Cardiac Rehab

[WilliamJE]

The Hosp. called me today to talk about it. I called them 3 weeks ago, they certainly took enough time.

I looked up cardiac rehab on the internet. This is what they tell me it consists of

* Counseling so the patient can understand and manage the disease process
* Beginning an exercise program
* Counseling on nutrition
* Helping the patient modify risk factors such as high blood pressure, smoking, high blood cholesterol, physical inactivity, obesity and diabetes.
* Providing vocational guidance to enable the patient to return to work
* Supplying information on physical limitations
* Lending emotional support
* Counseling on appropriate use of prescribed medications

I'm already walking two miles a day,
I didn't have heart disease, rather I needed repair of a heart aneuyrism in addition to having AVR. There was no need for bypass.
Medications? I take everything the doctor prescribes me. Other than a couple of tylenol for a headache since coming home on 8-29, I haven't taken anything OTC. In any case I rarely take OTC meds other than tylenol.
Nutrition? I still need to get my weight down which consists of me eating less.
I don't smoke, my blood sugars are under control, HBP I have but I take meds for already.

So do I need rehab basically to work out on a treadmill one or two times a week? The woman from the hosp. says my portion is 20% after my insurance pays 80% of the allowed contract amount. I think the hospital has it wrong, I'm maxed out for the year on my out of pockets. BCBS is paying 100% of every bill now.

Say I do owe the 20%, and that comes to a maximum of $61 a visit. Is Cardiac rehab worth what ever the price is?

BTW Monday is two months since my operation. I'm feeling great and been released to return to full work duties the beginning of next week. My main issues at present concern my still recovering right hand. The incision area is a tiny bit uncomfortable or painful sometimes, but I can lay on my stomach now for short periods.

 

[escargome]

You and I seem to think along the same lines. I opted not to do rehab either. First I looked at my physical shape and noted that I didn't seem to be having too much difficulty after surgery. Plus as usual family finances spoke out pretty loud. I had been off work with meningites from Jan til March of 2008, then had my surgery May 2008 so our wallet was pretty empty. Anyway, I returned to work and didn't really encounter much trouble other than missing my afternoon naps. So I guess what I'm trying to is that I believe it is a totally personal decision that each of us has to make. Good Luck with your recovery and follow your heart (no pun intended)

 

[RobNDenver]

Some of you may have seen my post about Cardiac Rehab in Active Lifestyles. I have been doing my own Rehab program since I got out of the hospital. . . I overdid it the second week, but with some guidance from friends here have settled in to a very healthy routine.

I went to the hospital Rehab twice with a $40 per visit copay. I thought that was really steep for what I was getting in return. When I spoke to the Cardiac Rehab Therapist she agreed that I would be able to manage my exercise and heart rate myself and send me the session report from the day that I did exercise. I went to Amazon and bought a Nike Triax Heart Monitor watch, but since I have been using it, I noticed that the HR monitors on all of the exercise equipment at the rec center are extremely accurate, so I may not have needed this piece of equipment.

So, I have been walking 10K steps per day and working out at the rec center for an hour on various cardio machines each day. I have also been riding my mountain bike back and forth to the facility, but I have not been given clearance to do that. It just feels good, so I have been doing it.

The therapist at the Cardiac Rehab facility did remind me that since I am on a beta blocker my heart rate may be suppressed and not to overdo it. Very good point and I let the effort guide how hard I am working.

If you are motivated and willing to exercise on your own I would not bother with Cardiac Rehab since it is not going to push you toward fitness any harder than you can push yourself.

 

[dcat96]

I also am in the same boat. Cardiac rehab at my local hospital was 2-3 dAYS aweek an 1 1/2 hr each time and was for 2 mo. 5 weeks out of surgery and I am walking 3-4 miles a day 5-6 days a week. I am going to meet with a trainer at the gym next week, she specializes in cardiac rehab and will be able to give me some ideas for what is ok/not as as I move along through the next 7 weeks. I feel as though I am young and active and much of the info at formal cardiac rehab I can get directly from my dr./ here on forum or from trainer
Dana
AVR 9-2-08

 

[ponygirlmom]

I'm another person who didn't need cardiac rehab.

I've heard people say they liked it for reasons like "being able to exercise with a group of people who are in the same boat," "having a place to go exercise" and "motivation."

 

[tomflies1]

I'm also an AVR/aorta replacement patient, 9 weeks out. But, I have to say that I'm very glad I'm in the rehab program, I've learned a lot, and as I did have damage to my left ventricle (LVH) from being over worked for so long, I can see the progress I'm making. I guess if you know how to build your own workout program and not worried about being monitored for a while after surgery, it'll work doing it on your own. My insurance was maxed out for deductible, so mine is covered, but I think I'm going to continue there even after my 'insurance' time is up. It motivates me, the people there are very helpful, and it's only $60/month after my 12 week program is up! (for the $60/month you aren't monitored with EKG telemetry)

 

[Superbob]

I'm also an AVR/aorta replacement patient, 9 weeks out. But, I have to say that I'm very glad I'm in the rehab program, I've learned a lot, and as I did have damage to my left ventricle (LVH) from being over worked for so long, I can see the progress I'm making. I guess if you know how to build your own workout program and not worried about being monitored for a while after surgery, it'll work doing it on your own. My insurance was maxed out for deductible, so mine is covered, but I think I'm going to continue there even after my 'insurance' time is up. It motivates me, the people there are very helpful, and it's only $60/month after my 12 week program is up! (for the $60/month you aren't monitored with EKG telemetry)

I'll just chime in that my experience was similar to this: my 36 sessions of CR were covered 100 percent, and I found it motivational, educational, and fun. Had I not moved away, I would have continued to take it -- the out-of-pocket continuation fee was only $5 a visit or something like that. But it's not mandatory, nor is it essential for everyone.

