Cardiac Rehab: Boosting Your Heart Recovery
February 5, 2018
If you’ve recently had a heart attack, or you’re recovering from surgery such as heart bypass or stent placement – or you have a condition such as hardening of the arteries, angina or heart failure – you should ask your doctor about cardiac rehabilitation.
Cardiac rehab is proven to reduce your risk of future heart episodes. It offers a safe, medically supervised way to gradually build your activity tolerance. Programs take place in specialized exercise facilities within the hospital, and you wear a heart monitor while you work out. The rehabilitation team includes doctors, nurses, dietitians, respiratory therapists, pharmacists and others.
Insurance covers cardiac rehab, which typically lasts 36 sessions. Patients attend several times a week, and many programs offer a variety of classes and speakers on topics from diet to medications to stress reduction. People who’ve completed cardiac rehab say they once again feel normal, whole and energized – ready to reclaim their family, work and social lives. So what are you waiting for?
Starting Slow
When people enroll in the cardiac rehabilitation program, they may feel hesitant at first – especially if they had experienced severe chest pain. But fear fades because we are right there with them, and they start off at a very low level of exercise.
Before patients start, the rehab team evaluates their EKG and echocardiogram results and looks over recordings from blood pressure monitors. As patients build their activity tolerance, medical staff monitors them every step of the way.
Patients start off on the treadmill at a low speed and just gradually go up until they are able to achieve what they should be able to do. On recumbent bicycles, patients pick their own speeds, and the team sees how their hearts respond. For instance, if the heart rate goes up too much, the staff will have them to do a lower load for a shorter period of time.
If symptoms arise during exercise, the rehab team is prepared. If it looks like there’s anything that might progress to cardiac arrest or arrhythmias, the staff would stop the patient, but that hardly ever happens. While a few patients may need repeat heart studies or procedures, most are able to complete the program without any problems.
More Than Just Exercise
During cardiac rehab, patients learn how their heart medications interact with exercise. That could mean deciding whether they can exercise safely on a beta-blocker [a blood-pressure drug] that might keep their heart rate from increasing. Diet education is a big part of the program because it reduces risk factors for high blood pressure, diabetes, obesity and, of course, heart disease.
Life doesn’t have to change forever after a heart episode. You can recover a lot of your activity if you go through a program that’s designed to build your muscles and evaluate what you’re capable of doing.
‘I Want to Go to Rehab’
After her 2008 heart attack, Carolyn Thomas didn’t feel like herself. “I heard about this cardiac rehab and thought, ‘Whoa, that’s what I need,’” she says. “Because I knew that I had undergone this completely traumatic emotional and physical event.”
Supervised exercise was the draw for Thomas, who had always been extremely active. But now she felt feeble and fearful. “Little twinges and tweaks had me clutching my chest thinking, ‘Uh-oh, is it something? Is it nothing? Should I call 911?’” And she was taken aback by her limited activity tolerance; she couldn’t walk around the block without leaning on her son’s arm for support.
Cardiac rehab was “completely about confidence,” she says. “There was a difference between the old, sick person who kind of tiptoed into the first rehab class and the person who finished."
Great Programs/Big Attendance Gap
Research is clear: Heart patients do better after cardiac rehabilitation. A 2010 study in the journal Circulation found that heart disease patients who completed 36 sessions had reduced risk of heart attack and death within the next four years, compared with those who did fewer sessions. A 2013 study from the American College of Cardiology found that women with coronary artery disease who completed a 12-week program were two-thirds less likely to die during the 15-year study time frame than those who weren’t referred to cardiac rehab.
Many doctors fail to refer eligible patients, research shows, and that's a big problem. Only about 20 percent of patients who should receive cardiac rehab actually do, studies show. Access is another issue. Many people, particularly women, may be reluctant to take time away from work and family to attend. Lack of awareness may also be a factor. Rehab is not a big moneymaking business. It is a service that is provided to improve health and outcomes.
Above and Beyond
When it comes to cardiac rehab, there’s an emotional and bonding benefit as well. It helps normalize the idea that your journey is a journey you’re making with other people. On some level, you’re all experiencing something that is very common, and you’re taking the stigma away from it.