By AMERICAN HEART ASSOCIATION NEWS

0509-feature-rehab_WP

After her heart attack, Michelle Robinson regularly feared she was going to die.

She had had a small artery that was 80 to 90 percent blocked that her doctor thought was best to treat through medication and a heart-healthy diet rather than surgery. She was afraid of what that meant and when she left the hospital, she wasn’t ready. She felt like she was being kicked out.

The hospital literally said, ‘You’re free to go home. Follow up with the cardiologist.’ It’s kind of crazy,” she said.

So, she worked to educate herself. She got a second opinion on whether she should get a stent. She asked questions.

That’s how she found out about a four-phase program of cardiac rehabilitation. The program helped her deal both physically and mentally with the aftermath of the heart attack.

“I try to go three days a week,” said the 45-year-old.

John Osborne, M.D., Ph.D., founder and director of State of the Heart Cardiology in Dallas, said there is a “significantly lower rate of secondary heart attack, by roughly in the 30 percent range” for those who do cardiac rehab compared to those who do not.

He said that it is can make as big of a difference following a cardiac event as heart medications or tobacco cessation.

“It has a similar degree of benefit as all those individual things and tends to be many times not promoted as an equivalent benefit or just not recommended or just kind of forgotten about,” he said.

Anyone who has had a heart attack, regardless of severity, should speak to their doctor about a prescription for the program.

Phase 1 of the cardiac rehab program takes place in the hospital and involves getting patients up and out of bed and moving around as much as possible. Robinson went straight into Phase 2, which begins after hospital discharge.

She typically did her rehabilitation after work, spending nearly an hour performing exercises on a variety of machines under close supervision. In Phase 2, a nurse tracked her heart rate and blood pressure and she was hooked to an EKG machine while she exercised on a treadmill, elliptical machine, stationary bicycle and other equipment.

Today, she’s in Phase 3 and has tried water aerobics at a local gym. Another goal is walking 10,000 steps a day, four times a week. She has to monitor her own heart rate, which is typical for Phase 3 where some of the monitoring is removed.

Rehab staff wanted Robinson to continue at the hospital where she did Phase 2, but they told her she could go wherever she wants. Robinson said she has struggled to keep up her exercise routine even with a supportive husband.

“I think going to Phase 3 and staying where you’re at in the program and staying in the regiment of doing that is a good idea versus jumping out on your own,” she said.

In Phase 4, patients are unsupervised and unmonitored. Hopefully they continue exercising with no endpoint in sight.

Knowing she’s working toward greater health brings peace of mind to Robinson, who has been nervous since her Jan. 8 heart attack when she thought the dull pain in her chest was probably indigestion.

Osborne said not only does cardiac rehab include physical conditioning for “below the neck” stuff, but it often helps with fear, anxiety and depression.

“It’s not just physical recovery, it’s really mental recovery,” Osborne said.

During the program, Robinson has learned about appropriate exercise, heart disease and nutrition. She’s lost about 20 pounds from her 5-foot-2 frame.

“I went from eating out every day for lunch and dinner to taking my lunch and really watching what I’m eating,” she said.

She found camaraderie in the group setting, as well. She and others swapped stories about what they experienced, what to expect next and their diet plans.

“It’s really in a sense like group therapy,” Osborne said.

“It’s been very life-changing,” Robinson said. “I had no idea that heart disease was this rampant, especially at my age.”