As I have worked my way through my recovery one of the things that has struck me is the  absence of other women to share it with. I’m not talking about my friends and family but the women I expected to see undergoing  cardiac rehabilitation. From my experience you could conclude that very few women experience cardiac events and that it is ‘male’ disease.  But this is certainly not the case. It is the second biggest cause of death of women. One in five women die of heart disease. The biggest cause being dementia and Alzheimer’s. So where are all the women?

Let me first explain the process of cardiac rehabilitation and how I have experienced it. There are four phases as far as I’m aware. Nobody has ever explained  the first two phases to me but as per usual Google came to the rescue. Phase one takes place whilst you are still in hospital. When I was preparing for surgery I read a lot about how I would be seen by a physiotherapist who would walk me around the ward and ensure I could cope with stairs before I was discharged. No chance. I just got on with it. I did question why I hadn’t been seen by a physiotherapist. The nurse just laughed. I’m being a bit unfair. He did laugh but then explained that there were very few of them so I, being young and mobile, wouldn’t see one. I can’t tell you how many times I was called young when I was in hospital. It hasn’t happened since.

The second phase takes place when you first go home. At discharge you are given advice about exercise and restrictions on what you can lift/push/pull. It’s all rather straightforward which is just as well as by 7pm on a Sunday evening following two weeks in hospital I just wanted to get out of there. I didn’t want to listen to the instructions the nurse was giving me. Fortunately you are given a lot of information to take away with you.

And then you are at home. And you walk and then walk some more.

You are then invited to attend a Cardiac Rehab Phase Three programme. This takes place in the hospital following an assessment by a cardiac rehab nurse. The sessions are run by a physiotherapist and consist of an exercise session and then a talk by a nurse or other professional on subjects such as diet, relaxation and cardiac medication.

The exercise session is very tame. Nothing like what I was use to. But it gave me back some of the confidence I had lost in my body. I had started to question whether I would ever be able to go back to lifting weights again and doing burpees.

Phase Four usually takes place in a local leisure centre. It is described as the maintenance stage of cardiac recovery and for some I think this is all they need particularly if they had previously exercised. For me it was the next step on my way to full recovery.  But for others I’m not so sure. An hour of exercise a week with no support to lose weight and address other lifestyle issues is just maintaining the route back to the cardiac ward.

But what struck me about the whole process of cardiac rehab was the absence of other women participating. There were only two of us in Phase Three and I was usually the only women in the Phase Four session. So I did a bit of research.

It has been demonstrated that attending a cardiac rehabilitation programme can reduce the risk of cardiac mortality by 26% which I suppose is not a huge number. But the programme is free and surely every little helps. What is worrying is that not everyone that experiences a cardiac event is offered the opportunity to attend rehab and if you are a man you are more likely to be referred. 66% of men compared to 48% of women. But only 15% of women who have been invited will attend compared to 30% of men. So why are women are less likely to attend?

From what I have read the reason for this is multifactorial. Women tend to be older when they have a cardiac event and are more likely to experience complications. This may result in them questioning the benefit of cardiac rehab.  They may have more difficulty getting to a programme or may be reluctant to exercise with men. One piece of research suggested that being encouraged to attend cardiac rehab whilst still in hospital increases the likelihood of women attending. But as I stated earlier for me this conversation took place when I was straining at the bit to escape. And if I recall correctly it was just a reference that I will be invited onto a programme. Nothing about the benefits of attending.

So if you know a woman who has been unfortunate enough to have a heart attack or other cardiac event including open heart surgery do encourage them to attend a rehabilitation programme. It may save their life.