Cheryl Martin (Host): Cardiac rehabilitation can help you prevent another heart attack or cardiac event. It also helps develop and maintain heart healthy habits. Up next, WakeMed Cardiac Rehab nurse, Kimberly Dail shares what every person should know about cardiac rehabilitation. This is WakeMed Voices, a podcast from WakeMed Health and Hospitals in Raleigh, North Carolina. I'm Cheryl Martin. Kimberly, great to have you on to discuss this vital topic.

Kimberly Dail: Thank you, Cheryl. Great to be here.

Host: First of all, who should have cardiac rehabilitation and who can benefit?

Kimberly Dail: So, anybody is eligible to participate in cardiac rehab if they've had a recent cardiac event. That would encompass having had a heart attack within the last 12 months; if they've had cardiac surgery, that's inclusive of possibly stents, having an angioplasty, bypass surgery, valve surgery, possibly congenital surgery; if they have heart failure with a reduced heart function and if they have stable angina. And anybody can benefit from cardiac rehab if they've undergone any of those eligibility factors that I had mentioned. We have people of all ages and all abilities that can benefit from cardiac rehab. We help them guide with exercise safely and effectively after an event.

Host: So, explain what is cardiac rehabilitation.

Kimberly Dail: Cardiac rehab is a medically supervised program that helps improve people's cardiovascular health if they've experienced a recent cardiac event. It's a team approach designed to help with exercise, cardiovascular risk factor management, heart health education, nutrition, and stress management counseling. A multidisciplinary team works with each patient individually and these people are inclusive of a supervising provider such as a physician or a nurse practitioner or PA, a group of nurses, fitness specialists and exercise specialists, nutritionists, stress management educator or chaplain, and volunteers who have been through the program.

 It's performed in a group atmosphere, so we can have up to 20 people at one time exercising, which is really nice because it helps them with socialness as well, and they get to know one another. And it includes cardiovascular exercise or aerobic exercise and also strength training with free weights and strength machines and relaxation techniques.

Host: You mentioned that it's a group program, so is it in any way tailor-made for each patient?

Kimberly Dail: Yes. Every person that comes in here will get an individualized plan following their event. Everybody has a different diagnoses that they come in with, different abilities. Some people have been marathon runners, they want to get back to running. Some people have never exercised a day in their lives and they're not sure how to move forward that. So each person, even though they're in a group setting, their plan is individualized and tailored to them and their abilities.

Host: Talk more about the goals and benefits of a program like this.

Kimberly Dail: So, our goals in cardiac rehab are to meet the patient's goals. Realistic ones, of course. When they come in, we do go over specific goals. They may have what they're wanting to get out of the program. And ultimately, we want them to feel confident, empower them to feel comfortable resuming or starting an exercise program after they've had a change in health status.

Host: And when should a person start a cardiac rehab program?

Kimberly Dail: Phase one of cardiac rehab actually begins in the hospital. And then, we're considered outpatient phase two program. So, we recommend starting outpatient cardiac rehab as soon as they can when they get home from the hospital, barring of course how they're feeling and recommendations from their providers. So typically, we will see people start anywhere from two to four weeks post-cardiac event. And again, depending on, let's say they've had surgery, they need a little bit more recovery time at the very start, they may choose to start a little later, whereas somebody who may have had a heart attack or a stent may choose to start within a couple weeks.

Host: Now, is there a typical length of time for someone to be in cardiac rehab?

Kimberly Dail: Yes. So, it depends on what they've had done and how they're doing after their procedure or whatever cardiac event they had. So, people will be seen from anywhere from 24, 30, or 36 sessions. And it's recommended to attend at least two to three times a week. So, people will be with us for probably about three to four months.

Host: And so, how does cardiac rehab fit into a treatment plan or your treatment plan?

Kimberly Dail: in addition to medications that may be prescribed by the provider, cardiac rehab fits to help them strengthen their heart muscle, decrease further heart disease progression over time. There's lots of education that's built into this program, so it's not just exercise. People can take advantage of all the multidisciplinary team that can work with them, regarding stress counseling, medication compliance, risk factor management, nutrition, and it's helping them get used to more of a new normal, so to speak, after having a health change status.

Host: So, how does the family benefit?

Kimberly Dail: That is a great question, because we definitely are inclusive of the family here. We want them to be comforted by knowing that they're working out, exercising in a safe environment that their loved one is being monitored. The family can also be motivated to help kind of look at their own health status and see the progression in their loved one doing cardiac rehab. And they might encourage them more to go out walking with them and go out exercising or maybe go join a gym or making better choices out at restaurants or at home with diet. The family can benefit from improving stress levels, their emotional health, socialness and engagement in the community. And the family members also can accompany the patients when they come for a one-on-one session with our nutritionist or dietician. And that's key because usually cooking at home is a group effort, and we definitely include the family members in that.

Host: That's great. Kimberly, anything else you'd like to mention about cardiac rehab?

Kimberly Dail: I'm very passionate about cardiac rehab. Anybody that knows me knows that. So, the benefits for cardiac rehab are just incredible. And I would encourage anybody that has had personally an event or within the last year or if they have a family member or friend that has had one, I would encourage them to really look at cardiac rehab and getting involved in a program. There's multiple programs around and we'd love to work with them and it just helps people get more energy, more stamina, build healthier habits. The rewards that I have seen from people doing a cardiac rehab program are impressive. We have people, like I mentioned before, of all different ages and all different abilities coming in. People are nervous, they're scared, they're afraid that their bodies may fail them when they return to exercise or get their heart rates up. But we help get them there safely to the goals that they want to achieve and we monitor them the whole time that they're here. We encourage them, lots of education. And some people come in using walkers and not able to tie their shoes or dress themselves or be independent. And by the time they leave, they may be walking a mile and able to be completely independent. They're able to play soccer with their kids or grandkids, carry their groceries, hold their family members.

Host: How encouraging. That is great. Thank you so much for sharing that. Kimberly Dail, we appreciate you sharing your insights with us.

Kimberly Dail: Thank you so much for having me.

Host: To learn more about WakeMed's Cardiac Rehab Program, please visit wakemed.org. And if you found this podcast helpful, please share it on your social media. You can check out the full podcast library for other topics of interest to you. I'm Cheryl Martin with WakeMed Voices, brought to you by WakeMed Health and Hospitals in Raleigh, North Carolina. Thanks for listening.