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Cardiac Rehab

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mtlieb Find out more about mtlieb
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  • Cardiac Rehab

    Well...

    I'm 10 weeks out from surgery today, and my insurance is still trying to decide whether rehab is medically necessary or not following a myectomy. Every week i go up to the rehab center to get started, and every week there's yet another form that needs to be completed by my PCP, cardiologist, or the rehab staff before they can make their decision. Ugh. Now they're telling me that i better get started soon, or they will have to deny the claim because i won't have started rehab within 90 days of the 'event'. LoL. It's craziness, man. I'm supposed to be halfway through this by now.

    Let's assume for a moment that i'm never going to have rehab... are there any resources available for the do-it-yourself rehab? Otherwise, i'm just going to pretend i've already had it and go back to life as usual. I mowed my lawn for the first time yesterday... it was starting to look like a hayfield. It took me all day, and i had some dizziness, palpitations and chest pain... but i recovered nicely and my lawn looks fantastic.

    Any ideas?

    Jim
    "Some days you're the dog... some days you're the hydrant."

  • #2
    Re: Cardiac Rehab

    JIM, mowing the lawn is very strenuous! Are you sure it is OK to do that ? It sounds like the things you felt was your heart saying stop right now. Just concerned is all , don't want anything to go wrong for you Jim.

    As far as the rehab , I hope you are able to get it all worked out. They flat out refused me unless I was willing to pay for it. I should have fought with them but I just gave up. I still think if I had been able to go it would have given me a better chance at reconditionning. Now I have the arthritis and neuropathy holding me back. I don't know other then walking and building up gradually what would be a safe alternative . Maybe others will respond.

    Keep your faith and positive outlook don't let them get you down with all their delay with paper trails . Your doc called them right? Maybe he needs to yell at them or have the person in his office who calls the insurance for the referrals speak to them more strongly.

    Good luck and I'll keep my fingers crossed. Pam
    Dx @ 47 with HOCM & HF:11/00
    Guidant ICD:Mar.01, Recalled/replaced:6/05 w/ Medtronic device
    Lead failure,replaced 12/06.
    SF lead recall:07,extracted leads and new device 2012
    [email protected] Tufts, Boston:10/5/03; age 50. ( [email protected] 240 mmHg ++)
    Paroxysmal A-Fib: 06-07,2010 controlled w/sotalol dosing
    Genetic mutation 4/09, mother(d), brother, son, gene+
    Mother of 3, grandma of 3:Tim,27,Sarah,33w/6 y/o old Sophia, 5 y/o Jack, Laura 34, w/ 5 y/o old Benjamin

    Comment


    • #3
      Re: Cardiac Rehab

      felix can answer better, but I know he never got cardio rahab. he just
      started to walk further/faster. on sunday we did a 3 mile walk and
      he pushed the stroller containing 70lbs of children when both were lazy
      and did not walk.

      sandy
      Fx

      Comment


      • #4
        Re: Cardiac Rehab

        Speak to your specialist and work out a plan - rehab is a good idea.

        Lisa
        Knowledge is power ... Stay informed!
        YOU can make a difference - all you have to do is try!

        Dx age 12 current age 46 and counting!
        lost: 5 family members to HCM (SCD, Stroke, CHF)
        Others diagnosed living with HCM (or gene +) include - daughter, niece, nephew, cousin, sister and many many friends!
        Therapy - ICD (implanted 97, 01, 04 and 11, medication
        Currently not obstructed
        Complications - unnecessary pacemaker and stroke (unrelated to each other)

        Comment


        • #5
          Re: Cardiac Rehab

          Jim,

          I had been wondering how your Rehab was going, now I know. Do try to push for Rehab, so you can learn that mowing your lawn takes working up to. I've learned how to properly warm up (which after years of exercise I thought I knew!) How to check my heart rate & lots of good stuff-not to mention all the 80 year old Men who have introduced themselves to me, this Summer.

          I was fortunate, my Insurance covered 36 total weeks of Rehab. Today I joined a workout facility, because I learned just how important it is for me to exercise 5 days a week, for the rest of my life.

          I wish you luck with this. I believe so strongly in rehab, I could do the commercial!
          RONNIE

          Comment


          • #6
            Re: Cardiac Rehab

            Jim... I've been in rehab for 8 weeks now. The myectomy was 14 weeks ago. All my rehab could be done on a treadmill (walking) and an Air-Dyne bike. The cost is in the monitor that you wear. My rehab cost $80.00 a visit. My DR had no problem signing me up. Thank the Lord for good insurance.

