Update on Cardiac Rehab

[Janea]

Just wanted to let you all know what happened to my cardiac rehab dilemma. I actually typed up a very nice letter to appeal to the review board of my insurance company (thank you to Bill for his AWESOME outline). I was already to send it and then I got a call from my nurse saying my echo was normal and my EF 60%!!! Hooray for me! She said that there is no way GHC would cover rehab with such a great echo. I was still going to send the letter but then I met with my cardiologist and he said that rehab would be just a waste of my time because you just learn how to warm up, cool down and there is no reason my heart needs to be monitered. Considering I would have to pay almost $400 in copays, I started to doubt if it would be worth it. Plus I would have to get babysitting twice a week for at least 2 hours which is a real pain.
The only thing that makes me want to consider pursuing the issue is the fact that so many serious runners on VR.com who were in great shape prior to their surgery still felt the rehab was very valuable. What specifically did you guys find was the most valuable aspect of rehab?

Thanks!

--Janea

[Blanche]

Jeana:
Poster "901" (Doug) posted the most eloguent reasons why cardiac rehab is inportant. I hope this post helps you. Please keep trying.

901
Rehab should be required for any OHS! The purpose of the rehab is not to build up your athleticism. The purpose of rehab is to teach healthy habits and check for post-surgery problems that aren't readily detectable.
In my case, the rehab nurse flagged a heart rate that didn't look right for someone doing mild exertion on a treadmill. Since I was being monitored, they printed out the info and showed it to a Card. who immediately diagnosed heart block.
W/o rehab I would have continued to struggle with this problem, probably through a lot of testing, for a much longer time. The only symptom was SOB from mild exertion. This was initially considered normal for someone recovering from OHS, so it wasn't investigated until the rehab nurse recognized that something wasn't right.
__________________
Doug

St. Judes 25mm AVR with ascending aortic graft (Bentall Procedure) 6-28-05
St. Judes 31 mm MVR 6-28-05
RF MAZE Procedure 6-28-05

All performed by Dr. James H. Wudel at the Nebraska Heart Institute

Kind regards,
Blanche

[MikeHeim]

As someone who would like to put themselves in the "serious runner" category, I waiver as to whether or not I would have liked cardiac rehab. My biggest issue workout-wise after surgery was being afraid to push myself. As a distance runner, your entire mantra is to push yourself long after your body says to stop. Immediately after surgery, that's definitely not the tactic you want to take. I remember being constantly afraid that I might do lasting damage if I pushed to hard. (Looking back, I doubt that was the case.) Cardiac rehab would have really helped by reassuring me and giving me more confidence as I tried to re-build my strength and endurance.

On the other hand, I am pretty sure that I don't need training on healthy habits. I have always been a self-starter for all forms of exercise, and I can't stand being lectured. I didn't, and don't, really want someone to put together a workout program for me. My surgeon said he doesn't prescribe cardiac rehab for people that he feels are in good shape and likely to keep themselves in good shape after surgery.

Anyway, those are my thoughts. Most people I've seen on this site have not regretted going to rehab...

[MarkU]

I think the need and/or benefit of going rehab is a very individual thing.

My cardiologist thought that rehab would be a waste of time for me and I agreed with him. I'd been physically active my entire life and had a very clear understanding of both my condition and limitations.

I've seen many patients go through reahab and then immediately revert right back to their old habits, not exercising, smoking, etc., so I don't really buy into the theory that it is effective in instilling new healthy lifestyles. That's something the individual has to decide to do on their own, rehab or not.

Mark

[msiwik]

I think the need and/or benefit of going rehab is a very individual thing.

My cardiologist thought that rehab would be a waste of time for me and I agreed with him. I'd been physically active my entire life and had a very clear understanding of both my condition and limitations.

I've seen many patients go through reahab and then immediately revert right back to their old habits, not exercising, smoking, etc., so I don't really buy into the theory that it is effective in instilling new healthy lifestyles. That's something the individual has to decide to do on their own, rehab or not.

Mark

MarkU and Mike gave you some good advice and perspective. From a running standpoint, I think the biggest issue is staying with low intensity workouts for the first six to twelve months, or 60 to 75% maximum heart rate and just letting the body/mind/spirit heal. Mark

[Rivet]

staying with low intensity workouts for the first six to twelve months, or 60 to 75% maximum heart rate

Where do these restrictions come from? I was under the impression that after three months, everything was pretty much healed and there would be no restrictions on activity.

Are these from a cardiologist or are they self-imposed?

[MarkU]

Where do these restrictions come from? I was under the impression that after three months, everything was pretty much healed and there would be no restrictions on activity.

Are these from a cardiologist or are they self-imposed?

60%-75% of your max HR is where you should be or optimum aerobic base-building and conditioning. It will get your "engine" back in shape after laying around for three months post-op.
In my case, I had developed some left ventricular hypertrophy prior to surgery, so I also wanted to see what was going to happen with that (fortunately it reversed itself after about a year).
I was never realy worried about my heart, but my slow-healing sternum was the thing the bugged me the most for six months or so.