Cardiac Rehabilitation

"Dr. Wickramasinghe explained that they are seeing women who had radiation years ago coming in with these kinds of heart problems."- Linda Brown, seen here with Exercise physiologist Erika Trillo
AT THE AGE OF 76, Linda Brown is as enthusiastic about working with children as she was when she taught middle school for 37 years for the Desert Sands School District, mostly in La Quinta.

“I taught history and a drug prevention class for sixth graders,” says Brown. “After I retired, I worked another seven years as part of a student assistant program, helping students with drug and alcohol problems. That has always been my first love — working with kids, especially kids with problems.”

Currently, Brown volunteers at the Coachella Valley History Museum as a docent for third graders. For several years she also found time to work in the garden and various areas of the museum’s property, wherever she could lend a hand.

“I love gardening,” notes Brown. “Then I developed some health problems, so I had to take a break. But I think I’ll be able to help out in the garden again.”

In 2000, Brown was diagnosed with breast cancer. Following a lumpectomy, radiation and chemotherapy, she was in full remission and has not had a recurrence. Her health remained stable until December 2017 when she felt dizzy and noticed that her heart was racing.

“I thought I had an ear infection and drove to Urgent Care,” explains Brown. “I was soon riding in an ambulance to the emergency department because my heart was racing 170 beats per minute. Fortunately, I was assigned to an excellent cardiologist, Dr. Chanaka Wickramasinghe.”

During his office visit with Brown, Dr. Wickramasinghe, who is Board Certified in Cardiology and Internal Medicine, mentioned the radiation Brown had received to treat her breast cancer. He told her that her heart problems may have been caused by the radiation which wasn’t as precise then as it is now.

“Dr. Wickramasinghe explained that they are seeing women who had radiation years ago coming in with these kinds of heart problems,” says Brown. “My cancer was located on my left side, about an inch from my heart.”

“Left-sided chest radiation therapy can cause damage to cardiac valves, leading to coronary artery disease several years down the line,” says Dr. Wickramasinghe. “It’s very crucial for patients with history of chemotherapy and chest radiation therapy to have a cardiac evaluation done. Post cardiac surgery, whether it be valves or coronary artery disease, the role of cardiac rehabilitation cannot be understated. It’s shown time and time again to improve long-term patient outcomes. I strongly believe it played a major role in Ms. Brown’s recovery process and rehabilitation to her current high functional status.”

Brown was diagnosed with atrial fibrillation and mitral valve concerns and underwent open heart surgery for valve replacement in September 2018. She was given medication for her atrial fibrillation but her symptoms did not subside. In March 2019, Brown received a pacemaker from Board Certified Electrophysiologist Leon Feldman, MD, which provided relief from her atrial fibrillation.

“Four weeks after I got the pacemaker, my relatives and I went to Disneyland with the kids and we walked eight miles,” says Brown. “I even went on most of the rides. I couldn’t have done that before I had my pacemaker. I feel like I have my life back.”

Cardiac rehabilitation

Following Brown’s successful pacemaker implantation, she was referred to the Cardiac Rehabilitation Program at Eisenhower Renker Wellness Center. Patients who have had a heart attack or specific kinds of cardiac procedures qualify for cardiovascular rehabilitation, procedures such as open heart surgery, valve surgeries, angioplasty and stent placements — anything that revascularizes the heart or valve issues. Brown qualified because of her open heart surgery.

“There are many benefits to doing cardiac rehabilitation,” says Lisa Berg, BA, RN, Eisenhower Cardiac Rehabilitation Program. “First and foremost is the educational component which covers a heart healthy lifestyle. We also teach our patients about the importance of aerobic exercise and show them how to exercise safely and effectively.”

“Many studies have shown the efficacy of cardiac rehabilitation, including reducing the risk of cardiac death and a lower risk of hospital readmission,” says Eric Sontz, MD, Board Certified in Cardiovascular Disease, Medical Director, Eisenhower Renker Wellness Center. “Despite the known benefits of cardiac rehabilitation, only about one-fourth of eligible patients are referred. Patients can be their own advocates — insurance covers cardiac rehabilitation with a physician referral.”

Patients participating in the cardiac rehabilitation program are stratified by risk, each with specific criteria. Low risk patients qualify for 24 sessions, moderate risk patients qualify for 30 sessions and high risk patients qualify for 36 sessions. Patients who participate in four sessions per week — three exercise and one education — can expect to complete their programs in nine to ten weeks.

“We get a fair amount of people who have never exercised before in their lives,” says Berg. “Or, they may know a little about lifting weights or doing basic exercises but they don’t do anything aerobically.

“For some, their confidence in their health has been shaken. Often, it’s the first time these patients have faced their own mortality. Being able to exercise with professional staff members who are monitoring them can be comforting.” Berg also discusses cardiovascular disease risk factors with her patients.

“Knowing family history is important,” explains Berg. “You can’t change your genetics but you can modify risk factors and manage your stress, diet and exercise, not smoke, and limit alcohol intake. For women, being postmenopausal is also a risk. “And it’s important to be aware that heart attack symptoms are often different for women and can include more neck, jaw, back and upper abdominal discomfort,” says Berg.

“The cardiac rehab at Eisenhower was wonderful,” says Brown. “I didn’t know what to expect but I felt so safe and secure there. You’re monitored the whole time and the classes were completely informative. I also built up my strength over time and eventually I was exercising 50 minutes three times a week. I feel like my old self again. “It was one of the most positive experiences in my life.”

To contact the Eisenhower Cardiac Rehabilitation Program, call 760.773.2030.