Getting Back to Normal
Kenneth Hultgren was just 54 when he suffered a heart attack. A firefighter, Hultgren was fit, working a job that takes physical strength, as wall as being an avid runner and hiker. When it came time for cardiac rehab, he was in good hands at Providence Saint Joseph Medical Center's Rehabilitation Fitness Center, where his therapists took time to truly know him and designed a tailored program to get him back to work and his active home life.
It wasn’t easy for a man who considered himself in excellent physical condition to be patient and to understand that the process would take some time.
Tanner Young, program manager and certified exercise physiologist with the American College of Sports Medicine, treats patients who have had heart attacks, bypass surgery, implanted stents, valve replacements or repair for arrhythmia. Each patient is different and requires experts who know what they are going through and how best to help them continue the recovery process.
“Our care team understands that undergoing a heart procedure impacts patients emotionally and physically,” says Young. “They’re afraid their heart might not be able to take the stress of exercise, so we immediately try to put them at ease,” he explains.
He acknowledges their fear and creates individualized exercise plans to strengthen the heart. "Additionally, an important part of recovery is educating patients on previous health habits and the effect hey have on the body," he says. "We give patients the tools they need to create a healthier lifestyle—and maintain it—and explain why they've been prescribed certain medications. If you know why you're doing these lifestyle changes, you're more likely to stick to them."
ONE SUCCESS STORY
Hultgren lives in Los Angeles with his wife, Sheri, and their children, Rochelle, 14, and Wesley, 11. “This is usually a retirement injury,” says Young of Hultgren’s heart attack. “But he wasn’t willing to accept retirement that way. He told me he wanted to get back to work.”
Hultgren’s strength, stamina and cardiovascular response were limited at first, but after a few months of exercising under the guidance of Young and his team, he was cycling 35 miles and going for hikes on the weekend.
“Tanner’s instruction and the plan we put together—lots of high-intensity interval training, one monitored session per week, three total per week, including training when at home—allowed me to make the necessary gains to get back to work eight months after the heart attack, and only four months of that were cardiac rehab,” says the firefighter.
“I did have a very good base of fitness before I came in,” he admits, “but it took those months for us to work on getting my cardiovascular system back to the level needed to perform firefighter duties. It was difficult to slowly get back my cardiac health—but the process was good.”
Hultgren continues: “I gave Tanner a copy of the test that I had to take to get back to work, and he modified the workouts to ensure I could perform each of the items.”
“The entire care team was thrilled when Ken returned to work, passing his physical test with flying colors,” says Young.
As for Hultgren, he credits Young and his team for bringing his strength level back up to its pre-heart-attack level. "That treatment facility is a true blessing," he says.
It's all about whole-person care, nurturing the mind, body and spirit. That is one of the critical elements of getting cardiac rehab patients back to good health. Another is living the Providence Promise: "Know me, care for me, ease my way."
Every day, Tanner and two cardiac nurses work with people of different ages and strength levels. “We walk them through each exercise, going at a comfortable pace, to see how the heart responds,” he says. "From there we develop an exercise program and increase intensities. We typically see that their mood improves, and their strength and energy increase with each new exercise.”
Tanner also encourages people to walk outside of the facility. “The goal is to get them strong enough so they can feel confident while going on walks, hikes, bike rides or other outdoor activities.”
Hultgren’s determination lifted the spirits of everyone at the cardiac rehab facility. And yet he says the other patients—including a 95-year- old who works out regularly—inspired him. “They all have their unique story, and we had wonderful interactions,” he says.
WHAT HAPPENS AT CARDIAC REHAB?
Evaluation: A “medical clearance form/approval to begin or resume medically supervised exercise” must be signed by the patient’s physician. During the first visit, Young reviews the medical history, lifestyle habits and likes and dislikes in an hour-plus-long evaluation.
Monitoring: Having a team of experienced cardiac rehab caregivers is very important. They monitor each patient’s heart rate and blood pressure before, during and after exercising to determine what they can tolerate. When Phil Wise first came to the rehab facility in 2009, he’d just had a double-bypass surgical procedure. One day when he began exercising, the monitoring equipment showed something wrong, and the staff stopped him right away. “Scar tissue had caused some blockage,” says Wise, who had to undergo another surgery.
Individualized exercise program: Young designs a fitness program that starts with simple exercises and progresses as the person’s tolerance increases. His classes, which include stretching, machine work and weight lifting, are popular. “I start out on the treadmill, then go to the elliptical machine and then do weights,” says Wise, who is 85 and has exercised his whole life.
Support: "They are neat people," Wise says of Young and his team, adding that he's made a lot of friends there.