Cardio-Rehab Drop out

[Bob-Veveka]

  I am a cardio-rehab drop out!  Had bypass 8 weeks ago, and started cardio rehab last week.  After one day in the program, I determined that it was not for me, and my doc agreed.  The problem is I am in excellent physical shape, age 52, didn't have a heart attack, and exercise regularly.  I stopped smoking 8 weeks ago on my own.  I don't need the group support, and need to work much harder to get to my target heart rate. I am a fairly disciplined person, and the bypass certainly raise the flag for me. I do need to make changes in my life however.  I need to lose 30-40 pounds, and reduce my cholestrol from 203 to around 160 (hopefully w/o medication.  My LDL is about 115.)
  My insurance pays for cario/rehab program, but I couldn't see them paying for the program I was in, where I feel I was getting little benefit or motivation.  I also feel that I need to be enthusiastic about a program as well.  
  Is there any type of cardio rehab program available that is tailored to the individual?  Can a primary care physician develop a cario-rehab program, and contract for outside services? Is there any type of immersion program (e.g. Duke/Pritikin) that would qualify for cardio rehab?  

[CCF Cardio MD - MTR]

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Dear Bob, thank you for your question.  Cardiac Rehabilitation is very important for patients with coronary artery disease.  The primary goal is to teach patients life-long techniques of exercise, dieting, weight-loss, and health-conscious living habits.  It sounds like you were an active person before your surgery, but you still have a lot to gain from a rehab program.  For you, daily aerobic exercise (30-45 minutes), a low-fat and low-cholesterol diet, continued smoking cessation, and successful cholesterol reduction will maximize your long-term benefit from your bypass surgery.  Some cardiac rehab programs are individually tailored so maybe you could check with the rehab centers in your area to determine if they offer such services.  I don't think a primary care physician can personally develop a cardiac rehab program because such a program requires exercise physiologists, technicians, and exercise equipment.  Duke does have an immersion program in their cardiac rehab center that I think is called Live for Life so maybe you could check that out.  However, you must remember that it will be expensive to develop your own cardiac rehab program and your insurance may not cover such a program.  It would be best to check with your own cardiologist.
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.   The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.