From Heart Surgery to Happy Pelvis: When Can You Return to Intimacy?
Happy Valentine's Day to all my heart buddies. Today is an extra episode just for you! Expert Dr. Kelly Sadauckas and I continue our series this month as we explore post-surgery intimacy and pelvic health for heart surgery patients. In this episode, Dr. Kelly educates us on the significance of understanding concepts like metabolic equivalent tasks (METs) and cardiac rehab to ensure safe resumption of sexual activities. She explains that a MET of five indicates moderate activity, similar to intimacy post-heart surgery. She touches on pelvic floor health, relaxation techniques, and the mental and physical impacts of surgery scars. It's important to consult health professionals in case of pain or issues, promoting informed, healthy recovery, and sexual well-being post-heart surgery!
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**I am not a doctor and this is not medical advice. Be sure to check in with your care team about all the next right steps for you and your heart.**
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Transcript
If you're a client, and maybe it is like, a couple weeks before Valentine's
Speaker:Day, you might say, well, am I allowed to,
Speaker:like, return to sexy time? And if no one has talked to you about this,
Speaker:this is a really important conversation. To have sex
Speaker:is awesome. It can be a part of a fulfilling life.
Speaker:And sometimes post surgery, it might
Speaker:hurt. Or is the heart ready for.
Speaker:Right. So those are the key things that we want to talk about in
Speaker:today's podcast, and I'm so excited to be able to talk about it with
Speaker:you. Hey, welcome back to Open Heart Surgery with
Speaker:Boots. I am your host, Boots Knightman, joined by my friend,
Speaker:Dr. Kelly Sudowkis, and we are
Speaker:rocking Love Month, Heart
Speaker:Month with pelvic health and open heart
Speaker:surgery. Yep. And
Speaker:today, normally, I air every Tuesday,
Speaker:but we are bringing you a special episode today on
Speaker:Valentine's Day because it is
Speaker:time to have a conversation about
Speaker:sexy time after surgery.
Speaker:Now, this. I was not aware of the things
Speaker:I needed to think about. No one ever talked to me about it. And I
Speaker:am learning with all of you listeners. I am still
Speaker:astonished. Everything that we've already talked about with Dr. Kelly this month
Speaker:has blown my mind. And I keep telling
Speaker:her, just treat me like I have just walked into her office. This
Speaker:is 101 pelvic health post open heart surgery, and
Speaker:it only continues today with a very, like,
Speaker:normal part of being a human being.
Speaker:Absolutely, Absolutely, Boots. And so if you're a client
Speaker:and maybe it is, like, a couple weeks before Valentine's Day, you might
Speaker:say, well, am I allowed to, like, return
Speaker:to sexy time? And if no one has talked to you about this, this is
Speaker:a really important conversation. To have sex is
Speaker:awesome. It can be a part of a fulfilling life. And
Speaker:sometimes post surgery, it might hurt.
Speaker:Or is the heart ready for this? Right, so
Speaker:those are the key things that we want to talk about in today's podcast, and
Speaker:I'm so excited to be able to talk about it with you. Now,
Speaker:some of your listeners may have had the privilege of
Speaker:going to cardiac rehab. Did you get any
Speaker:cardiac rehab boots or, like, do you have any statistics about, like, what percentage of
Speaker:heart surgery patients get cardiac rehab? Yeah. It's
Speaker:interesting you bring this up, because I was not referred.
Speaker:I was treated almost like a celebrity
Speaker:in the hospital because, quote, unquote, my surgeon
Speaker:said they only operated on fat people.
Speaker:His exact words. Those are not my words. I would not use
Speaker:that to describe people anyway. And I
Speaker:remember the nursing staff coming in and being amazed at me because at the time,
Speaker:I was really athletic. I mean, I still am, but just in a new way.
Speaker:But my defects was so unique to them.
