“Do I belong here?” Unintended barriers to cardiac rehabilitation

by Carolyn Thomas     @HeartSisters

It was 10 a.m. sharp when I walked into the gym where my cardiac rehabilitation classes were about to begin. The group’s coordinator was a friendly former cardiac nurse who now spent her mornings with freshly-diagnosed heart patients in the rehab program. She greeted me warmly, and toured me around the facility, introducing me to my fellow cardiac rehab buddies. And “fellow” was the apt word: it turned out that in that particular class, I was the only female heart patient in a gym filled with men. Old men. Old men who all happened to be golfers – which I would soon learn was the sole topic of their conversations.  My initial reaction was: “Do I belong here?”        .             .    

I noticed while we were introducing ourselves that I was the only participant who had had a heart attack. My buddies, by comparison, had all had open heart surgery (either heart valve replacements or double, triple and even quadruple bypass operations ). Each had called their family doctor after strange symptoms struck, tests swiftly ordered, revealing the need for that trip to the O.R. – likely preventing a heart attack. Many of the men offered generously to lift their T-shirts to show off their impressive surgical scars to me. One triple bypass veteran dramatically described his surgery as “having your whole chest cracked open like a turkey carcass!

I  also noticed that I was by far the youngest person in the room, by easily two decades.

And I was the only person there who was still working. Everyone else had retired from the workforce many years before their cardiac surgeries triggered a referral to rehab.  But I was back at work at my public relations post on a half-day return-to-work trial after my own heart attack. Cardiac rehabilitation was something I’d learned could help to prevent another heart attack down the road.  And I’d also learned that women are far more likely than men to be cardiac rehab dropouts. I was NOT going to be one of them! Having a heart attack in my 50s had been a catastrophic shock for me, and I was determined to do whatever it took to complete our full 3-month, twice-weekly program. 

My new rehab buddies turned out to be a jolly bunch. Their first question to me wasn’t about my own diagnosis, but this: “Carolyn, are you a golfer?” (Sadly, no – except for two corporate fundraising events many years earlier which convinced me that the pursuit of activities I’m that awful at doing is not good for my self-esteem).

I also noticed that most of my buddies were not that interested in exerting themselves. Two of them, for example, seemed to spend the entire 90-minute class strolling s-l-o-w-l-y on their treadmills, while chatting about their last golf game, or their upcoming golf game, or favourite courses they’d played over the years while spending winters down in Arizona. While I silently did my prescribed warm-ups, cardio, cool-downs and carefully counted reps on the weight-training circuit, most of my rehab buddies seemed happiest leaning  against the StairMaster and chatting, interrupted only occasionally by the encouraging reminders of our coordinator to actually try getting ON the StairMaster. One morning, I teased them that all they needed were a few glasses of Scotch to look like they were enjoying themselves down at the Union Club.

Once again, I couldn’t help but look around at my laid-back golfers each week and wonder: “Do I belong here?”  

Whenever I read about women’s known track record of dropping out of their cardiac rehabilitation programs, I feel terrible for them. And yet, hardly surprised.

Cardiac rehab hours have primarily been set for the convenience of program staff, not heart patients – especially if those patients are women with jobs outside the home.  Even pre-COVID, there were no evening, after-work or weekend hours of cardiac rehab classes available where I live. There was no child care or travel assistance provided. And absolutely no program funding to help pay hundreds of dollars up front for these classes. See also: Why Aren’t Female Heart Patients Showing Up for Cardiac Rehab?

