Wednesday, Aug. 6, 2008
Just before departing on a two-and-a-half week trip to Israel with some of his students, Rabbi Hirsh Chinn of Silver Spring felt some discomfort in his chest. A trip to the hospital led to two stents being inserted into his heart.
Chinn refused to let the procedure get in the way of his travels. But when he returned from Israel, Chinn knew he needed a drastic change in his lifestyle. That's where Suburban Hospital's Cardiac Rehabilitation program came in.
"You feel privileged to feel a part of it," he said.
Featuring a four-phase recovery program run in conjunction with the National Institutes of Health, Cardiac Rehabilitation helps about 500 people each week recover from a wide range of heart procedures.
Some, such as patent attorney Alan Ehrlich of Bethesda, have voluntarily stayed in the program for years, exercising two or three times a week. It gives him comfort to know the emergency room at Suburban is only 150 feet away.
"It's been a marvelous facility, both the facility itself and the people, that has helped me just turn my life around, really," said Ehrlich, who was 100 pounds overweight when he entered the program after a heart procedure in 2004 that included catheterization and angioplasty.
The first phase of the program includes a complete medical evaluation and bedside education sessions for patients in the hospital while recovering.
Patients who are directed to the program by their physicians are then placed in the second phase, which consists of a 12-week exercise and nutrition program closely monitored by cardiac nurses, nutritionists, exercise physiologists and other medical professionals. This phase commences about six to eight weeks after surgery and involves three sessions at the hospital per week.
The exercise can range from weightlifting and yoga to turns on the treadmill. Nutrition counselors teach people proper dieting techniques and ways to lower sodium and cholesterol. In addition, psychosocial counselors are on hand to help patients in the program deal with the traumatic experience, an aspect of heart problems that can be overlooked.
"The fear of exercise, the fear of recovery, and the fear of a subsequent heart attack caused by the exercise is something that needs to be overcome as part of the exercise program," said Dr. Philip Corcoran, a cardiothoracic surgeon at Suburban who refers patients to the program.
Shannon Winakur, a cardiologist at Upper Chesapeake Medical Center in Bel Air and a spokeswoman for the American Heart Association, said programs like Cardiac Rehabilitation are generally underutilized. Winakur is involved in a similar program at Upper Chesapeake.
"I think it's very beneficial for people who didn't know they had heart disease before," she said.
After suffering blocked arteries and requiring stents, Rita Carty, who is in her 60s, said she was very nervous about how she would handle her life after surgery four years ago. Even her career as a nurse didn't prepare her for the recovery period.
Now, even though she worked out frequently before her surgery, she comes to Suburban three times a week and takes comfort in the knowledge her rehabilitation is customized for her.
"I was fearful," Carty said of the time following her surgery. "The staff was and continues to be extremely good. They're very knowledgeable, they're very supportive, they're there when you need them."
Ehrlich recalled one day when a man exercising next to him merely put his hand to his chest to try to reattach a loose electrode. Immediately, two nurses who thought he was suffering a heart-related incident rushed to his side.
The third and fourth phases of the program are optional, open-ended "maintenance" periods when people can continue their routines on their own. According to the hospital, 80 percent of rehab patients choose to keep up with their regimens established in the program.
Just as the psychosocial counseling helps an often-neglected aspect of heart disease, a mutual support system develops between program participants.
Although the program has people from all backgrounds and a diverse age range, people find building relationships easy based on their common histories. Ehrlich, for example, is part of a "9:30 club" of people who regularly work out together in "maintenance" and then go for coffee afterward.
According to Corcoran, the 36-session program following a heart procedure is covered by insurance, while the maintenance program costs $11 per workout session. Corcoran said this is comparable to what people pay for equivalent usage of a health club.
As far as Chinn is concerned, the rehab program and the accompanying atmosphere are better than any trip to a local gym.
"It's like belonging to an exclusive club," he said.