Speaker:They had not usually operated on like
Speaker:skiers and so they just didn't think I needed to
Speaker:do cardiac rehab afterwards and that I could just go back. I remember the exact
Speaker:words at my six week follow up were, go live your best life. And that
Speaker:was all the parameters I was given. Now
Speaker:I've joined Women Heart, which is listeners who've been listening
Speaker:for a while have heard me talk about this nonprofit.
Speaker:It's a national nonprofit for women by
Speaker:women with heart disease. And we,
Speaker:we do a lot of lobbying at the federal
Speaker:level to get women better heart health
Speaker:care. What Women Heart has found is that
Speaker:more times than not, men are referred for cardiac rehab,
Speaker:but women are not. And I have spoken to so many women
Speaker:who were not referred at all, like myself, and it's, and it's
Speaker:such a missed opportunity. And so yet another reason for
Speaker:this podcast, we all, no matter what our backgrounds are, we all
Speaker:need to be referred to cardiac rehab. Exactly. And I
Speaker:would now also argue pelvic rehab. Right. But probably cardiac
Speaker:rehab. Yeah,
Speaker:cardiac rehab, probably a little bit more of a priority. And what
Speaker:it is for your listeners, if you don't know, it's just like you would go
Speaker:to physical therapy for knee rehab after a total knee replacement to retrain
Speaker:the knee to work. Cardiac rehab is
Speaker:progressively and scientifically challenging your heart at
Speaker:different levels of exertion while a trained staff
Speaker:monitors your blood pressure and your heart rate. And
Speaker:one of the terms they're going to use in cardiac rehab and if you start
Speaker:to do some research by yourself is a metabolic equivalent or a
Speaker:met. And when we talk about sexy time
Speaker:post heart surgery, a MET is really important.
Speaker:So the technical term of a metabolic equivalent, and I'm going
Speaker:to read it here because I don't have it memorized, and you'll see why. One
Speaker:metabolic equivalent is equal to three and a half milliliters
Speaker:of oxygen per kilogram of body weight per
Speaker:minute. What? So
Speaker:it's how much oxygen your heart and your lungs are processing per
Speaker:minute. And mets, it's a way of describing how hard
Speaker:you're working. So like zero mets is like sitting absolutely
Speaker:still. One MET might be walking around the
Speaker:house. But here's the thing. Chicken wings.
Speaker:One met for someone like boots at her heart
Speaker:surgery is way different than a different human's. One
Speaker:met a different human. Walking across the house might be
Speaker:moderately to extremely stressful. So walking across the
Speaker:house could be considered 5 metabolic equivalents. All Right. So this is like
Speaker:a whole nother topic to get into.
Speaker:But the skinny is post heart surgery, we
Speaker:need to be gradually progressing your activity and assessing your
Speaker:response to this activity and having skilled medical
Speaker:providers to assess your heart rate and your blood pressure response is
Speaker:awesome. And if we don't have that, you can do some
Speaker:judicious googling, Right? Mets
Speaker:after heart surgery, scholarly mets after heart surgery,
Speaker:and bring it to your medical practitioners, like, I want to understand this more,
Speaker:and then they can guide you. In general, mets of around one are
Speaker:like our lowest, easiest activities, like bed rest might
Speaker:even be considered a one. Sitting up in the chair, taking a
Speaker:shower might be a MET of 2 to a 3. Once we
Speaker:get up to 3 to 4 now, it's like leisure activities. So for
Speaker:some people that might be walking, for some people that might be sitting up in
Speaker:a chair, once we start to get to five
Speaker:now. And this is typically what's assumed to be the metabolic core
Speaker:equivalent of sexual activity as a met of five, a moderately
Speaker:vigorous activity. Now, depending on
Speaker:where we are literally in the position for
Speaker:on top or bottom, that's gonna matter. So if you are, you know, this is
Speaker:your, your first go at it and you're like, I'm a little nervous. Maybe you
Speaker:should be the more like, receiving partner, the partner that's doing a little bit less.
