AnMed Health LifeChoice Cardiac Rehab

1. AnMed Health LifeChoice
Health Science Student Internship Experience
Alyssa Lamb, Clemson University ‘16

2. Health 4200 Health Science Internship
This semester-long internship provided me with a
unique hands-on patient cardiac rehabilitation
experience. I primarily assisted registered nurses,
health specialists, and exercise physiologists in
providing patient care for individuals referred to
Phase II cardiac rehab classes.

3. AnMed Health Mission & Vision
“The mission of AnMed Health is to passionately blend the art of caring with the
science of medicine to optimize the health of our patients, staff, and community.”
Vision: “Our vision is to be recognized and celebrated as the gold standard for healthcare
quality and community health improvement.”
Building Blocks:
 Exercising a passion for serving others
 Exceeding the expectations
 Pursuing excellence and quality
 Fostering a nurturing culture
 Living a culture of “Yes”
 Benefiting the community
 Practicing financial responsibility
 Maintaining high standards
 Embracing “differentiology”
 Living the credo… “We’re in This Together”

4. AnMed LifeChoice
AnMed LifeChoice is a rehabilitation facility located in Anderson, SC. It’s
main function is cardiac rehab, but it also provides wellness, oncology
rehab, and psychological services to a wide range of patients.

5. Phase II Cardiac Rehab Classes
Typical day on the job:
• Morning Phase II class
• Check patient initial blood pressures and heart
rates, weight patients in, and assist patients with
setting up their heart monitors
• Obtain patient blood pressures and heart rates
during exercise
• Assisting patients with adjusting exercise machines
• Monitoring patient progress throughout the session
• Obtain patient blood pressures and heart rates after
exercise and a cool-down lap
These classes really helped me develop my
communication skills and made me comfortable
working with patients of various needs and
backgrounds.

6. Heart Monitors
Heart monitors like the ones pictured to the
right are worn by patients during their first 18
sessions (out of 36 total sessions). These enable
the nurses to monitor any irregular rhythms and
ensure patients are exercising at an appropriate
fitness level. After 18 sessions, under their
nurse’s discretion, patients graduate from
wearing the monitors, which many find very
relieving.
I would assist patients with attaching their
leads and ensuring their heart rhythms showed
up on the computer screen before they began
exercising during Phase II classes. Between
classes I would reassign monitors to incoming
patients and enter their information into the
computer system. At the end of the day, I would
put all heart monitors away and remove batteries
so as not to waste any battery life.

7. Graduation Day
One of my favorite experiences
was being able to walk around
the track for a patient’s final
lap on his graduation day. It can
often be a very emotional day
for patients when they graduate
because most come into the
program after suffering a
serious heart condition, scared
that they won’t make it
through. Being able to help
these individuals overcome such
physical and emotional
obstacles was truly rewarding. Patients walk a victory lab to the song “Pomp and
Circumstance” while their achievement is announced over the
loudspeaker. They receive a diploma certificate of completion
as well.

8. Health & Wellness
Wellness is available to graduates of
Phase II rehab and any other individuals
who are interested in joining an
exercise program. I was not only able
to interact with Phase II patients, but
also wellness patients who found time
to come in and workout on their own.
One of my daily tasks was to make sure
the wellness folders were filed and
secured in the file cabinet, and ensure
wellness patients were able to exercise
in a friendly and safe environment.

9. Other Internship Duties and Projects
 Updated facility educational boards and flyers
 Attended Phase II Orientation and Interviews
 Sat in on Dietician Consult
 Attended all educational Phase II cardiac rehab classes
 Cardiac medications, humor and hope, exercise physiology, angina, diabetes,
nutrition, blood pressure, emotional aspects
 Shadowed a session of Pulmonary rehab
 Assisted with Phase II oncology rehab classes and oncology rehab chair
aerobics classes
 Conducted patient case study

10. Oncology Rehab Chair Aerobics
One of my additional activities on the job was
participating in oncology exercise classes and
motivating them throughout the class.
Oncology rehab was particularly difficult for
several patients during my time at LifeChoice
because most had undergone chemotherapy
and were very weak. They were always happy
to see me and had my chair and weights set
up for me before every class. I enjoyed being
able to get to know many of these women
and how their lives have been affected by
their condition.

