly grab my iPhone to check my heart rate with the Cardiio app. After 60 seconds of rest, I checked my heart rate again. I had hoped that the differential between my maximum heart rate and my heart rate after 60 seconds would increase over time. I saved the data and then posted it on an Excel spreadsheet for future analysis.

During Weeks 1-3, I never got out of breath in the pool like I usually did in our main sets previously to my heart attack. Along with Dr. Lyle Nalli racing alongside me, we would push our pace to maximum exertion levels. But no longer. I was taking my aquatic rehabilitation casually and carefully in a controlled manner.

Perhaps, I will never get quite back to that intensity together with Dr. Nalli. It will also take me a while to have the requisite self-confidence to swim in the Pacific Ocean or to do a main set of butterfly in the pool. But those limitations are perfectly acceptable to me. I am swimming now and gradually returning back to cardiac health and overall fitness.

I am convinced that a lifetime of swimming with all its cardiovascular benefits helped me survive...and thrive in this second chance at life.*

For more information on Cardiio, visit here.

In addition to swimming, I am also concurrently doing KAATSU, primarily on my arms, but also on my legs at least three times per week. I wanted to start KAATSU immediately after waking up from my coma, but others around me encouraged me to wait. Three weeks after my heart attack, I started doing KAATSU regularly.

I am convinced that the combination of KAATSU and swimming is the ideal form of rehabilitation for my own cardiac issues. KAATSU allows me to maintain muscular strength and mass while swimming enables me to maintain flexibility and aerobic conditioning.

Copyright © 2016 by World Open Water Swimming Association

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