Sept 29, 2012. The Times Of India
“The objective is to proactively reduce the future risk of heart attack by at least 20%. If you have heart disease, Cardiac Rehabilitation is not merely an option, it is essential. If you are not undergoing it, then it is negligence,” says Dr Contractor
Cardio-Vascular Disease (CVD) is not something people like to think about, especially if they are mobile, energetic, and well, not old. But as today is World Heart Day, it is relevant to point out that a recently released survey by the Indian Public Health Association found that an astounding 72% of urban Indians across age groups run the risk of cardio-vascular diseases.
The bright side is that heart disease, heart attacks, bypass surgery or angioplasty need not signal the end of a normal active life. Indeed, the Delhi Marathon tomorrow will see the participation of people who will prove otherwise convincingly!
And what makes such activity possible is cardiac rehabilitation, an integral part of post-op care, usually ignored in India. Very few programmes exist outside of immediate post-op care at hospitals. But not undergoing a rehab programme actually means incomplete treatment for cardiac ailments, particularly since research has shown that cardiac rehabilitation can reduce heart disease-related deaths by as much as 26%.
“All major heart associations worldwide label it as a ‘Class 1 A’ recommendation, which means it is as essential a part of treatment as surgery, angioplasty and daily medications,” says Dr Aashish Contractor, Head of Department of Preventive Cardiology and Rehabilitation at the Asian Heart Institute, Mumbai, and a consultant at VARDAN.
Anyone with a heart condition should undergo cardiac rehab as an essential part of the recovery process, says Dr Contractor. Caveat: The programme is not meant for those with unstable angina, angina at rest, heart rhythm problems not controlled by medication, severe heart valve problems and uncontrolled heart failure.
While repair procedures like surgery or angioplasty are essential, cardiac rehabilitation focuses on the root of the illness — the causative factors. Typically, a heart attack and/or procedure leads to a drop in confidence and therefore of activity, leading to a downward spiral in both mental and physical states. But why let that happen when a cardiac rehab programme can not only help you recover but also improve both your longevity and quality of life?
The programme devised by Dr Contractor, especially for VARDAN, is exactly what the World Health Organization recommends: multifaceted interventions designed to optimise a cardiac patient’s physical, psychological, and social functioning, in addition to stabilizing, slowing, or even reversing the progression of atherosclerotic processes, thus reducing risk of further disease.
The outpatient programme at VARDAN begins one to four weeks after discharge from hospital. It is conducted three days a week for three to six months depending on the condition. The patient exercises using portable heart monitoring equipment (telemetry), to ensure that the optimal exercise is done in the safest way possible under supervision of specially trained therapists and a medical practitioner.
Further, an individualized programme of lifestyle modification, including nutrition, stress reduction, counselling and information about risk factors is provided.
A heartening fact that Dr Contractor also talks about is that a preventive cardiac program can significantly reduce the risk of heart ailment by more than 30% for high risk groups like diabetics, people with high BP or cholesterol, or even genetic predisposition for heart ailment.
Do yourself and your loved ones a favour this World Heart Health Day!
The programme devised by Dr Contractor, especially for VARDAN, is exactly what WHO recommends: multifaceted interventions designed to optimise a cardiac patient’s physical, psychological, and social functioning, in addition to stabilizing, slowing, or even reversing the progression of atherosclerotic processes, thus reducing risk of further disease
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VENKATRAMAN | 55
Bypass surgery
Ihave always been careful about my health as I have a family history of cardiac problems.Yet I had to grapple with serious blockages and went through a bypass surgery. Post surgery even basic, everyday activities became near impossible to manage. I started rehab, where they monitored me carefully as I walked, rowed, or lifted light weights. Rehab is a very important part of the recovery process because it builds confidence, and defines your physical risks. Now I know my limits so I have no fear. People need to go through rehab to help them reclaim their lifestyle, sometimes even a better one. I am back to an active life, and run at least one half marathon (21km) each month. In August, I ran three.
YELLURKAR DHANANJAY | 49
Bypass surgery
In 2009 I experienced bloating, back pain, numbness in my left hand, and lumpiness in my chest. While the GP said it could be indigestion or spondylitis, I knew something was wrong. The symptoms became very severe; I went for a stress test where I was told I had suffered a heart attack. I had been regular with morning walks and pranayam, didn’t smoke or eat non-vegetarian food, so the results surprised me. The surgery left me physically and emotionally drained. I wondered if I would ever be productive again. I joined the Cardiac Rehab programme and regained my lost confidence. Seeing people in similar situations doing exercises really had a positive impact on me. I enrolled for a full year. Within six months of my surgery I ran a half marathon, and a full one within a year. Now I run over 40km a week.
DILIP KAPOOR | 42
Angioplasty
I am relatively young, don’t smoke, and have no history of diabetes or high BP. Yet I had a heart attack and had to go through angioplasty. After the cardiac incident, I decided to go for the rehab programme at VARDAN. The programme offers special diet counselling and an exercise regime. It’s reassuring that the therapists continuously monitor ECG and all vital signs for strict adherence to safe levels during exercise. Confident in the knowledge that one is not overexerting, the progression to a higher level of fitness and activity is gradual, steady and very real.
AJAY MITTAL | 56
High cholesterol, preventive care
Ideveloped high cholesterol levels in spite of leading a very healthy life with regular exercise and careful eating. I decided not to take a chance with my heart health and joined the Cardiac Rehab programme at VARDAN. It’s the best thing I’ve done in the last 10 years. The rehab specialist keeps a careful check on heart health parameters, diet and exercise levels, making this programme uniquely beneficial. They put me on a structured programme of 40-60 minutes of aerobic exercises and moderate intensity resistance training exercises with emphasis on muscle building. The diet evaluation and counselling also helped. Today, two months later, my doctors are happy with my lipid profile and I’m looking and feeling much fitter.
