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February 19, 2013

Cardiac Rehab Helps Washington Hospital Surgeon Recover - for 14 Years

Gordon C. MacLeod, M.D., now age 82, had been a general surgeon at Washington Hospital for 23 years in May 1999 when he ended up needing surgery himself.

"I was out jogging and got a funny pain in my collarbone," he recalls. "I thought it was muscular and ignored it. The next day, I went jogging, felt the pain again, and again ignored it. The third day, I went jogging and when I felt the pain again, I was smart enough to stop running. The pain went away, but when I started to jog again, it came back. That's when I decided to call a cardiologist."

At the time, Dr. MacLeod's cardiologist at Washington Hospital was David Berke, M.D. After examining Dr. MacLeod, Dr. Berke ordered a treadmill stress test, which indicated that Dr. MacLeod might have myocardial ischemia - a condition in which blood flow to the heart muscle is decreased by partial blockages of the heart's arteries.

Cardiac ischemia can reduce the heart's ability to pump efficiently. A sudden, severe blockage of a coronary artery may lead to a heart attack. Cardiac ischemia also may cause abnormal heart rhythms.

"Dr. Berke decided to do an angiogram, which showed such severe blockage of my coronary arteries that he put me in the hospital right away on heparin - a type of blood thinner - to make sure I didn't have a heart attack while waiting for surgery," says Dr. MacLeod. "Two days later, I had bypass surgery on four coronary arteries, performed by cardiac surgeon Dr. Brian Badduke at Washington Hospital. About six weeks later, I joined the Cardiac Rehabilitation Program at Washington Hospital, and I've been in the program ever since - except for brief periods when I went through knee replacements for my left knee."

The Washington Hospital Cardiac Rehabilitation Program is now entering its 28th year of helping heart patients return to an active lifestyle after experiencing cardiac events.

"Over the years, we've worked with thousands of patients, some of whom - including Dr. MacLeod - have been in the program for many years," notes Cardiac Rehabilitation Manager Phyllis Fiscella, R.N., who joined the program in November 1985 as a nurse clinician. "In any given month, we have between 700 and 900 patient visits."

The Cardiac Rehabilitation Program offers one-hour exercise sessions under the close supervision of an exercise physiologist and a registered nurse. During exercises, the patient's heart is connected to portable monitoring equipment. In addition, registered dietitians from Washington Hospital provide counseling in heart-healthy diets and for managing diabetes, which can be a contributing factor in heart disease. A cardiologist who serves as medical advisor also is available as needed.

"The program can help improve overall physical condition, strengthen hearts, control blood pressure and blood sugar, reduce stress and anxiety, and restore patients' self confidence," says Ms. Fiscella. "It's very rewarding for us to see the dramatic difference in our patients, not only in terms of their physical health, but also in their mental outlook."

Patients usually participate in three sessions a week on Monday, Wednesday and Friday at various times throughout the day. Most insurance providers, including Medicare, will cover 12 weeks (36 sessions) following an acute cardiac event. The program offers the option of continuing after insurance coverage has expired, for a nominal fee of $8.50 per visit.

"They started me out gently, with light weights and easy machines, gradually building up to more strenuous exercises," says Dr. MacLeod. "One of the best aspects of the program is the emphasis on safety. The exercise physiologist and nurse are always there, as well as a defibrillator. The staff keeps tabs on you. If they notice anything out of the ordinary, they'll call your doctor. They're pro-active about watching out for you. For me, it's also a great advantage that the program is structured, because I appreciate the discipline. I go at the same time in the afternoon, three days a week."

Ms. Fiscella notes that during his 14 years in Cardiac Rehabilitation, Dr. MacLeod has served as a role model for other patients in the program.

"He not only has attended our exercises sessions here regularly, he also has played golf and tennis, and in the winter, he has enjoyed skiing and snowshoeing," she says.

A Colonel in the U.S. Air Force prior to joining the Washington Hospital medical staff, Dr. MacLeod had always been a trim, fit man. With no history of high blood pressure or diabetes, he had no known risks for heart disease except that his father and some of his father's siblings had died of heart attacks.

"I had noticed that my LDL cholesterol - the 'bad' cholesterol - was high, and the HDL, or 'good,' cholesterol was low, but back then I didn't pay as much attention to it, and I tried to control it with exercise," says Dr. MacLeod. "After my heart surgery, I later discovered that I have a genetic defect that causes the good HDL cholesterol to be low, so now I take medications for that."

Dr. MacLeod, who retired from his medical practice at Washington Hospital in 2002, also now has a pacemaker, installed in 2003 to correct a slow heart rhythm. That hasn't deterred him from his workouts in the Cardiac Rehabilitation Program, either.

"Some people stay in the program only for the period that's covered by insurance, but I am very glad I've continued to participate," he says. "Paying $8.50 per session is pretty reasonable, especially in view of the professional staff and the help they offer. I also have gotten to know a number of other people who have stayed in the program. We definitely have a common bond."

Participation in the Cardiac Rehabilitation Program requires a physician referral. For more information about the Cardiac Rehabilitation Program, visit www.whhs.com or call (510) 494-7022.