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Jul 14, 2023

Cardiac rehab helps people recover physically and emotionally

A cardiac rehabilitation program begins with a thorough physical, and also focuses on diet, exercise and mental health. Stock Photo Q: My dad is recovering from a heart attack. He wants to get back to

A cardiac rehabilitation program begins with a thorough physical, and also focuses on diet, exercise and mental health. Stock Photo

Q: My dad is recovering from a heart attack. He wants to get back to living his life, but I can tell he's worried. His doctors have suggested he start doing a program called cardiac rehab. Will that help him? My mom and I have never heard of cardiac rehab and wonder what it involves.

A: Cardiac rehabilitation refers to a supervised program that combines exercise, diet, counseling and education to support one's recovery from a heart attack or other type of heart problem. It's a team approach, and the specifics are tailored to each patient's individual needs.

For most people, a heart attack is a life-changing event. There's the risk of lasting physical damage to the heart, which affects how someone feels. There are also often mental and emotional repercussions, which can be significant. Following a heart attack, it's common for the person to feel overwhelmed and confused, to experience a loss of confidence and to become fearful.

Many patients also begin to struggle with anxiety, depression and grief. The goal of cardiac rehab is to help the person recover from both the physical and emotional effects of a heart attack. The program also focuses on learning behaviors that can help reduce the risk of future problems.

If your father decides to move forward, the first step will be a complete medical and physical assessment. This includes a medical history, a physical exam, imaging tests of the heart and surrounding blood vessels and blood tests to set baseline levels for a number of indicators, including blood sugar and blood lipid levels. A stress test to evaluate heart function and blood flow will also be performed.

The information and data that has been collected will be analyzed, and a rehab program to meet his specific needs will be created. The length of a rehab program varies depending on the facility that offers it, but the duration is typically three months.

The specialists involved include cardiologists, exercise specialists, dietitians, nurse educators, mental health specialists and occupational and physical therapists. The program will offer supervised exercise sessions to get your father safely active again, dietary education and lifestyle guidance. This last category often includes strategies for quitting smoking or losing weight, dealing with stress and anxiety and help in managing chronic health conditions such as diabetes, high blood pressure and unhealthy blood lipid levels.

Mental health and emotional support are also important elements of a cardiac rehab program. This typically includes access to counseling and mental health therapy, and to medications, if those are needed. Some programs offer support groups, where heart attack survivors can share their experiences and support one another's recovery. Once the structured program concludes, patients continue on their own. This includes regular exercise, a healthy diet, not smoking and maintaining a healthful weight. Studies have found that cardiac rehab can contribute to improved outcomes and lead to a better quality of life.

Q: I started getting patches of red, bumpy skin on my elbows last year. My doctor said it is eczema and prescribed some creams to deal with the terrible itching. They work pretty well, but I'm interested to know if there's anything I can be doing with my diet that may also be helpful.

A: Eczema is a common skin condition marked by patches of dry, scaly, itchy and inflamed skin. It occurs in people of all ages, including newborns, children and adults.

There are several different types of eczema, but the majority of cases fall into the category of atopic dermatitis. Chief among the symptoms of this type of eczema is the persistent itching that you have been dealing with.

As you may have noticed, the symptoms of eczema tend to ebb and flow. Periods of quiet are interspersed with a return of symptoms, known as flare-ups. These can have environmental triggers, such dry or cold weather; humidity or dampness; pet dander; dust mites; the chemicals in certain perfumes, soaps or detergents; pollen; and molds.

Although the exact causes of eczema are not yet clear, genetics and immune function are known to play a role. There is also a strong link to allergy. This has made the potential role of nutrition in the management of eczema flares an area of interest to researchers for several decades.

Some studies, along with anecdotal evidence from eczema patients, suggest that what someone eats and drinks can have an effect on the frequency and severity of flare-ups. For some patients, specific foods have been found to play a role in the recurrence of symptoms. These include eggs, citrus, soy products and tomatoes and other nightshade vegetables. Sugar, wheat, nuts and milk, as well as gluten and alcohol, have also come to be associated with eczema flare-ups in some people.

At this time, there are no official guidelines regarding the use of diet to manage eczema. That means someone living with the condition must become aware of whether they have an intolerance to specific foods or to certain food groups. This can involve the use of an elimination strategy to identify specific trigger foods. First, a suspect food is removed from the diet. Then, after a period of time, it is gradually reintroduced. If it coincides with an increase in eczema symptoms, it's possible that the food may be a trigger.

For many people, a good place to start is by adopting what is known as an anti-inflammatory diet. This means avoiding added sugars, simple carbs and highly processed foods. Instead, craft a diet with a focus on lean proteins, fresh fruit, vegetables and leafy greens and healthful oils. Some research suggests omega-3 fatty acids have a beneficial effect on eczema, so include fatty fish, such as salmon, sardines and mackerel. And steer clear of wheat and nightshade vegetables, which, as we discussed earlier, have been associated with eczema flares.

Some small studies, which looked at prebiotics and probiotics as a potential avenue for eczema relief, have had encouraging results. Adding naturally fermented foods to the diet may also be beneficial.

• Dr. Eve Glazier is an internist and associate professor of medicine at UCLA Health. Dr. Elizabeth Ko is an internist and assistant professor of medicine at UCLA Health. Send your questions to [email protected].