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Boots Knighton: [00:00:00] Hey there. Welcome to another episode of The Heart Chamber. I am your host, boots Knighton. Today I interview my physical therapist, Cassie Fuller. Cassie has been a physical therapist in Jackson, Wyoming since 2015. She earned her doctorate of physical therapy from Pacific University in Hillsborough, Oregon.

She specializes in the assessment, rehabilitation, and progression of the mountain athlete with additional certifications in the running athlete. As well as professional bike fitting. Cassie is also a yoga instructor. She started the Fuller Yoga Project in 2020 after finishing her 200 hour yoga certification, she teaches both private and group yoga classes.

where she combines the biomechanical background of physical therapy with the holistic approach of yoga. Cassie [00:01:00] and I's conversation is wide ranging. We talk about how she has progressed me through my cardiac rehab. We also cover the mental health aspects of open heart surgery and how she is.

Integrating the mental health aspects of healing from any injury into her physical therapy yoga practice. I hope you'll find this episode helpful, whether you are the patient or you are the caregiver. And if you like this episode, please share it wide and far. Also, make sure you subscribe. and I am accepting donations on my website.

You can go to www the heart chamber podcast.com where you can either buy me a coffee or make a donation on PayPal. Your support is greatly appreciated as this podcast continues to grow and is listened [00:02:00] to around the world. All right, let's dive in.

Cassie Fuller, thanks again for, joining me. know, Cassie and I, have become acquainted. Thankfully over my heart. She has been helping me. Bounce back, but Cassie has come on a little later in the game. part of me wishes I had found Cassie sooner, but I also have to trust that it's all, you know, my path, my healing journey has fallen into place as it's meant to be.

and so Cassie and I did not start working together, gosh, until, was it the sum this past summer 2022 or spring?

Cassie Fuller: have, yeah, I think it might have been

summer

Boots Knighton: together.

It runs

Cassie Fuller: Later

Boots Knighton: And originally, blessed my surgeon, but you know, his, know, directive to me after surgery. Cause I was like, what do I do? Do I go to rehab or whatever? He's like, just go on living your best life. And so I did, and then I kept hurting myself because I kept doing too much and.

[00:03:00] Then, you know, my heart kind of like teetered on heart failure and then it had palpitations. And you know, since Cassie and I started working together in a more focused cardiac physical therapy mindset, now I'm really starting to move the needle. And I'm finding that on a day-to-day basis, I'm experiencing the sense of hope, that I'm going to be okay. .

Cassie Fuller: yeah

Boots Knighton: So, yeah. And so I thought today we could, first talk about, what Cassie. Cassie, I was hoping you could explain what you and I have been doing together. and then we're gonna zoom out for the general cardiac patient and approach.

Cassie Fuller: Absolutely. so we have been kind of over, over the course of some months now working on some things and also kind of zooming out in other ways. So we initially talked about[00:04:00] Symptoms are, what symptoms are a part of the scenario? What matters more than other things? What's the priority as far as your symptoms go?

And then in some way, shape, or form trying to objectify them so that we could zoom out and see what the total picture was like. So not just looking at one workout or one ski or you know, even like a week, but having data for a bunch of different metrics that we could go back and see trends. Cause a lot of times, I think in all things rehab, especially for people who are in the middle of it.

It's hard see trends. to It's hard to see victims, though they may be small, sometimes they're huge, which is great and it's really obvious, but a lot of times it takes physically writing things down so that you and I have something to chat about as far as what's working, what's not working, then with those variables to figure out what the best scenario is for you.

And you said it, I mean, everybody's different in their mindset, in their goals, in their past, how much things like this have affected them in the past and where they were [00:05:00] coming from. and so all of that we've played around with, we did some treadmill testing to get, actually one of my colleagues did to get some baselines.

And then we've used that when we can be in person. To see and to also use it as a, new

a

we can bump up to new baselines and then have something to refer back to. so I think that's been kind of the main thing that you and I have been focusing on and trying to figure out how all of that works an environment. mean, we live in Jackson Hole, so everything is quite aggressive and. we push our bodies daily for better or for worse, and trying to figure out what's for better which is hard for everybody.

Boots Knighton: Yeah. And you and I have spent a lot of time talking about that. I hear a couple of things there. you helped me gain more awareness

Cassie Fuller: Mm-hmm

Boots Knighton: around my, I think you called it, like, load.

can you explain that real quick? What load is.

