The days that a heart attack was followed by a life of disability are largely past for many patients. Cardiac rehabilitation is now the standard of care and is busily changing the lives of many with heart-health challenges who commit to participating in improving their health.
Only certain types of heart problems are treated with cardiac rehab and participation in the program requires a cardiologist's referral, but those for whom cardiac rehab is appropriate have a great opportunity to both extend their lives and improve their quality of life.
Humboldt General Hospital has the only certified cardiac rehabilitation program between Reno and Salt Lake City, something that's impressive for a small hospital, according to local physical therapist Mike Snow. Snow is one of several physical therapists from Rehab Services of Nevada who are contracted with the hospital for cardiac rehab.
Since the Humboldt Sun last reported on HGH's cardiac rehab program in February of 2014, participants have doubled, said Snow.
“We are seeing an increased number of referrals because of the Affordable Care Act,” said Louis Mendiola, HGH Health Systems Development Manager.
Mendiola explained that the Affordable Care Act requires large health centers like Renown and St. Mary's in Reno are required to refer cardiac health patients to cardiac rehab programs.
“We were seeing 1-2 referrals a month but now it's closer to seven patients per month,” he said.
Large hospitals can actually be penalized in medicare and medicaid reimbursements for re-admissions if they have neglected to direct patients to follow-up care.
“If a patient who has come in with any kind of heart problem then participates in appropriate cardiac rehabilitation, the likelihood of having another heart attack is much smaller,” Mendiola commented. “What a great benefit it is to our local residents to have that cardiac rehab follow-up care available her in Winnemucca.”
The increase in cardiac rehab patients has necessitated the purchase of a couple of pieces of new exercise equipment and an expansion of the monitoring equipment.
Patients alternate their routine between the exercise machines that include two treadmills, a scifit machine that exercises arms and legs, two bicycling machines that also focus on both legs and arms and a cycle for arms alone.
Monitoring equipment has been expanded to be available to handle more patients than before. A technician uses the monitoring equipment to watch for any changes in heart wave forms, to ensure heart rate is appropriate and to make sure the heart is getting enough oxygen. The equipment provides a printout of the performance of each participant's heart during the exercise sessions and those printouts are forwarded to each participant's cardiologist for their review.
Snow often takes the opportunity to set a good example by exercising along with his patients, who report they like that — and they like meeting others who are in a similar situation, in a supportive environment that increases their confidence in their own health.
Snow emphasized that people don't have to do extreme exercise to build their endurance and heart health.
Those in the program learn to be aware of their body's signals and can learn to monitor their exertion level effectively.
“Really, you don't need to exercise as hard as you might think,” Snow said, adding that consistency is the key. “A brisk walk gives the lion's share of cardiac benefits.”
“We tell them if you can't carry on a normal conversation – if have to stop to get breath between sentences, you're pushing too hard. On the other hand, if you can sing a song without missing a beat, you probably need to go a little faster.”
HGH's cardiac rehab program also provides participants with the services of a registered dietician who meets with each person, reviews their diet and makes suggestions for ways to support their health through conscious food choices.
“Many people change the way they eat significantly after a visit with the dietician,” Snow reported. “In fact, most people, after being in the program for a while report being in the best shape they've been in for years.”
“So many just don't realize how de-conditioned they are,” Snow commented. Modern life doesn't often require much physical activity.
HGH Wellness Coordinator Billie Lucero said HGH's cardiac rehab improves lung function and muscle strength while improving heart function.
But, is it necessary to have a heart attack or be put in a cardiac rehabilitation program to realize the benefits? No.
“Many factors play into heart-related ailments; it's important to be proactive to minimize heart disease through exercise and eating healthy.” said Lucero.
Everyone can make better diet choices and there are many free resources available to learn how to choose to eat for heart health.
An exercise program doesn't have to be any more involved than taking every opportunity to walk and to move in enjoyable ways.
Most anyone can (and should) start small and work up to more activity. And today is a great day to start.
