Several times a week you can find Jim Eveleno doing squats, lifting weights, and running on the treadmill, with a trainer at his side. Eveleno wouldn't dare miss his workout, but he isn't your ordinary gym rat.
Eveleno, 57, had a heart attack last January while he was at work. He was rushed by ambulance to a hospital, where he had two stents implanted. Unlike many cardiac patients, who fall off the exercise wagon after finishing hospital rehabilitation programs, Eveleno has made fitness a way of life.
“Your whole body is in panic mode. You can’t breathe. 'You think, what is going on?'” recalled Eveleno, who was hospitalized for two weeks and placed on seven medications after his heart attack. "The worst part was not being able to catch my breath going up a flight of stairs, and after three steps you can’t walk. It was really terrible.”
Eveleno is not alone in fighting a chronic disease by incorporating fitness into his daily routine. Many patients, who are understandably shocked when they have a heart attack or are diagnosed with a chronic disease like diabetes or multiple sclerosis (MS), are making positive changes in their lives, including working out regularly and eating a healthy diet.
Speaking about his new fitness regimen, Eveleno said, “I’m not 100 percent now, but if I had not started a fitness program it would have been disastrous.”
While Eveleno was still in the hospital, he read about the importance of fitness following a heart attack, and after doing some research he found Bodhizone Physical Therapy and Wellness in New York City. The facility offered a phase 3 and 4 cardiac rehab program, which follows a hospital's phase 1 and 2 program.
“It was like having a private nurse around the clock. They monitored my blood pressure and pulse. I couldn't lift a five-pound weight. They worked me through it. They helped me with my balance and endurance," Eveleno said. "I was in bad shape. Now I’m doing up to 100 pounds of free weights with a machine that helps me keep everything lined up correctly. I lost 40 pounds and I am gaining back a lot of lung capacity. It’s always a challenge and it’s always really fun.”
Managing Depression and Anger
Working out also helped Eveleno manage his depression. “I didn't realize that people who have heart attacks go through a huge depression and a major rage that you don’t see coming. All of a sudden you find yourself screaming at your father on the phone for no reason. That was really tough, but working with these guys really helped me manage the depression. I am also sleeping better,” said Eveleno.
Eveleno’s recent follow-up exam with his doctor confirmed that he is on the right track. "My doctor said, ‘I can’t believe you are the same person I saw six months ago. I would never have recognized you. We are going to keep you on the same medications until February.’ That is huge. I don’t have to visit him until then,” Eveleno said.
Eveleno’s progress has convinced him to continue working out at his local gym once his cardiac program ends. Although he doesn't foresee himself dancing every night like he used to, he said, “I’ll continue in the direction we are going. I am wearing pants I hadn't worn in ten years, that I couldn't put on. I have 10 more pounds to go.”
Helping Cardiac Patients Recover
Dr. Scott Weiss, DPT, owner of Bodhizone Physical Therapy and Wellness, worked with Eveleno. He told Healthline that resistance training, flexibility, and strengthening bone mineral content to protect bones are all crucial in helping cardiovascular patients recover.
“We talk about body composition (body mass index) and make sure that is in check. We also check flexibility levels, through sit and reach. We’ll do balance tests and we do some function tests, to see how well a person can lift a box from the floor over their head. If they have to reach under the cupboard or under the sink to grab something, what techniques do they use and is that putting pressure on the heart?” said Weiss.
Photos of Jim Eveleno courtesy of Bodhizone Physical Therapy and Wellness.
A functional capacity test and MET (metabolic equivalent test) also tell physical therapists how strong a patient’s heart and lungs are.
“It’s a way for the doctor and therapist to talk about exercise, strength, and endurance with the heart. If you can only do three METs of exercise, that might not be enough for you to mow the lawn or push a cart around Costco. If you can’t do that, we will direct you not to do those things. That’s how we figure out what’s safe and what is not safe," said Weiss.
Realizing that heart attack patients like Eveleno feel isolated, Weiss said, “We purposely go out of our way, from the therapist to the trainer to the tech setting up equipment. Everyone knows who Jim is, and we try to make it like a family. The more a patient feels they are part of something and that everyone cares, the better the outcomes we have. Jim finished cardiac rehab and has continued training sessions. It’s not just exercise. He totally changed his life around," said Weiss.
Eight-Time Ironman Fights Diabetes
Andy Holder was fit and muscular, having been a competitive body builder, so when he was diagnosed with type 1 diabetes at age 35, he was floored.
“It really made me angry. My sons were age two and six months, and the thought of them growing up seeing me as diseased, with an insulin pump, and having to test my blood sugar all the time ― I wasn't having any part of it. I still wanted my sons to see me as a superhero. I didn't want them to see somebody who sometimes gets almost crippled with the ill effects of diabetes and low blood sugars,” Holder told Healthline.