Cassie Fuller: Yeah. so we were talking about kind of the overall stressors or what contributes [00:06:00] to the general load of you as a human, for any human. Whether that sleep's not great, whether my diet's kind of crummy, cause I don't make myself lunge, which I'm guilty of all the time, it's.

Stressors from social life or family or or the stuff that I'm having you do in pt. All of the things contribute to an overall load, and we're trying to play with all the variables within the load to figure out what can we turn up and what needs to turn down. So we find this like equilibrium of balance between. of it, which is hard because everything changes every single day. it's not like we can turn one up and then it'll stay up and nothing else will go up at the same time. So it's a lot of. I mean, it's, it is a bit of an experiment to see what each week will bring.

Boots Knighton: All

Cassie Fuller: think looking at the overall load, not just the physical tax on your system, not the physical tax on your heart and what those requirements are, but looking at of the other factors that can play into the load that is [00:07:00] on you as a human. Which I think is really important in healing. And a lot of that kind of gets pushed to the side. You know, if you go to the doctor and you're like, ah, my energy's low. And they're like, oh, well you're just depressed. Or you just have anxiety, or you just whatever. And then, you know, maybe you get meds, maybe don't, but then they send you out the door and like, what does that look like?

What are the symptoms and what does that mean and how does that contribute to a healing body? Cuz it does make a difference. Um, and I see it all the time in pt, especially for people who, you know, in, in this town, everybody's an athlete in their. Way. and so we often use our athletic ventures as stress release or as identity or social interaction with other people. And then when that changes, it changes the overall load so drastically that we kind of get thrown off our game. then,

Boots Knighton: Mm-hmm

Cassie Fuller: we come back too quick or maybe we don't push in the right way, or, there's a lot of, a lot of things that can contribute to that load and trying what those are

to figure out

Boots Knighton: And [00:08:00] perfectly stated and I was all outta whack when I came to you and I was trying to get back to a life. , just wasn't for me anymore. and I think I knew that deep down, but I definitely wasn't accepting it. And you know, I also just didn't have enough of the awareness and the knowledge.

Right? Like you had to teach me a lot, you know? And so for listeners who maybe don't live in our area, you know, Cassie works at. kilter PT in Jackson, Wyoming, and Jackson, Wyoming is a very active place and is filled with, you know, the typical extreme athlete, is by, you know, it's very numerous.

It's, it's a mentality that tends to, it, it, it's part of the everyday conversation. it's also, the butt of the joke. It makes for a lot of fodder and, you know, our local plays, and for good reason and, [00:09:00] you know, there's a lot of people proving themselves and it's a lot to be admired until. You know, that person is hurting themself.

And I feel like I, you know, in a way, I, I admit, you know, I got, I don't know if I got caught up into that, that level of intensity, but I definitely did not want to let go of. the life I was living, which was ski instructor and mountain biking a lot, and climbing peaks and, it just, my, my heart was just saying no more.

And know, it took finding Cassie and Cassie being willing to speak truth to me and to educate me in a gentle, loving way to where I was able to hear her. and you know, not every physical therapist has that ability and you know, sure. I'm sure a lot of physical par physical therapists I worked with in the past or doctors wanted to meet me where I was at, which I appreciated, but I wasn't even able to see where I was at.

Cassie Fuller: Mm-hmm.

with Well hard when you live [00:10:00] it

I mean, what we talked a lot about was. know, we're in this town where we kind of size each other up based on our athletic ventures. So on Monday morning it's like, oh, what did you ski? And how many times did you do it? And what kind of vert did you get and how long did it take you?

And who did you go with? And there's always this, even if it's subconscious, a love, like we're all kind of trying to climb a ladder. matters. It does. It does. Absolutely. But it's all. Physical. And then when that gets taken away, which happens a lot for athletes, cuz injuries happen, overuse injuries, traumas happen, surgeries happen. And when that gets taken away, I feel people

like

know what's underneath it. And it's scary. It's really And it's happened to me, it's happened to my husband. I mean, it's happened to all of our friends. There will be things like your. Will, and this is different, this is kind of a new side of my PT practice that has come in the last probably two years, [00:11:00] is exploring more behind the physical.

I do think that, you know, the things that we do physically as far as joint mobilizations and exercise prescriptions, all of that is very important, but I also see where. The emotional side plays into it, and we're not addressing that, especially in this town. We don't address that. because it doesn't get you anywhere on the ladder.

Nobody cares If you know you have a good relationship with your partner and you're a nice human and care

you

doesn't move up in, in

you

mountain town.

