This week is Irish Heart Week. David Labanyi looks at the work of the cardiac rehab unit at Beaumont Hospital, one of the first such facilities in the Republic
Taxi driver Brian Murphy recently promised to never let a week pass without exercising for at least three days. He made this vow after recovering from cardiac surgery.
Doctors found a major blockage in his heart at the start of the year. A stent was put in. "One doctor told me I was blessed that I didn't have a heart attack," he says.
Although the operation was a success his confidence collapsed. "It was hammered. My mind got hammered. And my wife, well, she put up with a lot."
Before the operation, Brian, who had once been very fit, admits: "I wasn't active anymore. I was rubbish. I wasn't sleeping right, wasn't eating right."
He joined five other men aged between 60 and 80 odd years of age recovering from heart surgery on a 10-week cardiac rehabilitation programme at Beaumont Hospital in Dublin.
"Going into it, I wasn't sure about it, but having completed the programme I feel it is the best thing anyone could do for their mind, never mind the body."
Helen Newton, one of the cardiac co-ordinators at Beaumont, says each participant is given an exercise plan tailored to their individual needs. "Exercise is important but it is not the only part of rehab. The education on diet and risk factors and the support they get are very important," she says.
The goal is to make people enjoy being fit and also able to recognise what caused their heart disease.
A recently published article in the New England Journal of Medicine found that "men effectively halved their relative risk of death by abiding by the physical activity recommendations of the American College of Sports Medicine: 30 minutes per day of at least moderate exercise on most or all days of the week".
Newton says: "Patients on the Beaumont programme have to recognise what they need to do, whether it's lose weight, cut stress levels, exercise more or get their cholesterol down.
Heart disease is a chronic disease. There is no quick fix."
Beaumont was one of the first cardiac rehabilitation centres in the State. The idea was brought back from the US by Beaumont's then-cardiologist, Prof John Horgan, in the early 1980s.
"We were one of the first to take this approach and it is now more or less the standard," says Newton. "We developed a teaching programme so other hospitals can set up services on the Beaumont template."
Cardiac rehabilitation centres are now available in almost all the major hospitals and many of the smaller ones, often based on training from Beaumont staff. More than €60 million was allocated by the Department of Health for the implementation of the cardiovascular strategy - Building Healthier Hearts - this year.
According to guidelines from the Irish Association of Cardiac Rehabilitation, the ideal time to start rehabilitation is six to eight weeks after the operation.
However, longer waiting lists are making it harder to keep this timeframe. "About 350-375 patients use the Beaumont service each year but we have a serious waiting list. There are probably at least 300 people waiting. We are under-capacitated by about 50 per cent," says Newton.
"Rehab is still beneficial even six months later but a person could be depressed during that time or put on a stone weight before you get to them."
Newton has been working in cardiac rehabilitation at Beaumont for 16 years. "The words that people keep repeating is 'my confidence has increased'. Cardiac surgery can be a huge loss to someone. There is fear and stress and frailty. It can be hard for them to see the future."
Patrick Rooney (62) had a triple-bypass last December 28th. He was in the same programme group as Brian Murphy.
"In the afternoons, after the exercise class, we met either a psychologist, a dietitian or the pharmacist. The dietitian outlined what we could and couldn't eat.
"In my case that meant I couldn't eat practically anything I used to. We had low-fat milk at home. They said: 'No, use super milk instead', that sort of thing."
"I also had a particular problem this year because in the middle of it all my wife died. They offered counselling services and bereavement counselling on an ongoing basis, which was a great help."
Along with the support, people on the programme are also encouraged to push themselves. "Before I went to rehab I was afraid of overdoing it," Rooney says. "Now I would be doing things at home that I would not have had the courage to do."
A third participant, 72-year-old Tony Breslin, had a quadruple bypass last November. He dropped his 40-a-day cigarette habit before joining the programme.
"I can now walk further than I used to. And even now the programme is stopped, I won't go into a rut. About halfway through the course I heard one of the lads say the sessions were building up his confidence. That's just what it did.
"The rehab gave me my confidence back and now I just walk as much as I want."
So impressed were the programme's participants that a number of them are planning to run a charity sports event to buy equipment for the unit.