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Cardiac Rehab: Getting Your Life Back

Originally published in October, 2006.

Late last year, Chicago resident Louis D’Antonio wasn’t feeling at all like himself. This normally active and energetic middle-aged man had become depressed, sluggish and often found himself short of breath when trying to do something as simple as carry groceries in from the car. So in September, he paid a visit to his family physician
who performed a routine examination and then told him that, at the age of 51, such symptoms were a normal part of the aging process.

Fortunately, Louis wasn’t comfortable with that diagnosis, so on the recommendation of a friend, he got a second opinion. Louis’ next doctor’s appointment was with John Arrotti, M.D., a cardiologist with offices in Palos Park and Mokena. Dr. Arrotti immediately ordered a stress test, along with blood tests and X-rays, and found four blockages in three of the arteries in Louis’ heart.

Louis underwent triple bypass surgery at Palos Community Hospital on November 1, 2005. Believe it or not, bypass surgery was probably the least difficult aspect of Louis’ treatment and recovery. 12 weeks of cardiac rehabilitation would challenge him not only physically, but mentally and emotionally as well and would change nearly every aspect of Louis’s life, including his outlook.

Not only can cardiac rehab help a patient recover from heart surgery or treat an existing condition, it also can significantly improve a patient’s cardiac health and help prevent future events from ever occurring. Here, we’ll tell you just how we do that at Palos Community Hospital.

Back to Basics

“The goal of cardiac rehab is to modify a person’s risk factors for heart disease, and increase his or her aerobic capacity and cardiac conditioning with the hope of preventing future cardiac events,” says Peggy Moore, R.N., the cardiac rehab charge nurse at Palos Community Hospital (PCH). Cardiac rehabilitation consists of three phases, the first of which begins when a person is treated and/or hospitalized for a specific cardiac condition or event. Cardiac rehab is designed to help individuals who have had:

  • A heart attack
  • Coronary bypass surgery
  • Heart transplant surgery
  • Angioplasty
  • Stents
  • Angina
  • Lung transplant surgery
  • Valve surgery (mitral and aortic)
  • Cardiomyopathy

When Louis D’Antonio underwent triple bypass surgery, he spent several days in PCH’s cardiac unit. On the very next day after his operation, nurses already had Louis sitting up in bed. And with that one small movement, the first stage of cardiac rehab had begun. Phase I of cardiac rehabilitation occurs while patients are still in the hospital, following treatment, a minor procedure or major surgery. The purpose of this phase is to teach cardiac patients about their condition, educate them about ways to take better care of themselves, and to get them mobile enough to perform the basics skills of daily life back at home. By the time Louis left the hospital, he was walking the length of the hallway several times over, and going up and down stairs.

Cardiac Rehab at Palos

Five weeks after surgery, Louis started the second phase of cardiac rehab by enrolling in PCH’s outpatient Cardiac Rehabilitation Program, a one- to three month monitored exercise and education course located at the PCH Primary Care Center in Orland Park.

The program requires a physician referral and includes a health evaluation, stress test review, an individualized exercise prescription developed by a board-certified cardiologist, and education about the risk factors for heart disease and how to control them. Seminars on heart healthy eating, stress management and physical conditioning are an integral part of the process.

Once patients are thoroughly evaluated and taught how to use each piece of exercise equipment, they begin tackling their own individually tailored exercise regimen, working at their own pace according to each patient’s restrictions and capabilities.

As patients exercise, their vital signs and progress are monitored constantly by cardiac leads attached to their chests, which continuously feed information about changes in heart rate and heart rhythm back to the nurse’s station.

If a person is working too hard, the monitors will reveal that, and the patient will be asked to slow down. Similarly, if they’re not working hard enough, nurses can help them pick up the pace.

Road to Good Health

The primary focus of Phase II is to teach patients about their own specific risk factors for heart disease — hypertension, high cholesterol, being overweight, smoking, poor eating, exercise habits and stress – and to help them get those risks under control through exercise, good nutrition and healthy lifestyle changes. “Phase II puts patients on a lifelong path of exercise and cardiac conditioning,” Moore says. “The educational seminars really help them identify the risk factors for heart disease, and for most of them, they make noticeable improvements.

“We had a 29-year-old man who had a heart attack,” continues Moore, “and he was able to compete in Hustle Up The Hancock shortly after completing cardiac rehab. Then we’ve had others who have had stents, and if they eventually end up having surgery, they recover much quicker because they’ve gone through the program.”

When Louis first started Phase II, he couldn’t walk on a treadmill for more than 30 minutes. After working out regularly three times a week for 12 weeks, he is up to nearly two hours of straight cardiovascular exercise, using a variety of machines. “Before, I couldn’t carry a bag of groceries in from the car without getting winded,” he says. “Now, I feel better than I have in two or three years. “I have to admit that I dreaded the first four weeks of cardiac rehab because I felt like I couldn’t keep up,” Louis explains. “But once I started getting stronger, I really enjoyed it. Cardiac rehab was the most important part of getting to where I am today.”

Physical endurance and strength aren’t the only things cardiac rehab builds. It also builds confidence and enthusiasm. “Many patients are scared and depressed, and trying to adjust to a whole new lifestyle when they come to us,” says Moore. “One of the things they find out here is that they can do more than they think they can, and that surprises them.”

And working out with others in the same condition also helps to inspire them. But the inspiration and training don’t end after 12 weeks. Many patients who graduate from phase II are referred to the Heart Fit program at Palos Health & Fitness Center, where they can continue their workout regimen under the supervision of a professionally trained staff. They also can take advantage of reduced Fitness Center membership rates and six free sessions. And any phase II patients who are still at high risk are moved into phase III, an unmonitored maintenance program that allows them to continue exercising at the Cardiac Rehabilitation Center.

PCH’s Cardiac Rehabilitation center is staffed with 13 educated and trained professionals: one registered nurse exercise physiologist, a cardiac technician, and 11 registered nurses who have either coronary or critical care experience. Each patient who enters the program is assigned to a specific nurse, who will follow that patient through the entire course, and is responsible for ensuring that the patient is progressing and keeping the patient’s doctor informed about his or her health status every step of the way.

If you or someone you know would benefit from PCH’s Cardiac Rehabilitation Program or if you would like more information, call (708) 460-5300. Remember, a physician referral is required to enroll in the program. However, the referring physician does not need to be affiliated with Palos Community Hospital.