Boots Knighton: maybe our conversation will change that today it it should. It should all matter, you know? And, Well, let's, you know, trace our steps here. we had to figure out my load, which took a while cuz I had to remember to write it down, .

Cassie Fuller: Yeah

Boots Knighton: And then I started to remember to write it down.

Cassie Fuller: Yeah.

Boots Knighton: I, I just slowly learn, but I get there eventually. I just don't get there very fast. and then, and then it just popped out on the page, you know, and, and [00:12:00] we had to really, remind me if I'm wrong, but we had to really adjust like amount of weight I was lifting in the gym, the frequency of the gym, the intent, like a lot of it went back to the gym

Cassie Fuller: Mm-hmm.

Boots Knighton: and then like sprinkling in other activity around.

the other days in a skillful way so that, and then, you know, we had to identify, well, what signs my body was sending, saying, Hey, this is, this is too much.

Cassie Fuller: especially in, in going back to the Jackson thing, but it's what I do and who I work with, but, and where I live, A mountain athlete, we push our bodies. That is how, like, that is our relationship to our physical self is we're gonna climb that peak and our body, our legs are gonna be screaming, our lungs are gonna be screaming, we're cold, we have frostbite on our toes, whatever. It doesn't matter because we're gonna do the thing, which is awesome. When everything's happy, healthy, great. But when things aren't happy, healthy, it takes. [00:13:00] Very clear awareness to recognize the signals that your body is telling you and to actually listen to them. of saying like, not now I'm gonna go ski Taylor, or I'm gonna, you know, go kayak on a snake.

Like, there's so many ways that we say no to our bodies and they will just scream louder and louder and louder and louder. Physically put us on our asses to the point that like we can't do what we were used to doing and we have to reset those priorities. so a

Boots Knighton: Mm-hmm

Cassie Fuller: it was stepping back and saying, you are an athlete and you have a certain relationship with your body as an athletic human, but what does that look like as far as the signals that your body is giving you that you may or may not been

the

of in the past?

Because you had to. You

haven't

needed to. There

Boots Knighton: Mm-hmm

Cassie Fuller: Communication, or maybe it was there, but it wasn't a clear need. it's easier for people on the outside to be able to educate you on that. I mean, you know, I have my own symptoms [00:14:00] that I'm figuring out myself in my own physical body.

But, it's, think initially as you're getting back into activity to objectify it to a certain point you know, whether it's whatever the symptoms. Zero to 10 scale or zero to seven scale. How hard was it for you? What did your heart rate do? How did you feel? What symptoms did you experience and how significant were they? looking at what your sleep quality was that week or what your lifts were using those clues.

as

That's

Boots Knighton: Mm-hmm

Cassie Fuller: we're dealing Puzzle that

just

have to figure out what pieces matter and what pieces we can kind of just put

Boots Knighton: right.

Cassie Fuller: to

Boots Knighton: I found that. . One of the more helpful things was, you know, being able to identify the parts of my body that were letting me know, and it was too much. And so one of the was obviously heart pain.

Cassie Fuller: Mm-hmm

Boots Knighton: the other was I would get deep crippling fatigue, and that would be just the immediate signal of [00:15:00] stop

Cassie Fuller: Mm-hmm.

For most strictly orthopedic or cardiac or, I mean, those are the ones that I most ex have experience with. But if we're quiet and we listen to ourselves, our body will let us know when we're getting too resistance before we get to whatever the symptom is. And most of the time we just blow past that and we hit full on fatigue or we hit full on heart pain. once we're able to recognize like, oh, I mean it's, it's a subtle symptom, but if I pay attention to it now, I don't get to that extreme anything cuz I don't have to

Boots Knighton: Mm-hmm Right

Cassie Fuller: well enough that I can trust that information and know from experience if I go past, there things on the other side that don't feel great. but

Boots Knighton: right

Cassie Fuller: It's really subtle. and you have to take

what that is, to

Boots Knighton: I know why, but can you explain to the listeners, like why it was so important that we nip all this? Because I was experiencing extreme pain, you know, ER level heart pain [00:16:00] and fatigue and the palpitations and the heart skipping. Like, why was it important that we keep me from even getting to that level?

