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| Helen Hamilton (Left) at the Jaqua Foundation Cardiac Rehabilitation Center, with Nancy Page. |
One year after her retirement, Helen Hamilton received some unsettling news at her annual physical. A chest scan revealed that she had a blocked artery in her heart. Then, more extensive tests showed that she also had two leaking heart valves. Ms. Hamilton was referred to cardiothoracic surgeon Paul Burns, M.D., Clinical Director of the Division of Cardiac Surgery, and underwent bypass surgery as well as double valve replacement at The Saint Barnabas Heart Center at Saint Barnabas Medical Center. It was a surprising turn of events for a woman who had experienced relatively good health for many years.
My initial reaction was total numbness, says Ms. Hamilton. It was like it was happening to someone else.
After a successful surgery, she began a 12-week program at the Jaqua Foundation Cardiac Rehabilitation Center at Saint Barnabas Medical Center. Initially, Ms. Hamilton rebelled against the introduction of exercise into her life.
I walked in with an attitude and told them that I hated exercise, she recalls with a laugh. I had never been a person who exercised. If I could have parked my car by my desk at work I would have. Now, after the surgery, exercise had to be a part of my life.
To her surprise and delight, Ms. Hamilton began to look forward to those three-day-a-week sessions. After only a few weeks she began to feel better and less fatigued. She enjoyed working with the caring and supportive Cardiac Rehabilitation team and their humor and encouragement helped her to continue. Exercise lifted her mood and gave her the energy to babysit for her two-and-a-half-year -old grandson.
By the end of the program I didn t want to leave, she relates. All my life people told me that exercise would make me feel better. They were right.
Today, Mrs. Hamilton continues to exercise twice a week and also uses a home treadmill. She has lost a dress size and continues to decrease her risk for future heart problems.
Risk Factors can be Modified
After a cardiac event, patients at the Saint Barnabas Heart Center at Saint Barnabas Medical Center work with specialists at the The Jaqua Foundation Cardiac Rehabilitation Center to improve their cardiac status. The program is designed to be a complement to the medical and/or surgical management of cardiac needs and focuses on exercise and reducing risk factors that may lead to another cardiac event.
Risk factors refer to conditions or habits that lead to damage of the blood vessels or increase risk of arteriosclerosis. Some risk factors, such as a genetic disposition to heart disease, cannot be changed. However there are risk factors for heart disease that can be modified. It is never to late or too early to begin to reduce these risks.
Obesity
Maureen Smith, R.N., Director of the Jaqua Foundation Cardiac Rehabilitation Center at Saint Barnabas, says that for every pound gained beyond appropriate body weight, the heart has to build an extra mile of capillaries to nourish it.
The heart of a person who is 40 pounds overweight has to pump 40 extra miles to replenish blood supply, says Ms. Smith. In addition, obesity increases fat around the heart and other organs, which compresses those organs. People do not understand how much extra strain the increased weight poses for their heart.
Obesity is considered a major risk factor for heart disease, according to the American Heart Association. People who are more than 20 pounds over their ideal bodyweight are more likely to develop heart disease, even if they have no other risk factors. Excess weight also raises blood pressure and cholesterol.
Tips to decrease obesity:
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One or two pounds a week is an ideal rate of weight loss. Lose weight slowly and permanently instead of sometimes temporary weight loss with fad diets.
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Understand food labels. Ingredients are listed from most to least. The earlier you see an unhealthy ingredient, the worse that food product is for you.
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Diets high in fiber tend to be low in fat and cholesterol. They also tend to be more filling, so you eat less. Sources of fiber include legumes (lentils, beans, pea), vegetables (spinach, broccoli, zucchini, sweet potato), citrus fruits, apples, raisins, prunes, and whole grains such as oat, brown rice and whole grain breads.
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It helps to have a family and friends who support your weight loss efforts at mealtime and snack time.
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Weigh yourself once a week. When you are three to five pounds overweight, begin eating less and exercising more until the weight is lost. Stop weight gain before it balloons to a level that is more difficult to lose.
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Keeping weight off can be as challenging as losing it. Make a commitment not to return to old eating habits.
