Rehab????

[Gemma]

Hi everybody,
Jim's just been for his rehab "induction". I wasn't able to go with him (some of us have to work you know!), but he's told me the basics over the phone, had his BMI checked, it's ok - he's lost a few kgs but is average weight for his height. Had blood pressure checked etc, they asked him loads of questions (including saying they'll have to get the results of the tests he had done a few weeks ago - now, the rehab clinic is in the hospital where he had the tests done and they booked this appointment 2 weeks ago. Say no more ).
What I'm wondering is how long you guys generally take to complete the rehab programme. Jim's been told that it will start on 16th Feb (can't go the 2nd because that's when he's finally meeting the surgeon for the post-op check up! and the 9th is fully booked), and he'll go 3 times a week for 3-hour sessions for 12 weeks.
Don't get me wrong - I think it's great that they're investing so much time and effort in his recovery - but this will take us into mid-May. They said he shouldn't go back to work until he's finished the rehab. This may be because of his job - he's a precision engineer and it involves lots of carrying heavy bits of metal and stuff around, but I'm not sure how his boss will react.
Maybe things will change as time goes on and they may change their mind about this timescale??
Basically, I'd like to know what your experiences have been of rehab - how often do/did you go, how long after surgery did you start, when did you finish, did you have to wait until you'd finished rehab to go back to work? Sorry for all the questions, guess I'm just a little bit surprised and disappointed it all seems to be getting put back further and further while you guys in America are already driving and back at work!! (Jim can't drive til he gets the go-ahead from the surgeon or cardio). Looking forward to your answers
Gemma.

 

[fyrfytr]

Hey Gemma,
My rehab started 3 weeks after surgery and for the first 3 weeks of rehab they worked my lower body. Didn't start the upper body work outs until the 6th week of rehab. Rehab lasted 16 weeks going 3 times a week. It was something that was very helpful for me.
Take Care

 

[Gemma]

Hi Dave,
Thanks for that - I guess the duration's about right, but he isn't starting until what will be 10 weeks after his operation!!!!!
The National Health Service is great in that we don't have to pay (directly - it all gets paid out of our National Insurance payments and tax) but unfortunately we have to wait for stuff to be done (took 4 weeks to get an appointment through for Jim to see the cardiologist and that was only after his dad rang up! - now he's seeing the cardio the day after the surgeon!!).
Gemma.

 

[elphie]

Hi-
I start my rehab today and I am exactly six weeks out of surgery. I am scheduled to to 3 times a week for 8 wks. Sessions are supposed to be only about an hour long. I won't be returning to work for another 6 wks because my job is also somewhat physical.
I think everybody's experience may be a little different, but I do think that the rehab is really going to help- not only physically, but mentally.

 

[JimL]

Cardiac rehab was great!! Even though mine was two years ago, it is a pleasant memory. Mine started about 6 weeks after surgery, and lasted six weeks, three times a week, one hour each time, eighteen sessions in all. This was called Phase II. Phase I was in the hospital. If I continued to go after the six weeks ended, they would call it Phase III. Three hours at a time sounds a bit long, but it all depends on what they do for those three hours.

 

[ALCapshaw2]

Hello Gemma,

The 12 weeks of Rehab sounds about right, but are you SURE it's for 3 hours per session? I've NEVER heard of sessions lasting over an hour.

Understand your frustration with the delays. I had a similar situation where it took several additional weeks to get insurance approval and then a few more for scheduling conflicts. So it goes.

*Some* doctors will allow very limited driving after 4 weeks, such as to get to their office for followup visits. The people who are returning to work after 6 or 8 weeks have OFFICE JOBS for the most part with NO LIFTING over 5 or 10 lbs for MONTHS, followed by an increase to 40 lbs. I've forgotten the exact time table, but I 'think' it was 6 months before my lifting restrictions were removed.

You DO NOT want to damage the sternum healing. That would REALLY set his recovery back!

'AL'

 

[Kenny F]

I am 2 weeks into Phase II, and it is a wonderful program. The Chattanooga Heart Institute uses INTERxVENT, a program started by Dr. Neil Gordon from South Africa. It is a combo of fitness training and education.

I go 3x week, 1 hour each session, for 12 weeks. It is extremely structured and conservative until they get a feel for what you can do. It is very confidence-inspiring to have a trained person watching the EKG!

My Rehab is very flexible, with scheduled slots from 8:00 AM on thru the day. I would highly recommend it to anybody as an essential component of getting back up to speed.