Even here in Canada (our beautiful “commie pinko land of socialized medicine”), our government paid every penny of my Emergency Department visits, all diagnostic tests, all drugs, all cardiac procedures including two separate trips to the cath lab, all medical and nursing care in the CCU, my hospital bed and follow-up consultations with a cardiologist (for life!)  – but they won’t fund a cardiologist-prescribed rehab program that has been shown to accomplish the following:

  • lower our risks of death or heart attack by a whopping 25-40 per cent (that’s better than statins, by the way)
  • reduce angina symptoms
  • increase functional capacity
  • improve lipid (cholesterol) levels
  • reduce smoking by 25 per cent
  • enhance psychological well-being
  • improve exercise tolerance for all – including the elderly, frail or those with heart failure

Cardiac rehabilitation really works. And because many studies continue to confirm its proven benefits, cardiac rehab is in  fact listed by all international cardiology societies as a Class I therapeutic intervention, meaning that all eligible heart patients worldwide should be referred. Should be – but physician referral rates are generally dismal. (And by the way, clicking a tickbox on a computer screen is NOT a referral if the physician has not spoken with a patient first about rehab).  See also: Failure to Refer: Why Are Doctors Ignoring Cardiac Rehab?

But pandemic restrictions have meant that in-person cardiac rehabilitation classes like ours were temporarily no longer possible.  Instead, online programs have emerged, and these may in fact evolve into a long-lasting tele-health alternative, post-COVID.  Cardiac researchers like Dr. Scott Lear at Simon Fraser University have lobbied for years for “the development of virtual cardiac rehabilitation programs that can be remotely conducted, reaching patients in their homes and communities. These programs use a range of accessible technologies such as telephone, internet, text messaging, and smartphones.”(1)

Do I belong here?”  It’s an ironic question, really. It’s almost as if cardiac rehab programs have been set up by people trying to deliberately dissuade some heart patients from participating.  The opportunity to fast-track other options that will attract more heart patients is upon us.

It’s important for hospitals and other cardiac organizations to acknowledge that there are at least two unique types of preventable obstacles that patients face in participating in this or any other type of post-diagnosis ongoing support program:

1. The first is a passive “You don’t belong here” message (like my cardiac rehabilitation program which, because of how the program is structured  – for example, weekday-only hours – is geared to appeal to only a specific type of participant). They don’t actively refuse to sign up younger or working or female non-golfers, but they also don’t seem to examine their own demographics to even notice what kind of patients are missing. And we already know that men are far more likely to be referred to cardiac rehab by their cardiologists compared to women. In short, most cardiac rehabilitation classes are designed for old retired men who can afford winters in Arizona. We might as well hang up a shingle that reads “Retired Old Golfers Only Need Apply”. 

2. The second is a more overt “You don’t belong here” message in which organizers deliberately bar the door to some (but not all) diagnosed patients.  This seems impossible to even imagine, but consider this example shared by Abigail Johnston, a woman who has been living with Stage IV metastatic breast cancer since 2017:

“My first introduction to the division between metastatic breast cancer patients and those with early stage breast cancer was when I was asked by a social worker NOT to come to the regular breast cancer support group. Her explanation as to why I shouldn’t attend was that I might scare the other early stage participants.”

That’s like telling me that if I meet old retired golfers at cardiac rehab who insist on lifting their T-shirts to show off their triple bypass surgical scars to me, I’ll be scared off.   (Well, after the first two or three, they’re actually not that scary). 

But the reality is that if a passive barrier exists, organizers are by default endorsing a form of overt barrier.

Personally, I was able, through sheer stubbornness – despite all of those “Do I belong here?” questions – to hang in, week after week, until I ‘graduated’ from my rehab program and hugged my golfing rehab buddies goodbye.  By then, I felt better, I looked better, I slept better – I can’t say enough about what cardiac rehabilitation did for my own recuperation – both physically and (even more critically important) psychologically.

We all know how reassuring it can feel to be genuinely welcomed into any type of group, as sociologist Dr. Tracy Brower, author of The Secrets to Happiness at Work, explains:

 “Belonging is more than just about having friends, and the pandemic has brought belonging into sharpened focus.  Belonging is good for our wellbeing as humans. And when we identify with groups of humans, it can provide a lens through which we can see the world.”

1. Lear SA. “The Delivery of Cardiac Rehabilitation Using Communications Technologies: The ‘Virtual’ Cardiac Rehabilitation Program.” Canadian Journal of Cardiology. 2018 Oct;34(10 Suppl 2):S278-S283. doi: 10.1016/j.cjca.2018.07.009.
Image: H. Braxmeier, Pixabay

Q:  What more can support groups do to reassure participants that we DO belong there?

