{"id":73707,"date":"2024-01-22T12:33:00","date_gmt":"2024-01-22T19:33:00","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=73707"},"modified":"2024-02-07T05:38:15","modified_gmt":"2024-02-07T12:38:15","slug":"cardiac-rehab-center-denver-helps-man-whose-heart-stopped-for-8-minutes","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/cardiac-rehab-center-denver-helps-man-whose-heart-stopped-for-8-minutes\/","title":{"rendered":"Life-giving cardiac rehab helps patient whose heart stopped for 8 minutes"},"content":{"rendered":"
<\/div>
\"Bill
Bill Kelker on a stationary bike during a cardiac rehabilitation session at UCHealth Steadman Hawkins Clinic Denver. Exercise physiologist Kendall Knetzger, behind the desk, and Joanne Deacon, RN, keep an eye on him and other participants as they exercise in ways precisely calibrated to boost heart function over 36 sessions. Photos by Cyrus McCrimmon for UCHealth.<\/figcaption><\/figure>\n

Bill Kelker looks out over the snowy fairways of the Inverness Golf Club as the morning fog lifts. He is walking on a treadmill in a bright corner of UCHealth Steadman Hawkins Clinic Denver<\/a>\u2019s third floor. He does so in a highly prescribed and closely monitored fashion. For three minutes, he walks 9.1-degree incline at 3.4 miles per hour. Then, for two minutes, he will dial it back to 2.5 mph at a 2.5-degree incline. He will repeat this cycle four times, after which he will ride a stationary bike for 20 minutes and then do a bit of strength work.<\/p>\n

Kelker, a youthful 68, is walking, riding and lifting for his life. Considering where he was just a few months ago, that\u2019s understandable.<\/p>\n

An EKG<\/a> device in a blue fabric pouch he tied to himself like a tiny kitchen apron transmits his heart rate to a console over in the corner. There, Kendall Knetzger, a UCHealth exercise physiologist, and fellow exercise physiologist Linnea Magee monitor the heartbeats of Kelker, and five fellow exercisers partake in Steadman Hawkins\u2019 newest service, launched in October: cardiac rehabilitation.<\/p>\n

On Knetzger\u2019s screen, Kelker\u2019s heart rate appears along with a seismograph-like trace of his EKG data. It\u2019s at about 110 beats per minute during the faster, steeper interval on the treadmill. That\u2019s about 110 beats per minute more than it was for eight or so minutes on May 17, 2023.<\/p>\n

The heart attack<\/strong><\/h2>\n

Kelker had been to his local gym that Wednesday morning, lifting weights and doing a bit of cardio. Back at his Denver home, he had read through his emails \u2013 despite having an eye on a Sept. 1, 2023, retirement, he was still employed at a wholesale floor-covering business, and there was work to do. Then he hopped in the shower.<\/p>\n

That\u2019s all he remembers. Because, despite the hours a week in the gym and the long walks with wife, Jeanne, and the routine cardiac checkup three weeks before (nothing out of the ordinary, besides slightly high cholesterol), a chunk of arterial plaque broke loose and lodged in his heart\u2019s left anterior descending artery.<\/p>\n

\"Kelker\u2019s
Kelker\u2019s 25th session at a cardiac rehab center in Denver started with 20 minutes on a treadmill.<\/figcaption><\/figure>\n

That particular blockage causes a heart attack known as a widow-maker, and it very nearly made Jeanne one. But she acted quickly. She heard the thump of her husband collapsing on the shower floor, found him unconscious, and immediately dialed 911. Paramedics got there fast. They detected no pulse, turned her husband over on the bathroom floor, pressed the defibrillator paddles to his chest, and zapped his heart back into action.<\/p>\n

They rushed him to the nearest hospital. Kelker\u2019s heart stopped twice more as doctors attempted to clear the artery. They would place two stents to restore blood flow. But Kelker was in a bad way, and things would get worse before they would get better.<\/p>\n

For two-and-a-half weeks, Kelker lay intubated and unconscious in an ICU. He would spend roughly the same amount of time on an inpatient floor after that. His list of ensuing complications included cardiogenic shock<\/a>, septic shock, pneumonia, metabolic encephalopathy<\/a>, and acute kidney injury. He needed an Impella<\/a> left-ventricle pump, a feeding tube into his stomach, and, to help him breathe after the ventilator tube was removed, a tracheostomy<\/a>. He lost 24 pounds and had to learn how to swallow, talk, and walk again. But there was also good news: Somehow, Kelker\u2019s brain had come through the long heart stoppage without damage.<\/p>\n

He finally came home on June 23, 2023, 38 days after admission. Jeanne rented a bed for the main level because her husband couldn\u2019t make it up the stairs. He was doing physical and occupational therapy, but his cardiologist also wanted him to do cardiac rehabilitation.<\/p>\n

Why cardiac rehabilitation?<\/strong><\/h2>\n
\"The
The UCHealth Steadman Hawkins cardiac rehab center opened on Oct. 11, 2023.<\/figcaption><\/figure>\n

Cardiac rehabilitation delivers proven benefits<\/a> for patients with heart failure and those recovering from heart attacks, as well as procedures ranging from valve replacements to heart transplants. Yet in metropolitan Denver, cardiac rehabilitation centers are closing their doors rather than opening them. Kelker was rebuffed from one program entirely and put on a two-month waiting list in another. Then, he got wind of the new Steadman Hawkins program. He was there on the program\u2019s very first day.<\/p>\n

