Cardiac rehab?

[dg_moore]

My cardiologist has recommended cardiac rehab post AVR. I am in good condition and have resumed my pre-surgery exercise regimen (60-90 mins per day, mixed/varied aerobic and resistance) and am tolerating it well. I have no heart or artery disease, and my cholesterol is good. I have been following a hearth-healthy diet for years. Given this, I wonder what I would gain from rehab - I already exercise regularly, far more than I would in hourly rehab sessions 3 days a week, and do not need dietary or behavioral counseling.

It would be very costly for me, both monetarily and with regard to absence from work, to do the rehab and I don't think the benefit will be worth the cost. Does anybody have any opinion on this?

Thanks
Dave

 

[clay_from_nj]

I had my follow-up exam with my surgeon before my referral came through for rehab. At that point, he told me that I didn't really need the rehab, as I had essentially already "graduated." I was glad to save the costly time off from work and co-pays. I was nowhere near in the shape you are, just now working up to an hour a day of strength training and cardio.

 

[haggis basher]

My cardiologist has recommended cardiac rehab post AVR. I am in good condition and have resumed my pre-surgery exercise regimen (60-90 mins per day, mixed/varied aerobic and resistance) and am tolerating it well. I have no heart or artery disease, and my cholesterol is good. I have been following a hearth-healthy diet for years. Given this, I wonder what I would gain from rehab - I already exercise regularly, far more than I would in hourly rehab sessions 3 days a week, and do not need dietary or behavioral counseling.

It would be very costly for me, both monetarily and with regard to absence from work, to do the rehab and I don't think the benefit will be worth the cost. Does anybody have any opinion on this?

Thanks
Dave

Hi Dave
I was slightly like you. I had been an athlete (runner) most of my life, but the 6months waiting for the operation i deteriorated very quickly, to the stage that I couldn't walk up a 'small' hill!
After the operation, i went for one rehab class, but for me I found it too slow. I began taking walks, gradually slowly lengthening each day. Being honest, I suffered more from my chest, and the cold. I know rehab has talks on nutrition etc, but you are the 'master' of your ship.
There are benifits for/against, but just realise - you can't put a price on your health!
Good Luck
Brian

 

[AZ Don]

Hi,
I skipped the rehab. It would have cost me in terms of travel time and money, and I saw little benefit. Like you I was in good condition prior to surgery and knowledgeable about nutrition and exercise, and exercising on my own regularly. I do suggest that you see if your Dr. suggests any limits/restrictions on your exercise.

 

[Debbrn]

I did go through cardiac rehab. I was not very impressed. The only thing that I enjoyed was the variety of equipment. It also got me out of the house while everyone else was at work. I was already exercising on my own. I certainly know my body and what it needed much more than anyone in cardiac rehab. I do have decreased exercise tolerance because of my congenital heart defect. Six weeks of cardiac rehab is not going to fix that. Three years post-op I get much more out of the local gym I joined with personal training than cardiac rehab.

Cardiac rehab may be good for those that are at risk for sudden cardiac death after a heart attack, but for me I did not get a lot out of it.

Debbie

 

[ski girl]

I agree with what everyone else has said. I'm just like you and my cardio said I could teach the rehab classes and not to waste my time!

 

[big_L]

Like you, I've stayed in shape and eaten healthily for many years. I too, question the need for rehab. I am going to go for a few sessions, but I may drop out even sooner than that. If they spend a lot of time on "don't eat french fries" etc., I'm going to get turned off and just quit. I do want to go and see how my rate does with the exercise, just to build my confidence.

When I talked to my cardiologist, he said that a lot of people do not do it. If you're tolerating your exercise well, you're making the best decision to not attend.

 

[dg_moore]

Thanks all for your input. My wife is an RN, and she agrees that I don't need rehab.

My hospital's rehab unit sent me a pre-admission questionnaire, and frankly I was turned off by the preposterous questions - "for the past 4 weeks have you felt full of life? felt downhearted or depressed?, etc." "How much cheese do you eat per week?", "Which of the following is known as 'good' cholesterol: LDL, HDL, Triglycerides, Total Cholesterol?" and on and on for 10 (!) pages.

I don't need the "don't eat french fries" lecture either - I think I'll take a pass on the rehab.

 

[Fundy]

I didn't do the rehab either. Just the suggested daily walking and frequent spirometer was all I really did.

 

[SuzanneSLO]

At 14 weeks post-OP, I still go to Cardiac Rehab when I can. I have spent so much on health care this year there is no monetary cost to me, but it does require leaving work early. I think each program is different, but mine only involved 4 half hour educational sessions, as well as the monitored exercise sessions.

I find the trainer and nurses to be helpful for health questions. They have also offered to put together a history of my low blood pressure readings to take to my cardiologist when I discuss continuing on metoprolol.

It was great to have support when I was 5 weeks out and starting upper body exercises. It was also my first time using a treadmill. Mostly, its a chance to get another hour of exercise in.