.

NOTE FROM CAROLYN:  I wrote much more about why female heart patients should complete their cardiac rehabilitation programs in my book, A Woman’s Guide to Living with Heart Disease. You can ask for it at your local bookshop, or order it online (paperback, hardcover or e-book) at Amazon – or order it directly from my publisher, Johns Hopkins University Press (use the JHUP code HTWN to save 20% off the list price).

See also:

Why your heart needs work – not rest! – after a heart attack

‘Women-only’ cardiac rehabilitation curbs depression for heart attack survivors

Do we need to change the name of cardiac rehab?

The familiar self, the unfamiliar self and the recovery of self

How expecting recovery can help heart attack survivors

21 thoughts on ““Do I belong here?” Unintended barriers to cardiac rehabilitation

  1. The University of Ottawa Heart Institute (UOHI) has an excellent web presence and rehabilitation program as well as peer support for women with cardiac disease.

    For women who live in Eastern Ontario, there is support available – check out the web site!

    Western Québec patients might qualify for online programs if they are patients of the UOHI. It never hurts to ask!

    I worked for many years at UOHI and remember when the majority of patients were men. The few women were elderly with congestive heart failure, the occasional younger woman was a transplant.

    Times really changed and we are lucky to have such outstanding cardiac care for everyone. Several years ago I was experiencing chest pain and was taken by ambulance to the ER at the Civic campus next to the Heart Institute. I was given the usual tests and although the resident was pretty sure it was GERD, after reviewing my family’s cardiac history which is impressive, I was referred to UOHI next door.

    Within days I was scheduled for a nuclear stress test and follow-up with a cardiologist. It was all good and provided future care givers with a baseline to check if I do develop cardiac issues.

    As a long time patient advocate, I cannot stress that women advocate for themselves when seeking treatment. I remember a woman telling me how she had voraciously advocated for her husband as a cardiac patient, but had lost her voice when it came to her own health. She shrugged and said “I was afraid they wouldn’t like me” when reminded that she had fought for her spouse she stated, “Oh that was different, he needed me to advocate for him.”

    So sad that she could not show herself the same grace.

    Liked by 1 person

    1. Hello Allison – I really enjoyed reading your comment this morning! The fine reputation of the UOHI extends all the way here to the west coast where I live! You were lucky to work there, and later to be referred there yourself.

      Geography is destiny. I often say to my “Heart Smart Women” audiences (only slightly kidding): “If you’re going to have a heart attack, try to have it in Victoria – where we have a state-of-the-art cardiac care facility, a strong research program that attracts learners from around the world, and 12-months of golf weather that attracts many cardiologists who want to live here!”

      But if you live in a northern community or small town or isolated rural region, your local hospital likely has limited cardiac services – if any! If you had a heart attack, you’d be air-lifted by Med-Evac to the nearest big city, often hours away.

      That story of the woman who advocated for her husband but not for herself is SO COMMON! We don’t want to make a fuss. Yet for somebody we care about needing help, we would be screaming blue murder for assistance, not caring if others liked us or not. Women continue to do this at our peril…

      I think you and I are both lucky! Take care, stay safe. . . ♥

      Like

  2. Hi again Carolyn,
    Another wonderful and informative article – thank you.

    Here is the US where all medical care, insurance and costs ‘stories’ you may hear are all true. However, I had a Cardiac Rehab program available through my insurance. Met with my RN after 6 weeks of stent placement. We went over my medicine, diet and exercise regimen in great detail. Then she sent me home with a booklet to work on my own, which has a daily tracker chart of where I should be on the scale and my weekly progress, I convey that to her during our weekly chats. The call and check-in has been of tremendous help. This is a 12-week program after which I will meet with the Cardiologist, go through a treadmill test and echocardiogram. If all goes well, I will be on my own.