Cassie Fuller: Just because the risk is so high for either even more change to your life, the, the risk to you Played everything else where we had to figure out how to navigate those variables so that you weren't pushing to the point and it wasn't purposeful, but that you weren't pushing to the point where, yeah, pain so bad that I need medical attention, like the risk of significant events, cardiac events happening. I don't want that on the table for you, . So trying to figure out what does that look like and can we keep you and progress you as an athlete and an active human in a mountain town, not to the point that you're pushing yourself to that level of risk. Cuz it is, it's a risk. gets scary at that point. and we don't have to. Because we can play [00:17:00] here with all the other variables, and they're really fun to play with and you can still ski,

Boots Knighton: that's the cool part. I'm still doing everything I wanna do. I just have to be really mindful and moderate and measured.

Cassie Fuller: Yeah, which to a certain extent, like we all should be kind of doing. we don't, and again, it's fine when everything's fine, but. Yeah, like I can, I went to PT school in Portland, Oregon, and my first job was working with a, not necessarily hel, uh, healthy population. and then moved to Jackson.

And I remember this like moment where in the initial eval you ask all the questions of, you know, what does your lifestyle look like? What are the symptoms? When do they come on? When are they better? What's your support network? And I remember having to consciously remember to ask. rest days mean to you regardless of what the patient was seeing for, because a lot of times I'd have people come in the door and they're like, I have chronic knee pain, I have chronic hip [00:18:00] pain, I have heart like all these symptoms, but, and I'm like, okay, when was the last time you took a rest day?

And it's very, Frequently that I'd have patients tell me two years ago I took a day off and their bodies just can't, it, it's, it can't do it. It's not possible. and it. it will make you stop either in a really big way or sometimes we're lucky and we listen to it and it like just slows us down a little bit and we let things heal and we rest and we let our body recover from the things that we've been pushing ourselves to do for years. know, chronic things like stress fractures need to be part of people's future there are things that we can do and a lot of them involve just listening to your body in a really healthy.

Boots Knighton: you hear a lot of like

replacements in our area at pretty young age or knee replacement. . I know we're talking about hearts today and, but like, that's something we hear about a lot in this, in our community is replacement of joints and[00:19:00]

Cassie Fuller: it's

Boots Knighton: I'm not interested in replacing my heart.

I'd like to keep mine and, you know, so that's why I went to Cassie

that was the main goal. So my heart has been remodeled

and it may need another remodeling, but, you know, and, and that's just because of the way I was born. But if I, I'd like to think that, you know, if I take good care of my bicuspid aortic valve and. you know, am mindful of how I use my heart that, you know, I might be one of the lucky few who lives a full lifetime with a, you know, a bicuspid aortic valve.

We'll see

Cassie Fuller: Yeah,

Boots Knighton: yes, .

Cassie Fuller: so close friends

Boots Knighton: well zooming out a little bit for our listeners. You know, like I wanted to just give my. As a, know, and as an example to others and you know, I know I'll have a lot of cardiac athletes that will listen to this podcast and. You know, I wanna hear from you, like, you can go to [00:20:00] my website, the heart chamber podcast.com, and you can leave me a voicemail and tell me about your cardiac rehab.

I'm, I'm curious to hear from listeners and, you know, I feel lucky that, you know, Cassie is in my life. you know, Cassie, Can the general open heart surgery patient for whatever reason they need open heart surgery, prepare for such a surgery from your perspective as

physical therapist.

Cassie Fuller: Yeah. that's a really great question and a lot of answers

to it.

Boots Knighton: Lay it on us.

Cassie Fuller: I. Think you lot

had

kind of the emotional side of, of the prep for that type of surgery because it is, I mean, it's your heart. It's a really personal thing. It's different than like, you know, having a shoulder operation or you know, whatever. so I think a lot of, to be therapy

be great. honest Um, I think there's a lot that our and our bodies [00:21:00] store up. in relationship to whatever it is that we're having done to ourselves surgically. And I think that disconnect carries over into our post-op protocols and our rehab and what that looks like as far as our relationship to this situation as well. and that's the part of PT that I think I'm starting to recognize more and more and more is that relationship between not just the, you know, the valves and the output and what does, you know, all the, the numbers. The progression as far as that goes, but what the rest of your perspective is on that. so I do think that there's a huge need for pre-op for all of us therapists in general, um, mental health therapists, but, Especially for something as personal as your heart, that's different.

It's very, very, very different.

