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Cardiac rehab program opens to low-income residents in Sonoma County

While working in a Mexico City bakery a half-century ago, Vicente Tlatilpa earned the name “Atómico” for his lightning speed moving tray after tray of Mexican bread. His talents as a street brawler eventually landed him in the Lucha Libre wrestling circuit, where he adopted the masked identity of Rayo Atómico - the Atomic Ray.

It took a recent surgical procedure for his clogged arteries to slow down the 75-year-old Windsor retiree. But with the help of a well-known cardiac rehabilitation program in Sonoma County, Tlatilpa is close to resuming the active lifestyle that’s always been part of his identity.

“They’re all good people here,” Tlatilpa said last week, just before beginning his closely monitored workout at HeartWorks Cardiac Rehab Center in Santa Rosa.

The program, run by the Northern California Center for Well-Being, offers an individualized exercise and education routine that takes place under the supervision of a cardiac nurse, an exercise physiologist and an on-call cardiologist.

The HeartWorks program, formerly operated by the Northern California Medical Associates physicians group, was taken over earlier this year by the Center for Well-Being, a Santa Rosa nonprofit health and wellness center.

Since then, the center has been trying to expand access to the successful program for low-income residents and provide “scholarships” for needy patients who are recovering from such things as heart attacks or open heart surgery. That effort got a big boost this fall, when the center announced that HeartWorks services would be available to patients on Medi-Cal, the state’s Medicaid program.

Partnership HealthPlan of California, the nonprofit health care organization that administers Sonoma County’s Medi-Cal program, now covers 100 percent of HeartWorks services, said Jennifer McClendon, manager of business development for the Center for Well-Being.

“It’s opening the doors to someone who is low-income and has Partnership HealthPlan,” McClendon said.

In Sonoma County, 31 percent of all deaths are due to cardiovascular disease, according to 2012 data from the state Department of Public Health. The 2010 Journal of Public Health Management and Practice found that cardiovascular disease was Sonoma County’s most costly chronic condition, accounting for an estimated $569.7 million in yearly health care expenditures - more than twice the cost of other chronic conditions, including cancer, diabetes and asthma.

Overall, California ranks 33rd in the United States in deaths attributed to cardiovascular disease, as measured by the rate of deaths per 100,000 residents, according to 2012 data from the federal Centers for Disease Control and Prevention. But among Latinos, the state has the 13th highest death rate in the country.

The HeartWorks program was started 30 years ago by Northern California Medical Associates, which developed a four-stage program to get heart patients back on their feet.

In 1996, the newly created Center for Well-Being took over the final two stages of the program, providing exercise and education services for heart patients in the latter phases of recovery from a major cardiac procedure, such as open heart surgery, treatment for a heart attack or a coronary stent intervention. About a year ago, it acquired the second stage of the HeartWorks program, overseeing patients who have just been released from the hospital and require more intensive monitoring during a critical phase of recovery.

The decision by Partnership HealthPlan to cover treatment through the HeartWorks program opens it to all low-income residents on Medi-Cal. Previously, these residents needed to obtain scholarships from the Center for Well-Being or personally pay for the program to participate.

The center now can use its funding to provide scholarships to other low-income patients whose insurance companies didn’t cover the full cost of the HeartWorks rehab program. Other patients have no insurance at all.

“At this time of need, to have to worry about insurance coverage - patients don’t need that additional stress,” McClendon said.

HeartWorks is the largest cardiac rehab program north of the Golden Gate, serving about 450 patients a year who make 13,500 annual patient encounters, McClendon said. The second phase of the program consists of 36 monitored visits that gradually give patients the confidence and strength they need to become active again.

Cindy Pehlke, a registered nurse who supervises the HeartWorks program, said patients who have gone through a cardiac episode often are fearful and anxious about overexerting themselves. The aggressive patient monitoring during exercises, conducted under medical supervision and using an electrocardiogram, helps eliminate that fear.

“This gives them back their confidence and it reassures them that it’s OK to push themselves,” Pehlke said. “We’re looking at their EKGs, monitoring their blood pressure, heart rate and oxygen saturation.”

All the various monitoring data often are used to show patients that their heart has actually been working harder than they thought, she said.

Last week, Tlatilpa enthusiastically lifted two small dumbbells in the HeartWorks fitness center. His small but stocky frame still evoked his long-gone days as a masked wrestler battling the likes of La Bestia, Chico García and Ultraman.

He said the HeartWorks program has helped him recover his vigor.

“I feel good,” Tlatilpa said. “I don’t feel old. I don’t feel so new anymore, but I don’t feel old.”

You can reach Staff Writer Martin Espinoza at 521-5213 or martin.espinoza@pressdemocrat.com. On Twitter @renofish.

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