Mount Hoods cardiac rehab center earns certification

Patients learn to deal with anxiety, anger and stress
by: Jim Clark Barbara Wheeler, who is recovering from stent surgery, has her blood pressure checked by cardiac rehab nurse Jill Wright as she works out at Legacy Mount Hood Medical Center's cardiovascular rehabilitation facility on Friday, Oct. 28.

For 35 years, Barbara Wheeler enjoyed square dancing with her husband. Subsequent health issues, such as two knee replacements, limited her dancing and other physical activities.

The 80-year-old Gresham resident also dealt with cardiac artery disease, and in August she had a stent inserted to help open up her arteries, which were blocked with plaque.

As part of her treatment, Wheeler was referred to Legacy Mount Hood Medical Center's cardiovascular rehabilitation program, where she now exercises three days a week with other patients who have also had heart-related problems.

'I'm losing a little weight, which I'm glad of,' Wheeler says on a recent Friday morning while keeping a steady walking pace on a treadmill. Registered nurse Jill Wright monitors Wheeler's heart readings and takes her blood pressure.

Wheeler, who has also been put on a low-salt diet, says she feels healthier than before.

'I tend to get up and move more,' she adds.

Helping people get and stay healthy

Legacy Mount Hood Medical Center's cardiovascular rehabilitation program recently earned certification from the American Association of Cardiovascular and Pulmonary Rehabilitation, which recognizes programs for meeting strict national standards and guidelines for patient safety and treatment.

Mount Hood's program, which was established in the early 1990s, is not the only one in the Legacy hospital group with that certification - three of Legacy's other

Portland-area hospitals' programs have also been certified. But the small program has seen a steady increase in referrals because of more public awareness of cardiac rehabilitation and efforts in health care to keep costs down.

The main room of Mount Hood's cardiac and pulmonary rehabilitation program resembles a small gym, aside from the nurse station and heart-monitoring equipment. Treadmills, exercise bicycles, NuStep trainer machines and free weights are scattered around the room. Diet and exercise tips are regularly posted on a board.

Most of the patients are referred to the program by their physicians after a 'heart event,' such as a heart attack, heart surgery, coronary artery disease, chronic angina, congestive heart failure or a heart transplant.

Through regular exercise therapy sessions, patients learn how to exercise safely, strengthen muscles and improve their stamina.

'Cardiac rehabilitation is essentially a case-management program, focused on recovery and guiding the patients to their optimal fitness levels,' says Wright, one of the program's two staff members. Besides preventing another heart event, the program's goal, she says, is to help the patients transition into a healthier lifestyle that is lifelong.

The program has an average of 20 patients on each of the three weekdays it is open, Wright says. The average age of patients is 60 and older, although they have ranged in age from their mid-30s to their 90s, Wright says.

Although risk factors such as age and family history play a role in heart health, the program is focused on helping people change modifiable behaviors, such as a sedentary lifestyle, smoking, high blood pressure and stress, Wright says.

Wright, who is also a certified health fitness specialist, says few patients meet the American Heart Association's recommendation of getting at least 30 minutes of moderate aerobic exercise five times a week.

Some patients have led healthy and active lifestyles, but because of a heart event, they need help in getting back to their regular exercise routine, she says.

Patients also learn how to deal with other psychological and social risks such as anxiety, anger and stress by learning relaxation techniques and by getting support from family, friends and fellow patients.

'Patients get a lot of support from each other, which is a major benefit,' Wright says. 'They like to tell each other their stories.'

Sandy resident Bill Brookhart, 66, another patient in the program, says he underwent a quadruple bypass surgery in July.

Brookhart says he wouldn't have described himself as a 'couch potato,' but notes that his strenuous physical activities were limited to yard work and a once-a-week visit to Mt. Hood Athletic Club in Sandy. When he started the cardiac rehabilitation program in mid-September, he found that he moved very slowly and had no endurance.

Brookhart says he's encouraged to keep active outside of the program, which he does by continuing to attend Mt. Hood Athletic Club and through walks around town with his wife.

'My wife tells me I can now keep up with her; I used to trail behind her all the time,' he says. 'On our last walk I was ahead of her.'

Brookhart says he has also altered his diet. On the rare occasion when he gets fast food, he always requests that his hamburger be made without salt.

'It tastes much better,' he says.

Making a change

Registered nurse Liz Ames says the program's success is based on how well the patients make changes to their lifestyles, whether it's quitting smoking, losing weight or cutting the sugar and salt from their diet. One past patient had enough motivation to lose 100 pounds, she says.

'When you see a person use what we teach them and incorporate it into their life, whether small or enormous, it's big for them, and it shows you they're ready to change,' Ames says.

However, it's not unheard of for a patient to go through the program a second time because he or she didn't make the necessary adjustments to improve their heart health, Ames says.

'It can be frustrating when (patients) look at it as just a program rather than a lifestyle change,' she says, 'but that's human nature.'

Continuing education

The cardiac rehabilitation program typically lasts from eight to 12 weeks. Once a patient completes the program, however, it can be difficult for him or her to stay motivated six to 12 months later, Wright says.

In addition to encouraging former patients to join athletic clubs and purchase athletic equipment, Wright says Mount Hood has an ongoing wellness program that is similar to the cardiac rehabilitation program. The wellness program requires a physician's referral, and is usually paid out of pocket, she says.

Wright also encourages patients to keep long-term diet and exercise logs because they tend to help patients follow their exercise routines and stay motivated.