I started about 7 weeks post-op, mainly because it took that time to get insurance to pay.

 

[Gemma]

Hi,
Al & Jim - yep, apparently it really is 3 hours a day!! They do about 30 mins or so of physical stuff to start with, and the rest of the time is talking about lifestyle issues (as a non-smoking, hardly drinking, healthy-eating active 26 year old I suspect this won't take too long ) then an hour or so learning about relaxation techniques... Apparently he's getting some stuff to read in the post so we'll know more then I suppose.
Jim had a 30-second (ish) rapid heartbeat episode earlier today - guess this was caused by getting up a couple of hours earlier than he has been lately, dashing round and not eating lunch until 3pm. After he sat down and had a drink it slowed down again.
I am certain that when he starts rehab he'll stop worrying about this kind of thing, and with any luck it'll stop happening, and really this is what bothers ME more than the physical rehab stuff - I think the reassurance from a medical person (as Kenny says) that everything's OK would really come in handy about now.
Hope everyone's doing well - expecting a cold spell here in the UK shortly, no doubt we'll all be snowed in as no matter how much warning we get nobody's ever prepared. No snow blowers here!!
Gemma & Jim.

 

[Georgia]

Mine was 9 weeks, 3X per week, 1 1/2 hours per session. Also rigidly structured; loved it; couldn't do without it. I started at 3 weeks after surgery; don't think I could have gone earlier.

Doc wouldn't release me until Phase II completed, but since that was just about 12 weeks out, I don't think it was necessarily because the therapy was complete but rather the time frame. And I have a desk job, no lifting; but have to be very alert and think well. I wasn't very good at that until about 16 weeks, to be honest; my coworkers carried me and my boss didn't give me very complex tasks. Good think, too.

I drove at 4 weeks but only in town to MD, grocery store, rehab, etc. And I wouldn't have driven in a large metropolitan area if that's where I lived, or on a highway, because I didn't think my reflexes and judgment were good enough.

Glad to hear things are going well, Gemma; hope Jim knows how lucky he is to have you!

 

[labguides]

getting rehab/outpatient PT/driving

getting rehab/outpatient PT/driving

How do you convince the doctor that you want cardio rehab? Our daughter's surgeon said she would not need it -- she just needs to walk. We forgot to ask her cardio at appt this week. Prior to surgery, her cardio said she probably would not need cardio rehab. (she had valve repair) She sees the surgeon again next week and will ask again. Her PT feels she needs cardio rehab.

She sees the cardio in another month -- 6 weeks post op. When do most people get to drive? She is hoping to drive at 4 weeks post -op.

Currently she is getting PT at home. At what point, do most people transfer to outpatient PT?

Good news --- visiting nurse discharged her today.

 

[Kenny F]

Instead of convincing, just tell him to right the RX. It doesn't affect him one way or the other, but any cardio should be thrilled that their patient wants to live a healthy lifestyle, which is what Rehab is really all about. The real issue is will insurance pay for it for valvers.

If everyone had access to Rehab early in life it would nearly put Cardios out of busness!

 

[Heather Fisher]

I got no cardiac rehab or PT (home, inpatient,outpatient) I was just told to daily walking. I started driving 4 weeks post-op. Topday, I still walk a couple of miles on the treadmill and have had no problems..... It's interesting how different doctors and different countries handle these things. I plan to ask the doc the next time I see her why some people get rehab and others don't. I guess I should have pushed for it!

Heather

 

[Marge]

I think I am going to be in the same boat as regards cardiac rehab as your daughter, Labguides.

My cardio's response all along, whenever I've asked about exercise programs for people with heart failure (I know there is at least one hospital in this area that has such a program) has been: "Just WALK."

When I asked him about cardiac rehab after the surgery, he said: "You'll meet with me and my post-op cardiac care nurse and we'll design a program, including exercise, specifically for your needs." Which sounds fine, but the exercise component will apparently be on my own, without the framework of a structured rehab program. He claims that there is "no evidence" that cardiac rehab programs are any more effective than patients doing exercise on their own.

My belief is that he is simply spouting a bogus "rationale" for Kaiser corporate policy. In terms of insurance coverage, I'm stuck: my coverage is through Kaiser, a nonprofit HMO with its own hospitals, doctors, clinics, pharmacies and other programs. If you're with Kaiser, you get what Kaiser provides; they will send you out of the network only for treatment if it's something they think you need that they don't provide. I'm really not dissing Kaiser; they've met my needs very well through most of this crisis, and they've taken good care of my husband through prostate cancer and other health scares, but I think they're dead wrong on this cardiac rehab business.

