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Cardiac Rehab as a Model for Reorganizing Health Care | Mary Biever | One Writing Mother

Cardiac Rehab as a Model for Reorganizing Health Care

Cardiac rehab is an effective model for helping people change lifestyles and improve their long term outcomes after a heart attack or other coronary incident. Why does it work? The dedicated staff who work in it do miracles:

  • They reach people where they are.
  • They find ways to help people increase their exercise.
  • They work to change the lifestyle habits that most likely got patients like me into cardiac arrest in the first place.

At each step of the rehab process, they set a small goal and when patients reach it, they set a higher goal. It’s a model of continuous, steady improvement.

Another key to its success is the careful monitoring of patients so immediate adjustments to rehab workouts can be made whenever needed.

This model works. Its secrets to success are how we need to focus more efforts, funding, and training towards: preventative healthcare.

Unfortunately, we work with a healthcare system which has not yet caught up with the rehab model. I have found that the system that did an excellent job of saving my life during my heart attack and then helping me change my lifestyle immediately afterwards still has a major learning curve.

I am a traditionalist and very much want to follow doctor’s orders.

But how does the healthcare system handle the patient who follows doctor’s orders? I’ve done that and more.

  • When they told me to drink more water and less of everything else, I quit drinking all soft drinks and iced tea. I cut my coffee habit from a minimum half pot daily to a single cup each morning, after I’ve already drunk 16 ounces of water.
  • When they told me to change my eating habits with more fruits and vegetables, I did it. I followed every guideline suggested to me: limiting beef to 2 times per week and limiting eggs to 2 per week. They said to add more fish and beans to my diet, and I did both.
  • When they told me to exercise more, I started gradually, built up my endurance during rehab and have now worked up to exercising 6 to 7 times weekly.
  • I’ve diligently taken every medication they prescribed on the schedule they recommended. My goal is to eliminate and/or reduce medication dosages as much as possible by end of this year.
Yes, I’ve had my stumbles – chocolate is one of them. Potato chips are a trigger food. But I’m working on it.

And lo and behold – guess what. When you completely change all the input of an equation, the output will change as well. When you lose 26 pounds in 15 weeks and add exercise, the way your body handles problems changes.

It’s one thing for a healthcare system to admonish us to eat better and exercise more. It’s another for it to be prepared to respond when a patient actually does it. With lifestyle changes as dramatic as I have made, maintaining the same medications and dosages they gave me four months ago can actually make me sick. Last night, my blood pressure was so low, I ate a single serving bag of baked potato chips because I craved them and also because I hoped the salt content would raise my blood pressure which had dropped so low I was sick.

They have cut one medication entirely and another one in half.

Today, as I waited to hear whether or not my prescription level for a pill was going to be cut, I delayed taking it. They changed another dosage instead of the one I’m convinced is too strong for me. I stared at the pill, gritted my teeth, and took it.

I have an appointment early next week, at which I’m going to push for lab tests to be run. My last labs were run over 2 months ago, and I sincerely hope my new lifestyle will be reflected in the results. And I’m praying with those results, I’ll be able to push to get more medications eliminated or reduced.

Maybe our healthcare system fails to respond in a timely manner to situations like mine because most people don’t change their whole lifestyle.

The pills that helped save my life and bought me time can become an albatross if I stay on them too long at former dosage levels. I wonder what would happen if our healthcare system were as proactive as my wonderful experience in cardiac rehab was.

And I think this is a system-wide problem and not a unique, individual issue.

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