            Please don't give up on getting into rehab and keep doing your exercises. But don't push your self to hard. I finally cut my grass last week-end. I have 3 healthy daughters that were glad i could do that again.

            Stay Positive and be Strong


            Tigger1
            " Real Courage Is Being Scared To Death But Saddling-Up Anyway "

            Comment


            • #7
              Re: Cardiac Rehab

              Hi Jim,
              Isn’t it great that everybody tells you the benefits of rehab, and you are anxious to go to rehab, and the insurance says if you broke your leg getting rehab would be a simple matter, but heart surgery just isn’t serious enough to qualify for it?

              What you need to do is buy a gun, (bullets are an unneeded extra expense.) Then go down to the insurance company headquarters and hold them up. Take the money you get and pay for the rehab yourself. Actually the insurance company is aware that you are not yet fit enough to really do that. That’s why they treat you so shabbily.

              Walking is the heart and soul of rehab. Walk as much as you can, slowly building up to more speed and steeper hills, but once you feel yourself getting SOB, or your heart working too hard, ease back to a slow easy pace before quitting. (You should start off at a slow pace also – and don’t forget the stretching exercises both before and after.)

              If you can get an exercise bike – or a regular bike – you could do some pedaling exercises too, but the same rules apply as when walking. If you have access to a pool you could try some water aerobics – but always with others around, and be careful you don’t over do. Pool exercising can be a sneaky proposition.

              Without a monitor the target should be to elevate your breathing and heart rate, but not to the point where you can not hold a conversation without gasping for air. As you become toned-up you will find you can do more without having to stop every few words to breath. Once you do it a couple of times you will get to know exactly where that boundary line is.

              Of course this is nowhere near as good as working out with a heart monitor on you – but it is do-able none the less. See if your cardio can work out a plan for you. Frequently they have pre-printed handouts prepared which they can mark up and tailor for you personally.

              Man, I can talk a good line – I just can’t do it anymore. Rots of ruck.
              Burt

              Comment


              • #8
                Re: Cardiac Rehab

                Hi All,

                Thanks for all the great advice.

                I spoke with my insurance company again today, and they have finally decided that my cardiac rehab is medically necessary and will pay for it. Woo hoo! Unfortunately, in order to get it approved they had to lower the duration from 12 weeks to six, but at this point i'm not going to complain. Six weeks of rehab is still better than none, and will at the very least get me started back into a regular, safe exercise program. Of course this still doesn't mean i'll be starting rehab immediately. Apparently my insurance still has to reach an agreement with the rehab folks concerning the cost. LoL. It's always something, right? But good news today, nonetheless.

                Jim
                "Some days you're the dog... some days you're the hydrant."

                Comment


                • #9
                  Re: Cardiac Rehab

                  Jim , I'm so glad it is starting to finally go in the right direction for rehab to begin. For God sake please do not mow the lawn again . Get a sheep or a goat or a cow or something that will chew your grass or better yet maybe a friend in the neighborhood with a son willing to put in the effort? Be safe and hope you'll soon be spinning on an excercise bike. Take care. Pam
                  Dx @ 47 with HOCM & HF:11/00
                  Guidant ICD:Mar.01, Recalled/replaced:6/05 w/ Medtronic device
                  Lead failure,replaced 12/06.
                  SF lead recall:07,extracted leads and new device 2012
                  [email protected] Tufts, Boston:10/5/03; age 50. ( [email protected] 240 mmHg ++)
                  Paroxysmal A-Fib: 06-07,2010 controlled w/sotalol dosing
                  Genetic mutation 4/09, mother(d), brother, son, gene+
                  Mother of 3, grandma of 3:Tim,27,Sarah,33w/6 y/o old Sophia, 5 y/o Jack, Laura 34, w/ 5 y/o old Benjamin

                  Comment


                  • #10
                    Re: Cardiac Rehab

                    Hey Jim,
                    Be the first one in your neighborhood that has a lawn that is braided. Some intricate weaving would turn it into a very nice looking rug. Wow, what a concept.
                    Burt

                    Comment


                    • #11
                      Re: Cardiac Rehab

                      Jim, That's not an unusual # for the ins. to start with. After you are in, you may find an extension on that time easier to get than the first approval. The staff will do their best to document what will serve as justification for an extension. Congratulations and Good luck! Linda

                      Comment


                      • #12
                        Re: Cardiac Rehab

                        Hi All,

                        Well i finally started my cardiac rehab this week... woo hoo!