Speaker:As you work a little bit farther out in your recovery, you can be more
Speaker:of a active participant and move around a little bit more. That'll
Speaker:be a higher metabolic equivalent. But this is
Speaker:really important for you to understand where it fits into things, because it's a, it's
Speaker:a pretty vigorous activity. So if you're still
Speaker:working on like walking on the treadmill for like 10
Speaker:minutes, and that's exhausting, you're probably not quite ready to
Speaker:participate in vigorous, intimate activities just yet. But it's
Speaker:something that you can work towards by increasing the duration of that time on
Speaker:the treadmill by introducing things like weight training and, you know, stair
Speaker:climbing and things. And again, I'm not a cardiac rehab specialist. I want
Speaker:you to get your cute butt and your cute heart into a trained
Speaker:cardiac rehab practitioner. But it's progressive
Speaker:load on the heart just as important as progressive load on
Speaker:muscles after a shoulder surgery or a knee surgery.
Speaker:And it's just, it's great to know. And then beyond, like the mets, like, what's
Speaker:the highest it goes to? I think it goes to like 10, actually. As far
Speaker:as, like the metabolic equivalent scale, 10 is like a high intensity
Speaker:activity. So we want to make sure that we're working up
Speaker:towards those activities when it's meaningful to
Speaker:you. So that's mets for heart surgery. The other
Speaker:important piece is heart surgery is stressful. We
Speaker:talked about that in our last couple of segments.
Speaker:Together with stress comes
Speaker:a passive elevation, an. A subconscious
Speaker:elevation of your pelvic floor muscles. So
Speaker:if you have a vagina, that could mean that it doesn't feel
Speaker:as good as it once did. It might actually be painful because honestly, ladies,
Speaker:the door's closed. If you have a penis, you might find that you're having
Speaker:trouble hoisting the main sail. And if that's the
Speaker:case, those two conditions, the pain with intimacy or the inability
Speaker:to have that erection or that climax, that. That can be due to these
Speaker:pelvic floor muscles resting too tight in general, and they're
Speaker:not really healthy. So as a treat, we're going to have a pelvic
Speaker:floor relaxation, whole segment for you to go
Speaker:through. But here, together, if we've had open
Speaker:heart surgery, if we're having it in the future, it's
Speaker:very important for you to relax your pelvic floor for overall health and wellbeing and
Speaker:for sexy time. So sitting here, wherever you are, I want you to relax
Speaker:your tummy, close your eyes if you're not like
Speaker:driving or something, and if you're out for a walk or a
Speaker:run, pause for a moment and take a couple beautiful, nice, deep belly
Speaker:breaths. Inhaling, fill up your lower belly in all
Speaker:directions. Exhale. Notice how your lower belly
Speaker:rebounds. Your beautiful pelvic floor is at the bottom
Speaker:of this pelvis. As you breathe in and your
Speaker:belly gets bigger in all directions, front to back, side to side,
Speaker:it should also soften and elongate in a downwards
Speaker:direction. Inhale, soften in that downwards
Speaker:direction. Exhale, Your belly rebounds in. Can you
Speaker:keep your pelvic floor soft? Taking a
Speaker:few breaths to relax and soften that pelvic
Speaker:floor will make all the difference in the world and your quality of
Speaker:life. And then if we're looking for sexy time, it
Speaker:will help open the door, so to speak, or prepare those
Speaker:muscular tissues for having the resiliency to have that erection.
Speaker:So those are just a couple of cool things to
Speaker:talk about. Does. Does that make sense? Boots? Yeah. And I just totally relax
Speaker:like I was. I just totally went into it just then. That was.
Speaker:That worked. It's so helpful. And. And that little bit during out the day.
Speaker:Yeah. And if you. Now that we tune into how that feels,
Speaker:can we keep that relaxed as we like, gently engage our core and then Go
Speaker:about our day. And that will do all the difference in the world,
Speaker:not only for sexy time, but also for, like, pee and poop complaints
Speaker:in general. So those are the biggest things if we're. You know, if we're
Speaker:watching this on V day. Hey, have. Have fun out there, kids.
