SRMC Week 2

Even though I don't have different "rotations" here at SRMC, I have spent most of the end of last week and beginning of this week working with cardiac patients. The dietitian I have been working with works on the cardiac floor, in cardiac rehab and on a general medicine/surgery floor, where a lot of the patients have cardiac issues. Yesterday morning we went over the cardiac rehab center. What I liked most about it was the fact that it is Medicare/Medicaid sponsored, so it wasn't restrictive in terms of who can afford to go. The population in this county is the poorest in the state, so a cardiac rehab program that isn't Medicare/Medicaid eligible would exclude almost all of the residents of this area. The cardiac rehab program is housed in the fitness center that the hospital owns. During normal business hours, some of the exercise equipment is roped off from the general equipment, and there is a nursing and medical staff. The patients have specific appointment times, in two hour blocks, that they come to the center. They first get baseline data taken, like heart rate and blood pressure. For the first two weeks that they are involved in the program, they were a heart monitor throughout their entire workout session. After the first two weeks, they are monitored both before and after their exercise. Each patient who enters the cardiac rehab program is required to meet with the dietitian at least once. For most patients, this is the only time they meet with an RD. Some of them are interested though, and the RD will meet with them as many times as they want, while they are in the program. The patient we saw Monday morning was very interested in changing her diet and we are meeting with her again tomorrow to follow up and provide more information. She had just had a triple bypass, and was beginning her road to recovery. I was impressed by how many changes she had already made, and how willing she was to learn any new changes. The dietitian said she really was the exception in this cardiac rehab program. A lot of the patients are willing to start exercising, but very few want to make any real dietary changes. The food is a huge part of the culture in the area, and making changes makes it harder for them to fit into their own culture. The dietitian tries her best to reach these patients, but has learned that getting them to make one small change, like no longer cooking vegetables in a fat back, is usually the best she can do.