So Holder taught himself how to swim and began to train for the Ironman Triathlon, an event that includes a 2.4-mile swim, followed by a 112-mile bike ride, and then running a 26.2-mile marathon.
“I was going to not only manage the disease, but use it as a catalyst to do something extraordinary, so that anybody who looked at me could be inspired, whether they are struggling with diabetes or they are a parent of a child who has diabetes and is worried about their child’s future,” said Holder.
Holder, now 46, has logged eight Ironman Triathlons. “The hardest thing was going from not having a disease to managing a disease that is 24/7. You are never not thinking about diabetes, planning your next meal, counting carbs, reading labels, weighing food, and testing your blood sugar," Holder said. "The metaphor of training for an Ironman shows how an endurance event and training for it has a parallel for what you have to put in every day for diabetes.
"You can’t always control what happens to you, but you can control what you do about it. With a positive attitude you can map a course of anything you want to do in life, even in the face of adversity like diabetes,” Holder added.
Photo of Andy Holder courtesy of Bob Scott at BobScottNYC.com.
Holder, who has traveled extensively to speak about diabetes and his success in battling the disease, set up a foundation several years ago to raise funds to send 100 kids with diabetes to camp.
“There are thousands of kids, teens, and adults getting diagnosed with type 1 diabetes. It is so burdensome; it can bring you to your knees. You can say, ‘I can’t do this. How am I supposed to work and have a family and manage diabetes?' I try to show them what you can do. I have a career, family, and I coach children’s sports. I’m a regular guy, with a family and a mortgage, who has diabetes and have become an eight-time Ironman.”
The Healing Power of Yoga
Megan Weigel, DNP, ARNP, is an MS-certified nurse who has seen the benefits of managing multiple sclerosis with yoga.
Weigel and her friend, who has MS, teach OMS yoga classes in Jacksonville, Florida, to people ranging in age from their mid-20s to age 70. The classes are based on Baptiste methodology, or power yoga. It is traditionally done in a heated environment, but heat is not used for MS patients, since it can make their symptoms worse.
“This type of yoga is a very empowering form of yoga. The language we use when we are teaching is uplifting and empowering, and it encourages hope, strength, and self-efficacy. It weaves in an extra characteristic to help people living with a chronic disease like MS to help them feel like they have more charge of their life — that there are things they can do through their physical body and minds, and through meditation, that helps them to feel like they have more control over their lives, Weigel told Healthline.
Weigel said that people with chronic illness are tired of going to doctors. They feel isolated and may think the only way they can fight their disease is to take medication.
“There’s so much that can be done with nutrition and exercise to help your body function like a better machine," Weigel said. "When you get into the whole spiritual side of it, one of the things that has come out of our program that is the most amazing is that the people who regularly attend yoga have formed a community with one another. They went from feeling alienated and alone to seeing each other two to four times a week.
"You can teach a person who feels powerless to feel powerful through exercise and movement," she added. "That gives them a greater sense of control over something that has left them feeling like they are floating without a life raft.”
Stacey Stevens is one of Weigel’s yoga students. She was diagnosed with MS nine years ago, and because of a worsening foot drop, she stopped walking with her friends in her neighborhood. Now that she is taking yoga, Stevens has gained strength, mental clarity, and new friendships.
“When I go to class I’m not intimidated. We start with some basic poses like down dog. It’s adaptable. If you can’t do something you can go in the child’s pose. It’s an easy pose on your knees. If you need a chair, you sit in the chair and do the poses. They are good at showing us different ways,” said Stevens.
Stevens is also reaping the benefits in terms of her mental health. “It’s an hour just to clear your mind and not think about anything else but how you are feeling in that moment. You are not thinking about anything else — your bills, or your MS. We meditate for a small period in the middle of the class and it’s really relaxing," she said. "A lot of times I don’t want to get dressed and go, but then when I do I’m so glad I went because of the benefits—it’s just amazing.”
When Stevens isn’t doing yoga, she is busy volunteering at Brooks Rehab Hospital, where she also participates in the Brooks Adaptive Sports and Recreation program. “I hand cycle with them and I’ve gotten up to 25 miles. I’m not your typical athlete, trust me. Next month we’re doing a 28-mile ride in South Florida with Brooks. I hadn’t been on a bike for 25 years and now I’m hand cycling,” she said.
Bidding Adieu to Diabetes Medication
Can exercise help you eliminate medication from your daily routine? Two young people, Sarah Boison and Nicole Legat, are both working (out) with that goal in mind.
