We know that the heart is a muscle and like all muscles, it needs to be exercised to stay in top physical condition — but if you survived a heart attack 100 years ago, you would have spent six weeks in the hospital, the first two or three of which would have been on complete bedrest. Upon discharge you would have been told you could never return to your former level of physical activity. Even as late as the 1960s, emotional and physical rest after a cardiac event was still the gold standard of medical advice according to a timeline of cardiac treatment by Eugene Braunwald, M.D., a well-known and highly respected cardiologist.
Paul Furbeck, Peconic Bay Medical Center’s director of therapy says cardiac aftercare is now nothing like what it used to be. Now patients surviving any kind of cardiac event – heart attack, placement of a stent(s), congestive heart failure, valve replacement or open-heart surgery — are encouraged to take part in a cardiac rehabilitation program.
Furbeck, who has a master’s degree in physical therapy and another in business administration, went to PBMC’s administration with a idea about beginning a cardiac therapy lab. With support from the hospital’s administration, Furbeck, along with Anna Law, the hospital’s vice president of post-acute services and physical therapist Claudia Cebada Mora planned the hospital’s cardiac therapy lab. They visited labs in other parts of the country to get ideas and compare various set-ups. It took them 18 months to plan the lab, purchase the equipment and get staff trained to develop new skills, but “we were ready to go on day one,” said Furbeck.
Patients come in and apply four leads to their chest that record a constant EKG. The nurse on duty receives each patient’s results wirelessly and reads them on a computer screen at her station.
The lab isn’t a large space but it’s very efficiently used. There are treadmills, recumbent bikes, a stair stepper, a multi-purpose cable column for weight training, an elliptical, a small arm bike and Cebada Mora’s favorite piece of equipment called a NuStep recumbent cross trainer.
Furbeck is proud that PBMC’s cardiac lab has a physical therapist on the staff rather than an exercise physiologist. Not all cardiac labs do, he said.
“There are patients who come in here who have medical problems, arthritis or something else that prevents them from using some of the equipment. Because Claudia is a physical therapist, she can adapt their treatment so they’re still getting the exercise benefits they need,” he said.
Before coming to PBMC, Cebeda Mora, who holds a doctorate in physical therapy, traveled the country working shifts in Alaska, coastal California, Pennsylvania and New York. She’d fill in positions for therapists who were out on maternity leave or sick leave — sometimes for a few weeks and sometimes for months.
“I like a job with a challenge.” she said. “When I was offered the chance to help design this lab and work here, I took it. My greatest joy is seeing my patients get better.”
Furbeck stressed that PBMC is able to care for the “whole cardiac patient — from the time they enter the ER until phase three.”
He explained that phase one consists of everything from the first time the patient gets out of bed after surgery until they are discharged. Thirty-six visits to the cardiac rehabilitation lab is phase two. Phase three is when patients come to the lab and no longer have to wear the telemetric equipment to monitor their hearts. There are support groups available to them. Each patient has an individual treatment plan. A dietician meets with each patient to discuss eating a heart-healthy diet. They teach patients how to read labels and give them shopping tips.
In the cardiac rehabilitation lab, the nurses and physical therapists develop relationships with the patients over the three-month-long sessions. Cebeda Mora says she asks them what they want to be able to do once they’re out of phase two. One patient told her he loved to tango and to bowl. He came in one day overjoyed to tell her that he had danced a tango over the past weekend. “It was a slow tango, but it was definitely a tango,” he said, grinning.
Another dance devotee told them that she didn’t realize how much better she was until she went to a party and “danced all night while her friends all had had to sit down.”
Cebeda Mora and Furbeck both nodded in agreement when RN Rosemary Tucker said, “Our patients are our best PR.”
This story is free to read thanks in part to the generous support of readers like you. Keep local news free. Become a member today.