After you return from the hospital, you will need lots of rest to recover from the trauma of a heart event.  Depending on the severity your heart event, it can take weeks to months to resume your normal activities. In addition to the time you will need to heal physically, you will need time to recuperate emotionally and psychologically from the shock of your brush with death. Your moods may go up and down, you may burst into tears, you may snap at family members. It's all part of trying to cope with the traumatic ordeal that you have just been through. Don't let anyone rush your emotional recovery - you can and will work it through at your own pace.

1. Go Slowly.  Talk with your doctor about when you can resume your normal activities. He or she will give you a schedule of what you can do at so many weeks or months, such as, returning to work, gardening, driving, walking, and lifting. Be sure to ask the doctor about specific activities that are unique to you, your living situation, or your job. When you resume your normal activities, do so gradually. Listen to your body and slow down if you are getting tired easily. Call your doctor if you begin to experience any worrying heart symptoms.

 It is important to stay socially connected to family and friends during your recovery, but you will have to take things slowly. During the first few weeks after your heart attack, keep visitors to a minimum. If friends want to visit, ask your family members to tell them beforehand they can only stay for 10 minutes or, preferably, ask them to postpone their visit for several weeks. You'll be amazed how tiring visitors can be! If they ask what they can do to help you, suggest they drop off a low-fat meal or some fresh fruit.

Resuming sex is often a big concern - for both you and your partner. Discuss your questions and fears with your doctor. Usually, after a month or so after your heart attack, you will probably be able to safely resume sexual activity. Go slowly, and gradually build up to your former level of sexual activity - there are no timetables or rules. Do what is comfortable for you, your partner, and your heart. If you experience rapid heartbeat, angina (chest pain), prolonged breathing problems, or are very tired after sexual activity, call your doctor.

2. Cardiac Rehabilitation.  Your doctor may recommend that you attend a cardiac rehabilitation program during which healthcare professionals and physical therapists will work with you to develop healthy eating habits and start you on a graduated program of exercise. These programs also offer guidance about reducing your risk for another heart attack, such as smoking cessation, and lowering high blood pressure and high cholesterol.  If your doctor does not recommend cardiac rehab, find out why and discuss whether this might be a good thing for you.

Sometimes cardiac rehab programs are geared for older men, so ask if any provisions are made for women your age. If you are working, scheduling may be a problem since many rehab programs are held during the morning. Also, check if your health insurance company will pay for cardiac rehab. (Most companies cover cardiac rehab after a heart attack or angioplasty).

3. Communicate with Your Doctor.  You will have a follow-up appointment with your doctor after your heart event and to evaluate your recovery. Your doctor should also review your medications with you, so be sure to discuss any side effects or problems you might be having. Depending on your progress, your doctor will schedule periodic check-ups with you that are vitally important to your recovery - do not miss them! You may also need to have your cholesterol and blood pressure checked every few months.

Before your doctor visits, make a list of any unusual symptoms, side effects to medicines, or questions you have. Make a copy and leave the list with your doctor so s/he can read it at leisure. During your visit, be frank with your doctor about any unhealthy behaviors - such as failing to take your medicines, regularly eating fast foods, smoking, or drinking too much alcohol - so, together, you can figure out ways to curb your behavior. Also, report any new information you learn about your family's history of heart disease, stroke, obesity, depression, and diabetes.

Depression is common among women with heart disease - and even more so among women who have had heart attacks. In many cases, the depression will lift several weeks after a heart attack but if it persists, tell your doctor. Symptoms of depression to watch for are: always feeling sad, often teary, having no energy, feeling restless and irritable, inability to sleep or eat, lost interest in activities you once enjoyed, or recurrent thoughts of death. Your doctor can treat depression with medicines or refer you to a therapist for counseling.

4. Follow Your Doctor's Treatment Instructions.  Take the prescription and over-the-counter medicines, vitamins, and/or additional supplements as your doctor prescribes.  Do NOT stop taking a prescription medication without first discussing it with your doctor.  If you disagree with your doctor about some course of treatment, ask him/her to explain the reasons for the treatment.

You are perfectly entitled to seek another opinion from a second doctor or, if, you are really dissatisfied, you can find another doctor. Some women have difficulty finding a doctor they feel comfortable with and who will listen to them. If you are unhappy with your medical care, shop around. Don't ever settle for second best!

5. Monitor Your Cholesterol.  Elevated blood levels of lipids, such as cholesterol and triglycerides, are associated with angina and coronary heart disease. Having a low HDL cholesterol, which is the "good" or protective cholesterol, is a risk factor for another heart event. Getting your lipid levels to a goal level is one very clear way to decrease this likelihood. Make sure your doctor has obtained an accurate fasting lipid blood test and discussed the results with you. All women who have had a heart attack need to make sure that their lipid levels are at goal, either through dietary changes or prescription medicines.

6. Stop Smoking.  You cannot recover if you continue to smoke. Call your local chapter of the American Lung Association or the American Cancer Society to locate a smoking cessation class near you, or ask your doctor for help. There are also new medicines available to help you stop smoking, as well as nicotine patches and gum. Find a friend to stop smoking with you - you'll need the encouragement and support!!

