Risk and recovery
By Stone Irvin
Stanley Wagner can once again wear the silver ring inset with green and red stones that his wife of 44 years bought for him on a Navajo reservation in 1994. That's after losing 31 pounds since starting the HeartWise Risk Reduction Program at Emory.
The weight loss is intentional, part of a strategy to improve the coronary health of the 80-year-old, who had a heart attack six years ago. His wife, Elaine, also has had her share of heart trouble, having a stent placed in her heart 19 years ago.
Both the Wagners participate in HeartWise, which helps reduce the risk of a heart incident or to recover after one. The program also emphasizes primary prevention by identifying and addressing those at risk to prevent cardiovascular problems.
"There's a certain amount of security here," Elaine Wagner says, while working out in a monitored session at Emory's Blomeyer Health Fitness Center. Every five minutes, exercise physiologists check on her and the other program members to make sure they are exercising within safe bounds and showing no signs of stress.
Supervised by physicians with case management by nurses, the HeartWise program is designed to optimize appropriate lifestyle therapies. Medical therapy is included as needed. The program emphasizes regular monitored exercise, consultations with registered dieticians, a lecture series on reducing heart risks, and education on cholesterol and blood pressure management, medications, and healthy habits.
"A program like HeartWise is the core of a comprehensive treatment plan for fighting heart disease," says, Laurence Sperling, founder of preventive cardiology at Emory and himself a veteran marathon runner. "Cardiac rehab and prevention programs are essential standards for heart health care."
The program helps address patients' concerns, which Sperling acknowledges are often different than those of their physicians. "As a doctor, you want to know what medications patients need, when their follow-up appointments are," he says. "But what patients really want to know is, how is this going to impact my quality of life, when can I go back to work, when can I take up my hobbies, when can I have sex."
HeartWise also fosters community among patients to reinforce healthy habits after a heart incident. For example, Don Baldwin, 65, plays ping pong three times a week with other HeartWise participants. A retired computer specialist for the Department of Labor, Baldwin has coronary artery disease. He enjoys the camaraderie among patients and the close engagement of Emory's exercise physiologists. "They ask, how are ya feelin', and it's not a casual thing," Baldwin says.
This concern reaches beyond the walls of the exercise room. On several occasions when Baldwin began feeling slight twinges of chest pain, he phoned the HeartWise team, who were able to get him an appointment with a doctor quickly.
Including a patient's family is another important component to cardiac rehabilitation, says HeartWise Director Kathy Lee Bishop. She encourages family members to attend monthly meetings with the program's dietician, which promote better eating habits among entire families. That is good not only for the patient who has healthy habits reinforced by a support system but also for family members who decrease their own risks of ever having a cardiac event.