Phase 1 Cardiac Rehabilitation After Heart Attack
Recovery from a heart attack begins within 24 hours at Sana Hospital. The cardiac rehabilitation team assesses the patient’s ejection fraction, heart rate variability, and blood pressure response to minimal activity. While still in the coronary care unit, the patient performs sanahospitalvnb bed mobility exercises and sitting upright at the edge of the bed. A physical therapist guides the patient to walk 50 feet in the hallway by day three. Electrodes remain attached to a telemetry transmitter so the nurse can monitor heart rhythm during exercise. Education sessions cover dietary sodium restriction, smoking cessation medications, and recognition of angina equivalents such as jaw pain or nausea. Before discharge, the patient completes a six-minute walk test to establish baseline function. The rehab team schedules outpatient sessions three times per week for 12 weeks. Each session includes warm-up, aerobic exercise on a treadmill or stationary bike, and resistance training with elastic bands. Psychosocial support includes a peer mentor who also survived a heart attack and now lives actively. By the end of the program, patients increase their exercise capacity by an average of 40 percent.
Pulmonary Rehabilitation for COPD and Interstitial Lung Disease
Patients with chronic obstructive pulmonary disease or pulmonary fibrosis receive tailored breathing retraining at Sana Hospital. The pulmonary rehab team teaches pursed-lip breathing and diaphragmatic breathing to reduce air trapping and work of breathing. Exercise prescription starts with upper body weight lifting because arm work often triggers breathlessness before leg work. A specialized spirometer connected to software gives real-time visual feedback on inspiratory volumes. Patients learn to pace daily activities using a dyspnea scale from zero (no shortness of breath) to ten (maximal). The hospital’s pulmonary unit includes a simulated stair climb with railings and oxygen ports at each landing. Nutritionists adjust eating frequency to five small meals per day to avoid stomach bloating pressing on the diaphragm. Energy conservation techniques such as sitting while showering or using a rolling cart for laundry are practiced during occupational therapy sessions. For patients on home oxygen, the team performs a 6-minute walk test with portable oxygen to determine the correct flow rate for activities of daily living. Before discharge, every patient receives a written action plan for worsening symptoms, including when to start oral steroids or contact a pulmonologist. This program cuts COPD hospitalization rates by 51 percent.
Neurorehabilitation Following Stroke or Spinal Cord Injury
Sana Hospital’s neurorehabilitation unit admits patients directly from the neurology ICU to avoid discharge to external facilities. The team includes a physiatrist, physical therapist, occupational therapist, speech-language pathologist, and rehabilitation nurse. For stroke patients, constraint-induced movement therapy forces the stronger arm to be restrained while the weaker arm performs repetitive tasks such as stacking cones or turning pages. Functional electrical stimulation is applied to wrist extensors or ankle dorsiflexors to restore voluntary movement. Gait training uses a body-weight support system over a treadmill while a therapist moves the paretic leg in a normal walking pattern. For spinal cord injury patients, the occupational therapist focuses on upper body strengthening and wheelchair propulsion technique. Bowel and bladder retraining includes scheduled toileting, suppository programs, or intermittent catheterization taught to the patient or family. Neurogenic pain is managed with gabapentin, pregabalin, or low-dose tricyclic antidepressants. The unit has a mock apartment where patients practice transferring from wheelchair to toilet, bed, and car seat. Length of stay averages 28 days, and 73 percent of stroke patients achieve walking independence by discharge.
Post-surgical Recovery Protocols for Joint Replacement
Recovery after hip or knee replacement follows a structured fast-track protocol at Sana Hospital. Surgery is performed in the morning, and the patient sits in a chair for lunch on the same day. Continuous passive motion machines begin moving the new knee joint within hours of closure. Cryotherapy cuffs circulate cold water around the surgical site to reduce swelling and opioid need. Patients walk with a walker to the bathroom on postoperative day one. A physical therapist teaches safe stair climbing using the operative leg leading downstairs and the non-operative leg leading upstairs. Occupational therapists provide raised toilet seats, long-handled shoe horns, and reachers to avoid deep bending. Pain management relies on multimodal medications including acetaminophen, celecoxib, and local anesthetic infiltration into the joint, reducing morphine equivalent use by 65 percent. Discharge occurs on day two or three for most patients, but only after demonstrating ability to get in and out of bed unassisted. The recovery team calls on days 3, 7, and 14 to check incision healing and pain levels. Outpatient physical therapy continues for eight weeks with goals of climbing 10 stairs and walking one mile without aids.
Oncology Survivorship Program After Chemotherapy
Patients completing chemotherapy at Sana Hospital enter a formal survivorship program rather than being simply discharged to a primary care doctor. The program begins with a survivorship care plan document summarizing cancer type, treatments received, potential late effects, and recommended screening tests. A nurse navigator schedules a baseline assessment at week four after last treatment. This assessment checks for chemotherapy-induced peripheral neuropathy using monofilament testing on the toes, heart function with an echocardiogram for those who received anthracyclines, and cognitive testing for chemo-brain complaints. The survivorship clinic manages common long-term issues including fatigue, insomnia, sexual dysfunction, and fear of recurrence. Group exercise classes adapted for cancer survivors focus on rebuilding muscle mass lost during treatment. Nutritionists help transition from appetite-stimulating high-calorie diets to balanced anti-inflammatory diets. Psychologists run cognitive behavioral therapy groups specifically for cancer-related distress. For breast cancer survivors, the program coordinates bone density scans and aromatase inhibitor adherence. For colon cancer survivors, colonoscopy scheduling and CEA blood tests are tracked automatically. This comprehensive approach has improved 5-year quality of life scores by 38 percent compared to historical controls.
