Getting heart back in shape after sugery

Patients urged to take post-bypass rehab

Health & Fitness

September 19, 2004|By Erika Hobbs | Erika Hobbs,SPECIAL TO THE SUN

For the first time in her life, 75- year-old Elenore Trotz is sweating to the oldies.

Thanks to a cardiac rehabilitation program at St. Joseph Medical Center in Towson, some five months after triple-bypass surgery, the Towson woman, who once hated to exercise, is now trotting on a treadmill to Motown tunes.

Trotz and about a half-dozen others recuperating from similar heart procedures gather three times a week at St. JosephM-Fs, where they exercise in a health-club-like setting. During the 12-week program, they work with nurses who monitor their blood pressure, heart rhythms and blood sugar, as well as teach them about diet, nutrition and the overall value of staying fit.

M-tI feel great,M-v Trotz said.

Like Bill Clinton, who underwent quadruple-bypass surgery earlier this month, Trotz did not have a heart attack. Tightness in her chest drove her to the doctor, where she learned that arteries in her heart were severely blocked. The bypass surgery almost certainly prevented a heart attack, she said.

The former presidentM-Fs surgery has triggered an inadvertent public awareness campaign for heart health, said Johns Hopkins cardiac surgeon Luca Vricella. Nationally, hospitals have experienced a bump in heart procedures M-y a phenomenon they are calling the M-tClinton syndrome.M-v

M-tAnd thatM-Fs a good thing,M-v Vricella added.

For post-surgery patients like Clinton and Trotz, doctors routinely recommend cardiac rehabilitation.

The concept of exercising for heart health is not new M-y St. JosephM-Fs program is 27 years old. Such programs are widely available nationwide, and Maryland alone has about 40 rehab programs.

About a half-million bypass procedures are performed nationally each year, mostly on patients older than 65, according to the American Heart Association. And one in five Americans has some form of heart disease (in Maryland, the rate is slightly lower M-y about one in four).

Advantages of programs

At St. Joseph, where about 1,200 bypass surgeries are performed annually, 162 people participated in the cardiovascular fitness program last year, said Ellen Gorman, who manages the program.

A formal exercise program can give patients expert guidance and support in areas from exercise physiology to depression counseling.

M-tExercise shouldnM-Ft scare people,M-v Johns Hopkins exercise physiologist Kerry Stewart said.

Maureen Gercke, an elderly woman who declined to give her age, had a heart attack in May that damaged about 20 percent of her heart. The retired teacher from Perry Hall said the St. JosephM-Fs cardiac program M-tis the most wonderful thing that could have happened to me. I learned a lot.M-v

The goal for people like Gercke, Trotz and Clinton, Vricella explained, is to restore the heartM-Fs function and to ward off new problems, such as a heart attack.

(ClintonM-Fs Web site reports that he is recuperating well, and area doctors speculate that the 58-year-old may soon start a rehabilitative program.)

Yet studies show that only about one-third of cardiac patients follow formal exercise schedules.

The reason for such low participation is that some insurance companies donM-Ft reimburse patients for postoperative rehab programs, Stewart explained. Also, some patients donM-Ft get adequate information about the programs. And some patients believe that they can exercise on their own, although, as Stewart pointed out, studies show that most patients going it alone never return to exercise.

Cardiovascular programs work well because they offer a support network as well as teaching fitness.

Rehabilitation programs typically start with a primer in nutrition and exercise. Then a cardiovascular and strength-training exercise program, monitored by professionals, is crafted to meet each personM-Fs fitness needs. Patients are hooked up to monitors, which gives them a sense of relief and security, Stewart said.

M-tIt also gives them a sense of control,M-v Stewart added. M-tThey can tell themselves, I am doing something now that will make me better.M-v

Most programs last three months. Some facilities, like Johns Hopkins, offer long-term voluntary programs for patients to continue their exercise.

In a group setting, nurses can also look for warning signs of depression, a common problem among heart patients.

M-tI suffered from depression at first,M-v Trotz said. M-tSometimes, when I lay in bed, I can feel my heart beating and I still wonder if I am gong to have a heart attack.M-v

Exercising as part of a group also encourages camaraderie and boosts confidence, said Shelley Rannie, a nurse at St. JosephM-Fs fitness center.

M-tI was shocked M-y everything happened so fast,M-v said Mark Edmead, 57, of Baltimore, whose chest pain led to a quadruple bypass in March. M-tI was so scared, but then I saw all these people [exercising] around me. I figured I could do it, too.M-v

Safe procedure

Doctors turn to bypass surgery when one or more major arteries is at least 75 percent blocked, Vricella said.

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