7. Start Moving.  Your heart is a muscle.  It needs physical activity so it can pump blood and oxygen throughout your body. The phrase "use it or lose it" is never truer - if you don't get exercise, you will further weaken your heart muscle. (Check with your doctor about when you can start walking again after your heart attack and for how long. Also, ask if you need to take any precautions when you exercise).

When you are well enough to begin a regular physical activity program, start small with a five-minute daily walk. Then increase to a 10-minute daily walk the following week. You can also go swimming, or sign up for water aerobics or low-impact aerobics classes at your local YMCA or fitness center. The important thing is to find some form of physical activity that you enjoy; otherwise you won't stick with it. Find a friend to exercise with - you'll keep each other motivated. A cardiac rehab program will also help you to develop a new excercise regime.

Your ultimate goal is to get 30 minutes or more of physical activity most every day. And you don't need to do intense aerobic workouts. Moderate physical exercise, such as brisk walking, dancing, gardening, and house cleaning, will do.

8. Eat Healthy.  Easier said than done! Changing our eating habits -- which we learned as children -- is terribly difficult and best achieved by making changes gradually over time, such as drinking skim milk and tea, eating more salads, fresh vegetables and fruit -- and skipping the pizza, cake and cookies, and greasy fast foods.

Sometimes it's easy to get confused, overwhelmed, and frustrated about these food changes - you may get so upset that you are afraid to eat, or you burst into tears at mealtimes. Start reading cookbooks, such as WomenHeart's ALL HEART Family Cookbook, and magazines, such as Heart Healthy Living, Cooking Light, Prevention, Weight Watchers, and Vegetarian Times for good low-fat recipes. Eventually, you'll feel more comfortable around food and you'll start to make small but important changes in your eating habits. Pretty soon you may actually prefer the taste of low fat foods!

9. Educate Yourself.  Understand what happened to you and your heart. Read articles and books that describe heart disease, how it develops, and how it is treated. Check out WomenHeart's online store through which you can order from our selected list of books on women and heart disease. Become an expert on and an advocate for your heart. If you have questions, write them down to ask your doctor during your next visit or discuss them in our chat rooms.

10. Find a Support Network.  Research studies show that women who have close family relationships and good friendships make better recoveries from heart events, as the healing power of love and friendship soothes both the heart and spirit. Having someone to talk to about what you are going through - your fears, sadness, anger, and vulnerability - is vitally important to your recovery. Your spouse or lover can listen to your concerns but may eventually feel burnt out and overwhelmed by your emotional needs. Some women talk with a therapist if they get too overwhelmed, depressed, or anxious. The important thing is to have someone to confide in -- a "place to put let it all out." WomenHeart now offers in-person and online woman-to-woman support through our Support Networks located in communities across the country and our vibrant online community site, respectively.

11. Re-Connect Spiritually.  Being part of a spiritual community - church, mosque, or synagogue - can help your recovery. If you practice your faith regularly, your blood pressure and stress levels will tend to be lower, you feel more peaceful, and are likely to take better care of yourself. You also can receive strength and comfort from your ties to a community of worshippers, and a sense of connection, purpose, and meaning in your life. Your recovery is a good opportunity to develop and explore your faith, and to connect with the roots and healing traditions of your faith.

12. Clean House and Set Priorities.  Recovering from a heart event affects every woman differently. Many women look back on it as a life-altering experience that gave them a special gift: the opportunity to examine their life's priorities, make choices about with whom and how they spend their time, and find new meaning or direction for their life. It’s likely, however, that you probably won't have this perspective until some time has passed after your heart event, when you will feel more secure about your health and can look back on the changes you have made. Well-meaning friends may ask you soon after your heart event if you have had a spiritual awakening or will be making dramatic life changes - taking a trip around the world or retreating to a Buddhist monastery. They don't understand that you are too traumatized to do much of anything, and that it will take time to recover and sort out the rest of your life.

Eventually and over time, you may let go of old friends who are not taking you where you want to go - who may still smoke and won't exercise or eat healthy. You may even question your marriage or intimate relationship, especially if you have been unhappy for a long time or if you spouse/lover doesn't support your healthy behavior changes. (Remember that your changes will likely affect your whole family. Go together and talk with a marriage and family therapist -- check out the American Association for Marriage and Family Therapy if things get too difficult.)

13. Dealing with Family and Friends.  Sometimes your heart event can cause more emotional trauma for your family and friends than for you. You know you have survived and are getting well, but they are often still shocked by what has happened to you and helpless that you came close to death - they almost lost you. They may overreact: either hovering over you or avoiding you. Understand that they are simply trying to cope with their own fears and panic. For your own mental health, however, you may want to keep anxious and overprotective friends and family at a distance until they get a better handle on their emotions. Otherwise, they will "kill you with kindness" and expect you to meet their own emotional needs. This can be exhausting!

Friends and family often fear that you will suffer another heart event and die. They should be encouraged to express their emotions, read books and articles about heart disease, and even speak with your doctor if need be. They may consider taking a CPR class at a local fire and rescue department or Red Cross chapter.