BRIDGEPORT, W.Va. (AP) - Nick Duryea worked out at a fitness club and swam 2 1/2 miles three times a week in spite of spinal injuries he received as a combat veteran who fought in Iraq.
Duryea thought he was in pretty good shape and he also had no family history of heart problems.
So when the retired U.S. Army Reservist stopped by the Louis A. Johnson VA Medical Center last fall on his way to work hoping he could get some relief for indigestion, he was surprised when, after an EKG, doctors informed him that he had experienced a heart attack and was going to be life-flighted to Ruby Memorial Hospital in Morgantown.
"Within five hours of me stopping by there, they were putting a stent in my heart," said the Grafton resident.
Because of his level of fitness and also the fact that he did not realize at the time that the chest pains he experienced was an actual myocardial infarction, Duryea, who turned 52 last week, still has trouble grasping his diagnosis.
"In my mind, I never had a heart attack," he said. "I know what they are telling me, but I didn't feel it. It didn't change my life."
That said, Duryea now attends cardiac rehab three times a week at United Hospital Center in Bridgeport as he gradually works his way back to his active lifestyle, this time attached to monitors with nurses looking over him and taking his blood pressure as he pedals a bicycle or walks on a treadmill.
"About the first week, they baby you," Duryea said. "When you first get in there, you walk on the treadmill for four minutes and all they are doing is watching your heart."
Even though Duryea feels fine and was accustomed to working out, he knows that getting back into exercising gradually is the right thing to do.
"They are letting me know how far I can push myself and I don't have to be second-guessing myself," he said.
Cheryl Farley, a registered nurse and manager of cardiac and pulmonary rehab at UHC, agrees.
"There are a couple of guys who are very physically fit, but that doesn't mean they can't have a heart attack," she said. "There are people who are thin who jog three times a week and they still have a heart attack.
"You don't have to have every risk factor to have a heart attack," she added. "One of the big things is knowing the signs and symptoms."
Although a heart attack put Duryea into cardiac rehab, other participants have different stories to tell.
Lee Gustafson, a Maple Lake resident and architect with The Thrasher Group, also had kept in shape, with swimming, running and biking. But last fall, he began losing weight, had no appetite and very little energy. He was diagnosed with a bicuspid heart valve. Most people have a tricuspid valve featuring three flaps that allow blood to flow. It was a condition with which Gustafson had been born.
"Over the years, the bicuspid valve had caused an enlarged aorta to the point where I had an aneurysm," he said.
He had the valve replaced and the aneurysm repaired at the Cleveland Clinic, returning home just in time for Christmas.
Then, in mid-February, he started cardiac rehab at UHC, a 12-week program open to all patients who have had a heart-related problem.
As someone who was accustomed to working out, Gustafson admitted the pace was boring in the beginning.
"It's picking up now," he added. "Everyone promised me it needed to be gradual and it would get more intense."
There are three phases to the cardiac rehab program, Farley said. The first phase is during a patient's initial hospital stay.
"We go see select inpatients," Farley said. "We don't see them all. If a patient is 95 years old and from a nursing home and is going back to a nursing home, we won't see that patient. We're seeing patients that have had a cardiac event who are going home and we want them to be able to be self-sufficient and need to know what to do."
The 12-week program that Duryea, Gustafson and Kirkpatrick currently are participating in is the second phase for early outpatients.
After patients have returned home from the hospital, had some recovery time and have had the opportunity to see the doctor, they can begin the program. They attend cardiac rehab sessions three times a week, on Monday, Wednesday and Friday.
Farley and the nurses hook the patients up to electrodes that are attached to a device the size of a transistor radio that the patients can keep in their pockets. One nurse watches a computer screen to see the patients' vital signs as they exercise while another goes around and checks blood pressures and makes sure everyone is comfortable as they exercise.
"We take their blood pressure at rest, during exercise and during cooldown," Farley said. "And they are wearing a heart monitor so we can watch their heart rate and heart rhythm."
Between 100 and 125 patients start cardiac rehab in a given year, Farley added, and any given class has up to 10 patients. Sessions are held at 8:30 a.m., 10:30 a.m. and 1:30 p.m. on Monday, Wednesday and Friday.
The Wednesday classes are longer because in addition to exercise, there is a session in which other factors that go into heart health, such as diet and medication, are covered.
And sometimes even patients already in the medical field are surprised at some of the things they learn about heart attacks, Farley said.
"We've had several physicians who go through the program and they come in with the attitude, 'I'm a doctor. I know this stuff,' or nurses or physician assistants, who come through the program and at the end, they say, 'Omigosh, I'm so thankful for this education. I didn't know some of that."'
But for many patients, the program never really ends. That's where phase three - maintenance - comes in.
Those sessions take place at the UHC's Clarksburg Clinic, formerly the 4C's Building, near the hospital's former location in Clarksburg.
Many similarities exist between the two programs. Patients work out while a nurse stands by ready to help. But they are not hooked up to a heart monitor during the sessions.
"People can go there as long as they want," Farley said. "We have people who have been there for 20 years."
John Brunett of Clarksburg has been in phase three since late February, after he finished the 12-week program.
At only 48, Brunett suffered a massive heart attack in early October and spent 25 days unconscious in Ruby Memorial Hospital. Physicians initially told his wife, Kristin, that there was nothing they could do for him. After stabilizing him and putting him on life support, an external pacemaker and two Impella devices, a machine that helps pump blood - one for the right side and one for the left side - surgeons eventually were able to place four stents in Brunett's arteries to help alleviate blockages.
Even after he left the hospital, Brunett had to spend a week in HealthSouth to gain strength and learn how to walk again before coming home in time for Thanksgiving.
Brunett took the 12-week cardiac rehab program seriously, not only exercising, but also changing his diet. He only has eaten red meat three times since his heart attack. Between his hospital stay and the changes Brunett made since getting out, he has lost 40 pounds.
"I am trying to be strict with myself and practice what they taught us," Brunett said. "They said we could have red meat once every one to two weeks, but I've taken it to the further limit and only had it three times in five months."
Brunett's father, Sam, died in 1992 at the age of 52 of a sudden heart attack, so Brunett knew that he also might be genetically inclined to have heart problems.
"Twenty-four years went faster than I thought," he said. "You always think, 'That's not going to happen to me.' It's better to be proactive and reactive in that sense. I'm reactive now but had I been proactive, maybe I wouldn't have been in the position I was."
Brunett, owner of Audio Visual Concepts and co-owner with his family of Tomaro's Bakery, has been easing back to work, where projects before his heart attack had been causing him stress.
And at cardiac rehab, Brunett has slowly been increasing his speed and time on the treadmill. In mid-March, he was at 15 minutes and 2.8 miles an hour.
Brunett can continue in the phase three cardiac rehab class for as long as he wants. He has not decided how he will handle his fitness in the future, but for now, he appreciates how it has helped him get back on his feet.
"I want to do several classes of this before moving forward, and even when I do go back to work, I'm thinking about doing an early morning class before I go to work because you feel great about the day. The adrenaline is there and you are ready to do something else."
Information from: The Exponent Telegram, http://www.theet.com