Speaker:But if you are actively having some pain with intimacy, work on relaxing the
Speaker:pelvic floor. And if you have questions about the intimacy, just
Speaker:don't be ashamed to ask. It's a functional activity. And if
Speaker:you're afraid to ask for any reason, you could then ask,
Speaker:well, how could I improve my athletic performance
Speaker:to tolerate five METs? Yeah, that
Speaker:was. I'm glad you just mentioned that, because I was gonna ask, like, for those
Speaker:out there. Yeah. Who might be wanting to be very
Speaker:private. Right. Which I respect. Yeah. There you go. So how
Speaker:can I improve to 5 Mets? I like to 5 Mets. And that's. And the
Speaker:cool thing about the Mets. Yeah. And they're. They're a little
Speaker:sciency. Right. But they're. There's also this
Speaker:cool scale called relative perceived exertion.
Speaker:That. There's a terrible version that's like one to
Speaker:26, and there's a relative, like, a one to 10. That's
Speaker:perfect. And so how hard we work.
Speaker:Right. One is super easy, 10 is super hard. Around
Speaker:a five or a six. You know, that's right around this
Speaker:five or six met. And it's not an exact science, but that is some
Speaker:way that you can kind of start to correlate. So if you are walking around
Speaker:your house, and that's five or six out of 10 on your
Speaker:relative perceived exertion scale, you're not ready for
Speaker:sexy time yet. But something that typically would be seen as the same
Speaker:as sexy time is like stair climbing for, like, 10 or 15 minutes.
Speaker:That should be up to five or six mets by the end. So if that's
Speaker:feeling medium hard to you, then you're probably
Speaker:ready. Um, so. So it's just a neat way to talk
Speaker:about it and something for us to all be aware of. Yeah.
Speaker:Thank you for this awareness and something that really, like,
Speaker:absolutely. Is so necessary and important.
Speaker:Yeah. And if you're having, you know, further difficulties, you know, please consider
Speaker:working with a pelvic floor specialist or a sexual counselor, because there's
Speaker:a whole load of stuff that goes into this. There's body
Speaker:image. We might have scars that hold a lot of emotional weight.
Speaker:The scars might be painful, and they shouldn't be painful, my
Speaker:friends. So if they are, we need to be working on the scar mobility,
Speaker:we need to work. If you've had a sternotomy, we need to work on that.
Speaker:Costal cage mobility. All things
Speaker:that basic physical therapists can help with. But you
Speaker:know, the cardiac rehab are kind of the progressive cardiac exercise.
Speaker:If you feel that functionally you're fine but you're still in pain
Speaker:or there's other stuff. Right. Regular pts can help with the
Speaker:physical pain. Sexual counselors, pelvic pts can help with some of the
Speaker:other intricacies. Always a good lube is
Speaker:nice as we age, but that's not going to cover all
Speaker:the other stuff. And it's okay to talk about. And if it's important
Speaker:to you and your partner, you both deserve to talk about it.
Speaker:Right. Cool. Excellent. Thank you for this.
Speaker:You're so welcome. So, yeah, I'm sure there's stuff that we forgot about, but I
Speaker:think this is a great start. And I don't have any
Speaker:like sexatum specific courses on my website
Speaker:yet, but I will and we're offering all of your
Speaker:podcast people the coupon of OHS2025 for
Speaker:25% off all of our online courses. So keep checking
Speaker:back and you know, check out the blog and Suzanne and I's Instagrams
Speaker:for fun topics relative to 6A 10.
Speaker:Yes. And thank you so much for being here, listeners for this special
Speaker:episode. And we'll be back on Tuesday where we're going to talk
Speaker:about who. All the best
Speaker:topics. I tell you, we are where it's at, people.
Speaker:So I love you, you matter and your heart is your best friend.
