Cardiac rehab heart smart. Read the Tribune story.
Chicago Tribune Primetime:
Cardiac rehab is heart smart for all
June 15, 2012
Statistics show that 25 percent of men and 38 percent of women die within one year of having a heart attack, according to Naperville's Edward Hospital. Proper post-surgical cardiac rehab is key to helping increase a patient's long-term odds.
"Cardiac rehab is one of the most underutilized but most effective ways to live a healthier life," says Dr. Kameswari Maganti, director of Cardiac Rehabilitation at Northwestern Memorial Hospital's Bluhm Cardiovascular Institute. "I find that only about 40 percent of women and about 60 percent of men come to cardiac rehab after a procedure even though that one hour, three times a week can make such a difference in their lives."
Do I have to?
Patients give many reasons for not attending cardiac rehab. Family and career responsibilities may seem more important than cardiac rehab, but Maganti notes, "It is important to take care of yourself so that you can be there for your family and work. Some people believe they can make changes on their own, but they don't. It is very easy to slip back into the old habits. We start rehab very early in the morning and have very late options to make it possible for everyone to attend. Many times I write letters to employers asking them to allow patients to go to rehab."
Fear is another reason that patients give for skipping rehab. "Being scared after a procedure is common," says Dr. Ann Davis of Midwest Heart Specialists at Advocate Medical Group at Edward Hospital. "There is often a feeling that they will never get better or be the same. But the reality is that after going through cardiac rehab, many people feel healthier than ever before."
Not gym class
Exercise might conjure up unpleasant memories of high school calistenics, but programs at cardiac rehab centers are far more complex than jumping jacks and sit-ups. Although a cardiac rehab center might look like a health club with treadmills, exercise bikes and fitness equipment, it offers a different approach to exercise.
The cardiac rehab process actually begins in the hospital. "We get patients moving as soon as we can," says Maganti. "Deconditioning of the muscles can happen very quickly so it is important to start walking. We call this phase one. Phase two involves enrolling in a supervised exercise program, usually three times a week for three months. Everyone is carefully supervised during exercise. We prepare a very individualized exercise prescription for patients based on where they are and where they need to be."
All patients begin with a warm-up period followed by individualized exercise plans. Patients are connected to heart monitors and are carefully supervised.
Robin Perlen, a 53-year-old Chicago resident, was concerned when she started her rehabilitation program after a quadruple bypass at Bluhm Cardiovascular Institute. "I did not want to go to rehab," stresses Perlen. "My doctor was pretty convincing though so for once, I listened. I was nervous at first, but my comfort level increased when I realized I was being constantly monitored by trained people."
Monitoring seems to be key in helping to put people at ease.
"Because there are so many people watching my heart rate, I have enough confidence to exert myself," says Pete Bean, in cardiac rehab at Edward Hospital following surgery to repair an ascending aortic aneurysm.
Although he had no symptoms, he underwent an Ultra Fast Heart Scan that revealed the condition. His cardiologist said that he would have died within a year if the condition had not been addressed.
"I am glad to be in rehab," says Bean. "Anyone would be crazy to turn down rehab because it can give you your life back."
Caring for the whole person
Support is also a big component of rehab. "This is a multidiscipline approach," says Maganti. "We are educating our patients constantly. There is input from a dietician and a psychologist as well as physical therapy." Goals addressed by rehab staff include stopping smoking, starting new eating habits and controlling stress factors.
"It was helpful to be in a room with people who were all going through the same thing," says Perlen. "Everyone shares what works for them and some of their ideas worked for me. I thought I would be the youngest one there but there were people from all walks of life — men, women, all ethnic groups, younger, older. It gave me impetus to want to learn what I needed to know to get my life back to normal. If they could do it, so could I."
The final phase
"Phase three of cardiac rehab is the maintenance phase," says Maganti. "It is unsupervised exercise, which we hope will continue. We used to suggest six months but now we believe it needs to be lifelong. There are studies that show that cardiac rehab is as effective as stenting."
Maganti refers to a study where one group of patients underwent rehab and the other group received stents, a device used to address blood flow constriction issues. At the end of the study, the group that underwent rehab had fewer cardiac events than the group that received stents.
The many benefits of cardiac rehab and exercise include improved fitness and quality of life, increased muscle strength, improved lipid profile, blood pressure control, stabilizing sugars, stress management, increased flexibility, better balance and more, says Davis.
"I know first hand about diet and exercise," he adds. "With lifestyle changes, I lost 125 pounds and am healthy. It doesn't matter how old you are or what your fitness background is. We can all benefit from lifestyle change."
"The important thing," sums up Bean, "is to get started living again."
Naperville, Illinois (IL) - Edward Hospital and Health Services