Most people come into the new year gung ho about their resolutions, but then life takes over and bad habits resume by the end of January.
Fortunately, American Heart Month arrives every February to raise awareness about cardiovascular disease and get people thinking about eating healthy and exercising regularly again.
“It comes at the perfect time and it’s a good reminder to get people back on track,” says Dr. Magdala Chery, assistant professor in the department of internal medicine at Rowan University School of Osteopathic Medicine.
“I think the big thing is for people to understand that cardiovascular disease is an umbrella term. It includes anything involving the heart and the vessels. Why that’s important is because a lot of people may think, ‘I just don’t want to have a heart attack,’ not realizing they’re doing little things each day that not only increase their chances of having a heart attack but also of having problems with how well their heart functions, the cholesterol that builds up in their arteries and everything else involved. So I think people need to understand that preventing cardiovascular disease isn’t just preventing a heart attack, but preventing all the conditions that may be associated with the heart.”
Dr. Chery breaks down treatment of cardiovascular disease into three categories: primary prevention, secondary prevention and tertiary prevention. The first deals with making healthy lifestyle choices and mediating the risk before there are any signs of cardiovascular disease. The second is when age and certain risk factors lead to the potential for problems, and a step such as cholesterol medication is needed. And the third is after a heart attack or other serious issue has developed, and a more significant option such as a cardiac catheterization is necessary.
“The field is advancing and that’s great,” Dr. Chery says of secondary and tertiary prevention. “But regardless, multiple researches have said that the best way and the most cost-effective way for health care in general is to prevent it all from happening to begin with.”
She recommends at least 150 minutes of exercise per week and 300 if possible, per recent guidelines released by the American Heart Association. She also encourages people to learn the difference between good and bad cholesterol and to monitor the sugar in their diet—particularly in regard to soda or coffee—with tools such as the MyFitnessPal app.
Dr. Chery stresses the dangers of childhood obesity and diabetes as well. “If you see diabetes you should automatically be thinking about heart disease,” she says. “They’re almost one and the same.”
The Road to Recovery
For those who have suffered a cardiac event or stroke, the good news is there are many rehabilitation centers in South Jersey doing commendable work to help people regain their independence.
Bancroft NeuroRehab sees a wide range of patients recovering from stroke, traumatic brain injury and neurological disorders. Every patient receives an individualized treatment plan based on a thorough evaluation and recommendations from the doctor or discharging hospital. The plan may include physical therapy, speech therapy, occupational therapy, psychological services or cognitive therapy.
“One of the biggest things we do here that might be different from a straight outpatient rehab center is our team approach,” says Michelle Valente, outpatient director at Bancroft NeuroRehab. “We are an interdisciplinary team. We come together and collaborate, and we include the client, their family, any case managers who may be involved, physicians and neurologists.”
Valente is amazed at how many of her stroke patients have gone years without seeing a primary doctor, and emphasizes the importance of regular check-ups. She also cites the F.A.S.T. acronym in identifying the signs of a stroke.
“F is for the face droop; A is for arm weakness, if they can’t move one or both arms; S is for speech difficulty, when their words are slurred or they’re just not making sense at all; and T is for time, getting medical attention as soon as possible,” she says.
Bancroft is also treating more and more stroke patients in their 30s and 40s. “I think that’s the biggest myth to demystify: You don’t have to be older or experiencing problems to have a stroke,” Valente says. “It can happen to younger people who think they are in pretty good health and aren’t realizing that something could be going on.”
Dr. Steven Bromley, the director of South Jersey MS Center and Bromley Neurology, is optimistic about the advancements made in stroke rehabilitation.
“We have come a long way in recent times in understanding the complexities of neurological rehabilitation after all forms of stroke,” he says. “A stroke represents injury to brain and brain function, and we are now potentially able to help recover from this injury with the use of newer medications, ‘intelligent’ prosthetic or stimulation devices and even stem cells. Understanding the individual nature of a patient’s injury and functional loss is essential to an ‘individualized’ plan of recovery.”
Kessler Institute for Rehabilitation is another local provider that stresses an individualized treatment plan and team approach to care.
“The patients stay here after leaving the acute care hospital,” says Michelle Davidoff, an occupational therapist at Kessler. “They get a minimum of three hours of therapy a day, so that could be occupational therapy, physical therapy or speech therapy if that’s something they need. We also have recreational therapy, neuropsychologists on staff, and of course they are seeing doctors and a case manager oversees their whole stay. All of those people care for the patient while they’re here and work together to make sure they’re as independent as possible when they go home.”
During the evaluation process at Kessler, the patient’s goals are determined and incorporated into his or her treatment plan. That might include simply being able to walk again without assistance, returning to work, being able to drive or being able to dress and use the bathroom without help.
Another important resource for stroke patients at Kessler is a weekly stroke education class. “All stroke patients as well as family members or friends are welcome to attend,” Davidoff says. “They go over how the stroke occurred, how to prevent another stroke from happening, how to be heart healthy in the future, diet and exercise, those types of things.”
Davidoff is excited about the ways Kessler is utilizing technology as well. One piece of equipment it uses is a Lite-Gait, which is a body weight support treadmill to assist with a patient’s gait, balance, standing tolerance and cardiovascular endurance. Another machine is the MOTOmed, which is used to facilitate upper and lower extremity recovery.
And the Bioness integrated therapy system (BITS) is used to help patients improve their physical, visual, auditory and cognitive abilities. Davidoff compares it to a 50-inch iPad.
“These are great tools and you can use them with so many different patient populations,” she says. “Because technology has advanced so much in the last 10 years, I think therapy is going to continue to advance.”
Published (and copyrighted) in South Jersey Magazine, Volume 15, Issue 11 (February 2019).
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