Two months after my open-heart surgery, through my cardiologist’s referral, I was cleared to begin a physician-sponsored cardiac rehabilitation program – a program of exercise and risk-factor education for individuals recovering from serious heart procedures and heart disease.
Some patients are healed enough to begin sooner, some later. The gym facility where I live in Santa Fe, NM, called the Center for Living Well, is spaciously housed in the basement of our one hospital. In the last thirty years, thousands of cardiac rehabilitation programs have sprung up far and wide in the U.S. alone, all featuring similar characteristics.
In my book, The Open Heart Companion: Preparation and Guidance for Open-Heart Surgery Recovery (Open Heart Publishing, 2006) I advise, “systematically increase your walking every day, to the point where you can visualize and look forward to the strength retraining and aerobic stamina offered in a good cardiac rehabilitation program. Once your doctor finally approves you for cardiac rehab, you will discover what may be a new experience, or the reawakening of an old pleasure — going to the gym!”
Beginning a cardiac rehabilitation program is truly an exciting moment. I was finally up to moving my body for real. I knew I had made tangible progress or I wouldn’t be there. I was assigned an exercise physiologist, or case manager. After a general orientation (completing a detailed questionnaire, learning to take my pulse, oxygen usage and rhythm monitoring guidelines) I was given a personal exercise worksheet. Preferably three times a week for one hour, I was to track my gentle progress forward in a customized program — using the treadmill, bike, stairs, UBE machine (aerobic ergometer), and so on. Adding weight training to the regimen was to come later, at the discretion of my case manager. In addition, numerous classes (stretching, therabands, free weights) and support groups (smoking cessation, stress management, osteoporosis and diet education) were all available in the package. Once a month there was an “Ask the Cardiologist” Q&A hosted by one of the New Mexico Heart Institute cardiologists. Most of all, the staff were caring, devoted, highly attentive, good-humored professionals. There was a palpable air of camaraderie and developing friendships that evolved into a memorable support group experience for me.
I was accepted into the program provided I agreed to wear a wireless heart monitor during exercise. What a good thing! My heart was still ricocheting in and out of irregular rhythm (atrial fibrillation). There was always someone at a computer screen monitoring my rhythm. If, as is more likely with exertion, my a-fib returned, even if I didn’t notice, a nurse or exercise physiologist would check in with me. How was I feeling? Did I feel lightheaded? Did I need to slow down? Maybe end my session for the day? Your pulse is x, let’s check your blood pressure.… Since a patient’s inclination may be to push through (my common approach in the past), the permission to simply stop, give yourself a break, can be welcome. I felt completely taken care of. With so many dedicated professionals around me, and the new friends I was making, I could never run too far into trouble. Although physically challenging at times, the cardiac rehab environment made for a positive, confidence-returning experience.
In the book, Heart Attack: Advice for Patients by Patients (Yale University Press, 2002), most of the eleven contributors go out of their way to rave about their cardiac rehab program experience. “The highlight of my day…”, “I credit the program with getting my life back on track…”, “I’ve been a member now for ten years and I know it is keeping me healthy…”, “My wife is now in the program with me. We’ve made some great friends….” The social and emotional support received can be priceless. Rather than returning to one’s previous gym or yoga class, many heart patients take advantage of ongoing membership in their cardio-directed program.