“Many people think cardiac rehab is just exercise, but it’s so much more than that,” said Karen Schutzer, RN, MS, Manager of Cardiac Rehab and Wellness at Lakeside Medical Center. “People sometimes come in really scared. Their whole lives have been shattered with their diagnosis, and they have a lot of questions. They need someone who can help them navigate through this.”
Cardiac rehabilitation – also known as cardiac rehab -- is a comprehensive lifestyle behavior approach to dealing with coronary artery disease. Through a medically-supervised program of exercise, nutrition counseling, and education, heart patients try to stabilize, slow or even reverse the progression of cardiovascular disease. At Lakeside Medical Center, Karen works with patients who may have undergone a life-altering diagnosis or event, including bypass surgery, stent placement, heart valve surgery, heart-lung surgery, chronic angina, and heart attack. Her job is to counsel and educate her patients on specific actions they can take to build stronger cardiovascular systems.
“I’m not afraid to be a little more aggressive, if the situation allows,” said Karen. “If you walk three miles an hour today, then let’s see if we can move it up next time. I try to move the patient as much as I can.”
Karen also plays the role of trusted advisor, as many patients feel a loss of control after their procedure. Since the heart is hidden from view, many patients are taken off guard by their diagnosis and frustrated by the new path they must now take to get healthy again.
The typical cardiac rehab program takes place in three phases. The first occurs just after surgery, when hospital staff starts walking the patient. Teaching with both the patient and family starts in this phase. The second phase is the outpatient work after the procedure, to establish a documented program for recovery. This phase is where Karen starts her work. Phase three allows the patient more independence, but supervision is still necessary. While Karen is able to work with her patients one-on-one two days a week, she encourages them to exercise on days they’re not with her.
“Some patients come in with bad attitudes about exercise. But it should be fun,” she said. “People should enjoy exercising and enjoy the benefits.”
Measuring results is crucial in keeping the patient on track for recovery. Karen begins each session by monitoring blood pressure, heart rate and blood sugar levels, which she reports back to the patient’s physician. Average blood pressure, weight and change in personality over time are all factors to consider in the patient’s progress. Exercise can even have an effect on some medications patients may be taking.
“Sometimes, if they get into a new lifestyle and stick with it, they are able to have their doctor reduce their blood pressure medications,” she said. “It really helps them see that there is a new way they can live.”
“I keep trying to push a little more, add a little more, trying to build up from where I started,” said Jane. “Exercising really helps my energy.”
The camaraderie that patients share in the facility's group-setting helps enhance the recovery process. For patients without family or supportive friends, isolation can be devastating, especially as they grapple with a serious diagnosis. While Karen can provide medical information and tools for recovery, the benefit gained from the encouragement of others who may be walking through a similar situation can’t be measured.
“When they are working together, I’ve seen it really lift their spirits,” said Karen. “The social interaction with others is even more valuable than what I can give them.”