Treatments for heart and lung diseases have improved significantly in recent decades with new medications, devices and surgeries to address a range of conditions. Too often overlooked following treatment are the benefits of such low-tech methods as exercise and lifestyle modification to boost heart and respiratory health.
“The focus has been on these medications,” says Tamara Horwich, MD, medical director of UCLA’s Cardiac Rehabilitation Program. “But, on top of all those medications and devices, lifestyle and taking ownership of your health continue to be important to reduce cardiovascular disease and deaths.”
Spending a few months attending a heart or lung rehabilitation program not only helps patients to recover from immediate problems, but also sets them on a healthier path moving forward. UCLA Health soon will expand its cardiac and cardiopulmonary rehabilitation programs to help more people access these life-changing services. Patients need to be aware of such services and ask their physicians to refer them, says Gerard W. Frank, MD, a pulmonary disease specialist at UCLA Medical Center, Santa Monica. The service too often is an afterthought while doctors focus on a patient’s immediate needs. But “rehab reduces the risk of future events,” Dr. Frank says.
Cardiac patients who can benefit from rehab include those who have experienced a heart attack or angina, received a stent or valve replacement or had bypass surgery or any type of cardiac surgery or procedure. Rehab for cardiac patients consists of sessions two-to-three times a week for eight to 10 weeks.
Pulmonary patients referred for rehabilitation often include those with conditions such as chronic obstructive pulmonary disorder, emphysema, chronic bronchitis, severe asthma and interstitial lung disease. “Most lung transplants at UCLA are being done for interstitial lung diseases,” Dr. Frank says. “We work with those patients before they have their transplants to get them ready for the operation.”
During cardiopulmonary rehab, which consists of sessions two-to-three times a week for six-to-eight weeks, patients exercise under supervision and learn how to make healthy changes to their diets and lifestyle, notes Sharon Randles, RN, manager of Cardiopulmonary Rehabilitation. They work with respiratory therapists, nurses, a dietician and psychologist. “A lot of pulmonary patients become couch potatoes,” Randles says. “We can’t really change their lungs, and we can’t really change their hearts. What we can do is improve their lifestyles and hopefully make them more active and improve their well-being. That is the goal of rehab.” Rehabilitation typically is covered by insurance. UCLA also offers a pay-for-service maintenance program to continue to work on exercise and rehab goals. “The trick with rehab is to keep it up,” says Ellen Wilson, executive director of UCLA Therapy Services. “The heart is a muscle, and muscles support lung function, and exercise will help strengthen them and improve output. But you have to continue with it.”
UCLA also offers a more intensive cardiac rehab program known as the Ornish Lifestyle Medicine program, created by Dean Ornish, MD. It consists of twice-weekly sessions, four hours each, for nine weeks. Participants engage in exercise, yoga, group support sessions and learn about the Ornish diet and how to prepare food. The program is especially helpful to people with heart disease or who have had heart surgery who want to prevent another heart attack or stroke. “The goal of this program is to bring people to a higher level of cardiovascular health,” Dr. Horwich says.
While beginning a cardiac or cardiopulmonary program can be daunting, patients and their families typically are pleased with the end result, Dr. Frank says. “Patients are so happy they came through the program,” he says. “Their families are very gratified at the change, too.”