Ask The Nurse: The Risks of Skipping Cardio Rehab Therapy

cardio rehab therapy

Dear Nurse Chris: After a heart attack two years ago, I took all the medicines my physician asked, but he also wanted me to commit to a long period of rehab. It seemed way too strenuous for me, and I was scared it might cause another attack so I didn’t go. I am 56 now. Was I right or wrong to skip the rehab?  Emily in Grayslake

Dear Emily: You took a big risk, and be sure to check with your cardiologist about this. Here’s what one study says: People who get all 36 sessions of cardiac rehabilitation that most Medicare plans cover are less likely to die or suffer a heart attack in the next three to four years than people who have fewer sessions.

You’re younger than that group, but if your insurance covers it, make use of the treatment.

If anyone pays attention, which they should, this research could encourage heart patients who don't follow doctors' orders to heed their advice. Only about one-fifth of heart patients even try rehab. Of those who do, few get all the sessions that are recommended. The new study is one of the first big efforts to look at how survival is affected by the "dose" of rehab that heart patients get. Researchers saw a clear trend in this 65-and-older group.
"What this study shows in a very convincing manner is that the more sessions a cardiac patient goes to, the better off they are," Dr. Stanley Hazen, preventive cardiology and rehabilitation chief at the Cleveland Clinic, told the Associated Press.

Say "rehab" and many people envision weak heart patients being pushed to run on a treadmill. Exercise is crucial, but it can be just a brisk walk or swimming or a stationary bike. That's important. Find something you enjoy and are willing to do.

More than three years later, 18 percent of those who attended fewer than 12 cardiac rehab sessions had died versus 11 percent of those who went to all 36 sessions. After taking into account age and other differences in these groups of patients, that works out to a 47 percent reduction in the risk of death for those attending 36 sessions. Heart attacks also were less common in that group.

There was a strong trend: as the number of classes went up, the risk of having a heart attack or dying in the next few years went down.

Four Heart Health Myths You Should Know About

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As American Heart Month draws to a close, it's important to encourage continued, year-round awareness of heart health as well as correct some of the common heart health myths or misconceptions people may have about heart disease: People who are physically fit and active are not at risk for heart disease.   While it's great to be fit and get plenty of exercise, it's not a guarantee of good heart health.  Cholesterol levels, genetics and other factors can contribute to heart issues -- and no matter how fit and active you are, smoking and overindulging in less-than-healthy foods will still take a toll on your body.

Women are at higher risk of dying from breast cancer than heart disease.  Wrong, by a long shot. Statistics indicate that across all age groups (including childbearing years), death from heart disease is more common among women than breast cancer.  Young women especially should begin taking care of heart health right now -- the combination of smoking and birth control increases their heart risks by as much as 20%.

When blood sugar levels are under control, diabetes is not a heart threat.  Think again.  Though good levels are healthier for diabetics, what many people don't realize is that the diabetes itself can cause inflammation, which in turn can damage blood vessels.  Monitoring and maintenance of  blood pressure, cholesterol and weight remain important to overall health.

Heart disease primarily affects the aging and the elderly.  Yes, many of the symptoms of heart disease manifest as we age - but the seeds of risk are often planted early in our lives.  They range from poor eating habits acquired in early childhood (including over-consumption of fast-foods or processed foods containing high levels of fat, sugar and sodium) to discreased levels of physical activity, increasingly sedentary lifestyles, smoking, excessive alcohol consumption and more.

Plaque does not accumulate in our arteries overnight.  It can take years to develop, so the earlier we become conscious  of healthier heart habits for ourselves and our children, the better our odds of avoiding heart disease later in life.   

Article by Kim Washetas, contributing writer and enthusiastic whole health advocate.  Sources:  USA Today, Ochsner Health Center

5 Amazing Heart Facts

Appropriately enough, February is American Heart Month.  Below are five fascinating facts about this vital organ:

  1. Your heart beats about 100,000 times a day. That means that in an average lifetime, a human heart beats close to 2.5 billion times! There's a powerful incentive to keep your ticker in good shape.

  2. When you're in exercise mode, it takes about 10 seconds for your blood to make the circuit from your heart to your big toe and back again.

  3. Your heart is always on the job! Even when you are at rest, your heart is working twice as hard as the leg muscles of a person who is sprinting.

  4. Your heart pumps the blood, which is then circulated by means of arteries, veins and capillaries to the rest of the body. Sizewise, your largest artery (the aorta) is nearly the diameter of a garden hose. Contrast that with the tiniest of your capillaries; it would take ten of them to equal the thickness of one hair on your head.

  5. How hard is your heart working? Think of it this way: All that pumping equals about 1 million barrels of blood for an average person - enough to fill 3 super tankers!

Article by Kim Washetas, contributing writer and enthusiastic whole health advocate.  Sources:  National Geographic, PBS

Angio Procedures - Consider Them Carefully

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 The various angio procedures have become so common that consumers may start to think of them as sort of a lube job. As if they’re routine maintenance like changing your car’s oil.  But that perception is dangerous and also expensive. There are always risks with any invasive medical procedure and an angiogram is an invasive procedure, therefore it should only be done when warranted. A physician who would do an angiogram on you because you insisted may be fearful of a lawsuit and will do procedures to cover himself. If you are worried, on your next visit to the doctor take a list of your concerns. Discuss these concerns one by one until you are satisfied with the answers. You are the consumer. Be smart.

There are other ways of assuring that your heart is healthy such as regular visits to a physician you trust, knowing your cholesterol level and blood pressure, eating a well balanced diet and making sure you are consistently exercising.

A troublingly high number of U.S. patients who are given angiograms turn out not to have a significant problem, according to the latest National  Institute of Health study to suggest Americans get an excess of medical tests. In the case of an angiogram or angioplasty, the hospital bill can run to $20,000 which your insurance might pay.  So, if your insurance pays, who cares about the bill? The hidden equation is that someone will pay and if your insurers make less money on your policy, they will make it up on someone else, either by raising rates or denying coverage. Someone always pays.

The researchers said the findings suggest doctors must do better in determining which patients should be subjected to the cost and risks of an angiogram. The test carries a small but real risk — less than 1 percent — of causing a stroke or heart attack, and also entails radiation exposure.

“We can do better. There is no doubt in my mind,” said Dr. Ralph Brindis of the University of California San Francisco, one of the study’s authors.

Angiograms are often given to patients who might be having a heart attack or have symptoms that suggest a serious blockage. They are also sometimes done on people who may have some less clear-cut symptoms, like shortness of breath, or no symptoms but some risky traits and an abnormal result on another heart test. This group accounts for about 20 to 30 percent of angiogram cases.

In the study, nearly two-thirds of the patients in this second group were found to have no serious blockages.  The researchers could not establish why so few proved to have heart disease. But Dr. Harlan Krumholz, a health-outcomes researcher unconnected to the study, said he thinks the problem arises because doctors are afraid of missing something, and also getting sued.

Copyright © Christine Hammerlund – 2010.Christine Hammerlund is a registered nurse and the owner of Assured Healthcare, a healthcare staffing service headquartered in Gurnee, Illinois.