But I'm determined to go to cardiac rehab even if I have to pay for it myself. My cardio has agreed to sign the referral which I will need to get into a program at another hospital in the area.

 

[Rich]

I could have gone to rehab after my surgery, my insurance would have covered it.
However my cardiologist said I really didn't need it.
He told me to just walk and that's what I did.
By the end of the first week I was home I was walking a mile twice a day, every day.
I don't mean just a stroll in the park but rather a hard fast walk.
It was the best thing I could have done and got me in great shape very quickly.
The only downside for some is the weather. If it is extremely cold like now around here or very,very hot then it's not good.
I drove after four weeks and went back to work after ten weeks.
I was told it takes ten weeks for the sternum to fully heal and that's why you will be resricted from lifting much over five pounds for that period of time.
Twelve weeks after my surgery I and my son did some major remodeling on his house, it didn't bother me a bit.
No I don't do that for a living, I'm an engineer who spent most of my time behind a desk.
I asked my surgeon prior to my surgery what restrictions I would have for life, he said none and he was right.

 

[cinda575]

I wish they would have offered me rehab... I have been out of the hospital for 3 weeks and can barely walk to the bathroon without being really out of breath and my heart pumping out of my chest.(so it feels like)...I would love to walk a mile or so by now LOL or sleep in my bed...

 

[Harpoon]

Rehab seems to vary a lot from clinic to clinic.

My program was light to moderate exercise for about an hour or so. They started out with a check of my weight (I weighed myself most of the time) then warm up exercises, a check of resting blood pressure, and getting hooked up to a wireless heart monitor (they would take a beginning "strip" of my cardiac rhythm when the monitor was hooked up.)

Then I got to start on whatever "station" was open. We had an armigometer (hand crank with adjustable resistance), a set of pulleys that worked your arms in a kind of cross-country skiing or swinging motion, a stationary bike, a treadmill, and a rowing machine. They would check your rhythms, pulse, and blood pressure periodically during your session and after you were done you couldn't leave until your heart rate was down to about where it was when you came in, you basically sat on a bench or chair for a few minutes...

They worked you up gradually to certain "performance levels" for the specific stations, 10 minutes on the treadmill at a 2-3mph pace, 10 on the bike at 45rpm, etc...

During or after your time on each station they used a "level of difficulty" chart to gauge how much effort you were putting into what you were doing. It was a scale of 6 to 20 something, with 6 being the easiest or no effort, and 20 being at the point of near collapse.

The nurses there told me that some places work you like a drill instructor in boot camp, but they prefered a "go at your own pace" approach. They'd push you a little bit if things were always "too easy" but never beyond your comfort levels.

Before I had my surgery I was told to expect about 8 weeks of recovery before any lifting over 15-20 pounds. That was the same time I was prohibited from driving and I think work. my actual experience in the hospital and afterwards was VERY VERY different than that, but once I got into rehab, about 3 weeks after leaving the hospital, 3 months after surgery, I was generally mobile without much difficulty, SOB, etc...

 

[ALCapshaw2]

Cinda -

Is your Cardiologist or PCP aware of your situration?
It sounds like you should be checked for fluid in your lungs /chest and have your heart rate checked (under stress).

"AL"

 

[cinda575]

they are supposed to be giving me an echo to see if fluid is around my heart... blood filled it b4 when i was 5 days out of my OHS. but who knows? I am waiting for the appt.

 

[Kathy]

I didn't start rehab until 8 weeks post surgery and continued it for eight weeks. Although I was using my treadmill at home, I REALLY needed the emotional support of the nursing staff to get moving without fear. I had glitches before and after surgery and wanted to avoid any more. It was a very secure feeling to be exercising with a heart monitor on.

Maybe one of those persons denying rehab needs to spend a few days in intensive care.

 

[tommy]

12 weeks rehab starting 6 weeks after surgery. I had complications that slowed me down by 2 weeks. Rehab was scheduled for 1 hour 3x per week.

Rx came from cardio. Going back to work was independant decision from rehab.


Stretch using 1 lb. dumbells, progressing to 8 lb dumbells as I got stronger. Specific stretching exercises.

20 minutes on a treadmill. 10 minutes stationary bike. Heart monitored the whole time. BP at the end. All was charted and reported to cardio weekly. I was not allowed to leave until heart rate got below 100.

Once each week, spent additional 1/2 hour watching educational videos.