Boots Knighton: Yeah Yeah

Cassie Fuller: of the emotional side of that is huge. I personally have gone down a little bit of a road for a variety of different reasons Internal family [00:22:00] systems. Yeah. So the, the theory behind it being that our body will physically give us some kind of clue to what it needs or what it wants to tell us or what it, doesn't want to do for a lot of reasons. And so it's taking time to feel what your heart is like. Do you have elevated heart rate because of anxiety? Do you, you know, have a pit in your gut because you're so, so anxious about what's to come? Rightfully so, it's a scary thing. and can you have communication with those, the parts of you that are trying to tell you something? All they wanna do is whisper. They don't wanna have to yell to get your attention, but it does take illness for you to be able to recognize that. So as far as leading up into it, from that side of things, I think some kind of guided. Relationship between your mind and your body emotionally matters a lot. I will say that like in this town and, and the clinic that I work [00:23:00] at, we don't really see many acute cardiac patients cuz they're centers, specialized centers. we see more of, once they go past that acute phase, there's a gap between, I'm seeing my cardiac rehab specialist PT this many times a day.

We're. You know, whatever the, the protocol is, the step in the protocol that you're in to going back to your life. I mean, just as you said, it's like, he's like, okay, off you go, like good luck, And that, that gap matters a lot because it can be, Significant heart pain, like, I need to go to the er, this is not okay. Or we can play in that gap and figure out a way to get you back to what you wanna do physically without those symptoms. So I'm kind of, I kind of look at it from leading up and then we'll let, we'll, we'll rely on the acute therapist for that phase. And then as far as like the

chronic and

what that looks like moving forward, that's kind of where at least my, Expertise, I guess, [00:24:00] um,

Boots Knighton: Mm-hmm

Cassie Fuller: it and what That's

Boots Knighton: great

Cassie Fuller: Mm-hmm

Boots Knighton: where you and I, that's the level you and I have been operating at.

Cassie Fuller: Yep.

Boots Knighton: how about,

would you recommend like,

any specific activity leading up to open heart surgery? I mean,

honestly listeners, if like you're greatly incapacitated, like, and always talk to your own medical providers, like this is just general.

Cassie Fuller: Mm-hmm.

Boots Knighton: general.

Guidance Cassie is giving.

Cassie Fuller: Yeah, I mean,

think I

so individualized. I don't know if I wanna really throw a blanket

Boots Knighton: Okay.

Cassie Fuller: Um, I do, mean, what would be awesome for all of us, especially for those of us that get you post-acute, do some of the, like the writing down that you and I did, boots as far as, um, looking at the different biomarkers of, you know, what your heart rate is, what your blood pressure is, what the heart rate variability is, those kind of metrics [00:25:00] leading up to it so that you know what you're getting into or what your body, how it's performing at its current state.

And then we can use. after. I do think that there's such a broad range of. Physical function that people can go into the surgery. So I don't really wanna throw a blanket statement out

Boots Knighton: Mm-hmm

Cassie Fuller: in, again, in mountain town, we tend to have a, generally, like the baseline human in Jackson Hole is very athletic. Um, so

Boots Knighton: Yeah

Cassie Fuller: our, population is gonna be very different. Like when I was in Portland and I was working with a lot of sedentary people, I do think that having, ideally this doesn't always happen, but, meeting with a therapist, a physical therapist, going into it and having whatever the personalized is that you can, and get in the habit of doing it. aware of the symptoms like we talked about before and listening to what your body tells you.

but I. as far as that [00:26:00] goes,

I would say more the like

setup behind the scenes. These are the things that I think matter as far as after you get past that acute phase.

So I think I'm gonna do a cop

Boots Knighton: It's definitely

Cassie Fuller: there instead.

Boots Knighton: not

Cassie Fuller: and throw that out,

Boots Knighton: I mean, everything you said though is still helpful and I can't emphasize enough the therapy, and I talk about it a lot in my first episode when I share my story. So if you're just picking up on this podcast now and you haven't listened to previous episodes, go back to episode one where my story's a little long.

Apologies, but it, it took, there's so much to it and I go in depth into the therapeutic work I did before. And after, and I will say even today, I had an incredible session with my therapist. We will hit nine years together this May, May, 2023, [00:27:00] and she and I actually were working on internal family systems.

We started doing that in preparation for my heart surgery. and I had this vision of a little girl who was in the form of a jumpy little heart with pigtails, um, blonde haired. And I had, I could see like, know, pigtails and my heart was letting me know it needed help, and it manifested as being stuck in a basement.

but prying opened the door and begging for help. And the moment I had open heart surgery, like I talked to my therapist within a couple of weeks after that, my jumpy little heart. Was completely at peace. So, you know, there's a lot of research into the internal family system and it, and it really is kind of, I think it's just now coming on board more, more mainstream maybe.