Dave, it sounds like you are already comfortable with your post-surgery exercise tolerance, so I understand why you would pass on CR. -- Suzanne

 

[Jkm7]

My cardio regularly recommends cardio rehab post op but for both of my OHS he told me that it isn't for everyone and he did not think I would get enough out of it to make it worth it. I was very motivated to work on my recovery, I understand healthy diet and lifestyle and while he certainly would have prescribed it if I wanted and my insurance would cover, I chose to continue recovery on my own. In my case, it was the right choice. I would make the same choice today.

 

[Jkm7]

Thanks all for your input. My wife is an RN, and she agrees that I don't need rehab.

My hospital's rehab unit sent me a pre-admission questionnaire, and frankly I was turned off by the preposterous questions - "for the past 4 weeks have you felt full of life? felt downhearted or depressed?, etc." "How much cheese do you eat per week?", "Which of the following is known as 'good' cholesterol: LDL, HDL, Triglycerides, Total Cholesterol?" and on and on for 10 (!) pages.

I don't need the "don't eat french fries" lecture either - I think I'll take a pass on the rehab.

Groan...... that would certainly have turned me off as well.
Depression is a frequent companion to heart issues but it sounds like you and your wife would recognize if you needed help with depression.

You certainly don't seem to need the "don't eat french fries lecture" or to be asked how much cheese you eat.
You should do just fine on your own.

 

[Debbrn]

I got asked some of the same questions when I did cardiac rehab. I have congenital heart disease. It has nothing to do with cholesterol, depression or diet. They checked my cholesterol at the beginning of rehab and then did not appreciate it when I refused to have it rechecked after I completed the program. When I told them that cholesterol had nothing to do with my congenital heart disease, they told my that it was part of their routine.

I am on beta blockers so you can't use the 220-age to determine target heart rate range. When they figured out my target heart rate by heart rate reserve they said that there was no way that I could exercise in that narrow of range. I had done it for years before and I continue to use it to this day. My current personal trainer who has his BS in exercise physiology agrees that the narrow target heart rate range works very well for me.

Debbie

 

[knotguilty]

My opinion, I recommend rehab. For me it gave me confidence as I progressed. I had an incidence that put me in the ER during rehab. It was due to the blood pressure meds I was on. After exercise, it lowered my heart rate and BP that I almost passed out. I had to see the cardiologist before I could go back to rehab and he took me off that med. So it was good that I went to rehab and found that out there.

 

[clay_from_nj]

I am on beta blockers so you can't use the 220-age to determine target heart rate range.
Debbie

I'm also on beta blockers and find that target heart rate stuff is even less useful than BMI. Really though, I get along just fine without it. Don't get too hung up on numbers.

 

[Debbrn]

I know that most people do not use target heart rate range to the extent that I do, but it works really well for me.

Debbie

 

[OldManEmu]

I found cardiac rehab good after both my surgeries. I had a slow decline in physical capacity prior to my first surgery from having endocarditis for 9 months. I went from swimming several kilometres 3-4 times a week to not being able to walk 50 metres without being breathless before my first surgery. Cardiac rehab gave me the confidence to push myself post surgery in a controlled environment. Beta blockers limit heart rate post surgery, however long term beta blocker use seam to be a US related preferred treatment for BP control post surgery where as beta blockers are only used for Heart Rate control outside the US while healing occurs in the first 3 months post surgery.

 

[dg_moore]

I found cardiac rehab good after both my surgeries. I had a slow decline in physical capacity prior to my first surgery from having endocarditis for 9 months. I went from swimming several kilometres 3-4 times a week to not being able to walk 50 metres without being breathless before my first surgery. Cardiac rehab gave me the confidence to push myself post surgery in a controlled environment. Beta blockers limit heart rate post surgery, however long term beta blocker use seam to be a US related preferred treatment for BP control post surgery where as beta blockers are only used for Heart Rate control outside the US while healing occurs in the first 3 months post surgery.

I can understand rehab if you were debilitated before surgery, but since I fortunately was not, and have been able to get back to, and even beyond, my pre-op level of exercise with no problem, I just don't see the need for rehab in my own case.

 

[neo]

Cardiac rehab?

Rehab has been great just to watch what your heart does in response to exercise. You hook up to a mini-ecg, and can see your heart rate while you're working out. It's comforting to know how your heart responds.

 

[clawie1]

Hi Everyone,

I believe starting cardio rehab, is a personal choice but here is my take on it.

I considered myself pretty fit considering I started working out in the Jane Fonda era and continued until July 17, 2013 when I was admitted to ER and consequently had an AVR. During the first few weeks post op, I accepted my physical limitations but I knew I would have to get back to feeling fit again. In my head, I knew what I had to do to start getting back into shape, but unsure about how much I could push my body without getting into trouble. Like many others, I thought I could do without cardio rehab, but then I felt reassured that I had a team of professional RN's monitoring me (many with physical fitness certification) in case there was a problem.

Bottom line, every time I attend my session, I push myself to do more and at the end, I ask for an evaluation particularly the HR and am pleased to see hard evidence that I am still within the acceptable level. Now I am motivated to push myself even more the following session. I know I will not stay in cardio rehab for the full 36 weeks, but I have a greater understanding (and confidence) of my heart and body re my AVR, so that I could return to my regular gym and start dancing salsa again!