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Stan Chandling

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Health Chatter

Cardiac Rehab

1104.034

So who provides the care? Are they actual physicians? Are they doctors? a cardiac rehab therapist, who, who, who would I be seen if I had the vet and I needed to do cardiac, who would I be seen?

Health Chatter

Cardiac Rehab

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We'll get into the aspects of prevention, the primary prevention and the secondary in our discussions, and also, obviously, in cardiac rehab. He's held many leadership roles in this arena. and is very, very well respected, not only at the state level, but also nationally as well. So Dr. Thomas, thank you. Thank you so much for being with us today.

Health Chatter

Cardiac Rehab

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So when I come to the clinic, I'm using me as kind of a guinea pig here. I come to a clinic for my first cardiac rehab. And who meets me at the door? Is it the exercise physiologist? Is it all 10 of those people that you just mentioned? I mean, who literally meets me at the door?

Health Chatter

Cardiac Rehab

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Right, right, yeah.

Health Chatter

Cardiac Rehab

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But there's always that one point of entry at the desk, I guess, and then you kind of go from there.

Health Chatter

Cardiac Rehab

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That's great. So one thing I alluded to before we started the show is in the case for cardiac rehab, we're really dealing with a secondary prevention, the acute treatment and kind of into the disease management end of things. In most situations, and correct me if I'm wrong, it's after there has been an event of some sort or a dire need. Is cardiac rehab or does cardiac rehab focus on

Health Chatter

Cardiac Rehab

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primary prevention? In other words, okay, use me as the guinea pig here. Stan hasn't had an event. Stan is on a cholesterol medication, and he takes aspirin and hasn't fortunately had an event. Would Stan benefit from cardiac rehab?

Health Chatter

Cardiac Rehab

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Yeah. So, all right, let's start out first of all, cardiac rehab. Why don't you give us like a little bit of a historical perspective on cardiac rehab as it stands and, you know, kind of bringing us up to the present.

Health Chatter

Cardiac Rehab

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Interesting.

Health Chatter

Cardiac Rehab

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medicare covers what did you say 36 usually 36 sessions 36 okay all right so now let's talk about the primary prevention what would they cover how many sessions would they cover in that arena they would cover 36 fewer sessions okay so there's our problem right yeah yeah so there are some uh

Health Chatter

Cardiac Rehab

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Yeah. So do you ever connect with like, or is there a potential to connect with programs that exist out in the community like silver sneakers, for instance?

Health Chatter

Cardiac Rehab

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Hello, everybody. Welcome to Health Chatter. Today's episode is on cardiac rehab. We've got a wonderful guest with us. We'll get to that in a second. My name is Stan Chandling. I'm one of the co-hosts for the show, along with my other Host for the show is Clarence Jones, who you'll be hearing from throughout this show as well.

Health Chatter

Cardiac Rehab

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So Clarence, you know, in the community that you work with, is there clarity around cardiac rehab or the need for it? You're on mute.

Health Chatter

Cardiac Rehab

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Yeah. You know, the logistics of it gets, gets in the way, you know, and you know, you, you know, access to clinics and care, you know, and, and travel, et cetera. So, you know, one thing I do want to bring up is, um, the linkage of the whole concept of cardiac rehab with public health. Okay. So, you know, which has kind of been near and dear to my heart all these years. So, um,

Health Chatter

Cardiac Rehab

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Just recently, and maybe you were made aware of it, the Department of Health, it was just a week or so ago, came out with a report that Minnesotans are missing out on life-saving cardiac rehab opportunities. And Some of the findings that they found, and by the way, this was just based, I believe, on 2017 data, but it always takes a while to get all the data in and analyze.

Health Chatter

Cardiac Rehab

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But less than a half of qualified patients initiated cardiac rehab within one year of a qualifying event. I mean, that's... in my mind, that's kind of frightening. Adults ages 45 to 64 years were most likely to initiate cardiac rehab. Older adults over 85 were 48% less likely to initiate. Okay. And so it's like,

Health Chatter

Cardiac Rehab

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and it kind of goes on women, for instance, are 10% less likely to participate in cardiac rehab than, than men, which is kind of counter to what I would normally think. It seems to me that, you know, women are kind of more, shall we say a little bit more health conscious overall, but in this case, um, not. So my question to you, Randy, is this, um,

Health Chatter

Cardiac Rehab

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Where do you see a place for the clinical aspects meeting on the bridge with public health in order to expand cardiac rehab messaging and implementation?

Health Chatter

Cardiac Rehab

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It's been going on for a while. Right, yeah.