And it really is powerful stuff. And today, you know, we were able to start [00:28:00] really addressing something called the Central Self, which is our like internal presence. And it's just amazing, you know. since my surgery and since I was willing to like dive in and do all this work and work with like my firefighter self, which is another part of ifs, and then there's the manager part.

and my poor manager part was like trying to save my life. My firefighter part was like trying to put out the quote fire in my heart. Like everyone was like, all systems go. We've gotta save this body that we're a part of and you know, now I can do like this. Really incredible continued healing. And Cassie is right, having heart surgery is, it's The highest level of intensity of like what can go wrong in a body or, right.

I mean, we have a choice in how we look at it. You know, I, I now think of my open heart surgery journey as one of the greatest moments of my life, and I think I'm able to say that because I [00:29:00] work through all of the muck of it, because there is a lot of muck and there's a lot of stories you make up about that you can make up about it.

You know, I talk a lot about. in another episode with, Carrie Potter. I, I talk a lot about how I went through this whole mindset of I'm defective, I was born broken. You know, how am I gonna fix this? Am I ever gonna be perfect? And there's just not even such a thing as perfect. But you know, you just go through all these different stories you tell yourself, and none of it helps you going into surgery.

Cassie Fuller: Mm. after

Boots Knighton: Or after. Exactly.

okay, so what does it mean to heal Well, after open heart

surgery,

Cassie Fuller: This is where

and I

Boots Knighton: pivot.

Cassie Fuller: Yeah.

Boots Knighton: Mm-hmm

Cassie Fuller: Feeling well is really hard. and there's a lot components just as we were talking into that play load to all of it and trying to be objective, but also their [00:30:00] subjective feelings and try to navigate that world. I do think healing well from my perspective, involves all of what you just said. So it's not just the physical healing of the structures that you had affected by this scenario. There's so much more to that. and especially if you're wanting to get back to highly athletic. Ventures, that huge. It's really, really, really big to figure out why it is that you're doing what you're doing.

What that means to your identity is that all of your identity, which happens a lot in this town where people come here to ski, they are skiers, all of their friends are skiers. All they can think about is skiing, and then skiing gets taken away and they don't. what to do. so I think doing a little bit of background work on figuring out why it is you wanna get back to doing what it is that you did before, if it's a modified version, same question.

Why is it that you wanna do [00:31:00] is that you are doing, and whose expectations are you putting on yourself? Because even the subconscious ones or the non-verbal ones that we get from other people, that plays into your making, my decision making as far as what steps we make in the healing process. so I do think, you know, all of the, the emotional work that you have done and it's emotional work is even, even the right terminology. It's so much more than that. but all the work with ifs and figuring out who you are as far as your essence, that matters way more. Then all of the ladder that we're judging people on as far as their physical feats over the weekend, of that is going to get you through rehab and healing.

Well, that

Boots Knighton: Yeah

Cassie Fuller: the, the end goal eventually. Yeah. We wanna get back to doing what it is that we wanna do, but are you comfortable enough in yourself to say like, oh, I, you know, I really wanna do this one thing a couple times a week, but then you write down all of your markers, your, [00:32:00] list of your heart rate and your heart rate variability and all the things that we've talked about. And you recognize like that may be something that isn't right for me right now because timing does matter. It may be right for you in the future, but right now there it's. when you write it down, it's easier to see. It's clear that that might not be the best use of your time right now.

Boots Knighton: Yeah

Cassie Fuller: there's a lot behind it.

There's a really a ton behind it, and I do think there's a huge need for more mental health guidance through that. regardless of what you're healing from, but especially for your heart. I mean, that's like your essence. That's your, your, when you talk about your true self, your center,

Boots Knighton: Mm-hmm

Cassie Fuller: it's right there.

That's what that is. and so trying to figure

out how to be true to yourself and what that looks like,

for you, and not based on your previous expectations of yourself, and not based on other people's expectations of you, because in the grand scheme of things, those aren't gonna keep your heart

Boots Knighton: yeah.

Cassie Fuller: gonna you

Boots Knighton: in my case, I mean, my feet were swelling and. My [00:33:00] heart rate was all over the place. I mean, I think back to last winter

when I was tried, you know, when I tried to go back to work

and in a very physical job teaching skiing, and my body just kept yelling at me over and over again and yeah, I just, lacked the education to know how to listen and it, it took me being put in the hospital.