    I am happy to report that at week-6, I am making good progress, and hope to get back to my running after 12-weeks. The medications are a different story, I don’t like the blood thinners, my body is full of bruises, the flu shot arm took 3 weeks to heal. Trips to the bathroom have increased considerably, sometimes I feel lethargic for no reason at all…..but overall now that I have finally accepted having the heart attack, I am feeling positive.

    Best,
    Romi

    Liked by 1 person

    1. Hello Romi – thanks for the 6-week report! That’s awesome! Such a good point about having that weekly check-in. The rest is important too, of course (exercise, diet, meds, etc) but just that regular scheduled chat to ask questions or update your nurse can mean a lot. You get weekly reminders that you’re not doing this all on your own.

      I know what you mean about the bruising! One day I noticed two perfectly round quarter-sized blue & purple bruise just below my belly button. I could not even imagine what I must have done to poke myself (twice) in my abdomen to cause such dark bruises. Then later that day, my cat Lilly jumped up on my lap while I was sitting on the couch reading – and sure enough did her ‘making biscuits’ kneading routine with her front paws before she curled into a ball on my lap to sleep. Just the force of a tiny cat’s front paws was enough to cause those bruises! It doesn’t take much. I consoled myself by the reminder that bruising shows my anti-platelet drugs were WORKING as they should!

      Good luck with your next 6 weeks until your rehab ‘graduation’! Take care, stay safe. . . ♥

      Like

  3. I had to advocate for myself in order to get into the cardiac rehab program but once I did, the instruction and support were excellent.

    However I was surprised to start having vaginal bleeding the first day of rehab as I pedaled on the stationary bike. I thought, “75 and way past menopause?” That lead to a lengthy workup that fortunately showed benign hyperplasia of the endometrium brought on by 8 years of tamoxifen to prevent a recurrence of breast cancer.

    I do understand the importance of group support as I’ve let go of regular cardio during the pandemic and plan to find a group activity for the coming Wisconsin winter so I don’t slug out again.

    Liked by 1 person

    1. Holey moley, Sara – vaginal bleeding at “75 and way past menopause”?!? NOT anything you could have possibly expected while on a stationary bike. What a shocker!

      I’m glad the diagnosis is benign, and I hope that you will be okay.

      Planning now for a winter group activity sounds like such a good idea – both exercise and socializing for the price of one. Reminds me of my sister Catherine – who just signed up for a beginners’ curling team!

      Best of luck to you.

      Take care, stay safe. . . ♥

      Like

  4. Hi Carolyn, haven’t commented here in a long time but this excellent post brought back some memories for me.

    My rehab experience was generally very positive — went through our local program twice because I have 2 stents, both in the LAD, and I think narrowly missing a heart attack both times. Received my first stent in February of 2015 (second one September 2016) and a nurse recommended rehab and I wanted to do it. It is an excellent program here with each patient receiving individual care, but only done on certain weekdays so for most people probably not convenient. I wasn’t working at the time, we were homeschooling and my schedule was flexible so it did work for me.

    I got to know the rehab coordinator and one of the nurses who I would still consider a dear friend. I think it was mostly men but I remember at least one other woman in there both times. They do a rehab reunion evening every fall and I was asked to share my experience for the 2015 one. (I love public speaking!) That year I also joined Weight Watchers (highly motivated!) and lost 38 pounds. Regular exercise and dieting made for the best time of my life physically.

    The interesting thing about all this, which for me resonates with what you wrote, is that this rehab program inspired a support group, which was made up of 5 or 6 men who had all had major surgery and had gone through the program together before I ever did and just wanted to keep meeting together. Their support group was open to anyone but not well advertised and I love support groups, had led a large homeschool group, so I started attending their meetings.

    Not long afterwards the leader of the group found he could no longer continue and guess who took it over? I think I led it for about 3 years. I did it because I needed a support group. (My motto at the time, from a bumper sticker I saw: “Get Involved! The world is run by those who show up!”)

    It grew into an official hospital program with the rehab coordinator and I working together. We met twice a month. She organized the first meeting as an informational lecture by a professional — I learned so much about the heart and how it works and met all the local cardiologists — and then my support group was the other meeting.

