A team approach to better cardiac & pulmonary health

Dave Brown appreciates the importance of being on a team with a shared focus.

The 87-year-old former military man served 25 years in the U.S. Air Force and later worked for the Federal Emergency Management Agency and the State of Maine.

For the past several years, however, Brown has been part of a very different group known as the Phase III Team. Consisting of retirees who have had cardiac issues, the group meets at the Thayer Center for Health in Waterville each Tuesday and Thursday to exercise as part of MaineGeneral’s Cardiac Rehabilitation Program.

It’s a team Brown is happy to be part of.

“I’m very pleased with the program and think MaineGeneral does a great job providing this service at a very reasonable cost,” he said. “Socialization for people my age is very important for healthy survival – mental and physical. I enjoy doing it and we all keep going because we know it will help us live longer.”

A phased approach to better health

Melissa Worth, RN, one of the program’s nurses who monitors participants while they exercise and provides helpful medical, fitness and nutrition education, said patients need a referral from a clinician – cardiologist, primary care or pulmonologist – to participate in the program, which consists of three phases.

The first phase involves a cardiac event for which the patient has been hospitalized, such as a heart attack, stent placement, bypass surgery, a valve replacement or even a heart transplant. Phase II is an outpatient phase, a one-hour, three-day-per-week monitored exercise program.

Once patients graduate from Phase II, they can transition to Phase III at a cost of $25 per month and continue exercising two days per week in unmonitored open gym sessions.”

Worth noted that Phase II participants exercise while wearing a cardiac monitor or pulse oximeter. The program’s nurses monitor them and provide clinical support and patient education throughout the program.

“We have two nurses in the gym at all times – one watching the cardiac monitor and the second who takes blood pressures, provides instruction to patients on how to use the machines and education while they’re using them,” she said. “On Phase III days, we have one nurse working.”

While the Augusta program is set up and staffed similarly, it offers an extra class each week specifically for pulmonary rehab patients.

Serving two patient populations

Despite its name, the program actually serves two patient populations. Worth said there are some differences based on the needs of each group.

“Our cardiac patients want to improve their heart function, so they’re here to increase the muscle’s pump factor. We want to prevent them from having heart failure – a condition where the heart is weak and can’t keep up with the demand of the body’s circulation – and end up having another cardiac event,” she said.

“Our pulmonary patients are different. They come to maximize what they have for lung capacity. We can’t increase their lung capacity so our focus is to maximize what they have,” she added. “They often have a lower tolerance for exercise, so we start them at a much lower level and progress more slowly.”

“Many of our pulmonary patients are referred to the program by MaineGeneral’s pulmonologists or their primary care clinicians,” added Worth’s peer Jane Landry, RN, who has worked in the program full time for the past four years and as per-diem staff for two years before that. “It’s essentially patients with chronic obstructive pulmonary disease (COPD) or interstitial lung disease.”

Helping patients regain strength, endurance and confidence

While the program’s primary goal is supporting patients who have had a cardiac issue, or are living with a pulmonary condition, its exercise and healthy living components help combat or improve many health-related issues.

“The benefits of exercise are exponential,” Worth said. “It helps to decrease blood pressure, lower cholesterol and blood sugar and increase circulation and oxygenation. It also decreases stress and improves sleep and mental health, as well as increasing muscle mass and balance. As we age, falling is another increased risk of being admitted to the hospital.”

Worth said she and her peers find great satisfaction in seeing the progress patients make.

“Once they see the benefits of exercise, they generally want to keep exercising. Our goal in educating our patients is so they will continue exercising after graduating from the program,” she said. “For me, the team feel of it is really enjoyable. I like working with these patients and seeing the gains they make. It’s wonderful.”

Landry agreed.

“It’s a great program, patients love it and we love them,” she said. “We see a lot of change and growth in our patients as they participate in the program.”

And patients like Dave Brown are grateful for the program and its staff.

“They enjoy what they do, they’re helpful and they do a good job monitoring us and overseeing our general well-being,” he said. “We all appreciate what they do for us.”