11. Breast Cancer Awareness Month
For the month of October
I researched breast
cancer and put together
an educational bulletin
board catered to the
patients at LifeChoice. I
included information
regarding its prevalence
in the U.S., early
detection, breast self-
examinations, diagnosis,
and treatments. I also
handed out pink breast
cancer ribbons for
patients to wear around
the gym.

12. Diabetes Awareness Month
For the month of November I
researched diabetes and put
together an educational
bulletin board for patients and
staff. I placed emphasis on
prevention and included several
resources about living with
diabetes. Many of the cardiac
rehab patients are diabetic so I
thought this topic would be
very relevant for this month. I
also researched nutrition for
diabetics and compiled a list of
food groups and easy-to-make
meals that patients could take
home as a handout.

13. Patient Case Study
 73-year-old diabetic male
 Diagnosed with severe 3-vessel CAD (coronary artery disease)
 Indications: class 3 dyspnea, ongoing shortness of breath, atypical chest pain, abnormal stress test, prior CAD,
and prior coronary artery bypass
 Procedural Conclusions:
 Severe 3-vessel CAD, patent bypass grafts x4, normal left ventricular function, successful Onyx Medtronic drug eluting
stent into native obtuse marginal artery after saphenous vein graft anastomosis with excellent results, brisk ante grade
flow and no residual stenosis
 Hospital discharge diagnosis: CAD post-PCI, hypertension, hyperlipidemia, diabetes mellitus, peripheral artery
disease, obstructive sleep apnea
 Physician referral to cardiac rehab on 7/7/2015 after PCA/stent
 Began cardiac rehab 7/21/2015
 Currently on session 23 out of 36
 Weight: 182, height: 5’8”, BMI: 27
 Exercise METS: currently on 5 METS, started at 3
 Scored a 3 on the PHQ-9 Questionnaire – overall fairly happy
 Patient describes initial feelings of having trouble sleeping or sleeping too much, feeling tired/having little
energy, and poor appetite/overeating when he first began cardiac rehab. Progress since then has greatly
improved, however his weight has fluctuated from 182 to 187.7lbs over the course of 23 sessions
 Is set to graduate in 13 sessions and has made great overall progress, very positive and motivational to fellow
Phase II patients.

14. Dietician Consult
Topics of discussion:
 Where diet is currently at
 Smoker/nonsmoker? If so how often?
 Living situation, who does the shopping
and cooking?
 What is their typical day like? Kids? Who
lives with them?
 Discussed how right and healthy molds
differently to everyone so they need to
work on fitting nutrition into the patient’s
mold
 Cholesterol and how it affects you
 Fats – which ones are good for you and
which ones are bad for you
 80/20 plan – 80% healthy, 20% splurging
 Dietician gave the patient a plan for 2
days worth of meals
Patient’s current status:
 Eats a lot of crackers
 Peanut butter and candy bars
 Smokes half a pack a day
 Loves M&Ms
 Drinks Dr. Pepper everyday
 Typical meals of choice: hamburger, egg
sandwich, fried turkey legs
 May 26 cholesterol was at 126
 Had stent placed in May 2015

15. New Patient Orientation – Cardiac Rehab
 AnMed LifeChoice has been around since 1987
 Patients are referred to LifeChoice after a cardiac procedure
 Procedures that referred patients to this orientation class: bypass, valve replacement, triple
bypass, stent (heart attack), open heart surgery – 6 bypasses, 5 stents post-heart attack
 The nurse manager asked who is currently working or planning to return to work
 Explained that South Carolina provides assistance by having employers pay for your cardiac
rehab, or they hire worksite engineers to make your work easier (if it is physically challenging),
and in some cases they will help you go back to school.
 Asked if anyone was diabetic or on insulin, to determine whether they get their blood sugar
checked before and after each phase II class
 The cost of cardiac rehab is $8,500 for 36 sessions (typically 12 weeks)
 Most insurance covers it
 Medicare/Medicaid pays for 80%
 Most private insurance will not pay for it
 Each patient has an assigned nurse that met them in the hospital when they were in the
recovery stages of their heart procedure
 This nurse guides them through their first few sessions and continually monitors and tracks
their progress

16. Conclusion
Overall, this experience really challenged me to open up
and establish supportive and friendly relationships with
patients and staff. I feel that I really developed my
communication skills and learned a lot about the fields of
cardiology and rehabilitation. I love working with others so I
felt this was an experience I was well-adjusted for. I could
not have asked for a more rewarding health science
internship experience and I will miss the friendly
atmosphere that LifeChoice provided me with.