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by Jane Kitchen 

The Central East Regional Cardiovascular Rehabilitation Service, which offers individually-customized education and exercise training to nearly 4,000 patients a year, has significantly enhanced support for patients with congestive heart failure.

Heart failure occurs when the heart is not pumping as strongly as it should, causing the body to not get the right amount of blood, oxygen and nutrients it needs to work properly. This can result in leg swelling, shortness of breath, fatigue and a reduced quality of life. In fact, heart failure is the leading cause of hospitalization for the elderly in Canada.

Patients with heart failure receive excellent care across the region from family physicians, specialists, hospitals and specialized clinics. The Central East Local Health Integration Network (LHIN) supports this excellent care through its ongoing investment in the regional cardiovascular rehabilitation service. This service develops self-management skills to help patients who are dealing with cardiovascular disease get on track to a heart-healthy lifestyle, and reduce their risk of future heart attacks, death or hospitalization. Now, it has been expanded with a congestive heart failure (CHF) enhancement.

“Cardiovascular rehabilitation is an essential component of care for heart failure patients,” says Dr. Joe Ricci, vascular health physician lead, Central East LHIN. “Since last fall, the service has grown to provide heart failure patients across the region with added education, counseling and assessments specific to their needs.”

One of these patients is Meryl Buen, who has been living with a diagnosis of heart failure since January of 2014. Following a second pacemaker implant, she enrolled in the regional cardiovascular rehabilitation service at the Legends Centre in Oshawa last October. Originally afraid of exercising at all, Buen now walks for 35 minutes five times a week.

She is thankful for the self-management skills that the program has taught her, particularly what she has learned through the CHF enhancement. “I’ve learned that heart health and lifestyle can lengthen your life,” she says.

This is exactly what the new heart failure specialists with the regional service, Mohan Singh, nurse practitioner, and Beth Ferguson, registered nurse specialist, want to hear. Since the specialized CHF enhancement was launched in September 2015, they have seen more than 355 heart failure patients throughout the Central East LHIN at the 13 community and hospital-based sites where the regional cardiovascular rehab service are offered — including Scarborough, Pickering, Ajax, Whitby, Oshawa, Port Perry, Bowmanville, Cobourg, Peterborough, Lindsay, and Campbellford.

“Many of our heart failure patients join the regional cardiovascular rehabilitation service after being in the hospital,” says Singh. “The first week after they come out of the hospital is important for a seamless transition to self-care at home. Without support, their condition can fade quickly and they may end up in the emergency department. Our goal is to teach these patients self-care skills so they can manage their condition at home and avoid going back to the hospital.”

Patients are enrolled and begin the program within seven days of referral or discharge from hospital. At the first visit, staff create a rehabilitation plan for patients and ensures that they are connected with their primary care provider and specialists for ongoing medical care. Singh or Ferguson will go over how to monitor the condition at home, including reviewing a heart failure zones chart, which ranges from green (all clear) to red (an emergency).  

“We teach patients how to make positive changes. We also make sure to include the family in these discussions, as their support is crucial,” says Ferguson. “We make recommendations to patients on how to change their diet, review how to take their medications effectively, and stress the benefits of exercise.” 

For Buen, she has learned how to modify her diet by watching her sodium level and limiting her fluid intake to no more than two litres per day. She even worked with a registered dietitian to reevaluate her relationship with food. Her condition has improved to the point where she no longer has to think about a heart transplant, which was previously being considered. 

“It’s wonderful support to go to cardiovascular rehab, especially with the care they take with heart failure patients,” says Buen. “Beth (Ferguson) and the team would go over any concerns I might have. There’s no fear; they won’t push you. They teach you to listen to your body. The service reinforces and builds on all the excellent care I receive from my family physician and my cardiologist.”

For more information or a referral

For questions or to learn more about the regional cardiovascular rehabilitation service, please call 1-855-448-5471or at 416-281-7022. To participate in cardiovascular rehab at one of the 13 sites closer to where community members live and work, a physician referral is required, which can be faxed to 416-281-7280. Download the regional cardiovascular rehabilitation referral form.

About the Central East Regional Cardiovascular Rehabilitation Service

The Central East Regional Cardiovascular Rehabilitation Service is a six-month exercise and education program that helps participants to get on track to a heart healthy lifestyle. This service is specially designed for community members with a vascular disease, or who are at high risk for a vascular condition — with risk factors such as a history of smoking, diabetes, high-blood pressure, high cholesterol, obesity, and an inactive lifestyle. Thanks to $1 million in funding and ongoing investment by the Central East LHIN, the regional service has expanded to 13 community and hospital-based sites in Scarborough, Pickering, Ajax, Whitby, Oshawa, Bowmanville, Cobourg, Port Perry, Lindsay, Peterborough and Campbellford —closer to where patients live and work. All participants are within 30-minutes travel distance of one of these facilities. Since the launch of the regional program in 2012, the number of patients participating in the program has continued to increase leading to reduced risk of hospitalization and the need for clinical interventions, and an overall improvement in patients’ blood pressure, level of fitness, smoking cessation and quality of life.