Health Chatter

Cardiac Rehab

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Give me a for instance.

Health Chatter

Cardiac Rehab

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You know, we have a colleague, And you do too, Dr. LaPrincess Brewer down at Mayo there. And we've had her on the show. And Clarence and I have been involved with her faith work, working in churches with the African-American population. And, you know, my question to you is, does cardiac rehab use apps or

Health Chatter

Cardiac Rehab

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like on phones or devices, you know, such as, you know, a cardia, you know, device or an Apple watch or those types of things to aid in the cardiac rehab.

Health Chatter

Cardiac Rehab

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Yeah. So Clarence, what do you think about all this? You're on mute.

Health Chatter

Cardiac Rehab

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And you know, and we have to, and one of the things, you know, generally speaking, the state of Minnesota is a heart healthy state. Right. Okay. But, but yeah, but we have disparities and, um, and I'm, I'm guessing that the cardiac rehab arena adds to the disparities, especially if people aren't taking advantage of them. So, um, Going forward, that's an important message.

Health Chatter

Cardiac Rehab

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Absolutely. Yeah. She's a great, great colleague. Great colleague. So, um, Randy, last thoughts.

Health Chatter

Cardiac Rehab

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And hopefully these types of mechanisms, you know, through podcasts and different ways to communicate with people will heighten will help to heighten the awareness of it and the importance of it going forward.

Health Chatter

Cardiac Rehab

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And, you know, that's encouraging. That's really encouraging just to know that, that there's enough interest in it professionally to really drive it forward. Last thought, Clarence?

Health Chatter

Cardiac Rehab

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Yeah, whenever there's updates, just give us a holler and we'll be happy to have you on on Health Chatter once again. So thank you for being with us. Everybody, happy holidays coming up to everybody. We have lots of great shows in line for us for 2024. So stay tuned for all of those and keep health chatting away.

Health Chatter

Cardiac Rehab

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You know, it's interesting because, you know, you think about just about any kind of surgery, for instance, or an event, you think that Everything's got to be rehabilitated somehow. Like, for instance, somebody has a replaced knee. Guess what? You better do your exercises. Otherwise, the recovery, frankly, is going to be a lot slower, for sure, that we saw in that arena. Similar in this.

Health Chatter

Cardiac Rehab

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We've got a great crew that makes all these shows very, very successful for us. Our research crew includes Maddie Levine-Wolf, Aaron Collins, Deandra Howard, and Sheridan Nygaard. Sheridan also provides some marketing expertise for us. And then our production manager is Matthew Campbell, who makes sure all these shows get out to you, the listening audience.

Health Chatter

Cardiac Rehab

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The other thing is that I think most people, I think they realize that the heart is a muscle. But on the other hand, when it's hurt, when you have a heart attack or when you have surgery, a stent, for instance, that's put in, it's still a muscle. And the muscle can get stronger really by working it, even though it has been affected, it still can get to a better place going forward.

Health Chatter

Cardiac Rehab

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So, all right, let's talk about, all right, you kind of brought us up to a certain point. Now let's talk about, you know, based on your experience as a physician, what are some of the current goals for cardiac rehab?

Health Chatter

Cardiac Rehab

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Our sponsor for this show is Human Partnership, which is a community health organization in the state of Minnesota. They do wonderful work, community health oriented work. And I highly recommend that you check out their website at humanpartnership.org, as well as our website at healthchatterpodcast.com.

Health Chatter

Cardiac Rehab

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So let's play this out a little bit. I had a dear friend who had to have a stent put in. And one of the things, and she contacted me afterwards, and she said, Stan, what about, this basically was the question, what about cardiac rehab? And so my answer was, do it. Just do it. Don't fool around. Do it.

Health Chatter

Cardiac Rehab

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And then one of the major concerns that she had was communication between her cardiologist and her primary care provider. Okay, so that there's a linkage of information flow going forward. Do you deal with that?

Health Chatter

Cardiac Rehab

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So let's play this out. Go ahead, Clarence. And then I've got a play out situation here.

Health Chatter

Cardiac Rehab

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With that, I'd like to introduce our guest today is Dr. Randall Thomas, who's a professor of medicine at Mayo Clinic, Alex School of Medicine, and is a consultant in preventive cardiology at Mayo Clinic. His clinical research has focused primarily on preventive cardiology.

Health Chatter

Cardiac Rehab

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Okay. Okay. So, all right. Does that depend upon the type of an event that a patient has? So if it's heart attack or if it's surgical or if it's, let's even go to the ultimate end, you know, a transplant. How is that determined?