Hockey is just a winter sport to many, but for Aslan Motahedin it's a year-round way of life.
A regular between the pipes with friends he's known since Grade 3, playing goal is a big part of who he is.
So when recovery from surgery to replace his mitral valve – which allows blood to flow from one chamber of the heart to the other – left him benched, he immediately started plotting his return to the ice.
"I was still in the hospital when I started wondering how I would find a proper exercise program to help me get back," Aslan says.
When his healthcare team referred him to the Cardiovascular Prevention and Rehabilitation Program at UHN,* Aslan knew he was on the road to his own personal victory.
Seven months after his surgery, thanks to a personalized exercise prescription that reconditioned his body, and nutrition classes that promoted healthy eating habits, Aslan achieved his rehab goal of returning to the rink, finishing his first game to the sound of applause from both benches.
"It was an emotional moment, and an unbelievable feeling," he says. "I couldn't wait to get out there again."
A healthier world – one step at a time
Cardiac Rehab is designed to drive the convergence of care, research and education – a strategic priority for UHN.
"First and foremost, we're here to provide evidence-based rehab to participants, to improve their cardiac health and fitness" says Nancy McCabe, Exercise Leader.
"But we also know that in order for them to sustain what they achieve here, we need to teach them long-term maintenance strategies."
The key, Nancy says, is helping participants develop healthier habits while they're still in rehab, so they're already feeling the benefits before they graduate from the program.
For Aslan, that meant starting with an exercise prescription of walking a 17-minute mile, five days a week, and slowly building upon that, until he was doing cycles of walking briskly for five minutes and running for one minute, for a total of one hour. Resistance training twice weekly was also part of his program.
"Exercise is easy for me now," Aslan says.
"I still follow the prescription five days a week, and I know I could do even more."
Nutrition lessons that go the distance
According to the research, it's a learned habit that will continue to pay off for him.
In fact, studies conducted by scientists at The KITE Research Institute at Toronto Rehab show participation in cardiac rehab is associated with much higher levels of fitness and lower rates of mortality and repeat hospitalizations.
Because fitness and nutrition go hand-in-hand in supporting well-being, the team also teaches participants about the role of healthy eating in managing their condition and medications.
"Many people don't realize how important their diet is," Nancy says.
"So we start back at the beginning, teaching participants how to read labels, make healthy substitutions, and understand the relationship between food and medicine."
Aslan learned about simple swaps he could make to reduce calories and sugar, such as replacing carbonated pop with lime-flavoured bubbly water. By choosing whole grain bread over white bread, he was also able to reduce the dosage of his cholesterol medication.
As Aslan's heart grew stronger, so did his confidence that a return to the ice was in his grasp.
What helped him stay motivated, was the team's practical approach to measuring improvement – and in Aslan's case, it was identifying his cardiac age.
A cardiac stress test measures oxygen uptake – how efficiently your body is pumping oxygen through your body. The results help to determine your cardiac age.
"When I first started rehab, my cardiac age was 65 years old – and I certainly felt older than my age," says Aslan, who is 54.
"But it motivated me to say, 'I need to make this better.'"
As rehab progressed, Aslan's cardiac age decreased. And by the time he completed the program, his cardiac age dropped to 50.
"It took me a long time to come to grips with the fact that I have a cardiac condition," he says. "To know that my heart is operating at an age younger than me tells me I'm going to be ok."
When the time came to pick up his goalie stick again, Aslan still remembers feeling scared.
But he also remembers that clarity of focus that takes over when you're in the zone – a focus he had missed for so long.
"At one point, when the play went down to the other end, I was standing by our net when it hit me: I'm back – and it's awesome."
*We are proud of the cardiovascular care we provide at UHN. From prevention, to acute, to rehabilitation, we offer an integrated continuum of care through the Peter Munk Cardiac Centre and Toronto Rehab. The Cardiovascular Prevention and Rehabilitation Program at UHN is located at Toronto Western Hospital's GoodLife Fitness Cardiovascular Rehabilitation Unit and Toronto Rehab's Rumsey Centre.