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Beth rickers/Daily Globe
Steve Zandstra, a graduate of Sanford Worthington Medical Center's cardiac rehabilitation program, demonstrates one of the pieces of exercise equipment used in the program.
Beth rickers/Daily Globe Steve Zandstra, a graduate of Sanford Worthington Medical Center's cardiac rehabilitation program, demonstrates one of the pieces of exercise equipment used in the program.

Making hearts healthier: SWMC rehab program helps cardiac patients achieve optimal results

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Worthington, 56187

Worthington Minnesota 300 11th Street / P.O. Box 639 56187

WORTHINGTON -- When Steve Zandstra's wife signed him up to take the Heart Screen at Sanford Worthington Medical Center, he figured it would be routine. He was, after all, in perfect health, and didn't expect any negative results.

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"She used to be a nurse at the hospital, and during February they always have this Heart Month thing where they do the Heart Screens for $25," Zandstra said. "A few people she knew, their husbands had a heart attack, and she said, 'Well, I'm going to get one, and I'm going to make an appointment for you, too. I said, 'I don't need one. I feel fine.' But she went ahead and signed me up."

John Widboom also figured he'd sail through the tests with flying colors.

"Here I was, a man of perfect health," said Widboom, who decided to have the screening anyway, just as a precaution.

But in both men's cases, the Heart Screen -- which includes an EKG, blood pressure, Heart Score CT, and lipid panel for a reduced package rate -- revealed a serious problem.

"They sent me a letter: "You need to see a cardiologist right away,'" recalled Zandstra, who was 57 at the time of the Heart Screen. "I'd never been sick a day in my life.

"My wife said, 'This isn't good.' That reassured me," he added, sarcastically.

In Zandstra's case, follow-up tests detected three blocked arteries: one 70 percent, one 90 percent and one 100 percent. Attempts to insert a stent failed, and Zandstra had bypass surgery.

Widboom also had a blockage -- 90 percent -- and had a stent inserted to clear it.

As part of their follow-up care, both men participated in the Cardiac Rehabilitation program at SWMC.

"We get referrals from both Avera McKennan and the Sanford Heart Hospital," explained Gwen Post, nurse manager of the SWMC Cardiac Rehabilitation Program. "They are both national recognized heart care facilities, and part of the certification they go through is they need to refer patients to cardiac rehab programs for different types of qualifying conditions. We see quite a few people who come here after they have had angioplasty, or they have a stent placed. We see patients who have had heart attacks, or have valve surgery. We don't see too many who have had a heart transplant, but that would be a qualifying condition, too."

Cardiac rehabilitation has three phases, Post explained. Phase I usually happens during the patient's hospitalization following a procedure or surgery, and then they come as outpatients to SWMC for additional rehab.

"Phase II is for patients who have recently had a condition that they need some rehabilitation for," Post explained. "It's a physically monitored program, and we develop a treatment program and exercise program for them."

One Phase II is completed, patients can elect to continue with a maintenance program.

"When they graduate that, through the Phase III program, since they've become familiar with our staff and our equipment, they can continue to come here and exercise on their own," she continued. "It's not as observed as the other program -- not as much oversight -- but we will put them on a heart monitor to see how it is going and watch to see how they are doing. In some facilities, they will do Phase III in a fitness center, like at the Y, but we've just continued to offer it and charge a nominal fee."

Cardiac Rehab is offered three days a week, at 8 a.m. and 3 p.m. each day. Besides the exercise component of the program, the patients also receive education about how to better manage their heart health.

"Heart disease is a chronic thing they have to learn how to manage, and they learn that through the program," Post said. "They don't just come and exercise. They learn how to make healthier choices, lifestyle changes, and there's also psycho-social health, stress management -- a wide range of care that we give."

For many of the rehab consumers, the program acts as a support group, putting them in touch with other people who have similar experiences and concerns.

"Something like this is a life-changing event, and depression is a large concern in patients who have cardiac disease," Post explained. "So that support-group atmosphere they get with the other patients is really great, too."

Post and her staff take pride in offering a comprehensive program that helps their patients get back to living their lives to the fullest.

"We have very experienced RNs who staff our program, who have been with it a long time, and they are very supportive and have a lot of passion about the program," said Post.

After Zandstra's bypass surgery, he was anxious to get started on the rehab portion of the program so he could return to his work in landscaping.

"After I got home, I started rehab the second week," he said. "I wanted to get back to where I was ... and you have to start at the bottom. They told me I was a great candidate for bypass, because I really was physically fit, but the rehab built me gradually up. It conditions you, and gets your body back to doing things."

Widboom recalls being a bit apprehensive when he started cardiac rehab, but those qualms were quickly dispersed by the SWMC staff.

"They started you out so everything was very comfortable," he said. "The people in charge were extremely friendly. By the last day, they started you out on each machine at the same place you started 24 weeks earlier, and then they cranked it up to where you were at the end and wanted to know if you were impressed."

Both men also went home a bit more educated about what they could do on a daily basis to improve their heart health.

"You watch videos, you go out to Hy-Vee and look at heart-healthy food items, so there are a lot of interactive things going on," Widboom noted. "One of the first things I learned was that you can work out, but unless you're getting your heart rate increased to a certain rate, you probably weren't doing any good. When I was working out in past years, I probably went in and walked a half a mile and went home, thinking, 'Wow, aren't I good.' After this, I know you have to get your rate up to have it do you any good."

Zandstra learned he had several health-risk factors that probably contributed to his need for bypass.

"My main factor was I had high cholesterol, but I thought I could just watch it and take care of it myself," he reflected. "Plus, I was adopted, so I had no family history to go by. I also have high blood pressure. They put me on Lipitor, and I have to watch what I eat -- can eat certain things, but not the same thing day after day after day. I know I need to do exercise, so I try to walk every day. They said they don't think I will have any more trouble, but told me to watch what you eat, watch your weight, and if you get tired, rest and take it easy."

In retrospect, both Zandstra and Widboom realize there were some subtle warning signs that might have predicted issues with their hearts.

"That winter before, in 2011, when we had a lot of snow, I did a lot of scooping by hand, and I would get tired," Zandstra remembered. "Now I can see where I had a heart problem, but I didn't pay attention to it, just thought I was getting older, slowing down."

"If I was singing in the church choir, there were a lot of times I couldn't hold a note as long as I was supposed to," Widboom related. "Now I know I was short of breath (because of the heart blockage)."

Now, Widboom can hold that note a bit longer, and Zandstra can shovel snow without tiring so easily --and they credit SWMC's Heart Screen and Cardiac Rehabilitation Program for their success stories.

"Some people say, because they start feeling better, that they don't need to go to rehab, but it's made a difference," said Zandstra. "Some people are just stubborn and don't listen, but I figure if that's what they tell you, that's what you should do, because they know what they're doing."

For more information on the SWMC Cardiac Rehabilitation program, call 372-3188. A Heart Screen can be scheduled by calling 1-800-445-5788.

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