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Tryin’ to Get Down to the Heart of the Matter

9/26/2016

 
On a Friday evening last December. Dr. Robert Marchi thought he was experiencing a bad case of indigestion.  It persisted through the weekend, but cleared up by Monday.  However, Dr. Marchi made an appointment with his regular doctor, just to be cautious.

There were no sharp pains or other traditional warning signs of a heart attack, but his physician, also preferring to err on the side of caution, made an appointment with a cardiologist for him – again, just in case.  Dr. Marchi, the principal of P.S. 17 in Williamsburg for the past 16 years, was in generally good health, and had a regular gym routine that included a 10-mile stationary bike ride four days a week.

Of course, as you have probably guessed by now, the “indigestion” was not indigestion at all.  It was a heart attack.

Within days, heart surgery was performed and a stent was inserted.  Cardiac Rehabilitation (CR), that is, a supervised exercise program, was strongly recommended.  The problem was – and still is – that no such rehab facility exists on Staten Island.

I’m trying hard to understand why it is that we accept the need to crack open someone’s chest, cut into a person’s heart, stitch ‘em up, and then simply release the patient to find a rehab facility in some other borough.  Studies have shown that there is a significant decrease in mortality rates for patients who studiously follow their recommended CR: as much as 20 to 30 percent.  To not have such a facility on Staten Island is unconscionable.

In the case of Dr. Marchi, his decision was to return to his gym – not an easy decision to make and not one he was completely comfortable with.  “I was very apprehensive returning to the gym,” he told me, “for fear of having another heart attack while I was there.”

We have two hospital systems here on the island.  Two.  It is not too much to expect cooperation from them on this. A CR facility is not just a luxury – it is a necessity.  While such a joint effort may not be a large money-making proposition, insurance reimbursements guarantee that it won’t be a money-loser, either.  And with the value-based shift in covering healthcare costs, the time is, without a doubt, now.

“There definitely needs to be a facility located on Staten Island that provides the trained professional medical staff and the appropriate rehabilitation programs and equipment that can be properly monitored in a setting that provides total confidence to the recovering patients.”

Those are the words of Dr. Marchi.  He gets right to the heart of the matter – and I couldn’t agree with him more.


NOTE:  Decreases in mortality rate obtained from various sources including:
http://www.cmaj.ca/content/156/4/527.full.pdf
http://thefristclinic.com/hl/?/655517/Exercise-based-Cardiac-Rehabilitation-May-Decrease-Risk-of-Death-and-Future-Heart-Procedures
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