Once at Mary Greeley, cardiologist Dotani hustled Goodmanson into the hospital’s cardiac catheterization laboratory and in an impressive 22 minutes had woven in the catheters to examine the damage. The right side of Goodmanson’s heart was 95 percent blocked; the left side contained three blockages, each 75 percent to 85 percent closed. Dotani inserted a stent on the right side, but knew the rest of the heart would require bypass surgery.
Cool It
Back in intensive care, Goodmanson, who had yet to regain consciousness, was wrapped in the “Arctic Sun,” a therapeutic hypothermia cooling treatment. Cold water flowed through the wrap to lower his body temperature about 10 degrees. This slowed his brain’s metabolism and protected it from damage that could occur from lack of blood flow and oxygen. It wasn’t until Wednesday morning, June 26, that his body temperature was brought back up to normal and Goodmanson was conscious. McFarland Clinic cardiologist Dr. Stuart Christenson consulted with him and his wife, Kim, and they agreed to transfer Goodmanson to Des Moines for quadruple-bypass surgery in early July.
A Healthy, Social Setting
By the end of July, Goodmanson was ready to tackle cardiac rehab back at Mary Greeley. In short order he’d joined the “8 a.m. crew” of fellow patients.
“We were an ornery crew,” he says now with a laugh. “We’d see how much trouble we could get into.” “The social aspects of cardiac rehab are such an important part of the process,” Sue Tjelmeland, RN-BC, with Mary Greeley’s cardiac rehabilitation unit, says. “These groups get a lot of support from one another. We find that the groups that are the most cohesive get the most out of their rehab.” Tjelmeland credits both Goodmanson and Kannel for their positive attitudes during challenging times in their lives. “Many cardiac patients deal with a lot of anxiety because things happened quickly to their bodies that they weren’t aware of, and now they have to come to terms with it,” she says. “They have to learn what they can control to help prevent future problems with coronary artery disease.” Today, Goodmanson still battles some post-bypass complications affecting his feet, but he says his heart “is in great shape.” Kannel walks several miles weekly and has lost 20 pounds since his heart attack. “Everything worked out for these gentlemen,” Tjelmeland says. “They were in the right place when their arrests occurred, surrounded by people who knew CPR and had AEDs available. This just points out how important it is for people to know how to perform CPR and follow the simple step-by-step instructions of an AED.”
AN EXTENSION OF HEART CARE C A R D I A C R E H A B I S V I TA L S T O P O N T H E R O A D T O R E C O V E RY.
Mary Greeley cardiac rehabilitation nurses Sue Tjelmeland, Patty Huisenga and Gina Smith could fill volumes with stories like Kannel and Goodmanson’s, stories of heart patients whose lives have started over following cardiac arrests. Coronary disease is often considered a men’s disease, but it affects women too. The risk of coronary artery disease for men increases significantly at age 45. For women, it’s 55. By mid-70s, men’s and women’s risks are equal. The cardiac rehab program averages 120 to 135 new participants annually in its early outpatient phase. Patients have ranged in age from 18 to 93. “We basically provide case management for these patients, making sure they get all the help they need,” Tjelmeland, RN-BC, says. “We help them with physical therapy consults, diabetes education, nutritional counseling — we facilitate it all. Our goal is to help them get on track overall to lead healthy lives.”
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Since 2002, the American Association of Cardiovascular and Pulmonary Rehabilitation has certified Mary Greeley’s cardiac rehab program. Mary Greeley nurses also base their rehab prescriptions on guidelines from the American College of Sports Medicine. “We’re an extension of the physicians,” Tjelmeland says. “By doing the ongoing monitoring of their patients during rehab, the doctors know we’ll get in touch with them if we see anything that concerns us.” Often, the nurses see cardiac patients one to two weeks following their hospitalizations, typically two to three times per week for 18 to 24 sessions. During this outpatient treatment, they help patients create a comprehensive monitored exercise program, measuring their hemodynamics during exertion (e.g. heart rhythms, blood pressures, levels of oxygen in the blood). They also set up exercise regimes for patients to practice outside of the rehab clinic. And they counsel them as patients cope with the anxieties over lifestyle changes that often came out of nowhere.