Mending an (almost) broken heart

Six years ago on a typical cold prairie morning, Bob Haennel took his springer spaniel out for their usual walk. He suddenly felt discomfort in his chest. A non-smoker and frequent gym-goer at age 49, he didn't think it was a heart issue.

"But after experiencing it two mornings in a row, I knew I had to go see a doctor," said Haennel, a professor of cardiac rehabilitation in the University of Alberta's Faculty of Rehabilitation Medicine.

He soon found out he had heart disease and needed quadruple bypass surgery. Fortunately, he found out sooner rather than later, and before he had a heart attack.

Haennel's research centres on how to help cardiac patients in the 75-80-plus age group regain strength and improve their ability to do daily activities after a heart attack. The combination of his career and his personal experience has given him particular insight into heart disease.

"I think most men like to deny there's something wrong, and we never think it could be the heart. But I learned that when in doubt, go see a physician.

"It used to be believed that cardiac patients shouldn't lift weights, but now we know that if they learn how to lift a weight properly-exhaling when they lift the weight up, and doing multiple repetitions with moderate amounts of weight-they can safely do resistance training and regain their strength. They can go home and move groceries and do other daily living activities," Haennel said.

For all cardiac patients, it's important to make lifestyle changes. Many who've had Percutaneous Coronary Interventions (PCI, previously called angioplasty or balloon angiosplasty) or bypass surgery feel much better, but sometimes forget they still have the disease.

"You need to make changes. Control your stress, change your diet and exercise," said Haennel. "For me, I was living a healthy lifestyle before the surgery, but I still made changes. I read nutrition labels now and check the fat content. I watch the hidden fats, like what's in salad dressing."

Before the surgery Haennel, a self-proclaimed "health nut," ate meat only once a week. Now, he still eats meat once a week but only eats bison. "It's got less fat than other meats," he explained.

Haennel can't stress enough just how crucial exercise is. "I know 'be active' is easy to say but hard for most people to do. But make exercise accessible. If you like swimming but it takes 20 minutes to drive to the pool and you only have an hour in your day to exercise, you probably won't go. Make exercise convenient so you can easily fit it into your daily routine," he said. Haennel works out every morning where his office is located.

Haennel has particular words of advice for smokers. "Quit smoking. There's no way around it. It is essential. It's not easy but you need to do it."

Haennel is part of the Canadian Association of Cardiac Rehabilitation, a national leader in cardiovascular disease prevention and rehabilitation. The association is releasing new guidelines for cardiac rehabilitation this year.

Cardiac rehabilitation teams consist of physicians, nurses, dieticians, physical therapists, psychiatrists and sometimes occupational therapists. In Edmonton, cardiac rehabilitation programs are available at the Glenrose Rehabilitation Hospital and the Grey Nuns Hospital.

"It's a team approach. Nurses are the first point of contact for most patients. Physical therapists help with exercise and develop exercise programs; psychiatrists deal with stress and coping with the disease; dietitians deal with the nutrition aspect, and cardiologists oversee the process," Haennel said.

Cardiac rehabilitation has proven to be quite beneficial, for most people who experience PCI, bypass surgery, heart attacks or heart failure, he says.

"After a medical procedure such as PCI, people feel better and some choose not to attend cardiac rehabilitation. Others who experienced a heart attack or heart failure are apprehensive about cardiac rehabilitation. However we need to remind ourselves that these programs offer health professionals with the expertise needed to help patients make healthy lifestyle changes which will reduce the risk of future heart problems," Haennel explained.

"Some people think they're too old to worry about exercising and making changes, or they already feel better after surgery, but they still need to exercise. Lifestyle changes are vital to everyone with cardiac disease."

Photo by Laurie Wang

About the University of Alberta Faculty of Rehabilitation Medicine
As the only free standing faculty of rehabilitation in Canada, the University of Alberta Faculty of Rehabilitation Medicine balances its activities among learning, discovery and citizenship (including clinical practice). A research leader in musculoskeletal health, spinal cord injuries and common spinal disorders (back pain), the Faculty of Rehabilitation Medicine aims to improve the quality of life of citizens in our community. The three departments, Occupational Therapy (OT), Physical Therapy (PT) and Speech Pathology and Audiology (SPA) offer professional entry programs. The Faculty offers thesis-based MSc and PhD programs in Rehabilitation Science, attracting students from a variety of disciplines including OT, PT, SLP, psychology, physical education, medicine and engineering.