This article originally appeared in The Time of Your Life special section, Spring 2016.
The 25th annual Older Americans Conference is 9 a.m. to 1 p.m. Wednesday, May 18 at the Elks Lodge (4131 Pine Road NE, Bremerton). Is is free and open to the public.
Jerry Mecham and Karen Kline are shining examples of how cardiac conditioning can help heart attack survivors regain their physical stamina.
Mecham, 70, had congestive heart failure and had to have open heart surgery in May 2015. His heart was enlarged and he had to have an LVAD, a pump to help his heart work, inserted in his chest. The LVAD helps the left ventricle pump blood to the aorta. The aorta is the main artery that carries oxygen-rich blood from the heart to the body.
“I was always so weak,” Mecham said. “I couldn’t even walk from the front door to my truck.”
But after his surgery, he began to feel better. Still, his ability to walk and his breathing weren’t what they should be. So his cardiologist sent him for physical therapy.
He chose Kitsap Physical Therapy and Sports Clinics in Kingston.
“The doc said I needed cardiac physical therapy,” Mecham said. “I hated the idea. I’d never been to physical therapy before and the idea of somebody telling me I had to do this or that wasn’t what I wanted.”
But he went along with the idea and found the physical therapists at KPT to be wonderful.
“Those guys, they really watched over me,” he said. “I was assigned to one of them each time I came in and they kept track of my pulse and watched how I did things.”
At first, he could only do one minute on the stationary bicycle. That amounted to about 200 feet in distance.
“We worked up to two minutes and now we’re at seven,” he said, noting that that’s one and a half miles. “I do two sets of seven minutes with a break in-between.”
He can also do seven minutes on the treadmill, usually two or three sets. And he uses an arm bicycle which works his upper body. In the four weeks that he’s been in cardiac rehab therapy, he’s seen a great deal of improvement in how he feels and what he can do.
“It’s a marked improvement,” he said. “I can walk to my truck without feeling tired and I even walk the dog.”
Currently, his time at the physical therapy gym is every Monday, Wednesday and Friday for an hour, first thing at 8 a.m. sharp.
“I hate exercising,” said the former Washington state ferry captain who retired in 1997. “But I hate being out of breath more. Boy, have they ever been helpful. I can tell that the physical exercise is helping.”
After his retirement from the ferry system, he went back to work for the state Attorney General’s office as a witness for the state. He also worked for 14 years at Coast-to-Coast Hardware in Poulsbo. He’s active in the community and hopes to have more good years in him.
His short-term goal, however, is to be able to put on his socks.
“I can’t do that yet,” he said. “I can’t bend over to do that. But I’m getting closer.”
While Mecham knew he had signs of heart trouble, Kline did not. Also 70, Kline owns her own business and encountered significant stress in the year prior to her heart surgery.
“I just thought it was indigestion,” she said of her chest pains. “As women, we don’t realize that that’s a sign of heart problems.”
She made a trip to the emergency room, but her heart issue wasn’t caught that day. It was a few weeks later when she told a friend about how she was feeling.
“The friend said ‘You need to go to a cardiologist right now,’” Kline said.
She made an appointment with Dr. John Banzer, a cardiologist with The Doctors Clinic in Silverdale.
“He told me I needed surgery,” Kline said. “They had to put in a stint.”
She said she didn’t realize how her stress had affected her body. And soon after surgery, her doctor sent her to cardiac physical therapy. She, too, chose Kitsap Physical Therapy in Kingston.
“At first I thought this was just another way to milk the insurance companies,” she said. “But they assigned me to Rich (McDowell), and he got it that I was a type A personality. He helped me get the stress under control.”
Like Mecham, she’d never had physical therapy before and wasn’t much of an exerciser.
“They taught me how to breathe properly from the stomach,” she said. “Because I am exercising and using my yoga breathing, my heart rate and my blood pressure have dropped.”
Now she wears a FitBit so she can monitor her own vitals.
“In a way, it’s taught me to fix myself,” she said. “I’m focused on the fix because I don’t want to be a victim.”
After several weeks working with a physical therapist, she’s continuing her training on her own. She’s met another person in rehab at Kitsap Physical Therapy and now they work out together twice a week.
Still working in her retail business, and working with her husband at their Christmas tree farm, she never wants to retire.
“My goal is to stay healthy, stay active and stay alive,” she said. “I’m still having a lot of fun.”
Any time Rich McDowell, a physical therapist at KPT, gets a new patient, he’s ready.
At KPT there’s a standard protocol when introducing a cardiac patient to exercising, once he or she has had a cardiac event.
