Special Interview: The Importance of Cardiac Rehabilitation For Heart Valve Surgery Patients With Dr. Ram Dandillaya

In my case cardiac rehab was referred but insurance would not cover it.

It is amazing how often insurance companies practice medicine without a license these days.

Doug

Doug,

Agreed.

My insurance did not cover my cardiac rehab sessions either. (However, there are insurers that do cover this very important, post-operative form of therapy.)

In total, I had to pay about $400 for my sessions. Looking back on it, I would have paid $4,000 considering the benefits I received as a result of cardiac rehab. 🙂

Keep on tickin!
Adam

Hi Adam,

I’m glad you have brought this subject up! Four weeks after my surgery I asked my cardiologist about Cardio-rehab and was told that I was already “past that.” Well, I wasn’t and still don’t think I am. I could definitely benefit from some monitored cardio type exercise. I try to walk daily but – as the walking tapes Fran recommended have proven – I am not going at a clip that is raising my heart rate sufficiently.

After reading this, I think I will find a program in Denver and pay for it myself. I just don’t think we can ever have too much of this type of rehab.

Thanks,

Anne Shannon

Adam, As you know, Cardiac Rehab is the best investment you or your insurance company can make in helping you recover faster and keeping you healthy longer! If more insurance companies invested in this program upfront, they would likely save money later by creating healthier, long-term, post-op patients! John D.

Adam,
Thank-you so much for a wonderful post on cardiac rehab. You could not have picked a more caring and competent cardiologist than to partner with Dr. Ram Dandillaya, to help create more awareness regarding issues around accessing cardiac rehab for heart valve patients. It’s not just the young who face discrimination, my own mother Kato Pomer 93, who was mentioned in this article faced discrimination post-MitraClip procedure at one of the cardiac rehab facilities she tried to get into. They had recently downsized and did not have the staff to accommodate someone who needed individualized attention. To her credit she did not give up. We found a great cardiac rehab and she is getting stronger every day.
Karen

Hi All, I had to beg and beg to get to go to rehab. I’m 68 and I felt that they maybe thought I was to old. I did go and it was the best thing that has happened to me other than my new aortic valve. I am able to do so much more and with so much more confidence than i had before. I wish it could have lasted longer. The real test comes after your finished. Do you continue to work out. I did lapse but now I’m back. Hope every Surgeon heeds this . Marlane

Nice to see a frank discussion about cardiac rehab. In my case it was the excellent staff at the cardiac rehab centre who first encouraged me to get going, then kept my enthusiasm in check as I started to push to hard. My Left Ventricular Hypertrophy slowly diminished as they eased me back to my pre-surgical exercise levels (and beyond). One thing they told me at the centre that really struck me was that the great majority drop out without completing the program. And that most never move to the new dietary habits they are taught in the rehab’s nutrition seminars. Too bad.

I’m a 44-year-old woman, four weeks post-surgery for mitral valve repair. For the past two weeks I’ve been hiking 2 to 3 miles/day through hilly terrain (which I never had time to explore before!); I have no pain; and my energy level isn’t *quite* what it was presurgery, but it’s pretty close.

My diet is largely farm-share driven; my weight is fine; I haven’t had any post-surgery depression; and though I only know one person who’s had heart valve surgery, that’s been enough support (a WWII vet! If I can be in anything close to his shape at his age, I’ll be very happy.).

I know you really advocate cardiac rehab, but I can’t think what it would do for me. But I don’t want to be missing something important…

Thank you for this article. I had aortic valve replacement Nov. 8 so not quite a month yet. I was dischaged from hospital Nov. 22 and my progress has been remarkable. I was called in to rehab for a cardiopulmonary exercise test (Score 9.7 out of a possible 28). Up to this point insurance coverage is included. Now I will rejoin the Sports center I usually went to before surgery to continue rehab on the exercise bike as well as getting out for a walk everyday. I am 72 and feeling great these days. I live in Japan and had the surgery here. I also received a DVD of the surgery so I know just how much my heart was handled. Gives me great respect for the surgeons and my heart.

