Tales from cardiac rehab: The return of S

I posted on Monday about my cardiac rehab buddy S. She was hauled away by EMTs after complaining of chest pain and registering a very high blood pressure.

Glad to report that S returned to rehab on Friday. Once again we were treading treadmills side by side. She's 13 years younger than I am but, as I'm discovering, age doesn't spare you from heart disease. I've met people in their thirties who've had heart attacks. I've met people in their eighties who've had heart attacks. We have cardiac rehab participants who've had angioplasties and stents and single bypasses and quadruple bypasses. We are the lucky ones, the quick rather than the dead.

I'm reading Thriving with Heart Disease: Live Happier, Healthier, Longer by William M. Sotile, Ph.D. When the book was published in 2003, Dr. Sotile was the director of psychological services at the Wake Forest University Cardiac Rehabilitation Program. I checked out the book from the library at my rehab program. Nurse Julee recommended it, and I thank her for that. Sotile recommends an assertive approach to cardiac rehab. He urges us to get a second opinion, and possibly a third or fourth. He writes: "If you haven't been referred to a cardiac rehab program, find out why."

Research shows that people who begin cardiac rehab while still in the hospital and continue with the program after they're home -- even if it's only for a few months -- suffer less anxiety, depression and disability than those who try to manage on their own. Further, both rehab patients and their families have a fuller understanding of the illness and so they are better able as a group to weather the storms that invariably blow in.

I like going to rehab and, thanks to health insurance, can keep it up until I'm well on my way to some sort of normalcy. The CRMC Rehab unit employs a great group of cardiac nurses, exercise therapists and nutritionists who supervise our time on the treadmills, rowing machines and universal equipment. They monitor our vitals and intervene if things are going a bit haywire. Witness their intervention with S earlier in the week. The nurses have been a bit concerned over my low blood pressures and have worked with the cardiologists to fine-tune my many medications. This is the first time I've had to store my meds in a plastic container the size of a shoebox. I can begin to understand a patient's confusion over what drug to take and when. I have a list, and it's constantly changing.

Dr. Sotile notes that there is an aura of mystery surrounding heart attacks:

All known cardiac risk factors combined account for only three out of four cases of heart illness -- the others are attributed to unknown causes.

I have no history of heart disease. My family has no history of heart disease. I don't smoke. I exercise regularly and have lost 30 pounds during the past year. My cholesterol is not abnormally high. I don't have a high-stress job.

I still had a heart attack.

Unknown causes. This appeals to the mystery lover in me. It also speaks to my fiction writer self. Stuff happens. We don't always know why.