DEAR DR. DONOHUE: I am in my 70s and attend vigorous aerobic exercise classes three times a week. We monitor our heart rate. Mine increases only about five feats. Others get significantly higher increases. I take nadolol to control a heart-rhythm problem. Is my exercise regimen benefiting my heart? — W.S.

ANSWER: An increase in heart rate indicates the intensity of exercise. Because you take nadolol (Corgard), a beta blocker medicine, you will never be able to raise your heartbeat to the levels required to benefit the heart. Beta-blocker drugs slow the heartbeat. Don’t despair. Your exercise gives you and your heart plenty of benefits.

Aerobic exercise is the kind of exercise that gives the heart a workout and lowers blood pressure. The intensity of aerobic exercise has to reach a certain level to obtain any gains from exercise. Monitoring heart rate provides evidence that you are in the “training zone.” Subtracting your age from 220 gives a rough approximation of your maximum heart rate. Taking 60 percent to 80 percent of your maximum heart rate indicates the lower and upper bounds of your training zone. You cannot use this approach because of your medicine.

You can, however — and so can all exercisers — use another method for determining exercise intensity. That is perceived exertion. You determine the intensity of an exercise by how it feels to you. You can forget taking your pulse. The scale of perceived exertion runs from six to 20. Six is so light an exertion that it really can’t be called exercise. Twenty is so demanding that few people are able to perform at that level. Thirteen is the level of intensity that gives the heart a sufficient workout. Thirteen translates into “somewhat hard.” You judge if the exercise is somewhat hard. It’s as valid a way of determining exercise intensity as heartbeat is.

What you deem as “somewhat hard” at the beginning of an exercise program may drop down to a lesser ranking as you gain stamina and conditioning. “Somewhat hard,” therefore, evolves as you evolve into a better-conditioned athlete.

DEAR DR. DONOHUE: You stress that people should walk for exercise. I am unable to walk. What exercise can I do to help my heart? — M.M.

ANSWER: You can do upper-body exercises while seated. You have to do them without much of a pause so the exercise qualifies as aerobic exercise. Exercise with stretch rubber bands or light dumbbells will give you a good workout and will help your heart. Do them for a minimum of 10 minutes without a break. As you become accustomed to the exercise, aim for a total of 30 minutes a day. Three 10-minute sessions are acceptable.

Is swimming possible for you? It’s an excellent way to stay in shape and help the heart.

People with disabilities should contact the National Center on Physical Activity and Disability for a slew of information on how to exercise. The toll-free number is 800-900-8086 and the website is www.ncpad.org.

DEAR DR. DONOHUE: I lifted 5-pound weights a few weeks ago and shortly after developed a trigger thumb. My other hand developed a trigger index and middle finger. It seems odd, because I have lifted weights before with no problems. My doctor said to soak my hands in warm water 15 minutes twice a day. It’s not working. What else can I do besides surgery? — B.P.

ANSWER: A trigger finger is one that locks in a bent position for a while until it suddenly straightens with a snapping sound. It sounds like a gun’s trigger. The usual causes are overuse, injury or arthritis. For how many days did you lift weights?

Soaking in warm water several times a day usually calms the inflammation that’s causing the problem. Aleve, Advil, Motrin and similar medicines help too. If these don’t work for you, the doctor can inject the fingers with a cortisone drug. That almost always works. Save surgery for last.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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