When Donald Burns, a captain of the Wilmington Fire Department, had a heart attack at age 35, one of his biggest fears was that he wouldn’t be able to return to work. After all, he had three stents in his heart, and firefighting required him to be in peak physical shape.
Burns needn’t have worried. His after-surgery recovery plan included attending New Hanover Regional Medical Center’s Cardiac Rehabilitation Program. There, through exercise, nutrition counseling, and continuing education, cardiac patients reach their lifestyle goals—even when those goals include strenuous physical activity.
“I’m back to my job,” Burns said. “I am totally released to go back to full duty.”
It took Burns three months to get back in top form. He started slowly—by walking on a treadmill. In just a couple of weeks, Burns pushed to do more. He wanted to regain the strength and endurance to run 15 miles a week in 50 pounds of firefighter gear.
The cardiac rehab staff was more than accommodating. Goal setting is an integral part of the cardiac rehab program, said Colleen Daubert, the program’s exercise physiology coordinator. A nurse and exercise physiologist meet with every patient and review history, medications, and any limitations. Then they design an individualized treatment plan that also meets goals set by the American Heart Association.
“The individuals set goals for themselves, and we’re here to assist them,” said Sue Schoolfield, the exercise physiologist who worked with Burns on his training regimen.
Upon learning that Burns wanted to return to firefighting, the cardiac rehab staff gave him a cardiopulmonary exercise test, which included an electrocardiogram and monitoring of his blood pressure, oxygen consumption, carbon dioxide production, and perceived exertion. When the test showed that Burns was in good physical condition, they updated his program.
The patients don't necessarily have to be in good physical condition to do the cardiopulmonary exercise test (CPET) or do high intensity interval training. The CPET is a tool to gather information to design a more effective exercise prescription that is tailored to the patient.
“With the tests, exercise physiologists can be very specific with the program they design for patients,” said Schoolfield. “For Don, we could exercise at a high intensity in a safe environment.”
Burns did moderate continuous intensity exercise and high intensity interval training (HIIT). With HIIT, Burns alternated between high and moderate intensity exercise on the treadmill (though he could’ve chosen a bike, elliptical, or other aerobic machine) while wearing his firefighter gear. He also did strength-training exercises.
As most cardiac rehab patients do, Burns worked out for about an hour three times a week. He also, like the others in his rehab class, wore a heart monitor during exercise, and at the end of his workouts staff checked his blood pressure, heart rate, and other markers to ensure all was well. The patient's vital signs (heart rate, blood pressure) and heart rhythms are monitored throughout the session (before, during and after exercise).
“They were constantly monitoring me,” Burns said.
The program’s staff know that numbers don’t tell everything. That’s why they talk to their patients after each session to learn how they’re feeling, their perceived effort, and any other issues that come up, Daubert said.
Burns said the program’s nutrition counseling also helped. He learned to satisfy his sweet tooth with substitutions and started eating leaner meats and lots of veggies.
“I didn’t think I had a bad diet, but I learned new tips to make it even healthier,” he said.
Overcoming the Mental Hurdle
The final, and possibly most important aspect of Burns’ recovery, was the counseling he received. The program offers classes on mindfulness and depression and as many individual sessions with a licensed clinical social worker as a patient needs.
Burns suffered from anxiety. That anxiety is common with heart patients, whether they have had a heart attack, stents, or surgery. By working with the social worker, Burns learned how to calm himself and was able to give up his anxiety medication.
“The mental aspect was the biggest hurdle,” said Burns. “It was so important to have someone to talk to and help you deal with it.”
Through intense cardiac rehab, Burns regained his fitness and the assurance that he could continue in the career he loves.
“When I first started the program, I was nervous,” Burns said. “With my heart condition, I didn’t know what I could do. They give you all these resources to help. They gave me confidence that my heart was good ... I’m changing my lifestyle to make sure I can fulfill my life.”
Learn more about cardiac rehabilitation available at NHRMC.