“We do a full evaluation on them and assess the risk factors before we ever get them up and going on equipment,” McDowell said. “That includes a muscular, skeletal and orthopedic study, and we assess their cardiovascular health.”
A stress test, where the patient walks on a treadmill to see how long they are able to maintain their walking, is common.
“With all that, we have a base measurement and we can formulate a treatment plan and set appropriate goals,” McDowell said. “Cardiac rehab has always been offered by KPT, but in the past five or six years we’ve developed a formal program. We knew there was a need to offer something locally. Many of the people who needed it around here (Poulsbo and Kingston) were having to drive to Bremerton to get it. We saw the need and we jumped up and met it.”
The program is well known at all KPT locations and many of their patients come by way of word-of-mouth.
“We are always having conversations with the local cardiologists and surgeons,” McDowell said. “We’re proud of this program. But many of our patients learn about us from other patients who’ve been here.”
Steve Goldrick, another KPT cardiac rehab specialist who practices at the KPT Silverdale Clinic, said cardiologists, surgeons and family physicians, and friends refer patients to KPT.
Goldrick has been a physical therapist with KPT for five years. He’s a board-certified orthopedic clinical specialist. He’s a doctor of physical therapy and specializes in orthopedic work, occupational therapy, chronic pain management and cardiac rehab.
Just how long the rehab will last, depends on the patient, Goldrick and McDowell said.
“It varies,” McDowell said. “Some (patients) have a history of exercise and we just need to guide them. Some have never exercised and we work with them to make it a part of their lives. Getting it to be a routine is the goal.”
A physical therapist works one-on-one with each cardiac patient to watch their heart rate and make sure that they are doing their exercise correctly. McDowell finds that once a patient gets a treatment plan and begins walking on the treadmill, and sees improvement, they are committed.
“That helps keep them coming in three times a week,” he said.
Once patients are released from physical therapy they receive a 30 day pass to use the gym and to encourage them to continue exercising on their own.
He stressed that continued cardio exercise can be as simple as a walk in the neighborhood, or using equipment like a treadmill at home.
“In many rural places, there are no gyms close by,” he said. “What do you do if there’s no where to work out? Just getting out and moving is the key. Start to move the body again and get into an exercise routine.”
Goldrick said patients who have had a heart attack or heart surgery need someone who understands how they are feeling.
“They’ve been knocked down a peg,” said Goldrick. “They’re not up to the level they were before the heart attack. They’re frustrated and they want to be able to do what they’re use to doing.”
The job of the physical therapist is to walk along side of them and be a coach and a booster.
“We’re there to help them reach their goals,” Goldrick said. “But that’s not just about exercising. It’s about being able to do what they were doing before, things like their hobbies.”
McDowell, also a board-certified orthopedic clinical specialist, has been a physical therapist for 16 years, learned about cardiac rehab during an internship in a hospital cardiac unit. He’s aware that some people who have had heart attacks or strokes, or heart surgery, are reluctant to get going again.
“I saw that in my own family,” he said. “My grandpa had a stroke and was prescribed physical therapy following that. I had a hard time convincing my grandma that he needed to get moving. She kept saying all he needed was rest. But once she saw him improving, she saw he needed it.”
Goldrick said the patients can be hesitant.
“Having a heart attack is extremely stressful,” he said. “There is a degree of hesitancy because they don’t want another event. So it’s a balancing act and that’s where physical therapists come into play. We are there to make sure they are working at a level that is right for them.”
As for a national trend that shows fewer women with heart conditions are referred for cardiac rehab, McDowell isn’t seeing that in Kitsap County.
“We have an equal balance of men and women here,” he said. “There’s just so much research out there that shows the benefit of aerobic exercise that people are understanding its value, especially when they have or have had heart problems.”
Goldrick said KPT is different from other physical therapy places because it’s owned by the physical therapists.
“We’re hometown people,” he said. “Many of us grew up around here. We have a certain sense of pride in watching our business grow and making sure our patients are satisfied.”
And, he said, in many cases, the physical therapists are able to keep in touch with their former patients because many decide to continue their exercising at KPT fitness gyms.
“We will see each other coming and going,” Goldrick said. “They’ll tell me how many minutes they’re doing on the treadmill, or say ‘check out my grip strength.’ I love being able to keep in touch with them and make sure they’re doing well.”
Kitsap Physical Therapy and Sports Clinic has locations in Silverdale, Bainbridge Island, Poulsbo, Kingston, Port Orchard and Bremerton and was founded in 1979.
Its mission is to play a valuable role in helping the people living in our communities to overcome the physical limitations (and sometimes mental) restrictions that interfere with their ability to fully participate in their activities of daily living.”
For more information or to make an appointment, go to www.kitsappt.com.