Exercise
A sedentary lifestyle is a risk factor for heart disease because it limits the amount of exercise the heart receives. Like any muscle, the heart can lose strength and flexibility from lack of conditioning. A physically active lifestyle increases the heart s ability to pump blood. In addition to promoting weight loss and increasing levels of good cholesterol, exercise increases your heart's strength.
A goal of at least 20 minutes of continuous exercise at least three times a week can improve the entire cardiovascular system, says Gary J. Rogal, M.D., F.A.C.C., Chief of Cardiology for the Saint Barnabas Health Care System. A fit heart pumps 25 percent more blood per minute when at rest and over 50 percent more blood per minute during physical exertion than an unfit heart.
Tips to Increase Your Exercise Activities
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Create a realistic workout schedule. To begin, set small, attainable goals.
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Choose an enjoyable activity. If the activity is pleasurable, you are more likely to make a long-term commitment.
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Make exercise a priority in your life. Decide how much you are willing to incorporate into your schedule.
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Join a class or a club or find an exercise partner. You are more likely to maintain an exercise program if you have someone to support you.
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If you are middle aged or older, or have a medical condition, check with your physician if you plan a vigorous exercise routine. He or she may be able to indicate any activities to focus on or to avoid.
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If you are in good health, focus your exercise program on aerobic activities such as jogging, swimming, biking and walking.
Smoking
The nicotine in one cigarette increases the heart rate and expands blood vessels for about 20 minutes. As the smoker lights up throughout the day over a period of time, the constant expansion and contraction of blood vessels ruin their elasticity, which makes it more difficult for the heart to nourish the body. Cigarette smoking is a major cause of coronary heart disease, which leads to heart attacks. It also increases blood pressure, decreases exercise tolerance and increases the tendency for blood to clot.
Tip to Stop Smoking
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Nicotine is a highly addictive and powerful drug. Many people quit several times before quitting for good. The Center for Health and Wellness at the Saint Barnabas Ambulatory Care Center offers the Tobacco Dependence Treatment Program, providing assessment, behavior therapy and pharmacotherapy (such as the patch, gum, medications) to help quit smoking. For further information, please call (973) 926-7978.
Controlling other health conditions
High blood pressure, diabetes and high cholesterol are conditions that increase the risk of heart attacks.
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Uncontrolled high blood pressure can lead to stroke, heart attack, heart failure or kidney failure. The only way to tell if you have high blood pressure is to have it checked.
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People with diabetes are two to four times more likely to develop cardiovascular disease due to a variety of risk factors. Obesity and physical inactivity are two risk factors for type 2 diabetes. It is important to visit your physician to diagnose or manage diabetes.
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High cholesterol causes plaque to build up
in the arteries, making them harden. Plaque may partially
or totally block the blood’s flow through an artery.
To control your cholesterol, get a cholesterol screening,
eat foods low in saturated fat and cholesterol, maintain
a healthy weight, exercise regularly and follow your physicians
recommendations.
Stress management
Mental stress causes the inner layer of the blood vessels to constrict, which may increase the risk of sudden cardiac death, researchers reported in a past issue of Circulation: Journal of the American Heart Association. Maureen Smith encourages patients to find an outlet for their stress, which might include laughing, doing a hobby, exercising, or finding anything enjoyable to do.
Tips to Reduce Stress
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Talk with family and friends about your stresses.
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Take 15 to 20 minutes a day to breathe deeply and think of a peaceful scene.
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Learn to accept things you can't change. You do not have to solve all of life's problems.
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Count to 10 before answering or responding when you feel angry.
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Don’t use smoking, drinking, overeating, drugs or caffeine to cope with stress.
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Think ahead about what may upset you and avoid it. Spend less time with people who bother you.
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Learn to say no. Don't promise too much.
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Seek out a mental health professional or counselor. Ask your physician for a recommendation.
To reach the Jaqua Foundation Cardiac Rehabilitation Center, please call (973) 322-5006. To reach The Saint Barnabas Heart Centers at Saint Barnabas Medical Center, please call
(973) 322-2200.
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