The Tribune Democrat, Johnstown, PA


February 8, 2014

Cardiac care emphasis shifts to prevention

— Doctors aren’t just telling their patients they should quit smoking, lose weight, be more active and eat healthier. They can now direct them to programs that will help.

Cardiac rehabilitation programs available at all area hospitals provide a wide range of prevention help, not only for those recovering from cardiac events, but for nearly anyone who wants to improve their odds.

“Health care is changing to that – to prevention,” said Michelle George, program manager for cardiac rehabilitation and prevention at Conemaugh Memorial Medical Center.

“Even if you don’t have heart disease at this time, it’s looking at risk factors that can lead to heart disease.”

Knowing one’s risk factors is a key first step in preventing heart disease, heart surgeon Dr. Savas Mavridis said at Memorial.

 “The most important thing is: Take charge of their health,” Mavridis said. “You have to eat healthy. You have to exercise. You have to know your history.

“You should not wait until you are sick before you see the doctors. Go and make the appropriate lifestyle changes.”

Although cardiac rehab often is associated with workout facilities and strenuous routines, programs address all risk factors, George explained.

Smokers are directed to cessation help. Those with diabetes are referred to Conemaugh Diabetes Institute. There are dietitians to help address obesity and nutrition issues. And psychologists help patients understand stress management and overcome obstacles preventing lifestyle change, George said.

Similar programs are available through cardiac rehab facilities and community health programs at Windber Medical Center and Somerset Hospital.

“Cardiac rehab is a program of both exercise and education,” Jill Fox, nurse manager for cardiac and pulmonary rehabilitation, said from Somerset Hospital.

“One is just as important as the other to help them with recovery and help them learn how to manage their conditions on their own.”

But patients should not lose sight of the importance of exercise – both in recovering from cardiac events and for preventing future events, said Gary Pagano, Windber’s cardiac rehabilitation director.

“I like to use the term ‘exercise as medicine,’ ” Pagano said at the hospital’s HealthStyles fitness center.

“If there is one pill we could make that would make people healthier, it’s exercise – if we could bottle that.”

Some patients recovering from heart angioplasty with stent placement or bypass surgery ignore the doctors’ recommendation to follow up with a rehab program or with lifestyle modification on their own, Pagano noted.

“There are some who continue to be in denial,” Pagano said. “They think everything is going to be OK once they have the stent or bypass. Unfortunately, many of them have a number of events.”

“The stent takes care of that particular blockage,” George said at Memorial. “But the cardiovascular disease is going to advance.”

“They think they are fixed and it is taken care of,” rehab nurse Patti Huber Smith said at Memorial. “It is the lifestyle changes they need to make to stay ‘fixed.’ ”

Medicare studies show those recovering from heart attacks, angioplasty and heart surgery are less likely to die or have additional complications if they complete a rehabilitation program, Fox noted.

Cardiac rehab programs can last from six to 12 weeks and provide one-on-one guidance by nurses and exercise physiologists.  The personal connections help improve outcomes, Fox said.

“It is a unique opportunity for our nurses,” she said. “We get to know our patients better and help them recognize symptoms or we notice different symptoms and can refer them for more help.”

All of the area’s cardiac rehab operations have arrangements for patients to continue using the facilities after they have completed the initial rehab programs.

At Windber HealthStyles and Somerset Hospital Rehabilitation and Wellness Center, anyone can purchase a membership for access to the fitness center and its support staff. At Memorial, those with significant risk factors can join a continuing program, centered in the Good Samaritan building.

“I want them to do cardio-rehab for the rest of their lives,” Mavridis said.

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