Nutrition guidance was also provided.

I think cardiac rehab is a vital step to reaching our new “Normal” and a safe new normal. I have HCM and at 32 came out of open heart hoping to just have a septal myectomy but I also had a new mitral valve. Apparently I was too young for rehab. So I put myself through my own rehab with a treadmill and weights. I know I did too much too soon, which continued to cause me to take one step forward and three steps back. Physically I had constant aching pain in my chest that took years and alot of yoga classes to finally heal properly. Mentally and emotionally the whole ordeal was rather overwhelming. I felt like I was going through a death in the family but the secret was I was the only person who knew about the death. Three years later I attended the Annual WomenHeart Symposium. This is where the real healing began when I knew that I wasn’t the only one dealing with heart disease. That all being said I think Cardiac Rehab would be beneficial to All.

Adam,

I too had to push to get into Cardiac Rehab, but my insurance is covering 20 sessions although I will have to start my job which is a lot of traveling before I finish them all. I really appreciate having them monitor me and they take any pain felt very seriously. I would be going too fast I am sure if my heart rate wasn’t monitored and they didnt give me heart rate and METS targets to aspire to. Cardiac Rehab should be done by all, even stent patients, I am trying to get my dad to go, he had a stent two weeks before my problems started, and to my knowledge, no one mentioned rehab. One last thing, I am not sure I would have been so insistent about rehab had I not read your book Adam, thank you.

There is a database for all the cardiac rehab programs in California. It can be accessed at http://www.cscr.org (lower case) and then click on searchable program directory. CSCR stands for the California Society for Cardiac Rehabilitation and we have been around for over 25 years. Our national organization is the American Association for Cardiovascular and Pulmonary Rehabilitation (AACVPR). They also have a searchable program directory available. Go to http://www.aacvpr.org, click on the Resources and then searchable program directory.

On June 16th I Had my Mital Valve replaced at Union Memorial hospital in Baltimore Md.I was released on june 22nd,would have been released earlier,but the had to get my INR @ a level between 2.5 and 3.5.I Will be on coumadin the rest of my life,but that’s ok,I was on it for 10 yrs before my replacement.I started cardic rehab on Aug.2nd,had 36 classes,really enjoyed it.It was very helpful.I have so much energy,I Fell good,had a good recovery,family and friends could not believe that I had open heart surgery when thy saw me 6 weeks later.i highly recommen cardic rehab.medicare paid 80%and my insurance paid 20%.I am blessed,haven’t had any problems,i’m enjoying my new life at 58 yrs old.

I am an 84 year old widow, live on my own, and had an emergency porcine aortic valve replacement six years ago in South Africa where I live. After ten days in hospital I was released with the minimum of instructions and no rehab. I had resident care for three weeks and after that I was on my own.

Since then I have travelled to England, Italy, Russia, Scotland and twice to France. I have just finished writing my biography which is published on my blog site in instalments. It is full of humour and adventures so look for it on http://onthewayto84.blogspot.com

The valve is now calcifying slowly, and further surgery is not an option. BUT I have had a jolly good six years so far, and thank God for every day he gives me on my way to 85.bles

Hi Adam,

Just a PS to the post above when I said I was going to find a cardio-rehab program. I did locate one about 35 minutes from the house and began going over the holidays. It was over five months since my AVR when I enrolled. The program is providing exactly what I had hoped it would. They administered a stress test and now have me wired up and working within the prescribed parameters for 30 minutes 3 times a week.

I had been exercising prior to the classes but had no idea what my target rates should be. Now I know and I am looking forward to increasing my fitness level.

Anne Shannon

By the time my staples came out I was going back to work as a janitor, I wish rehab wasn’t so boring the older ones there act like its a damn social hr,plus I work nites so I have to give up sleep to go. My legs & arms hurt like hell too.