Recovering from a heart attack takes courage. The old conventional wisdom told patients to lay low, and popular myths still keep some from living as fully as possible. Recent strides in cardiac rehabilitation, however, are changing that. Today the best advice is still to change your lifestyle, but not to a sedentary one. In fact, you can — and probably should — lead a more active life than you did before your heart attack. 

  It's up to you to take charge of lifestyle changes. You'll need to change personal habits and make the changes last. If you don't adjust your lifestyle, your condition won't improve. Bypass surgery alone is no cure for heart disease. Healthier living, however, can improve your life and possibly prolong it, too.

  Exercise is one of the keys to rebuilding stamina. It begins with a gentle regimen while you're still in the hospital. Within a month after you've returned home, your physician will conduct tests that will help determine an individualized exercise routine that's safe for you. 

  Formal exercise programs are based on aerobic activities. They last about four to six weeks, after which you can continue on your own. But it's recommended that you stay with a supervised program for up to two months. 

  The Johns Hopkins Medical Institution advises a walking program starting 10 to 14 days after surgery. Start slowly and build up. It's generally okay to walk 1/4 mile to 1/2 mile in 10 to 15 minutes. Do this for the first 6 to 8 weeks, gradually increasing your speed to 2 to 3 miles in 45 minutes to 1 hour. 

  Consider joining a cardiac rehabilitation program in your area or a hospital-based cardiac rehabilitation program. Please ask your doctor for information about programs in your area.

  Reducing stress after a heart attack is important. You don't have to stop working or avoid all challenging activities, but you should rethink stressful habits.

• Avoid being a workaholic. Cut back your hours and work load.
• Plan around typical frustrations such as commuting and high-pressure deadlines.
• Take time to relax.

  Diet is a rehabilitation essential. Review your current diet with a registered dietitian while still in the hospital. Artherosclerosis, the buildup of fatty plaque in the arteries, is the chief health danger to avoid. Stay away from foods high in saturated fats and cholesterol. They produce plaque. Also, keep your weight down. Extra weight taxes the heart.

  Nicotine affects your blood pressure and heart rate, and smoking accelerates artherosclerosis.

  Despite popular fears about triggering another heart attack, the truth is that most people can resume normal sexual activity within six to eight weeks. Sexual intercourse raises the heart rate to only about 130 beats per minute — not in itself a dangerous level. You simply need to be aware of a few complicating factors.

• You're probably ready for sex if you can walk around the block or climb a flight of stairs without pain, shortness of breath or fatigue. Ask your physician if you should wait longer, particularly if you have had significant complications since your initial heart attack.
• Certain medications can cause impotence. Substitute medications are available, so consult your physician if necessary.
• Allow several hours to pass after eating a large meal or drinking alcohol. Both are taxing to the heart.
• If any pain or palpitations occur that last for more than fifteen minutes, contact your physician. You may be prescribed a nitroglycerin tablet to take before or during sex. 

Contact your physician if you have any questions or concerns about what you should or should not do following a heart attack.