Getting your Heart Back in Gear
A rehabilitation program can restore your strength and confidence and teach you how to make lifestyle changes that aim to improve your health and help you live longer.
Cardiac rehabilitation is not just for people who've had heart attacks. It's also for those who've had coronary artery bypass surgery, balloon angioplasty, intracoronary stents, valve replacements, congestive heart failure and other heart surgery. "I encourage virtually all patients to enroll in cardiac rehab after a cardiac event or procedure," says Will Hurley, M.D., cardiologist at Yankton Medical Clinic. “The education and support offered in a rehab setting can benefit even those who have not had a major event."
What's in a Program?
Cardiac rehabilitation programs usually concentrate on lifestyle changes, including diet and exercise as well as psychological issues. Because individual circumstances vary, these programs must be tailored to each person. What's appropriate for someone who's had a heart attack with minimal heart damage is different than for someone who's had an extensive bypass operation. Sometimes a situation requires several rehabilitation strategies.
Cathy K. Larson, R.N., cardiac rehab specialist at Avera Sacred Heart’s Cardiac Rehab Clinic, sits down with new people entering the program and goes over their particular risk factors. From there, the program is customized to their needs. "The main parts of a program include watching your diet, losing weight, smoking cessation and exercise,” says Larson.
Exercise offers a number of important benefits. These include increasing blood flow to your heart and strengthening your heart's contractions so that it pumps more blood with less effort. Exercise will help you achieve and maintain a healthy weight and control diabetes , high blood pressure and high blood cholesterol. It also helps reduce stress and increases your energy level.
“We start an exercise regimen out slowly and monitor the patient’s heart rate and blood pressure,” explains Larson. “As patients get stronger, the cardiac rehab program gradually becomes more intense with the long-term goal to exercise moderately at least 4 to 5 times a week for 30 to 40 minutes."
Diet. Eating too much fat and cholesterol can clog arteries and increase the risk of another heart attack. Registered dietitians can help create a healthy eating plan.
Smoking. If you are a smoker, it's vital to quit. Continuing to smoke doubles your risk of another heart attack or death due to cardiovascular disease. A smoking cessation program can help.
State of mind. Up to one-fourth of those who have a heart attack suffer from depression afterward. Being depressed can interfere with recovery by decreasing the will and ability to take care of yourself. A cardiac rehabilitation program provides information about depression as well helping patients cope with stress and anger, emotions that actually can contribute to another heart attack.
Social support. Although exercise, nutrition and stress management remain the core of treatment, establishing group support can also enhance a person’s lifestyle and help them feel better than they did before their heart attack or surgery. Cardiac rehab often includes group sessions where people can can share feelings with others who've had a similar experience.
Keep up the Good Work
A study published in the October 2000 issue of Circulation-Journal of the American Heart Association found that during a 7-year period, people who remained physically active after a first heart attack had a 60-percent lower risk of having a second heart attack than those who were sedentary.
Phase II (Early Outpatient)
Phase II (Early Outpatient) cardiac rehab is a specific therapy for individuals with heart problems. A physician order is necessary to enter the program. The usual course of therapy is three times a week for 4 to 12 weeks. The benefits of therapy include restoring strength and confidence and the knowledge to improve health and live longer.
The program includes gentle exercise and lifestyle change education. The heart is monitored along with blood pressure and oxygen level. Education is given on an individual basis with regards to nutrition, stress management, smoking cessation, and exercise.
Each participant has an initial assessment to better tailor the program to specific needs and goals. The therapy is individualized and progression is made as a participant can tolerate.