    Most of the time my group was all men whose cardiac issues had been much more severe than mine and I definitely felt like I was in over my head in the Good Ole Boys club. I so appreciated the 2-3 women who came semi-regularly! I think women get their support from many places, while men don’t always have a strong relationship network to draw from.

    It was a great time while it lasted. We did activities together, met for spaghetti dinners, set up an information booth once at the annual local chili fest featuring one of the doctors’ slogans for a lecture he used to give — “Is it the chili or am I having a heart attack?” Looking back now I can’t believe I coordinated all that!

    Unfortunately the whole program was poorly attended and eventually the rehab coordinator left to take a different position and then it all fell apart when the hospital stopped sponsoring it due to lack of interest.

    After awhile it became too much for me and I stopped doing the support group. But it’s too bad because I know it helped a few people a lot. I’m grateful to our hospital for sponsoring it for the time they did. And it shows what just one patient can do with the support of medical professionals.

    Thanks again for a great post, Carolyn!

    Liked by 1 person

    1. Hello again, Meghan – thanks for weighing in here to share your remarkable experiences, both attending and leading your support group.

      I love your bumper sticker quote (“Get Involved! The world is run by those who show up!”) So true! I think they must have had people like you in mind – sounds like you are the person who, when you see a need – you DO show up. Volunteer organizations worldwide function because of involved and generous people like you. I’m sure you helped far more than just a “few people”.

      I ran a guest post here about a cardiac education group in my town that’s been active for over 25 years – it was started by a woman who was alarmed by how little her Dad knew about the heart attack he had just survived. She somehow wheedled a meeting space from the hospital and recruited guest speakers (cardiologists, pharmacists, social workers, etc) to speak to groups of recently discharged heart patients (AND – very importantly! – their spouses). It helped that she was a retired nurse, so knew lots of people at the hospital. This became the “Heart To Heart” 7-week program, now fully funded by our provincial government. I was first a participant, and much later a group facilitator for this important support program. It all started with a daughter who was worried about her Dad.

      Sadly, many heart patients aren’t well enough to “show up” as much as they used to or want to.

      I also suspect you’re right about why men appreciate cardiac rehab programs (yes! even the ones who just lean against the StairMaster for the whole class). For many, it’s not just about following the recommended exercises from the rehab coordinator (as I followed to the letter!) but it’s about checking in every few days with a friendly cardiac nurse who monitors your numbers and advises on issues that may come up, and just hanging out with other men in the same boat. They find those connections at rehab that they likely do NOT find in the rest of their lives.

      Which is also ironically the reason that many women walk into groups like these and feel “I don’t belong here!”

      Take care, stay safe. . . . ♥

      Like

  5. I lived just across the river from Ottawa on the Quebec side ..there was no rehab available at that time, and I was not eligible for the Ottawa Heart Institute program, which was superb I heard.

    With no support, I finally connected with an on-line rehab video based in northern England which was useful and may help other readers.

    I always enjoy your insight and input, thanks for keeping us informed.

    Liked by 1 person

    1. Hi Karen – I’m so impressed that you took the initiative to track down your rehab video from Northern England – would you mind sharing the link to that video with us? There are a number of such virtual cardiac rehab programs for heart patients out there, but it’s good to start with one that comes with a personal reference!

      Also, ironic that you were so close to Ottawa – yet so far! I think that was called Hull when I was growing up in Ontario, right?

      Thanks for sharing your experience here. Take care, stay safe. . . . ♥

      Like

      1. hi Carolyn,
        To see the video for rehab exercises I used Google;
        (East Cheshire NHS trust cardiac rehab exercises)… there are more videos on the website http://www.BHF.ORG.UK so lots of choice.

