Cardiac rehabilitation builds heart stamina and confidence

Running man: Erik Sandstedt hopes to compete again in marathons after completing cardiac rehabilitation.

Erik Sandstedt has kept active during his 45 years, running a half dozen marathons and hitting his stride on the trails around Asheville, his runner’s physique the picture of health.

Last June, he noticed he was having some minor chest pains, and then, during a run near the Blue Ridge Parkway, he nearly collapsed in pain.

“I was running, and it just knocked me down to my knees,” he says. “It was very scary. I thought, ‘My life, that’s it, it’s over.’”

After resting for a while, he managed to walk back to his car and drive home. Doctors at first thought he had a bad case of indigestion, since those symptoms mirror heart attacks, but soon found he had a genetic condition involving his aortic valves, something Sandstedt was unaware of.

On Oct. 1 of last year, he had surgery to replace his ascending aorta, which had become dilated due to the genetic condition. When surgeons took his aorta out, they saw scar tissue and the beginning of a tear, which had become infected. This was what was causing the pain in his chest.

When he received the news, Sandstedt said he was “surprised that I had problems. I had low cholesterol; I was running, biking, skiing and eating well. It was a shock to me, but this proves it can happen to anybody,” he says.

Sandstedt is just one example of a cardiac patient who doesn’t fit the typical risk model, which is someone older, with a family history of heart problems, a poor diet, under high stress and a tobacco user.

As part of his recovery, he’s taking part in a 12-week cardiac rehabilitation program through Mission Health called Heart Path. The outpatient program started in 1983 and moved to the the gymlike facility at Asheville Cardiology Associates in 2000. Patients exercise with heart-rate monitoring equipment and receive education about effective exercise habits, diet, stress, medications and smoking cessation.

Nurses monitor heart activity while patients rotate from the treadmill to stationary bikes to elliptical and weight machines — all while conditioing their heart strength back to normal and building a plan for cardiac success for the future. Sandstedt’s stamina is coming back as he heals, and he did a 5K run in less than 30 minutes in early February. He hopes to get back to his usual 5K time of under 20 minutes.

“It was slow in the beginning and hard to get motivated. I was nervous, I came here and looked at everyone else and wondered if I fit in here, but it’s been great,” he says. “Any patient who has had a heart issue, you’ve got to do rehab. I was not planning on it, but it’s boosted my confidence; it’s nice to know how hard I can run safely.”

Bill Sites‘ journey to cardiac rehabilitation has followed a different path, but one that is no less remarkable. The 71-year-old had his first heart attack when he was 45 years old, despite no family history of heart trouble and no history of high blood pressure.

No quitting: Bill Sites is keeping active, riding his bike between 25 and 50 miles every weekend. His doctors tell him every mile helps his heart's strength.
No quitting: Bill Sites is keeping active, riding his bike between 25 and 50 miles every weekend. His doctors tell him every mile helps his heart’s strength.

“After it happened, I couldn’t walk 25 feet without pain,” he says. “It was terrible.”

His lifestyle as a traveling salesman for IBM hadn’t done his health any favors and had caught up to him. Although he didn’t smoke, he was constantly attending smoke-filled business meetings and eating on the go.

“When you’re traveling, you can’t eat as well as you should. In addition to that, I was addicted to ice cream,” he says.

According to Sites, he single-handedly kept the ice cream maker Haagen Dazs in business.

“Before boarding a flight, I’d grab an ice cream bar. After landing, I’d grab an ice cream bar. After every meal I’d look for the ice cream bar. It was ridiculous,” he says.

Heart disease remains the No. 1 cause of death in the United States. Dr. Stephen Ely, cardiac surgeon with Asheville Heart, says the issue of fast-food consumption in this country is a complex one.

“It is difficult to generalize, but it seems that our culture has become one of doing more and more with less and less time. The emphasis on families dining together and eating quality home-cooked meals has been overshadowed by the availability of a multitude of fast-food restaurants, providing relatively inexpensive foods, quickly, 24 hours a day, that are anything but heart-healthy,” he says.

To reduce the risk of heart disease, he says, people should follow a diet low in fat, restrict salt intake and reduce  portions consumed at each meal. February is American Heart Month, and the Centers for Disease Control and Prevention is urging the 67 million Americans with high blood pressure to know their numbers and make control a goal.

“Education is the most powerful tool we have to raise the awareness of the threat and prevention of heart disease,” says Ely. “Unfortunately, many learn this lesson too late.”

For Sites, it was almost too late for him after his first heart attack.

Doctors told him he had six months to live after multiple angioplasties failed to open his arteries. As a last resort, he started chelation therapy, a blood treatment typically used to remove heavy metals from the blood. Although he was told it would never work in making him feel better, after eight sessions he walked five miles with no pain.

Despite keeping active and eating healthier, he suffered another heart attack five years ago. A routine angiogram last year revealed a blockage that a stent would be ineffective against, and this led to coronary bypass surgery on Oct. 1 last year.

“Fortunately I didn’t have time to think about it. I asked how soon they could take care of it. The doctor said, ‘How about tomorrow morning?’ The next morning at 6 o’clock, I was on the table,” he says.

He is now in cardiac rehab for the second time and doing much better, biking 25 to 50 miles during weekends with his grandson on a two-person tricycle he built himself. He has a goal to bike from Cumberland, Md., to Pittsburgh, Pa., via the Rails to Trails passage.

“I consider myself fortunate in a number of ways,” he adds. “People say, ‘Yeah, you had a bad year because of heart surgery.’ I say, ‘No, they found it, they fixed it. It was a good year.'”


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About Pat Barcas
Pat is a photojournalist and writer who moved to Asheville in 2014. He previously worked for a labor and social rights advocacy newspaper in Chicago. Email him at Follow me @pbarcas

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One thought on “Cardiac rehabilitation builds heart stamina and confidence

  1. James Biddle MD, Asheville Integrative Medicine P.A.

    Regarding Bill Sites’ excellent adventures in cardiac rehab, it was a bit understated in your Feb 25th article that his self-determined choice of IV EDTA Chelation Therapy to treat his vascular disease delayed his bypass surgery for a full 25 years! This is particularly poignant when we realize that a first bypass surgery lasts about 7 years, on the average, then needs to be re-done. Congratulations to Mr. Sites for all his hard work to regain his health, especially the willingness to be an empowered medical consumer.

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