Life after the Big Scare Baystate Cardiac & Wellness Program Keeps Heart Patients Out of the Hospital

Robert Berry says the name of Baystate Health’s Cardiovascular Rehab & Wellness Program is important.

Sure, the rehabilitation aspect gets people who have suffered a heart attack or other cardiac event back on their feet, but the wellness side is equally crucial — teaching them how to maintain good habits so their acute cardiac issues don’t return.

“If you come into the hospital with a heart attack, or if you’ve had bypass surgery, valve surgery, a heart transplant, things like that, we’ll help you prevent complications like pneumonia,” said Berry, program manager. “We’ll also talk to you about what the risk factors are for heart disease and how you can prevent something like this from happening again.”

Berry calls the program, located in a sprawling facility on Main Street in Springfield, “ridiculously underutilized,” with about one out of five patients who qualify actually using it. He said most people are also unaware that they can make Baystate their health club, with all the exercise equipment and guidance they need, but with trained medical professionals always on hand if something goes wrong.

“People think if they’re moving, they’re exercising, when they’re just waving their arms around like Robbie the Robot from Lost in Space,” Berry said. Seeking guidance from the Cardiac Rehab & Wellness Program, he argued, is a far better option for not only staying in shape, but staying out of the hospital. “We’re positively affecting people’s lives.”

Something for Everyone

Berry and his staff are making that impact in three distinct phases, each with its own goals. Phase 1 is for inpatients who are recovering from a heart attack or surgery and involves imparting that crucial information Berry mentioned about lowering risk factors and stabilizing one’s heart health.

The second phase — like the first, typically covered by insurance — lasts for between six and 12 weeks and is designed to help people recovering from a heart attack or heart disease to learn how to return to their former activity level, or close to it, and craft a plan to do so.

“Education is important,” Berry said. “Where we differ from traditional rehabilitative services is, the physical therapist doesn’t spend a lot of time telling you how not to tear your rotator cuff again. We say, ‘your cholesterol is 232; that’s way too high. What can we do to bring it down? These are your goals.’

“We also do some work with depression because a lot of people are understandably depressed right after a cardiac event, and depression is huge risk factor for another cardiac event,” he continued. “We screen everyone for depression when they come in, and if we find anybody who’s scoring too high and not being treated, we ask them if they want to see a psychologist, and we give their primary care physician a heads-up.”

Patients obtaining phase 2 services include those recovering from angioplasty, stenting, bypass surgery, heart-valve surgery, and heart transplants, as well as heart attacks.

“The goal is to get people to understand how their behaviors are interfering with their health — exercise habits, dietary habits, how they deal with anger and stress, all those things impact your health. We help people understand all those things, so when they leave here, they know the basics of a good diet, how much exercise they should be doing, and what changes they should make in their routine. With that information, they might either go to Planet Fitness or the YMCA … or stay here.”

Berry was referring to phase 3, the maintenance phase of cardiac rehab, which is paid for out of pocket. Many people use the program in place of a gym or health-club membership because they feel more comfortable in that environment. For one thing, the entire staff is certified in advanced cardiac life support, and know how to use the crash cart, with its array of emergency equipment, in the corner of the room. Meanwhile, Baystate cardiologists have offices across the hall.

“If something goes wrong, we’re equipped to handle it,” Berry said. “It’s like the military: you plan for something, and hope you never have to use it. People here like having that safety net.

“We have a 96-year-old who comes here and exercises,” he continued. “Phase 3 is a commercial gym in a hospital environment. We have 4,000 square feet of space out there. It’s huge.”

Parental Advice

“Our focus on education is what really sets us apart from commercial gyms,” Berry said. “We’re not trying to compete with commercial gyms; we’re not after the same people.”

That said, he argued that Baystate’s program is better-equipped to help people, even those not recovering from a heart attack or surgery, understand the relationship between health and habits.

“You have to be careful because certain medical conditions affect your response to exercise,” he said. “All Planet Fitness can really do when something happens is call 911. We’re trained for more than that.”

Throughout the process of recovering and maintaining good health, Berry says the goal is to instill lifelong habits.

“Implicit in lifestyle change is the idea that these have to be changes you can live with,” he told The Healthcare News. “If you just do it for three months or six months, then go back to your old habits, your old medical conditions are going to come back.”

The key, Berry said, is balance and setting firm but realistic goals.

“I don’t want you walking out of here thinking you have to eat celery stalks and tofu for the rest of your life, but I also don’t want you to eat every meal at McDonald’s,” he said. The same goes for exercise, which some experts recommend 60 to 90 minutes, five days a week. “I believe in this, and I don’t have time to do that,” he added.

“I tell you the same things your parents would tell you; I just have to find new, interesting ways to say it. The basic message is to eat less and move more. We have to find ways to motivate people to incorporate that into their lifestyle.”

Other aspects of the Cardiac Rehab & Wellness Program include heart-healthy cooking, smoking cessation, and stress reduction, all areas that can impact heart health. In all cases, Berry wants to ease people into what he hopes will become lifelong habits.

“I have a strong preference for starting people off pretty easy, where they are, and for some that might be a treadmill at 1 mph with no elevation for three minutes, and then sit down for two minutes, then get back on for three more minutes,” Berry said. “The reason for doing that is, I want people to have a good experience when they come in here. I can’t do more with them if they don’t come back.”

He encourages the same small steps getting readjusted to the outside world. If someone is able to work up to walking around Stop & Shop, grocery shopping at his own pace, without getting tired, that’s a goal to be commended.

The idea is to gradually get people to a place where they’re comfortable with maintaining a certain diet and exercise regimen even if they stop coming to the Baystate program — not that anyone has to stop coming. Just ask the 96-year-old.

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