                        I have to admit however that i thought there would be a whole lot more instruction than what i have received. So far, my rehab has been simply to show up, get a heart monitor strapped on me, and then they point me to the machine i am to start out on first. After that, they come around occasionally and ask you if you are experiencing any chest pain or anything... but for the most part, you are working out by yourself. I even got a bit of a scolding today when an instructor came up to me and said i was using a particular machine wrong... but nobody had ever instructed me on how to use the machine right! LoL.

                        I don't want to complain though, because honestly i am quite happy that my insurance is willing to pay for anything at all. A lot of folks don't get any cardiac rehab following their myectomy. At the very least, i feel like i'm getting 18 free passes to the gym, and as a bonus i get to be monitored while i workout. I do however seem to be getting quite a different experience from what many of you have received. I thought there might at least be an initial classroom presentation or a video to watch. During my rehab... we watch talk-shows!

                        Jim
                        "Some days you're the dog... some days you're the hydrant."

                        Comment


                        • #13
                          Re: Cardiac Rehab

                          Jim,
                          I am glad that you are at least getting to go . Did your cardiologist office or the facility give them an instruction sheet or any guide lines for a myectomy patient? I would assume that a facility such as the one that did your surgery would have a lot of experience with these things?
                          I know it is a pain but you may have to be the middle man in finding out if this was done as we have learned from others that the re-hab often is tweeked specific to our needs.
                          You know from past experiences that we usually and unfortunately have to stick our noses into the whole process and micro-manage our medical care.
                          Sorry but this is how it too often is ,ie. I have yet to have anyone call me and set up the nerve studies that were cancelled at the facility that recently said my situation was more then they could manage with my cardio. not being at the facility. Part of me has decided to wait and act like a patient AND LEAVE ALL THE FUMBLING TO MY MEDICAL PROFESSIONALS. Now we both know that is going to get me nowhere.
                          So don't do as I do, do as I say, "Take the ball and run with it."
                          Good luck and keep at it Bud.
                          Pam
                          Dx @ 47 with HOCM & HF:11/00
                          Guidant ICD:Mar.01, Recalled/replaced:6/05 w/ Medtronic device
                          Lead failure,replaced 12/06.
                          SF lead recall:07,extracted leads and new device 2012
                          [email protected] Tufts, Boston:10/5/03; age 50. ( [email protected] 240 mmHg ++)
                          Paroxysmal A-Fib: 06-07,2010 controlled w/sotalol dosing
                          Genetic mutation 4/09, mother(d), brother, son, gene+
                          Mother of 3, grandma of 3:Tim,27,Sarah,33w/6 y/o old Sophia, 5 y/o Jack, Laura 34, w/ 5 y/o old Benjamin

                          Comment


                          • #14
                            Re: Cardiac Rehab

                            Hi Pam,

                            Thanks for your response.

                            Of course my myectomy was performed in Cleveland but i reside in PA, so my rehab is being conducted in the small-town hospital where i live. I wouldn't expect that they would even know much about HCM (which they don't), much less have a large enough client-base to be able to differentiate between different heart problems and individually tailor my program accordingly. As a result, i get exactly the same program as the older folks in the group who have just had bypass surgery. And to be honest, there aren't even enough of those to warrant an official classroom presentation or much instruction at all.

                            As a result, i've had a few people come up to me asking why i needed to have bypass surgery at such a young age. LoL.

                            But nonetheless... as i said, i feel very fortunate to get any rehab at all, so i won't make too big of a fuss over this. I just thought it was kind of odd how little up-front instruction i was given, and was pretty much just left alone to do my own workout.

                            Take care,

                            Jim
                            "Some days you're the dog... some days you're the hydrant."

                            Comment


                            • #15
                              Re: Cardiac Rehab

                              I still feel you should ask if they heard or recieved anything from The Cleaveland Clinic. Then you could do your own little research, by talking to someone at the Cleaveland Clinic Rehab. Just my suggestion. I think these little facilities have a lot to learn and we can help the process. I probably have a longer nose then you.
                              Pam
                              Dx @ 47 with HOCM & HF:11/00
                              Guidant ICD:Mar.01, Recalled/replaced:6/05 w/ Medtronic device
                              Lead failure,replaced 12/06.
                              SF lead recall:07,extracted leads and new device 2012
                              [email protected] Tufts, Boston:10/5/03; age 50. ( [email protected] 240 mmHg ++)
                              Paroxysmal A-Fib: 06-07,2010 controlled w/sotalol dosing
                              Genetic mutation 4/09, mother(d), brother, son, gene+
                              Mother of 3, grandma of 3:Tim,27,Sarah,33w/6 y/o old Sophia, 5 y/o Jack, Laura 34, w/ 5 y/o old Benjamin

                              Comment

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