Knoxville Man Builds Healthy Heart Practices with Parkwest Cardiac Rehabilitation

Greg Mangan and his wife Jodie own a driving instruction academy and enjoy taking long walks together. Mangan knew he had a heart murmur, or an irregular heart rhythm, as a result of rheumatic fever that he suffered as a child. Yet he remained active through adulthood by biking, skiing and playing softball without experiencing any severe health problems.

But when symptoms of heart failure appeared last year, Mangan underwent an aortic valve replacement at Parkwest Medical Center. He recovered with the help of Parkwest’s cardiac rehabilitation program and continues to improve every day.

Surgery at Parkwest

“I didn’t have the typical symptoms of a bad valve,” recalls Mangan. “I sometimes became winded walking uphill, but it was slowly getting worse. After speaking to the doctors and getting all the tests done, it turns out my heart valve was in critical shape.” In aortic valve replacement surgery, a poorly working aortic valve is replaced with an artificial valve. This ensures that blood can exit the heart and flow out to the body normally.

After being evaluated by Ayaz Rahman, MD, for a transcatheter aortic valve replacement (TAVR) procedure, it was determined that Mangan needed open heart surgery. His expert cardiology team at Parkwest Medical Center included John Hance, MD, cardiovascular surgeon; Michael Maggart, MD, cardiothoracic surgery specialist, and cardiologist John Meriweather, MD, who ensured Mangan’s heart was in a regular rhythm before leaving the hospital.

“I woke up after the surgery — I took that as a good sign,” he laughs. “I did not have any pain. The doctors did a great job. I was just looking forward to getting back to my life and
feeling better than I had before.”

Recovery and Healing

After surgery, Mangan was prescribed cardiac rehabilitation, a medically supervised exercise pro- gram for people who have had heart surgery or a health event involving  the heart or lungs. He began attending daily exercise sessions at Parkwest Cardiac Rehabilitation. Mangan began in December and completed the program in February, just before Valentine’s Day. Parkwest is one of the few cardiac rehab programs in the nation that offers rehab five days per week, and patients complete the program in approximately five weeks.

Most programs have patients come in three days per week, so the program takes about three months to complete. Patients’ physical abilities are assessed at the beginning of the program, and they are asked about personal goals.

Exercise and Nutrition

Exercise programs are individualized for each person and increase in difficulty through the duration of the five-week program. Rhonnda Cloinger, MS, is an exercise physiologist who has
served as a certified cardiac rehab professional (CCRP) at Parkwest Cardiac Rehabilitation since 1995. Cloinger says Mangan was a motivated patient who didn’t miss a day of exercise. “When we did his assessment, I learned he didn’t exercise on a regular basis,” Cloinger says. “He was active; he snow skied and did a yearly 150-mile bike ride, but he didn’t have a regular  exercise routine. I think after he finished the program, that was one thing that stuck out to him. If he got into a routine, he would get stronger and build endurance, so he could more easily do those physical things that he feels passionately about.”

Increasing Difficulty

Each week, Cloinger increased the difficulty of Mangan’s exercise prescription. “He was attentive, motivated, and realized those small incremental changes were valuable,” she recalls.
“He pushed himself and was interested to see how much he could do.” Nutrition education classes are also an important part of the cardiac rehab program. Mangan  and his wife are eating more fruits and vegetables, cut back on processed meats, and switched from mashed potatoes to roasted potatoes. He says, “We have made several adjustments to our diets. Nev- er before have I had nonfat yogurt. Now I’m eating it regularly with fruit.”

The Big Picture

Cloinger says Mangan “was enthusiastic and saw the benefit of cardiac rehabilitation. He wanted to lose weight, improve his fitness ability to perform daily activities and return to work. He met all those goals and he doubled his MET level, which is a unit of measurement that has to do with how much oxygen is required per minute to do any type of activity or exercise. “The higher the MET level an activity or exercise has, the more oxygen it takes per minute to perform that activity or exercise. This greater demand for oxygen requires the heart to be
conditioned enough to pump the required amount of oxygenated blood per minute.” She explains, “Think of it as the number of watts a light bulb can produce per minute when it is
turned on.”

Mangan increased his exertion level and was doing 50-minute workouts by the time he finished the program. To keep up his momentum, he joined a local gym so that he would not miss a day of exercise following his graduation from cardiac rehab.

His advice? “ What I want people to know is if they have a heart issue of any kind, Parkwest is the best. From the time I found out I had to have surgery all the way through cardiac rehab, everybody was great. I would definitely recommend this program. All the staff was pleasant. At the hospital, one of my nurses gave me a handmade star that said I was the funniest person she had met this side of Texas.” To learn more about cardiac rehabilitation through Parkwest Medical Center, call (865) 531-5560 or visit TreatedWell.com/cardiacRehab.

Parkwest Cardiac Rehab –A Prescription for the Heart

To combat the effects of heart disease and negate risk factors such as high blood pressure and high  cholesterol, physicians often prescribe cardiac rehabilitation. This heart-strengthening program includes gentle exercise with the guidance and supervision of a team of nurses and exercise physiologists. Each “exercise prescription” is personalized for every patient. Our team of trained healthcare professionals works with patients one-on-one to help them achieve their best health after a heart event.

Heart-Healthy Tips from a Registered Dietician

Allison Bridges, RD, LDN, registered dietician, explores healthy patterns of eating with each of her cardiac rehab patients. As part of the cardiac rehab program, she leads group classes and one-on-one sessions. “With Greg Mangan, one goal we identified was to eat more whole fruits and vegetables, which helps with blood sugar management and has overall wellness benefits for the heart and whole body,”  she says. “We eat more processed foods than we realize. Identifying food swaps to cut out some of the added sodium and added sugar is where we can really make a difference.”

Tips for better heart health

1. Read labels – “Be a savvy consumer. Look at the nutrition label and read the ingredients. Be aware of what’s in the food you eat. Or better yet, eat something like a banana with no ingredient list at all.”
2. Break it down – “Take broad goals like ‘eat more fruits and vegetables’ or ‘eat less fast food’ and break them into smaller goals. That might translate to eating take-out only once per week and cooking more meals at home. It might be adding fruit to your breakfast a few days a week until it becomes an automatic habit.”
3. Give grace – “Be graceful and forgiving with yourself. The ultimate goal is long-term, manageable changes, not an overnight shift in all behaviors.”

Bridges advises that weight management and stress management also help improve mood and overall well-being. The more we can curb our unhealthy habits, the better
the happier our hearts will be!