SIUH’S NEW CARDIAC REHABILITATION FACILITY FOSTERS A TEAM APPROACH BETWEEN PATIENTS AND PHYSICIANS
BY JESSICA JONES GORMAN • PHOTOS © AMESSÉ PHOTOGRAPHY
Staten Island University Hospital unveiled its new Cardiac and Pulmonary Rehabilitation Center this past June, offering borough residents a comprehensive solution and long term treatment plan for many of their heart and lung ailments.
“There are very few things in medicine where, after completing 36 sessions, your life expectancy can be increased by 10 years,” noted Dr. Leonard Lefkovic, director of cardiology for SIUH South, who was instrumental in the center’s development and creation. “Cardiac rehabilitation is designed especially for patients after heart surgery or other cardiac events to help them return safely to a healthy life. If heart surgery is like an engine repair for your car, cardiac rehab is the tune up before you get back on the road. And the opening of a program like this right here on Staten Island is very exciting news.”
The center is ideal for patients who have had a heart attack or who suffer from coronary artery disease (CAD), heart failure, or angina, Lefkovic explained. Treatment is tailored to those who have undergone coronary artery bypass graft surgery, angioplasty, stenting, valve replacement, TAVR, or congestive heart failure.
“Studies have shown that participation in a cardiac rehab program can lessen a patient’s chances for another cardiac event re hospitalization and help control heart disease symptoms such as chest pain or shortness of breath,” Lefkovic said. “There is some evidence it can stop or reverse coronary artery occlusive disease and lessen the physical and emotional effects of heart disease. It improves patients’ stamina and strength and helps get them back to their usual activities, such as work, hobbies, and exercise. It certainly has the potential to improve confidence and well being.”
During the 36 session program, participants undergo supervised exercise on a treadmill or bicycle while they are monitored via cardiac telemetry. Data is transmitted to a cardiologist for review when needed. The rehab staff will assess each patient’s personal risk factors for heart and blood vessel disease and begin and maintain a personalized exercise plan that works for them. Each patient will then receive a psychological stress assessment and counseling.
The staff will provide education and support to help a patient make healthy lifestyle changes, including maintaining a healthy weight, heart healthy eating, and avoiding tobacco. Also encouraged is participating in monitoring and getting better control of blood pressure, lipids, cholesterol, and diabetes. Patients receive additional instruction on effective communication between themselves and a physician, and when to seek medical treatment.
Lefkovic, who at a young age lost his father to heart disease, said this type of treatment can be “lifesaving.”
“My father’s death was the driving force behind my decision to become a cardiologist,” he said. “I was only 19 when he died, and I decided that if I could help even just one family not go through what I did, it would be worth it.”
Lefkovic, who is board certified in cardiology and internal medicine, attended Albany Medical College and then completed his internship at Albany Medical Center Hospital and a residency at Staten Island University Hospital. He completed a fellowship in cardiology at Connecticut’s Hartford Hospital, and in 1985 became an attending physician at SIUH and joined Island Medical Specialists, a multi specialty group.
“So much has changed within this specialty over the past 30 years,” he said. “When I first started, if you had a heart attack or heart failure, no matter what your age, you weren’t going to survive much more than a couple of years,” Lefkovic said. “But that was before all of the new cholesterol meds and stents and angioplasties. With all of the medical advances that have transpired over the past 30 years, people with heart disease can live to be over 100 as long as they commit to living a healthy life.”
That new reality is the basis of one of the tenets of medicine that he fully embraces: health is a partnership between doctor and patient.
“My feeling is that patients have to do their share of the work,” he said. “We’ll give you the medications and take care of the necessary procedures. You have to eat right, exercise, and live an overall healthy existence.”
An avid runner who took up the sport as a hobby in 1969 and has since run six New York City Marathons, Lefkovic lives his own advice. “Long before the data showed that exercise helps just about everything, I’ve felt very strongly about the power of physical movement,” he said. “It’s undeniable that cardiovascular exercise has a positive impact on the body.”
SIUH’s new Cardiac Rehabilitation Center supports that belief. “This is a stellar rehab program that encompasses everything a patient with heart disease needs to achieve a longer life,” he explained. “Dieticians teach patients how to eat properly, exercise physiologists teach them how to exercise properly. And this program isn’t just 36 visits, it’s a lifetime worth of changes,”adding that there’s a common misconception about what the aftermath of treatment will consist of. “Patients don’t understand that even though they feel better after a stent or bypass, they’re not cured; they have heart disease, which is based on their genes or lack of exercise and bad diet and bad habits. If they do nothing, those blocked arteries will return. We clear the blocked arteries with surgery and stents, temporarily fixing the problem, but it’s the patients who have to change, too.”
Pulmonary rehabilitation is also addressed at the center, and participation in the pulmonary program can benefit patients with a wide range medical concerns, including COPD, bronchiectasis, sarcoidosis, pulmonary hypertension, pulmonary fibrosis, interstitial lung disease, lung cancer and lung cancer surgery, lung volume reduction surgery, and lung transplantation.
“Although pulmonary rehabilitation does not ‘cure’ lung disease, it can be of great functional benefit to the patient,” Lefkovic said. “They may notice an improved breathing effort and less breathing problems. Further, they may experience an improved ability to function better in the activities of their daily life, an increased ability to exercise, and a decrease in symptoms related to anxiety and depression.”
Pulmonary patients are offered education classes that focus on COPD as well as other chronic lung diseases, providing them with information about medications and their side effects, the use of an inhaler, and a range of self care techniques. The use of oxygen therapy as well as the importance of diet, nutrition, and weight management are also addressed, and there is a focus on breathing retraining, the importance of exercise, and strategies for managing breathing problems.
Exercise therapy for both the cardiac and pulmonary divisions is supervised by registered nurses and a team of highly experienced ICU nurses, plus exercise physiologists, a respiratory therapist, a dietician, and a psychologist.
“They are truly interested in engaging, and producing the best possible long term outcomes,” Lefkovic said. The best part of this local program? It’s completely geared toward the wellness of local residents.
“This is a Staten Island based program for Staten Islanders,” Lefkovic concluded. “I’m elated that finally our patients who live here and have cardiac or pulmonary problems no longer have to travel to receive this important treatment. This is a comprehensive program that ensures a patient gets healthy and remains healthy.”
Staten Island University Hospital / Northwell Health
475 Seaview Avenue / 718.226.9000 / northwell.edu