CARDIAC REHABILITATION

Cardiac rehabilitation is a medically supervised individualized program designed to improve the quality of life in terms of physical, mental, spiritual and social functioning after a cardiac event. The final goal is to stabilize, slow and when possible to reverse the progression of cardiovascular disease, reducing the possibilities of another cardiac event or early death. Rehabilitation should start as soon as the patient is medically stable. This concept is already established in developed countries but is yet to gain momentum in developing countries including India.
Today, Homoeopathy has achieved its due place in the medical fraternity. It is also seriously attempting to develop itself on scientific lines so as to shoulder its responsibility of catering the Sick in this era of fast changing disease scenario. Apart from its domain of holistic care, it has proved effective in managing cases where advanced pathological changes have effectuated. Although, technological advances have enabled us to precisely localize pathologies, yet the cure for many such disorders remains a dream. It is here that scientific homoeopathy is playing a vital role. Today, an inter-disciplinary approach is the need of the hour. It requires an understanding of the separate contributions made by other disciplines within the ambits of their fundamentals and the integration of that information into a unified whole. This shall reflect on our services to our patients.
The National Academy of Homoeopathy, India is committed to the propagation and advancement of Scientific Homoeopathy. It has already taken a leap towards this goal of Cardiac rehabilitation by establishing a separate department of homoeopathic cardiology in 2004 at Nagpur. Our cardiac rehab program entitled “Dil Ki Seva (A)Dil Se” includes:
1. A detailed history is taken as soon as the patient registers. It includes the causation, onset, modalities, symptoms of heart disease, life-space, mental state (before and after the cardiac event), physical generals and their alterations, past, personal and family history. 2. Initially, if the patient is symptomatic, palliative homoeopathic remedies are used. Once settled then the patient is prepared to receive Constitutional Homoeopathic treatment.
3. Counseling the patient and care takers so that they can understand how homoeopathy can help them to manage the disease process and the patient.
4. Beginning an individualized structured exercise program
5. Diet planning - increased intake of fibers, reduction in saturated fats, change of cooking oil to sunflower or safflower; and reduction of quantum of common salt.
6. Helping the patient modify maintaining factors of heart disorders as mental stress, smoking, alcoholism, other addictions, physical inactivity, obesity, etc.
7. Providing vocational guidance to enable the patient to return to work. Account is taken of the type of work, the environment and patient’s psychological state.
8. Supplying information on physical and sexual limitations
9. Lending emotional support to tackle depression (42%: our centre) and anxiety (31%: our centre) that are the most frequent accompaniment of any heart disease.
10. Educating the patient that almost everyone with heart disease can benefit from some type of cardiac rehabilitation. No one is too old or too young and emphasizing that the most important person in the rehabilitation team is the patient. Patients should be encouraged to take charge of their own recovery.
11. Underlining the fact that feedback is an important requirement for deciding the correctness of the first prescription, to decide the second prescription, potency selection and other auxillary measures that are adopted for management. It should be in the form of a daily dairy or record book.
In our experience, the long-term success of any such program is directly related to patient compliance. Evidence suggests that such a holistic approach is the only sure way that benefits patients. And those who quit smoking and tobacco significantly reduce their risks of another heart attack, sudden death, stroke and total mortality compared with those who continue to smoke.
We have found that when supervised by a homoeopathic physician, cardiac rehabilitation is helpful to patients with
1. Angina pectoris and recent myocardial infarct,
2. Patients who have undergone recent Coronary artery bypass graft surgery or PTCA (Balloon angioplasty)
3. Congestive heart failure (stable),
4. Pacemaker implant candidates for heart blocks,
5. Heart valve replacements
6. Persons with peripheral arterial disease,
7. Patients with congenital heart disease who may or may not have had surgery
8. Heart transplant recipients.(We still have not had any transplant candidates at our centre)
Infine - Combining all aspects of cardiovascular rehabilitation in appropriate patients improves functional capacity, quality of life, reduces or eliminates maintaining factors and curtails the miasmatic evolution of the sickness. This in turn creates not only a sense of well-being but also optimism about the future. So dear homoeopaths, let us start rehabilitating our cardiac patients!