Sunday, February 25, 2007

Overview of my Cardiac Rehabilitation program

For the last several weeks the Cardiac Rehabilitation program at the Alle-Kiski Medical Center has been an important commitment for me three days a week. For the benefit of my readers who may never have experienced a cardiac rehabilitation program, I thought I would try to describe what I am doing with that time.

The Cardiac Rehab staff team has three members: a nurse and two therapists. They are super people. One of the therapists has special expertise with diabetes; because diabetes is one of the risk factors for heart disease it is not unusual for some of the users of the program to be simultaneously managing their diabetes. Because of my Type II diabetes, there are some extra things I do in the rehab program.

My medical insurance covers participating in the cardiac rehabilitation program because the cardiologist prescribed it for me with a diagnosis of Myocardial Infarction. My insurance approved 36 sessions, which is more than what some other insurance programs approve.

I go to rehab on Monday, Wednesday, and Friday. On the days when I have rehab I make a point of testing my fasting blood sugar first thing in the morning.

When I arrive for my class, I go to the locker room and change into clothes that will be comfortable for exercising. I put four electrodes on myself: two right below my collar bone, and two lower down at each side. I briefly visit the main room to pick up a heart monitor transmitter, and make sure one of the therapists knows which transmitter I will be using. I go back to the locker room and attach the leads from the transmitter to the appropriate electrodes. I put on a harness to hold the transmitter snugly against my chest, and slip the transmitter into the pocket on the harness. By the time I return to the main room the computer monitors are showing my heartbeat.

Because of my diabetes, I immediately go to a desk at the far end of the room, test my blood sugar, and leave my glucometer there. Because of the blood thinners I am using, my fingertips bleed longer than they used to, so I end up putting band-aids over the spots where I did the finger-stick.

I then return to the main desk, find a chair to sit in, and tell the staff my fasting blood sugar and my pre-exercise blood sugar. On Wednesdays everybody gets weighed, so I would also tell them my weight that morning.

I wait until one of the staff members takes my blood pressure and tells me that they have recorded a strip of my EKG. Then I start my exercise routine.

All around the room there are posters showing the RPE scale. RPE stands for Rate of Perceived Exertion and it is a totally subjective measurement. The pieces of exercise equipment all have displays and meters to show various measurements of what I am doing, but I am the only one who can tell where my activity falls on the RPE scale. Periodically the members of the staff will ask me how hard I am working, and they will make a note in my file. My goal is to work between an 11 and a 13, and definitely not to go beyond 13.

At some point in the middle of my exercise routine one of the staff members will take my blood pressure.

I am using five pieces of equipment at this point. I have the freedom to choose the order in which I use them, subject to whether someone else is already on the particular piece.

The first piece of equipment I usually use is a Monark Upper Body Ergometer. This machine sits on a table-top and I sit in a chair to use it. I need to adjust it to the appropriate level of resistance and then I work on it for four minutes. (When I was first introduced to this machine I used it for 3 minutes.)

The second piece of equipment I usually use is a Schwinn Airdyne exercise bike. I have to make sure the height of the seat is right for me before I get on. I need to remember to set the timer that will count down how much time is left. I use this piece for 15 minutes, but I think I started out using it for just 12 minutes.

The third piece of equipment I use is a NuStep recumbent stepper. When I use this one I need to adjust the seat to get the leg extension that would be appropriate for me. I also need to adjust the length of the handles for exercising my arms. Before I start I need to adjust the load using a lever under the seat on the right side. When I first started using this machine I set it to the first level of load and used it for 12 minutes. Now I am using the third level and going for 15 minutes.

The fourth piece of equipment is a treadmill on which I can set the pace and the elevation. I like this machine the best because I don't have to keep looking at gauges to see if I am working at my targeted pace; I simply keep up with the track. When I first started on this piece of equipment I was walking uncomfortably slowly (it was actually harder work for me to slow up) and no elevation. Now I am going about 3.3 miles per hour with a 3% grade. I use this machine for 15 minutes.

A little over a week ago they started me on a fifth piece of equipment: a rowing machine. I am now using this machine for 5 minutes.

When I finish my exercise routine I go back to the desk where I left my glucometer, test my blood sugar again, and then go back to the waiting chairs by the main desk. I tell the staff my post-exercise blood sugar (which often is 100 points below my pre-exercise measurement). They make note of my blood sugar, take my blood pressure and tell me when they have recorded my post-exercise EKG, and I am ready to go.

Once a week, usually on Fridays, there is a lecture given to us while we exercise. The lectures are on various heart health issues, and there is always a hand-out summarizing the points of the lecture.

Before I leave I pick up a voucher for a parking token, return the transmitter, take off the electrodes, and change into my street or working clothes. I usually stop at the hospital cafeteria for lunch, and sometimes I make a hospital call on a parishioner before I get my car from the parking garage and head back to work.

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1 comment:

Arnel B. Endrinal said...

Hi there,
I am a dealer of medical equipment and I have a customer who is asking us about some cardiac rehab equipment. I have no idea what these products are until I saw your blog. Even if we do not know each other, you are able to help me. Amazing! Thank you very much.