What to Expect from Cardiac Rehab
My Undergraduate degree was in Exercise Science and my school’s main focus was Cardiac Rehabilitation. We had a Phase IV Cardiac Rehab center on campus as well as a small lab to do VO2max testing and submaximal testing. I learned a lot about what people go through when they are recovering from a heart attack. After school, I was unsure if I wanted to do Personal Training or Cardiac Rehab, so I interned at a local hospital that had a Phase 3 Cardiac Rehab center on site. For people that have had heart attacks or are currently going through the process, it can be very scary with lots of unknowns. My goal is to shed some light on what the experience is like to make it less scary.
So You Had a Heart Attack, Now What?
It happens all of a sudden, you have a tight feeling around your chest or pain rushing down your left arm. You think “it is just gas” and try to take a few more labored steps when you suddenly wake up on the ground, unsure how you got there. People rush around to help and call an ambulance. You get to the hospital and the doctor tells you you have had a heart attack and you are lucky you were in a crowded place and got help as fast as you did. The doctor goes on to explain what options you have stent or bypass. Depending on what your option is for treatment, the time for recovery will vary. However, after recovery the doctor will usually prescribe Cardiac Rehabilitation afterwards.
In-Patient Cardiac Rehabilitation (Phase I)
This is done post procedure in the hospital. You spend the with a Physical Therapist, Occupational Therapist, and/or a Speech Language Pathologist (SLP) if necessary. The Physical Therapist will focus on strength goals in the hospitals Fitness Center; walking, sit-to-stand (squat), and preparing you for when you leave. The Occupational Therapist will focus on activities of daily living (ADLs); reaching up for a glass, getting in and out of the tub, etc. Finally, SLPs will help with talking and thinking issues if there are any.
Outpatient Cardiac Rehabilitation (Phase II and III)
After you are released from the hospital, if your insurance allows, you will be written a prescription for Phase II Cardiac Rehab. Insurance will typically pay for 6-8 weeks of outpatient rehab, depending on your insurance. Not all insurance will cover outpatient rehab, so you might want to make sure your insurance meets your needs. While in Phase II, you will Cardiac Nurses and Exercise Physiologists monitoring you on a three lead EKG while you exercise. The target Heart Rate that you will be aiming for will be predetermined by your cardiologist before you start Phase II rehab. In addition to the EKGs, the staff will be continuously monitoring your Blood Pressure and Rate of Perceived Exertion (RPE), while you perform different kinds of exercises.
Phase II Rehab really focuses on a lot of information in a short period of time. They not only have to discuss exercises and limitations, but they have to go over healthy eating habits. Many times older adult with have co-morbidities (secondary health issues), like diabetes. They mainly focus on basic realistic changes that people can make to live a healthier lifestyle.
The rehab programs also foster a support group. It provides accountability and a social meeting place for people. This helps keep consistency in the program and health changes.
In Phase III rehab, it is very similar to phase II. It is a monitored exercise situation, but it is set up to be more independent. This is helpful for people who want to exercise, but are not fully comfortable working out on their own. Most of the time this is just a blood pressure reading before and after exercise. People get an exercise card with exercises to follow, but it is very independent.
The only downside to Cardiac Rehab programs is they have to end. People have to take it upon themselves to continue what they learned in 8 weeks. The real challenge starts on the first day without the rehabilitation program. If someone was never a big exerciser, they might not be likely to continue without their support group.