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Monday, November 30, 2009 - Living an Independent Life: Cardiac Rehab

Cardio RehabWith each passing year, millions of Baby Boomers join the ranks of senior citizens. Many of them are accustomed to living active lives, and losing their ability to live independently is a major concern.
Methodist Medical Center of Oak Ridge is offering a series of articles called “Living an Independent Life.” These articles are intended to provide seniors and their families with information to help them enjoy a better quality of life through better health.

In this article, Sharon Ollis, manager of Methodist’s cardiopulmonary rehabilitation program, discusses the role of cardiac rehab in helping people with certain heart conditions enjoy a better quality of life.

What is the purpose of cardiac rehab?
Sharon Ollis: Cardiac rehab is an individualized plan of exercise and education for patients with certain heart conditions who have been referred by their doctor.

Doctors may refer patients who have had a heart attack, coronary artery bypass surgery, coronary angioplasty, coronary stenting, heart valve repair/replacement or heart transplant. Other patients that may benefit are those whose medical history includes certain heart diseases present at birth, coronary artery disease, angina, peripheral artery disease, congestive heart failure or cardiomyopathy.
The goals of cardiac rehab are to help patients regain strength, prevent their condition from becoming worse, and reduce the risk for other heart problems in the future. The main components of the program are medical evaluation, prescribed exercise, cardiac risk factor modification, education and psychosocial support.

What can patients expect during rehab?
Sharon Ollis: There are three phases of rehab: hospitalization, early recovery, and long-term recovery. Hospitalized patients may begin cardiac rehab with non-strenuous activities such as sitting up in bed, doing range-of-motion exercises, and walking. During early recovery, which may last from two to 12 weeks, patients gradually increase their activity level under the close supervision of cardiac rehab specialists. They also may do moderate exercises at home. Long-term cardiac rehab may continue for the rest of a patient’s life. It may include exercise at home and at a cardiac rehab center, along with continuing education on diet, weight loss, and lifestyle choices.

Initially, patients undergo a thorough medical assessment to assess their medical limitations, overall health, and physical capabilities. Assessments include an evaluation of a patient’s cardiac risk factors such as high blood pressure, diabetes and other conditions that lead to cardiovascular disease.
Cardiac rehab improves a patient’s cardiovascular fitness through physical activities such as walking, cycling and other aerobic exercise. It also may consist of exercises to increase muscular strength.
Lifestyle education includes information on diet and nutrition. The goal is to help patients choose healthier foods and reduce their fat, cholesterol, and salt intake. Patients also receive guidance on stress management, medication, smoking cessation and making other healthy choices that affect their cardiovascular system.
People often experience anxiety and depression after having a heart attack or receiving a diagnosis of heart disease. A cardiac rehab program helps them find ways to cope and rebuild their lives, and it gives them opportunities to meet and share their concerns and triumphs with people in similar circumstances.

To achieve the best possible outcome, patients may work with cardiologists, nurse educators, dietitians, pharmacists, exercise rehab specialists, occupational therapists, physical therapists, and mental health professionals, as needed.

What can people do to reduce their risk factors for heart disease?
Sharon Ollis: Smoking cessation is extremely important for patients who smoke. When someone decides to quit, it’s a good idea for them to change routines that trigger their urge to smoke, stay away from other people who smoke, substitute low calorie snacks or gum for cigarettes, join a smoking cessation class or support group, and take it one day at a time.

Dietary changes vary depending on each individual patient’s needs, but in general, they include eating less red meat and dairy products; baking, broiling, steaming or grilling foods rather than frying; and reading labels for fat content.

Patients should check with their doctor before starting an exercise program at home. When starting an exercise program, begin slowly and gradually increase time and intensity. Aerobic exercises such as walking or cycling are good choices. The person should stop exercising if he or she experiences chest pain; pain that radiates into the neck, shoulder or arm; increased shortness of breath; irregular heartbeat; or excessive sweating. If any of these symptoms continue, call the doctor.

Controlling stress is also important. Patients should identify things that cause stress, learn stress management and relaxation techniques, get plenty of rest, and pace themselves.

Sharon OllisAbout the Author: Sharon Ollis, RRT, MS, is manager of cardiopulmonary rehabilitation at Methodist Medical Center of Oak Ridge. She earned an associate of science degree in respiratory therapy from Cleveland State Community College, as well as a bachelor of science in health arts and a master of science in health services administration from University of St. Francis in Joliet, IL. Ollis has 18 years of experience in cardiac rehabilitation.