        You Tube is the platform you can find the programs on as well. As a long retired ICU/ cardiac RN, I appreciate your
        putting into words the feelings and emotions which we can’t always articulate ourselves… thank you, it is incredibly helpful. Keep safe 🤩

        Liked by 1 person

  6. Hi, Carolyn, this is an exceptional article, and it triggered me in so many ways.

    Not so much the medical area, because Australian Medicare and private hospital insurance have made it possible for me to have access to some wonderful rehab and preventive programs, but your thought process could be applied to so many other areas — i.e. political.

    We have a dearth of women in politics in Australia for the same reasons you expressed “do I belong here?” and meeting times being set to accommodate men.

    So because of that, other things happen due to the lack of women to be agents of change– i.e. change of view on the health industry, which is a quasi-political process itself.

    I suggest that is similar in Canada and the provinces. But thank you for expressing it so eloquently– do you mind if I quote you?

    Liked by 1 person

    1. Lesley! How lovely to hear from you from Down Under! And yes, of course, you may quote all you like. . .

      Thanks so much for that very astute analogy: the barriers to women in politics are not that different from the barriers to cardiac rehab. They are both about NOT creating an environment that is as welcoming as possible to a diverse demographic. Without that, you keep getting what you have always had (whether it’s male-dominated cardiac rehab classes or male-dominated legislatures.

      It can seem like the entire system, no matter where, is designed for people who are “NOT LIKE ME!” Whether deliberately non-inclusive (like Abigail’s experience in her breast cancer support group) or incidental (like mine) this sense of “I don’t belong here” can become an overwhelming barrier.

      I often experienced this when I worked in corporate P.R. – which back then (late-1980s) was a classic ‘old boys’ club. I recall a senior territory sales manager in my company, for example (the only woman on an 8-member team of managers) who finally had to ask if her team could NOT book their after-work dinner meetings at the guys’ favourite strip club? She was new, so put up with this discomfort for the first two months so she’d be seen as a good sport, a team player – while her colleagues snickered throughout the ‘meetings’, sneaking glances at her to watch her reactions. Talk about deliberate efforts from colleagues to deny her any sense of “belonging” within this group!

      In medicine, we’re also seeing internal groups of female physicians banding together to voice their concerns over barriers to fair working conditions/advancement or leadership opportunities/equal pay in their medical careers (e.g. the Women In Cardiology #WIC group). One of their campaigns ended up published in the Journal of Women’s Health – e.g. male physician speakers are typically introduced as Dr. Smith or Dr. Jones, while female physician speakers are more often introduced by first name only (e.g. Mary, Betty). That may seem at first blush to be a minor microaggression – but what it says to women is clear: “You don’t belong here with the rest of us!”

      Thank you again for weighing in here, Lesley. Take care, stay safe. . .♥

      Like

  7. Thanks for so much for this — it gives me some spunk to continue on my quest for rehab. I’ve now found a comprehensive rehab program about an hour away, even though I live in a major metropolitan area.

    My local rehab was gutted, and the cardiac staff appear to be so stressed and strung out that they can’t even articulate a recommendation, let alone be informative. So I asked for the referral outside their service, despite their discouraging words, and will start in a few weeks, 3 months after my heart attack which I think is appalling.

    I had to be super assertive to find rehab while we are still in pandemic mode, which took energy and hopefulness I wasn’t feeling. This article gives me the reasons why I will pursue this and commit to complete it.

    What I’d like to know as follow up: is the Dean Ornish plan really so much more effective than standard rehab programs, particularly for women?

    Liked by 1 person

    1. Wow, Tomi! No heart patient should have to work THAT hard just to get registered for Cardiac Rehabilitation. I’m so glad you persevered! I hope you will get as much out of your rehab as I did during mine.

      I’m not a physician so of course can’t comment too much on the Dean Ornish plan (ultra low-fat/plant-based/exercise/social support programs) except what I’ve heard from my readers who have completed this program.

      The closest independent stat I’ve seen is that 90% of the people who complete an Ornish 18-class program are still following the program one year later compared to 30-50% of people prescribed cholesterol-lowering drugs like statins (still taking them after only six months). That’s an apples-to-oranges comparison, but you get the idea.