 

[DeWayne]

No one ever mentioned rehab to me.

 

[Freddie]

No one mentioned rehab to me either until 2 months ago - 14 months after the fact.

 

[ruthienc1]

I've been doing rehab- have only 4 (out of 36 ) sessions remaining and have, for the most part, enjoyed it. It's pricey ($25 co-pay, which does ad up) and takes a lot of time, since it's 3 times a week. I think I'll end it in better shape and be more likely to continue a healthier lifestyle because of it. Without insurance the cost for 36 sessions is $5300 which seems ridiculous to me!

 

[Taysgrama]

My surgery was in May, 2008 and my cardio just finally decided that I needed to go for Cardiac Rehab. I checked with my insurance company and they are paying 100% since my deductible has been reached for this year (woo hoo). I have a total of 36 visits in a 12 week consecutive period, but since the end of the year is near, I will not make it for 36 visits before I have to start paying for it until my deductible is reached again. I start my rehab on Friday and I am looking forward to it since I do not seem to get enough exercise outside of that!

Right now my cardio is trying to decide if they want to implant a pace maker, so I am hoping that he decides soon so that my insurance pays 100%!

Diana - AVR with a St. Jude Valve in May 16, 2008, Doctor John Miller, Dayton Heart Hospital, Dayton, Ohio

 

[Jkm7]

Do you mind sharing why, so long after surgery, your cardio is now recommending rehab when, apparently, he didn't earlier?

Thanks and good luck. I hope you enjoy it as much many here have said they do.

 

[Superbob]

My surgery was in May, 2008 and my cardio just finally decided that I needed to go for Cardiac Rehab. I checked with my insurance company and they are paying 100% since my deductible has been reached for this year (woo hoo). I have a total of 36 visits in a 12 week consecutive period, but since the end of the year is near, I will not make it for 36 visits before I have to start paying for it until my deductible is reached again. I start my rehab on Friday and I am looking forward to it since I do not seem to get enough exercise outside of that!

Right now my cardio is trying to decide if they want to implant a pace maker, so I am hoping that he decides soon so that my insurance pays 100%!

Diana - AVR with a St. Jude Valve in May 16, 2008, Doctor John Miller, Dayton Heart Hospital, Dayton, Ohio

Took me several months to get in cardiac rehab because of a waiting list at the local hospital. Once I got in, though, I enjoyed it. It was like having a personal trainer.

In fact, I have become a shameless consumer of rehab/therapy.

Had PT for my spinal stenosis -- it cleared the problem right up, whereas docs had been talking surgery.

Had the cardiac rehab -- it lifted my spirits and got me back in exercise. I enjoyed it thoroughly.

And now I am in PT following my knee surgery, and getting great results now. Walking easily without a cane.

Wish I could afford a permanent personal trainer with a PT background.

Anyway, I digress. I hope you enjoy your cardiac rehab and benefit greatly from it.

 

[ctyguy]

I chose not to do the cardiac rehab. If your familiar with the equipment at the gym you can taylor a workout if you keep the weights light and increase your rep counts. Do something that targets each of the major muscle groups and try to do your routine a few times a week. The most important aspect of the rehab in my opinion is the cardio work. Start with walking, work your way up to a slow jog over the next few weeks. Wear a heart monitor and target a specific heart rate. Ask your Cardiologist if your unsure of what your heart rate should be. Same goes for a bike or a stepping machine. Your heart doesn't know the difference, the key is keeping your heart at the target rate.

I figure its best to let the insurance companies pay for those who really need it. If the gym is a place your not familiar with then certainly going to several sessions will be worth the time. You gotta know your limits and the rehab can help you figure out what yours are.

 

[Jkm7]

I definitely walk (a lot) and followed precisely the walking plan given me when I left the hospital. NO Question about it.... the consistent and increasing amount of walking makes a huge difference in recovery. Everyone should walk as soon as they are able as much as their hospitals instruct. You really cheat yourself to not do so IMO

But there was no 'working up to a jog' for me. I am still at my (almost) daily walks but will never be jogging. It isn't the right thing for all of us.

Maybe for you young 'uns but my doctors have no desire to make me into a jogger.

 

[Taysgrama]

I am not really sure why he waited to get me started in Cardiac Rehab. I go to a Cardiac office where there is more than one doctor....and the doctor that told me that I needed cardiac rehab is not the one I usually see. So, my guess is that one of them prefers it and the other one doesn't. I also think that my regular Cardiac Doctor is concerned about my heart rate going so high when at rest. They have started me on new medications, so we are hoping that they work even though one lowers my already low blood pressure. I took my blood pressure last night and my hubby asked me if I felt ok since it was sooooo low.....80/47 - not a really good number with a heart rate of 92, which is high for me.

I did start walking before I ever left the hospital and continue it today. I try to walk at least a mile a day, sometimes it is more than that, depending on my work schedule. I do not have a gym membership and really do not have the time to go to one enough to warrant the cost for one. I have 12 grandchildren and 4 of them live with me, so I keep pretty busy with them and my husband.

Diana

 

[Jkm7]

Sounds like you are doing things right, Diana. As long as you are walking, you are getting cardio exercise which is important.

Congratulations on all those precious grandchildren. Enjoy every minute with them. And yes, I am sure you are very busy with four of them living with you and your husband.