Cardiac rehab specialists determine the participant\u2019s heart function and then monitor it over 36 sessions (that\u2019s what insurance typically covers). Each lasts 90 minutes, two to three times a week, and focuses on moderate exertion. How \u201cmoderate\u201d plays out in practice will depend on each patient\u2019s baseline capabilities, health status, estimated VO2<\/sub> max<\/a>, resting heart rate, estimated maximum heart rate, and other factors.<\/p>\n

In Kelker\u2019s case, that\u2019s a heart rate of between about 105 and 120 beats per minute once he gets warmed up, Knetzger says. As the heart gets stronger, those heart rates will deliver more blood to the body, and that manifests in improved METS, a key cardiac rehab metric.<\/p>\n

\"Kelker
Kelker checks his heart rate on his watch as he rides the stationary bike. It\u2019s also being monitored via the EKG device he and fellow UCHealth Steadman Hawkins patients wear during their cardiac rehab sessions.<\/figcaption><\/figure>\n

METS stands for metabolic equivalents. One MET is the energy it takes to sit quietly in a chair. Two METS is twice that, and so on. A study looking at the METS<\/a> of various activities pegged cooking at 2.5 METS, playing basketball at 11.1 METS, and rowing fast at 19.1 METS. On his first day in cardiac rehab on Oct. 11, Kelker managed 3.6 METS \u2013 roughly the output of someone who is weeding, bowling, or fishing.<\/p>\n

On his 25th<\/sup> visit two months later, that same moderate effort yields 7.9 METS, which could have him backpacking uphill with a 44-pound pack. That\u2019s a roughly 120% improvement in heart function.<\/p>\n

Building confidence at cardiac rehab center in Denver<\/strong><\/h2>\n

Kelker has moved to a stationary bike. His heart rate is 134 beats per minute. A drop of sweat collects at the end of his nose.<\/p>\n

Knetzger notes this. \u201cWhat are your watts at?\u201d she asks, referring to another measurement of energy output, this one displayed on the bike.<\/p>\n

\u201cNinety-six to 103,\u201d Kelker pants. \u201cI\u2019m maybe getting a little carried away.\u201d<\/p>\n

\u201cYeah, you are getting a little carried away, aren\u2019t you,\u201d Knetzger says.<\/p>\n

\u201cI\u2019ve been scolded by Joanne,\u201d Kelker admits. He eases up.<\/p>\n

Joanne is Joanne Deacon, the UCHealth registered nurse who leads the cardiac rehab center\u2019s four class sessions every Monday, Wednesday, and Thursday. She happens to be standing next to Knetzger. She explains that the team is fine with participants pushing it a bit, but they need to let the staff know because adaptations from exercise reduce the heart rate required for a given amount of power over time \u2013 and unsafe rhythms can also happen with these patients. (There\u2019s always a cardiologist on call during cardiac rehab sessions.)<\/p>\n

Kelker\u2019s motivation is more than boosting his longevity for his sake and that of his wife Jeanne, son Jesse, and daughter Sydney, and for granddaughters Penelope, 3, and Lucy, 1. He wants to be as healthy as he can for as long as he can and knows that exercise is medicine.<\/p>\n

\"The
The cardiac rehab session wraps up with about 15 minutes of strength and flexibility work.<\/figcaption><\/figure>\n

He\u2019s also doing a once-weekly physical therapy session with Steadman Hawkins physical therapist Matthew Lopez. Lopez emphasizes leg, core, and shoulder strength, as well as improving balance. Kelker is working out on his own based on what he has learned in cardiac rehab. While patients can self-pay and continue with a maintenance class after the 36th<\/sup> session \u2013 Kelker says he plans on doing so \u2013 the aim is to provide patients with a sense of how to best exercise for heart health so they can continue on their own in the years ahead.<\/p>\n

\u201cWhat this is all about for me is confidence \u2013 the confidence to know what to do, how long, and how hard,\u201d Kelker says.<\/p>\n

Despite his cardiologist\u2019s assurances that the odds of another heart attack are low \u2013 and lower yet given the work Kelker is putting in \u2013 Kelker says he occasionally does feel anxiety about the possibility of another heart attack. But he soon subdues it.<\/p>\n

\u201cI keep telling myself, \u2018That\u2019s why I\u2019m doing this,\u2019\u201d Kelker says.<\/p>\n","protected":false},"excerpt":{"rendered":"

Bill Kelker looks out over the snowy fairways of the Inverness Golf Club as the morning fog lifts. He is walking on a treadmill in a bright corner of UCHealth Steadman Hawkins Clinic Denver\u2019s third floor. He does so in a highly prescribed and closely monitored fashion. For three minutes, he walks 9.1-degree incline at […]<\/p>\n","protected":false},"author":23,"featured_media":73717,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[6],"tags":[9184,3512,3300,130],"class_list":["post-73707","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-healthy-living","tag-cardiac-rehab","tag-heart-and-vascular-care-cardiovascular","tag-heart-surgery-treatments","tag-rehabilitation"],"acf":[],"yoast_head":"\nCardiac rehab center in Denver helps man whose heart stopped for 8 minutes - 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