BTColumn – Cardiac rehabilitation made simple

Disclaimer: The views and opinions expressed by this author are their own and do not represent the official position of the Barbados Today.

 

by Dr. Dawn Scantlebury

So, you’ve been diagnosed with a heart problem. Maybe you had a heart attack and ended up requiring an angioplasty to dilate a blood vessel in your heart.

Or you had heart surgery.

What’s next? You’ve been home for a few weeks and your family refuses to allow you to lift anything more than your plate. The doctor said that you can go back to work in two weeks, but what if you get a heart attack at work? You are terrified!

This is where cardiac rehabilitation comes in. Let’s introduce Sonny. Sonny was 35 years old when he was diagnosed with diabetes. He was good about managing it for a while, but then he stopped being vigilant.

At 45 years old, Sonny had a heart attack and ended up having heart surgery. Following surgery, his doctor gave him a referral to the Heart and Stroke Foundation of Barbados to enroll in cardiac rehabilitation.

He was quite skeptical at first. Go exercise with all those sick people, though he used to be a workout freak? He could do it on his own! When he started to exercise at home, though, he found that his ability to exercise was so reduced that he was taken aback.

He got to thinking, suppose he damaged something in his chest, or even got another heart attack? He stopped exercising.

Then, at his follow-up visit with his cardiologist, he was encouraged to make the appointment to start cardiac rehab, and he finally agreed.

From the first day, Sonny was impressed. He spent a good hour and a half with a nurse doing his initial assessment. From his heart problems and medications, his current diet and exercise patterns to his psychological health, his life (at least as it related to his heart) was turned inside out.

She examined him and tested how far he could walk in six minutes.

His assessment was quite illuminating.

When they did the mental health survey, he realized that he had unwittingly started to become withdrawn and anxious about his health.

The diet recall showed that he was not as disciplined with his meals as he thought he was being. A few days later, he and his wife met with the nutritionist. The Rehab’s Medical Director reviewed his information and prescribed a course of exercise just for him.

Sonny attended the rehab gym three days a week. At each session, he was hooked up to a box that transmitted his cardiac electrical activity to a central monitor and nurses monitored him throughout his exercise session.

This was very reassuring, and his fear of exercising melted away. He made friends with the other clients.
He had thought they would be all elderly people, but some were younger than he was.

That said, a lot of the 70-something year old clients could run rings around him! He checked his blood pressure and blood sugar before every exercise session and got accustomed to checking them at home too.

He learned more about heart health as, every week, one of the health team led an educational session, and they were always available to answer questions otherwise. Bit by bit, Sonny’s exercise capacity improved.

At the end of the three-month programme, he felt confident that he could exercise on his own.

He had lost 15 pounds, and his blood pressure and blood sugars were the best they had been in years.

His anxiety had melted away and he was enjoying all aspects of life.

He felt great.

Sonny’s story is not unique. Cardiac rehabilitation is a medically supervised programme designed to improve cardiovascular health for patients who have had an event such as a heart attack or heart surgery.

It has been shown that patients who go to rehab after a cardiac event, live longer than those who do not go, and they feel better overall.

The Cardiac Rehabilitation Programme at the Heart and Stroke Foundation of Barbados is accredited by the American Association of Cardiovascular and Pulmonary Rehabilitation; meaning that it meets international standards for service delivery and outcomes in cardiac rehabilitation.

Qualifying diagnoses for enrollment include coronary heart disease such as heart attacks or angina; heart failure, recent heart surgery and peripheral arterial disease. Patients who are at high risk of heart disease may also benefit from the prevention programme, and a stroke programme is also offered.

This week (February 14-20) is Cardiac Rehabilitation Week, highlighting the role of cardiac rehab in heart disease management.

Dr. Dawn Scantlebury is consultant interventional cardiologist, and medical director of The Heart & Stroke Foundation of Barbados’ Cardiac Disease Prevention and Rehabilitation Programme.