Cassie Fuller: Mm-hmm. Mm-hmm. get our

Boots Knighton: So with that, you know, what's the importance of cardiac rehab? why is it important to go to cardiac rehab

after open heart surgery?

Cassie Fuller: Because of these parameters that we're talking about

Boots Knighton: Hmm

Cassie Fuller: trying to navigate them. There's so many to be aware of, and. I think that, you know, to see things written on paper or to even have somebody, whether it's a doctor or a pt or whoever you these things and then kind of send you out into the world. I do think that having somebody to come back to and saying, this is what I tried, and I'm talking more of on the chronic [00:34:00] side of, or like the past acute side of things. This is what I tried. This is what worked, this is what didn't work. How do we revamp that that we're making progress every time instead of just like, trying one path and that path definitely didn't work.

So then you go back to the beginning and then you try a different path and that path definitely didn't work. And then you come back where you can kind of be a little bit more fine tuning. think

Boots Knighton: Mm-hmm

Cassie Fuller: having guidelines as far as this is what we want your heart rate variability to be. this is what parameters we want as far as the level of symptom that you're getting with, you know, if it's a cardio activity or weight training or whatever the case may be. having those. Guidelines in the back of your head, but then knowing what that means practically, cuz there's a difference, you know, for me to say, okay, I don't want you to go above a three out of 10 for whatever the symptom is. Okay, that all is fine, but what does that mean for you and what does that look like and what variables do we need to adjust to get there? So I think having. Somebody who understands [00:35:00] the, like mechanics of and the,

it

function and the need for

our body when we're doing the physical activities that we're doing. but also helping

you figure out what that looks like in your life that's what matters the most, is can you then do that for yourself

Boots Knighton: It's like you have to be kind of like part mental, ther health therapist, part

life coach,

Cassie Fuller: Approach ,

Boots Knighton: I Mm-hmm.

Cassie Fuller: mean,

Boots Knighton: you

at it

Cassie Fuller: about myself. graduated from PT school in 2014, so I've been out for a while and I feel like I'm just now figuring out of this least from not just the physical part of the physical therapist. and we get some of this training in school, but I mean, it's similar to what we just talked about until you do it and you figure out what it looks like for you and how you can relate to other people in that way.

you know, if you're, if you have blinders on and you're just gonna do the protocol and

that's all that's gonna happen, there's a huge part that I think you [00:36:00] and I would have missed if we weren't able to have these conversations.

Boots Knighton: I think that, you know, that it's important

for listeners to understand, you know, I

I'm not afraid to go there and I, you know, I feel like when

I had, well, I hit my head several years ago, and that has helped make. That's helped me become more vulnerable in a healthy way. but then my heart surgery really kind of solidified that skill of willingness to be seen to, you know, to be vulnerable, to ask for help.

And so, Cassie and I are able to go there because I allow it and I welcome it. And I just wanna invite you to do the same with your healthcare providers. It's amazing when you're willing to ask for help and to ask for honest feedback and you know, lay it all out on the table and be like, what am I doing wrong here?

A lot of magic can happen and your life can be so much brighter and the spectrum on what you're living as far as emotions and just [00:37:00] being a human just becomes so much more expansive. , it's really an incredible journey.

Cassie Fuller: Mm-hmm

Boots Knighton: does come down though, to being the willingness to be vulnerable and to be seen and knowing that, you know, you're not necessarily knocking it outta the park that day, but someone could help you get on the

right track.

Cassie Fuller: it's your story really. The rest

Boots Knighton: Mm-hmm

Cassie Fuller: of in the background kind we can, but I think we've done a really fantastic job of. Yours now. Like this is, this is your story. And I mean obviously, and with the stories that you get to tell with this podcast is amazing. but I think knowing that that is the case, and the rest of us are just here to support, to you with your story, whatever you want that to be. as with anything, I mean, there are patients that have no desire to sit still and listen to what their body's telling them. And there are PTs that have no desire to recognize that that's a thing. [00:38:00] do think timing matters, and I do think finding somebody that you connect with in a, in a deeper quite helpful. And or practitioners recognizing that like, maybe I'm not the right fit for

you right now, and being

Boots Knighton: Yeah

Cassie Fuller: send people out

to other resources, because

it's not our story. This is not my story to tell. I'm just, I'm in the background and happy to

and so should everybody else. We're all, we're all background.

Boots Knighton: I

Cassie Fuller: in the

Boots Knighton: lot of wisdom is needed and. , you know, to know, to know when it's the right time

and to know when to ask for

help.

