Cardiac Care - February '08
Cardiac Rehabilitation: Patient maintenance
Dalynn Badenhop, PhD
Research shows that patients who go through a cardiac rehabilitation program reduce their risk of a heart-related death by 25 to 30 percent, compared to those who don’t. March marks the ten-year anniversary of the cardiac rehabilitation program at The University of Toledo Medical Center. Since the program began, specialists have dedicated themselves to improving the quality of life for patients with cardiovascular disease and using education as a tool for effective long-term treatment plans. “We focus on the four E’s: exercise, eating right, education and effectively managing stress as the cornerstones of our program,” says Dalynn Badenhop, PhD, professor of medicine and director of cardiac rehabilitation at UT Medical Center.
At UT Medical Center, the cardiac rehabilitation regimen consists of three phases.
Phase I and II
Phase I happens in the hospital to get patients up and moving again, using light exercise.
About two to eight weeks after leaving the hospital, patients are referred to the outpatient, Phase II segment. Here, patients work with an exercise physiologist and nurse who closely monitor blood pressure, electrical activity in the heart and watch for any concerning symptoms while they exercise.
“Patients receive a personalized exercise program on all the equipment throughout the 20,000 square foot facility while we make sure they’re exercising at a safe and effective level,” says Dr. Badenhop. Patients also receive educational classes that include nutritional counseling, diabetes education, smoking cessation, stress management and cardiac risk factor awareness training.
Phase III
Patients are encouraged to utilize the information they learn in Phase II to help them succeed on their own. After completing 36 sessions in Phase II, Dr. Badenhop and the patient discuss the goals they set at the beginning of the program and the accomplishments they’ve made. Patients are given the option to perform maintenance on their own or to continue on in the cardiac rehab facility in the Phase III program. “Patients are in the same setting with the same nursing staff and exercise physiologists available, but there is less supervision,” Dr. Badenhop says.
At UT Medical Center, teaching maintenance for heart health can have a remarkable impact in the patient’s success. “Since patients aren’t as closely monitored, they need basic guidelines to use in Phase III or after leaving the program,” Dr. Badenhop says.
Living a heart healthy lifestyle
According to Dr. Badenhop, patients can be quite successful in managing their heart health by adopting Therapeutic Lifestyle Changes (TLC) for the rest of their life. These include:
- Quit smoking.
- Control high blood pressure – Resting blood pressure should be less than 120 over 80 and can be controlled with medication and therapeutic lifestyle changes.
- Manage diabetes – Hemoglobin A1C levels need to be 7.0 or less and can often be managed with medication, a healthy diet and exercise. Diabetics need to check their blood sugars routinely.
- Lower your cholesterol – LDL cholesterol, the bad cholesterol, needs to be lower than 70 mg./dl. Many people can do this by eating a diet low in saturated fat and high in fiber.
- Maintain a healthy weight – Decreasing your weight by only 5% can have a significant impact on your health. That means a 200 pound person would need to lose about 10 pounds. Abdominal girth measurements need to be below 40 inches in men, 35 inches in women.
- Be more physically active – “People should set a long term goal of 150 minutes per week of intentional exercise,” says Dr. Badenhop. Intentional exercise works the heart muscle through activities like brisk walking. To get in 150 minutes a week, Dr. Badenhop suggests increments of 10 - 30 minutes. The benefit is the same for ten 15-minute sessions as it is for five 30-minute sessions. But if you go more than 48 hours without some intentional exercise, you lose some of that benefit,” he adds.
- Eat a healthy diet – Restricting portions is key. “Meat portions should be no bigger than a deck of cards and all other portion sizes should be no bigger than your fist,” says Dr. Badenhop “Eat more fruits and vegetables, eliminate fried and processed foods and drink low-fat milk and sugar-free beverages.”
- Manage stress – People who are stressed often adopt unhealthy behaviors. “As I tell patients, when you are stressed, all roads lead to the refrigerator,” says Dr. Badenhop. The cardiac program helps people identify their stressors and manage them, making treatment more effective.
To make an appointment with a UTMC cardiovascular physician, please call 877-451-2299.
