Participants reduce chances of dying from any cause by more than 40 percent
When television personality Star Jones prepared for heart surgery, she knew she had a lot more life to live. Embarking on post-surgery cardiac rehabilitation proved crucial in her successful recovery.
“There’s no question that preventive open-heart surgery saved my life. But there is also no question that cardiac rehabilitation gave me my life back,” said Jones.
Because her 2010 aortic valve repair surgery wasn’t an emergency operation, she had time to make plans—and do her homework.
Cardiac rehabilitation is a medically supervised program of exercise training, stress-reduction counseling and education about heart-healthy living. The course typically consists of 36 one-hour sessions over 12 weeks, with some patients continuing on for longer.
Those who participate reduce their chances of dying from any cause by more than 40 percent and lower their risk of re-entering the hospital by 25 percent, according to a 2014 study published in The American Journal of Medicine.
“In order to restore the patients to a full life, there needs to be follow-up,” said Jones, an attorney and author who was 48 when she began her post-surgery program.
After six days in the hospital, she had a week of bed rest at her home in New York City. Then she started at-home rehabilitation in which a therapist instructed her how to cough using a pillow to protect her chest and helped her walk around her home and on nearby streets.
“I would walk very gingerly, almost like I was tip-toeing,” Jones said. “I really needed help feeling whole again.”
She started cardiac rehabilitation four weeks after surgery. On the first day, medical personnel assured her they would monitor her at all times, checking her heart activity and blood pressure.
At first, she walked on a treadmill slowly for five minutes. Then, after a break, she did another exercise, such as riding a stationary bike, for five minutes. Her workout continually expanded.
To graduate from the program after three months, she had to complete a “sub-max” workout of nine minutes each on five different machines with one-minute breaks in between, all in less than an hour.
“It was really awesome,” she said. “Awesome, awesome, awesome!”
Many of the lessons learned she still uses, including exercising four to five days per week, at least 30 minutes each time.
Jones places half of each meal she is served on a smaller plate and tells herself she can eat some of the rest of the food if she desires. “But nine times out of ten, I never go back for any more,” she said.
Breakfast is usually her biggest meal to give her energy for the day. She doesn’t eat carbohydrates after 6 p.m., and for dinner almost always has lean protein and green vegetables.
Like many others who have had heart surgery or experienced a serious heart problem, Jones said her doctor did not initially bring up cardiac rehab. In fact, only about half of the people eligible for cardiac rehab are referred for it by their doctors.
Use of cardiac rehab remains low, especially for women and older patients. One recent study in JAMA: Internal Medicine found that only about a quarter of heart attack survivors referred to a cardiac rehab program actually went to all 36 sessions.
Some patients do not have a program in their community or do not have insurance coverage to pay for it, while others may not be referred by their doctor or may not enroll in the program even if they are referred, according to an American Heart Association (AHA) presidential advisory published in 2011.
“I say, ask,” Jones said. For those not sure how to bring it up with their doctor, she suggests saying, “I have been reading about cardiac rehabilitation. Let’s talk about that.”
One obstacle for Medicare patients is a requirement that the program be under the direct supervision of a physician. The AHA, American College of Cardiology and the Heart Failure Society of America are among the groups supporting legislation in Congress that would allow physician assistants, nurse practitioners and clinical nurse specialists to supervise on a day-to-day basis.
As an AHA volunteer, Jones said she’s proud the organization works to make cardiac rehab more accessible. She credits her rehab with helping her to thrive.
“There are times that I literally forget that I had open-heart surgery,” she said. “I saved my own life by being conscious of my health, and cardiac rehabilitation really and truly gave me that life back.”