Cassie Fuller: Mm-hmm.

Boots Knighton: we all have that innate wisdom like, . No one listening here

lacks wisdom. I just don't believe that. I truly believe we are all very powerful, wise humans who can live a beautiful life no matter what is thrown at us.

I fully believe that, and you know, that's one of the reasons why I've decided to launch this podcast [00:39:00] is because. , you know, I had, I had two choices. I could be a victim and the fact that I needed heart surgery or I could just dive right in and make this the most incredible opportunity I could for living my best life.

And you know, my best life to me is being vulnerable and messing up and then asking for forgiveness. It's like all the part par, messy parts of being human and beautiful parts of being human. And. asking for help and doing it all, you know, from a wise mind who just shows up every day doing the best they can, like that.

That to me is such a purposeful life and I am, as long as I continue to on tr the trajectory that you have me on, I think I will be able to. be even more active than I am. But you know, I've, I've kind of let go of that. It's, it, it's interesting. It doesn't have the level of importance that it used to because I've come to [00:40:00] a more peace filled, joy filled place that no longer needs the level of activity that I used to, to fill in what was missing.

Cassie Fuller: Mm-hmm. . You have compassion for lovely. which is

Boots Knighton: a concept.

It seems to be the theme of the year for me.

Cassie Fuller: Yeah. You're doing amazing. I'm so proud of

Boots Knighton: for being my teacher, . Thanks for saying yes. You could have run outta the room screaming when you first met me, so Cassie, this has been great. Is there any other nuggets that you were just anxious to tell our cardiac friends or, and or their caregivers or

advocates?

Cassie Fuller: Yeah.

I mean, I do see it can be a very frustrating process, to find the right people to work with. and they're out there. It may take. you know, some, some [00:41:00] being vulnerable and maybe that not being well received or, you know, some shutdown from whatever the practitioner is.

But I think to think about it as your story.

And if they don't wanna be a part of the story, that's great

and they can keep doing their thing and we can find somebody else

that can help you in a way that's really healthy. is, I mean, that's kind of the name of the game. Yeah.

Boots Knighton: And don't faith or hope, like if, if a practitioner isn't the right match

for you, the quicker you can say no move on. The quicker you'll

find the right person. So don't stay in something because you're worried,

you know that it's not gonna work out. , it will work out, be in the flow, like trust that the universe, God, whatever is your, belief system has got your back.

Because if they've gotten, if whatever you believe in, let's just call it God for now has, you are surviving and you got through open heart surgery, there is a plan for you. [00:42:00] You will be cared for this. I can promise

you.

Cassie Fuller: Mm-hmm. . and finding practitioners that are okay. Letting you.

go to some other practitioner ,

Boots Knighton: Yes.

Cassie Fuller: to

Boots Knighton: Yeah. If they're not okay, then you really need to run, like don't walk, run

Cassie Fuller: I, do think that to have practitioner is, pt, mean, I, there are times where I'm not the right fit either. And to be able to be a part of the team enough to recognize that from a professional perspective, I think is huge as well.

So if you do have a practitioner that's just like, this isn't working for whatever reason, know, it's not a failure. Any side of the coin, it's just not either the right time, not the right person. and that's just kind of part of the story. And for people to be able

to recognize that for the patient, for the caregiver, for the practitioner, for all of us, we're all on the same.

We should all be on the same team. and sometimes

I'm not the right answer for the certain, the situation that we're in right now, or I might be the answer later.[00:43:00]

And that's great.

Boots Knighton: Wise advice from Cassie Fuller. Thank you so

much,

Cassie Fuller: Yeah.

Boots Knighton: and

Cassie Fuller: this.

Boots Knighton: This is really fun and you'll be able to, in the show notes, you'll be

able to go find Cassie. please don't fill up her schedule cuz I still need to see

her. she's really hard to get into. but yeah, I, I'll highlight our interview in the notes and give you all kinds of great ways to connect with her.

Cassie Fuller: Thank

you Boots

Boots Knighton: And that's the show for today. Thank you for spending part of your day with me. The heart chamber exists because of you. If you find value in this podcast, consider donating to this cause. Go to the heart chamber podcast.com and go to the donate link. And hey, while you're there, feel free to leave me a voicemail.

I want to hear from you. Lastly, don't forget to leave a review and make sure you subscribe so you never miss another Tuesday edition of the heart Chamber. [00:44:00] Thanks again. Have a great week, and I'll be back next week with more stories of open heart surgery and recovery.