By Denise Williams | News & Views
She’s only 56 years old, but Sandra Hoffman has graduated from cardiac rehabilitation (CR) five times already. Heart disease — part of her family history — showed up in her 40s and settled in, lobbing one medical challenge after another in her direction. “I got the gene,” she quips, with a sense of humor that belies everything she’s been through. But, Sandra says, with the help of CR — both the physical aspect and the people factor — she’s built up the resiliency to face and overcome those hurdles.
Sandra’s father had heart disease for many years; and ironically, she had relocated back to New Jersey from Florida to take care of him and her mother when her own heart troubles struck. In 2015, at age 49, cardiac arrest resulted in a prolonged hospital stay, implantation of a defibrillator pacemaker and her first introduction to CR. She wasn’t much of an exercise enthusiast prior to rehab so that, too, was something of a challenge. “That’s all I could do,” Sandra says of the paces the staff at Riverview Medical Center in Red Bank, N.J., put her through. “I was barely doing the minimum. I wasn’t getting any other exercise because I couldn’t — I had trouble keeping up.”
A Special Bond
Even if she doubted herself at times, the Riverview staff never gave up on her. “They made me feel comfortable,” she shares. “They really encourage you.” In that positive environment, Sandra successfully completed all 36 of her prescribed sessions — and chalked up her first graduation. That wouldn’t be the last the team would see of her face, however. “I was hospitalized several times for heart problems,” she explains. “I had a lot of problems with fluid retention. [The doctors] would have to diurese me, and then they’d send me back to cardiac rehab.” The cycle repeated itself intermittently over the better part of five years, with each subsequent round of treatment improving her progress on exercise and deepening her bond with the cardiac rehab staffers she saw three days a week.
Sandra is quick to point out that the team at Riverview treats all patients with respect and have their best interests in mind, but there’s no denying the extra special relationship that has formed between herself and the staff over the years. “They truly care about everybody, and they really have cared about me,” she agrees. “They took an interest in my story and made me feel comfortable about my situation. They’re so professional with everybody and they have good personalities; and while we have a stronger bond [than most], you can tell that everybody likes them and enjoys going [to rehab] and seeing their faces.”
The friendship and counsel of the staff was critical at a time when Sandra was not only trying to take care of herself but also her aging mother and father, whose health had begun to deteriorate. The staff became her second family and support system — especially when her mother passed away in December 2020, followed by her father’s death in December 2021.
Sandra’s heart was broken, figuratively but also literally — she wasn’t getting better. The gravity of her prognosis was made clear in 2022, the last time she needed to be diuresed. “The doctor told me I had the heart of an 80-year-old,” she recalls. “They said it was going to keep happening more and more over time.” Sandra promptly consulted with a heart specialist, who then sent her to Columbia Hospital in New York. The team there concurred with the referring doctor’s assessment, telling their patient that she was a “ticking time bomb” and agreeing that she was a viable candidate for a heart transplant.
Sandra was listed in August 2022; and by May 2023, the pressures in her heart were so alarming that Columbia admitted her to the ICU and hooked her up to a balloon pump. The new circumstances moved up her placement on the list, and within two-and-a-half weeks, she had her new heart.
Resilience
One of her first questions for the transplant care team was, “Can I go back to cardiac rehab?” Sandra remembers. It was too soon at that point but CR came to her, in a sense. Her Riverview family “kept in touch, checked in, and were really supportive” during the nearly two-month-long stint in the hospital leading up to and following surgery.
As soon as she got the green light last August, Sandra made her way back to Riverview, with an additional source of motivation. Not only was she determined to be the healthiest she could be with her new heart, she was also set on being well enough to attend her nephew’s wedding a couple of months later. Sandra communicated her wishes to the staff, whom she credits with helping her reach that goal safely. Because of their expertise, she says, Sandra was able to see her nephew exchange his vows.
The joy was short-lived. This past December, with just one session to go before what would be her fifth graduation from the Riverview CR program, Sandra developed an acute respiratory syncytial virus (RSV) infection that put her in the hospital once again. She was septic — a dangerous diagnosis for anyone but especially for people with immunocompromised status, which transplant surgery had conferred to her.
She missed Christmas but Sandra cleared the infection and, just like after her heart transplant, quickly bounced back. In both instances, she attributes that resiliency to participation in CR, which made her strong enough to withstand the medical traumas she’s experienced. “I felt great after [my heart transplant],” Sandra declares. “I didn’t have a lot of pain; I was up and around in no time, and I attest that to the fact that I was exercising all the time.” The bout with RSV realistically could have killed her but she recovered quickly — again, she's certain, because of the impact of CR.
With a fifth CR graduation now under her belt, Sandra is ready for Riverview’s maintenance program, which she appreciates as a safe environment for her as an immunocompromised individual. Even if she were to decide to maintain a regimen on her own outside the structure of rehab, the program has taught her the fundamentals of survival: “Just try to do something [active] every day. Stay healthy, eat right,” she drills. Sandra marvels at how far she’s come since first stepping on the rehab floor years ago. She’s lost weight, and physical activity is no longer a chore to her. In fact, she concludes, it’s fun. It’s even more enjoyable because she gets to do with a group of workers who have become like family.