Boison was 24 when she found out she had type 2 diabetes. “My A1C was 10.6, which is very high. They said if I kept waiting to see a doctor, I could have been at risk for getting in a diabetic coma. After I was diagnosed they put me on metformin. I was in a little bit of shock but happy that I found out what it was and that I could do something about it. What was pivotal was having a positive outlook on the situation and saying, 'What am I in control of at this point?'” Boison told Healthline.
Boison saw a nutritionist to help her change her diet. But when it came to exercise she found that even though she had danced prior to her diagnosis, her endurance was lacking.
“One night I tried to push myself. I was walking on the treadmill at a speed of 3 and I got so winded. After I exercised, I felt so out of breath and my heart was beating so fast. I pretty much almost passed out. Luckily, I woke up fine. I talked to a fitness instructor, and asked, 'What can I do to incorporate exercise now that I am taking this medication?'”
Boison was instructed to do circuit training and to start out slowly.
“My mindset was 'I want to do something to get my blood glucose level down.' It was still in the 300s even though I had started the medication," she said. "I was doing crunches, squats, leg lifts, pushups, and using barbells to make believe I was rowing. I dropped 15 pounds in a month without stepping foot into the gym. I have huge purses and sometimes I’ll put stuff in them and walk. That has helped to build up upper body strength.”
Eventually Boison joined a gym, and she has incorporated more weight training into her regimen. “Since I was diagnosed I’ve dropped about 45 pounds. My last doctor’s appointment was three months ago. My A1C was at 5.9, which is fantastic. It’s the lowest number I have had since my diagnosis. The doctors are considering possibly taking me off the medication if I continue to do well.”
Nicole Legat, 26, was diagnosed with type 2 diabetes four months ago. With an A1C of 9.7, she was also placed on metformin. Legat is also hoping to live medication-free. She goes to the gym five to six days a week and spends 30 to 45 minutes doing cardio workouts.
“People with diabetes have complications 10 or 15 years after they are diagnosed. I’ll be 35 then, and it’s not old enough to lose my eye sight or not do a pedicure because my feet don’t have feeling in them," she said. "I have lost 38 pounds. The better the physical state you are in the better your diabetes could be. I’ve talked to tons of people who’ve gotten off the medication and that is my goal.”
In three months Legat’s A1C has dropped from 9.7 to 8.4. "The doctor said in three months that’s a big drop, so I’m definitely headed in the right direction.”
Moving, Even a Little, Helps
Karen Kemmis, PT, DPT, CDE, who works at the Joslin Diabetes Center in Syracuse, New York, told Healthline, “A lot of people with chronic disease tend to be less active because everything is so challenging. But if people can be more active, everything else in their life becomes a bit easier.”
Kemmis said many people she sees find it hard to stand up from a chair and to climb stairs, so the natural tendency is to avoid stairs, to use arms more when standing up, and to use a lift chair. “If people could be more active in a careful manner, they would be able to do more rather than constantly cutting back on what they do,” said Kemmis.
If a patient with diabetes comes in for knee pain, Kemmis incorporates exercise into her intervention. “I may say, you have knee exercises, but while you are here, let’s see how you do on the stationary bike or something else to help get them started on doing more fitness, with the hope that in the long run they will pursue those things on their own,” she said.
Kemmis said aerobic exercise, such as walking on a treadmill, using a stationary bike, dancing, and swimming are helpful for diabetes patients. “If we use our muscles for strengthening exercises, they become more active, and we actually boost our metabolism. The more muscle mass we carry, the higher metabolism we have. So if people struggle with their weight and blood sugars being high, if their muscles are calling for more fuel to work, we are actually going to burn calories and lower blood glucoses.”
People with chronic conditions are frustrated because of their limitations, which leads to feeling isolated. “Exercise is a really important part of helping to work on depression and anxiety ... Work on doing five minutes, three times a day, of just walking in front of the TV, if the thought of going outside or doing 30 minutes at a time is stressful,” said Kemmis.
Treating patients as individuals is also crucial. “For some it might be to lower blood sugar or lose weight, and for others, ‘I want to dance at my daughter’s wedding,’ or 'I want to play with my child or grandchild.’ I can say if you work on this exercise or activity that will help them do something that is really important to them," said Kemmis.
Not everyone can be an Ironman. Still, Holder said, “Having a positive attitude throughout is what you need to train for an Ironman, but you also need that every day to get through diabetes. There are days when I throw my hands up in the air and say ‘I can’t do this,’ but then I snap out of it and keep positive and keep chugging along. In the face of something like type 1 diabetes, if you have a positive attitude you can achieve anything.”
What advice does Stevens have for people like her who have MS? “I never ever thought in a million, million years I’d ever be doing anything like this," she said. "You just really don’t know what you have in you until you try it. Just do it. You’ll really be surprised.”