- November 2013
Cardiac Rehabilitation Gets Heart Patients Back to Their LivesBy: Roxanne Jones
If you’ve had any type of intervention to treat heart disease — a stent placed to open a blocked artery, bypass surgery, an operation to fix a valve problem, even a heart transplant — cardiac rehabilitation (rehab) plays an essential role in reclaiming your health and your life.
“Cardiac rehab is all about wellness,” explains Michelle Tinkham, RN, BSN, MS, PHN, CNOR, CLNC, RNFA, a cardiac pulmonary rehabilitation nurse at the Eisenhower Renker Wellness Center. “While the program includes medically supervised exercise to help patients improve their physical and cardiovascular strength and endurance, it also focuses on helping patients achieve individual lifestyle goals.”
“Many people with heart disease have had to give up certain activities after they had surgery,” says Tinkham. “Still others may have given up physical activities long before they underwent stent placement or bypass surgery because exertion brought on chest pain (angina). Or a sedentary lifestyle is what contributed to their heart problems to begin with. Regardless, these patients need to ‘recondition’ their cardiovascular fitness in order to resume — or start — activities they enjoy, prevent future heart issues and live as long and healthily as possible.”
“The program also places a great deal of emphasis on education,” says Tinkham. “We help individuals understand why they developed heart disease in the first place, and fix the reasons that contributed to the problem that are within their control, like diet and stress management.”
How, exactly, does cardiac rehab work? “Each patient undergoes an evaluation, including a six-minute walking test, to determine their current fitness level,” explains Tinkham. “We also set goals at this first visit, which we review at the end of the program.”
“It’s important for the individual to tell us what they want to achieve,” she notes. “We can say what we’d like to see happen, but if it’s not important to the patient, they won’t embrace and commit to it. Here in the desert, getting back to playing golf is a frequent goal.”
The cardiac rehab program includes eight-to-12 weeks of aerobic exercise and weight-training sessions held three times a week. This exercise component is individualized based on each participant’s condition and goals. Specially trained nurses carefully monitor each participant’s heart rate with a four-lead EKG during every session.
“No local gym or fitness center has this capability for monitoring each person’s heart,” says Tinkham.
Michael Appelhans, General Counsel, who has had open-heart surgery, agrees.
“The rehab nurses are just outstanding,” says Appelhans. “They monitor you closely and also encourage you. They do a really good job.”
Importantly, the program also includes bi-monthly educational sessions that address heart disease risk factors, medication management, nutrition and stress management.
“Cardiac rehab is much more than just working out,” Tinkham stresses. “We’re trying to help participants rehab their entire lifestyle and teach them to be healthier in all aspects of their lives, to heal from what happened and prevent further problems.”
And it works. Research shows that patients who complete 36 sessions of cardiac rehab have a 47 percent reduction in the risk of death of any cause, and a 31 percent risk reduction for a heart attack in the subsequent four years, compared with those who complete just one session.
But that’s not all. “Many patients, when they first come in, feel very depressed, afraid that they’re going to die and there’s nothing they can do about it,” says Tinkham. “But when they go through the program and see how much better they feel and how their ability to function has improved, their confidence is so much higher.”
More good news: cardiac rehab is covered by Medicare and private insurers. To be eligible for coverage, you must be diagnosed with coronary artery disease (CAD) and have had some sort of intervention to treat it (such as angioplasty and/or stent placement within the past six months or open-heart bypass surgery within the past year). Patients who have had a heart attack within the past year, have undergone a heart transplant, or who have a heart valve disorder also are eligible. A physician referral is required.
“The vast majority of our patients see improvement,” notes Tinkham. “Mike was younger (61) to begin with, but he had risk factors like high blood pressure and a lot of stress that the program helped him get more under control.”
“The most important thing is to just do it,” adds Tinkham.