Posted Feb 27, 2009
Most have heard the healthy living advice for years: Don’t smoke, follow a low-fat diet, exercise regularly and control diabetes to prevent more serious illnesses.
But having a heart attack creates a whole new outlook, said Jill Fox, manager cardiac rehabilitation services at Somerset Hospital.
“It takes people off guard,” Fox said.
“They come in looking like the deer in the headlights.”
Fortunately, Somerset’s cardiac rehabilitation class and similar programs at Windber and Memorial medical centers give patients a fighting chance at a strong recovery and reduced risk of future heart attacks.
All three facilities offer similar components.
“It is an exercise and diet integrative program for people who have had bypass surgery, heart attack, stent placement, valve replacement or (heart) transplantation,” said Gary Pagano, cardiac rehab director at Windber.
Progress is closely tracked by trained technicians using the latest electrocardiogram monitors, which are connected to patients during exercise. The six- to 12-week classes meet three times a week, building slowly as the damaged heart gains strength, Fox said.
“They exercise with other people who have been through the same thing,” Fox said.”A lot of camaraderie is built up.”
Patients learn to take charge of their health, said Michelle George, cardiac rehab manager at Memorial.
“It is an education and exercise program,” George said. “They learn how to exercise safely.”
Nutrition counseling, weight management and smoking cessation help are crucial elements.
“People need to understand food labels and calorie intake,” Pagano said. “It is not just calories, but the type of calories — how high in fat they are.”
The key is showing patients how to continue healthy living after the class is over, Fox said.
“It’s very much a subjective thing,” Fox said. “It’s their decision whether they make those changes or not. We arm them with information. They leave here knowing: This is what I can do about it.”
Building slowly, Fox said, patients eventually reach a vigorous exercise level many thought would not be possible.
“When they leave, they know they can do that level,” she said. “It gives them a lot of confidence.”
The cost of cardiac rehab is covered by medical insurance — but only after a cardiac event like a heart attack. If insurance covered classes for those with significant heart disease risk factors, Pagano said, it could delay or prevent the disease in many patients.
Following the class’s lifestyle could steer many people away from developing heart disease, Pagano said.
“In cardiac rehab, they have had a procedure costing $30,000 to $50,000,” Pagano said. “It’s already after the fact.”
A changing culture is promoting heart disease, he believes.
“We sit behind our computers and talk on the phone all day,” Pagano said. “I think there is a huge need for insurance companies to get involved in prevention.”
Windber Medical Center introduced a program for those who want to reduce their risk of heart disease.
N.E. Body is a nutrition and exercise program offered through Windber Medical Center’s HealthStyles public fitness center. It is not limited to those who have been diagnosed with heart disease, Pagano said.
Although the N.E. Body designates nutrition and exercise, the name also describes the target audience.
“It’s for anybody,” Pagano said.
Exercise is essential, he added. The American College of Sports Medicine has recently increased its minimum activity levels to between 200 and 250 minutes of vigorous movement a week. That’s about 30 minutes a day.
“When you say exercise program it doesn’t mean you have to hurt yourself doing it,” Pagano said. “Walking can be enough if you are getting heart rate up to a point recommended by our exercise physiologists. It is tolerable, yet effective.”
Memorial has also addressed prevention with a series of mobile screening and counseling programs across the region, George said.
The screenings, funded by heart-valve manufacturer Edwards Lifesciences, analyze blood tests, body weight and personal data to evaluate patients’ risk factors and refer them to existing programs.
Date: Feb 23, 2009
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Copyright © 2009, Tribune-Democrat, Johnstown, Pa.