      Compared to ‘standard’ rehab (i.e. NOT a branded 72-hour Dean Ornish Reversal Program), the addition of the very strict Ornish dietary rules plus the general 4-hour class schedule (1 hour of supervised exercise + 1 hour of stress-management techniques + 1 hour support group + 1 hour of group meal/lecture) make this option attractive to many heart patients if they are highly motivated to complete the program and if they can afford it.

      Very few ‘standard’ rehab programs are as intensive (or as expensive) as the Ornish program. If costs are not a concern, or if it’s covered by your health insurance plan, it certainly sounds like an option that would appeal to those who are very keen on keeping themselves out of the cardiology ward.

      Please keep me posted after you complete your rehab (Ornish or any other) – so you can share your opinions of the program with our readers.

      Good luck! Take care, and stay safe. . . ♥

      Like

  8. I am a twice rehab drop out. . . sorry to say. I was referred by my cardiologist enthusiastically and had it paid for.

    I myself had one of those chest scars for a ventricular septal myectomy. There was one other woman in my class but she quit early on because fitting the class into her work schedule got way too stressful.

    I look back at why I quit and it was 3 things:
    1) It took me 45 mins each way to get to the program which was early morning and this exhausted me
    2) I did not feel any comradery, though in general I would admit I am not one that is group-motivated.
    3) I felt everything I was doing I could do at home.

    Did I do it at home??? No

    A couple things that might have improved my “compliance” might have been a choice in hours.

    But even more specifically I think these programs need to have Rehab ITPs Individualized Treatment Plans. Each person assessed and looked at individually for their diagnoses, age, medical issues, home barriers etc. – with a rehab program goal being to help each individual figure out a program of lifelong activity that will keep them healthier. So that even though you start out on professional gym equipment you are taught how to translate that into your “real world”.

    I still struggle with getting “regular exercise” decades later. Would I join Zoom Rehab?? So far I’ve managed to never Zoom anything through the entire pandemic so I don’t know.

    Thanks for your column. It always gets me thinking. 😉

    Liked by 1 person

    1. Hi Jill – translating professional gym equipment into “real world” routines at home reminds me of a friend who lifts 4-quart water-filled milk jugs instead of professional hand weights.

      I think it’s valuable feedback for group organizers to try to learn what specifically made participants drop out – or not sign up in the first place!

      A friend told me a similar story of her daughter whose job is organizing workshops for newly arrived immigrants to Canada – to help newcomers adjust to their new lives here. It’s a federally funded initiative – so lots of money to hire trained facilitators, etc. Yet her last workshop attracted only two participants. So she’s now planning to introduce financial incentives for signing up, like giving out grocery gift cards. But is that the reason people aren’t showing up? Or is it the lack of child care services, or lack of translators, or the hours the workshops are offered, or – as you found – a long travel commute? How can we fix things when we don’t even know the reasons they’re broken?

      Couldn’t agree more about the need for INDIVIDUALIZED plans. Same with Zoom. Most people I know are feeling Zoomed-out by now (although having said that, I just got off a 2-hour Zoom chat with my three paper crafting buddies; we have been meeting every Sunday morning since March 2020 when COVID started. We get to do our own artwork while we chat about life, and then hold up our finished projects for ‘show & tell’ at the end! Today, I attended in my jammies! I also have a friend who’s been “meeting” via Zoom with her personal trainer for that long too. She says, also like you, YES I could exercise at home on my own – but she knows she won’t without that regular support!

      Every person is unique, yet every program offered may or may not meet the unique needs of that person.

      Take care, stay safe. . . ♥

      Like

  9. I live in Ottawa – I went through the cardiac rehab program at the Ottawa Heart Institute. It’s an excellent program, fully funded by OHIP (Ontario Health Insurance Plan)

    Liked by 1 person

    1. Hello Joan – because health care in Canada is run by provinces, each province can make up its own rules! Another reader just told me that her own rehab program was not funded because it was “experimental”.

      You’re so lucky to live near the Ottawa Heart Institute! Take care, stay safe. . . . ♥

      Like

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