The beat goes on
Hearts, bodies get stronger at cardiac rehab
February is a month synonymous with red and pink hearts, candy conversation hearts and frilly valentine cards covered with hearts. It’s also designated American Heart Month.
Healthy hearts that pump blood through bodies have been priorities at St. Joseph’s Medical Center’s cardiac rehabilitation program since it began in the mid 1980s.
Lisa Bertoglio, R.N., is the nurse in charge of the cardiac rehab program on the third floor of the hospital. A nurse for 27 years, Bertoglio has been working in St. Joseph’s cardiac rehab for about four years. Bertoglio, exercise physiologist Julie Bauer, volunteer Dave Swayne and Pink Lady Donna Jacobs keep cardio rehab running smoothly.
Explaining her job, Bauer said an exercise physiologist is “kind of a combination of physical therapist and cardiac nurse.” Bauer has been working in cardiac rehab almost 20 years beginning in Fort Wayne, Ind. Currently she works at St. Joseph’s Medical Center one day a week, usually Monday, where she focuses on teaching, and two days a week at Community Medical Center in Missoula.
According to Bertoglio and Bauer, there are three phases in cardiac rehab. The first, Phase 1, takes place in the hospital. Since many cardiac patients from Polson are treated in Missoula, patients usually are referred to cardiac rehab.
Phase 2 begins after the patient is discharged from the hospital, when he or she can begin cardiac rehab, including monitored exercise. The patient’s doctor and the cardiac rehab staff devise an exercise plan, and the patient wears an electrocardiogram monitor during exercise to record the heart’s activity. The electrocardiogram monitor relieves many patients’ worries about whether or not their heart can take exercise. The cardiac rehab staff stays in contact with the cardiologist or the primary care doctor, too. Phase 2 lasts about three months, and about 10 patients are in Phase 2 at St. Joe’s.
Maintenance, or Phase 3, is for the rest of a patient’s life by helping a patient choose activities and an exercise program, which fits his or her needs and abilities. About eight patients continue “on maintenance” at St. Joseph’s.
Cardiac rehab is open on Mondays, Wednesdays and Fridays from 10 a.m. to 2 p.m. The room is home to an elliptical machine, a treadmill, a couple of Schwinn Airdyne exercise bikes, an arm machine, a NuStep machine and a machine which sort of looks like a recumbent bicycle. Exercisers can gaze out the window at trees, a cross-section of west Polson and across the river to the beginning of Irvine Flats. There is also a separate weight room with free weights if any of the rehabbers are interested.
When patients arrive, Bertoglio attaches electrodes, monitors heart rates, keeps records on pulse, weight, blood pressure, blood oxygen, blood sugar levels for patients who are diabetic, as well as other health issues, such as asthma and stoke.
On Mondays both Bertoglio and Bauer man cardiac rehab. While the two health professionals work cooperatively, Bertoglio monitors the exercisers while Bauer teaches them. Some of Bauer’s topics are: risk factors, a heart healthy diet, cardiac anatomy, medications, stress, relaxation, aerobic exercise, label reading, stretching and strength, angina, stroke, family dynamics, living wills, lipids, smoking, eating out and cooking healthy, alternative therapies, exercise equipment/environment, nursing concerns, diabetes, blood pressure and home exercise. Bauer tailors her topics for specific patients, also.
Bertoglio reinforces Bauer’s instruction on Wednesdays, and the cardiac rehab patients teasingly say she’s merciless and “she quizzes us all the time.”
Bauer said, “We work with the whole person.”
Part of working with the whole person is making exercise fun, Bauer added. Keeping patients motivated as well as suggesting a variety of exercise options and new ways to look at nutrition and food preparation are all part of her job.
For instance, Bauer suggested the rehabbers pretend their dinner plate is divided into fourths.
“One-fourth should be your protein,” Bauer said, making a cross motion with her hands. “One-fourth should be your potato, rice or starch, and the other half of the plate should be veggies.”
The folks who go to cardiac rehab enjoy each other’s company and make friends. The patients are very attached to the staff and vice versa. Bertoglio greets each person by name and listens intently to any problems or issues. Almost all the exercisers visit as they make the NuStep whine or stride along on the treadmill. That’s okay.
“You should be able to carry on a conversation while you’re exercising,” Bertoglio said, slinging her stethoscope around her neck.
Sometimes the rehabbers tell jokes, too. And everybody in cardiac rehab has a story.
For instance Dave Hummel is the “stent king.”
Hummel has had seven stents placed since 1995, with the last being inserted in 2008. Hummel then entered the cardiac rehab program.
“I try to get here three days a week,” Hummel said. “It’s enjoyable. They know us, and we know them.“
In October of 2009, Hummel was exercising in the cardiac rehab lab and got dizzy. The dizziness turned out to be a small stroke.
“Dave and Julie were here and called a code,” Hummel said.
Hospital personnel had him “downstairs quicker than I could get out of my basement,” Hummel said.
Fellow rehabber Paul Fugleberg suffered a heart attack on May 1, 2008, following a five-way bypass in 1995. Fugleberg comes to cardiac rehab for an hour to an hour and a half three days a week, he said.
Another frequent exerciser is Bill Weaver, know as “Blue Eyes.” Weaver had seven stents placed, but he also had significant damage to his heart, according to Bertoglio. However, he stopped smoking, which dramatically changed things for the better.
“And he increased his muscle strength by 10 percent,” Bertoglio added.
Weaver worked hard on the machines, but he didn’t have much to say about his heart. Weaver’s from Alabama where he used to work for the Alabama Journal and the Montgomery Advertiser.
Weaver has lived in Montana for seven years.
One of the few females, Melita Fonda had surgery to repair a tricuspid valve. The DaVinci robot assisted with Fonda’s surgery.
“Ms. Melita … we’re trying to get her back to her strongest potential,” Bertoglio said.
Dan Crevar is also trying to get strong. Crevar had several significant heart events before he went to Billings on the first of June last year for graduations. While he was in Billings, Crevar had a severe heart attack. To prevent another attack, Crevar kicked smoking and chewing.
“I just couldn’t stand that pain again,” Crevar said, “So it was easy to quit.”
Now Crevar, a flirt with big brown eyes, exercises 60 to 90 minutes a day.
Allan Quist says he will probably go to cardiac rehab “as long as the place is open.” Quist had a quadruple bypass in 1993. Then one of the veins from his bypass got plugged up a year and a half ago.
“Now I’m keeping those things open,” Quist said with a grin.
Medicare approves 36 visits, Bertoglio said. After that the cost of cardiac rehab is $25 per month, comparable to local gyms. All in all, cardiac rehab is a great place to exercise and make your heart healthy.