Tuesday, 12 March 2013

The Four Phases of Cardiac Rehabilitation

We are very lucky in the UK as there is a very organised and structured programme that quickly and efficiently helps people to get back on their feet after having a heart attack or heart surgery, although this may depend on the area you live. I was  talking to a client recently who told me that he had woken up in the middle of the night with chest pains and went immediately to the CTC unit at Basildon Hospital  By 2 am he was wired up too machines being assessed, by 4:am he had received Angioplasty treatment ( a tiny balloon  used to stretch blocked or narrowed arteries of the heart),  by 5:am he was sitting up having a cup of tea and by 10:am, he was back in the comfort of his own home. I am sure you will agree that's incredible effiiciency! This treatment and follow up services is just as good and is divided into four phases that are set out below.

Phase 1 is the hospital stage when a diagnosis of a heart attack has been made or heart surgery has taken place. This phase includes a medical evaluation and a risk assessment of heart failure in the future.

Phase 2
starts after discharge from hospital which is probably the most difficult time for people who have had surgery and they may be at their most insecure and anxious during this phase. During this time Cardiac nurses and Physiotherapists  will advise patients about when they can attend a phase 3 Cardiac Rehabilitation programme

Phase 3 Attending as an out patient group exercise program  that is run by a physiotherapist and cardiac rehabilitation nurse,  and sometimes with a level British Association of Cardiac Prevention & Rehabilitation (BACPR) instructor.  The aim of the programme is to help patients rebuild their confidence and encourage regular activity that will strengthen their heart and reduce the risk of a future event. The exercise includes aerobic training such as walking , cycling , jogging , rowing or circuit training.  There is also and educational element that helps patients assess their lifestyle and understand their medication.

Phase 4  is the 'getting back to better than normal' phase and the long term maintenance of physical activity and lifestyle change.  Patients are usually referred from phase 3 to a BACPR qualified instructor who will  help them continue with a regular cardiac rehabilitation phase 4 exercise programme, although a GP may also refer.

Why bother with Phase 4?

The body is  amazingly resilient  and efficient at healing itself given the right conditions. Many of the cardiac patients I have worked with have achieved a level of health and fitness they have never previously experienced, even in their youth! As anyone who has had heart problems will tell you, having confidence in our body is key to a happy life and  this can be achieved by taking care of our health through sensible food choices and regular activity.  The supportive atmosphere of a phase 4 group where there are other people who understand what has happened is very reassuring  and can help ease the  depression that is very common after a heart attack. In short Phase 4 is  a community of people who what to enjoy life to the full.

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