Long-distance rehab makes difference in the NW Bronx

Technology found in a cardiac telehealth program from Texas improved one man’s quality of life


A cardiac rehabilitation center in Texas has helped a man from Riverdale build up his physical strength.

David Saltman, a 76-year-old Riverdale resident, did cardiac rehab stints three times. Once was his first heart attack when he spent his 50th birthday in the hospital. Then, he needed it for pleural pericarditis and congestive heart failure. He was not surprised when he found out his condition was hereditary and that he could have died from the so-called “widow-maker.”

The program became popular when it was announced in February in honor of American heart month a change for thousands of regional cardiac patients. Four of New York City’s leading sub-acute rehabilitation centers partnered with the remote rehab.

With the exclusive collaboration of Bainbridge Nursing and Rehabilitation Center, East Haven Nursing and Rehabilitation Center, Mosholu Parkway Nursing and Rehabilitation Center and The Wayne Center for Rehabilitation and Nursing patients receive cardiac when they return home.

The four facilities operate under Medco management network, representing a dedicated commitment to quality healthcare services.

Cardiac rehab increases physical and cardiovascular fitness through exercise and education sessions.

Ninety percent of heart attacks are hereditary, according to the Centers for Disease Control and Prevention. The CDC says that one person dies from cardiovascular disease every 34 seconds in the United States, while every 40 seconds, someone has a heart attack.

Saltman spent 10 days in the hospital, and his recovery was smooth as he worked hard to regain his strength. But it was difficult, as he calls it, “learning to walk for the first time.”

“I was living in New Jersey in those days and walking in the suburbs and there’s nobody out on the street. It was like just me — or someone else who might have had a heart attack,” Saltman said. “I recovered really well and got to full strength.”

He practiced martial arts and Tai Chi, which has proven to improve cardiovascular fitness by increasing strength, flexibility and balance.

Saltman was one of the pioneers to bring Tai Chi into hospital and cardiac rehab.

His doctor was taken aback after looking at scans of his heart and said, “your heart looks like you never had a heart attack,” Saltman said.

Saltman and his doctor have a friendly relationship, as well as his doctor said to him “listen, he said I know a lot of 76-year-old martial artists who haven’t had a cardiac failure and stopped doing the spinning kicks.”

However, after suffering congestive heart failure — which is not a disease or a heart attack but caused by a virus that attacks a weak heart. But it is still dangerous — he spent his 75th birthday in the hospital for 25 days.

Congestive heart failure “sounds worst because it is heart failure, but it just means your heart isn’t pumping enough blood,” Saltman said.

“I was lying flat on my back attached to 15 machines for 25 days — I couldn’t even wiggle my finger,” he continued. “I used to practice as a magician and do magic tricks — forget about rolling a coin on my fingertips.”

Besides magic tricks, he couldn’t do the basic things in life. Such as buttoning his shirt or putting his socks on. He has to learn all of the basic essentials again, including walking.

“I would walk two steps and then I have to go back to bed. And then the next day I’d walk four steps and then eight steps,” he said. “Then one big day it would be like 20 steps. And then one day I walked all the way around the ward.”

After doing physical therapy on his own he went to cardiac rehab at Weill Cornell when there was a rehab center on York Avenue. However, it was expensive to keep the outpatient center running. Manhattan real estate was expensive and required qualified staff such as nurses, dieticians, physical therapists and a physiologist, including a doctor on board.

It became a hassle for rehabs until RecoveryPlus.health — the first nationally available remote cardiac rehab platform for patients recovering from heart surgery or condition, expanded to New York.

Saltman was pretty convinced that telehealth for cardiac rehab was a terrible idea. He couldn’t think of monitoring himself remotely. He asked himself, “like how can I do that?”

“People were hesitant because they were like, I don’t know because the likes of virtual acceptance and medicine was — like the new shiny thing,” said Tim Bilbrey, president and co-founder of RecoveryPlus.health.

The program was founded by three people: Peter Niemi, chief executive, Bilbrey and Dr. Zhen Lei, chair. About two years ago, they decided to commercialize it.

“Dr. Lei — his parents both had health events that left them basically couch-bound

There’s usually a re-admission problem with patients with heart failure. Within 30 days, 18 to 24 percent of patients nationwide can go back to the hospital.

Bilbrey always had a background in cardiac rehab, but he thinks deeply about telehealth because heart disease also runs in his family.

For decades 15 to 20 percent of patients are eligible for cardiac rehab but don’t go.  According to Bilbrey, many of the reasons are because of work and travel.

Saltman was looking into rehabs in New Jersey to avoid Bilbrey’s company at all costs. But he thought to himself — how will I get there?

Bilbrey tried to see the night and day difference. It’s the correlation between people who participate in rehab and those who don’t. Giving them access to do it from home and experience life is what the program does, he said.

“Seeing my grandpa and how beneficial it changed his life and he was one of those stubborn Native Americans — a stubborn, gentleman, you know, World War II guy and he was one of those unless I’m bleeding to death or a bone is poking out, I’m fine,” Bilbrey said.

With his grandfather’s first heart attack, he waited to see if it would go away. After eight hours, he started passing out and then told himself, “I’m actually having a heart attack,” he said, mimicking his grandfather.

During high school, Bilbrey drove his grandfather to cardiac rehab after his second or third heart attack because he had no way to get there. After several weeks of recovery, the “light switch” came on and the strength came back.

“While rehab is a 12-week program — usually Monday, Wednesday and Friday each week — inside of an outpatient center, you would have to drive to the hospital which means working is very difficult to do,” Bilbrey said.

After discharge, employers reach out to the outpatient asking when they will return to work. Because sick days add up, following up with in-person appointments can be challenging.

RecoveryPlus ais working with the Bronx centers on site. And then when patients are discharged to home, they are given access to an application that can be run on their phone — but Niemi said it looks great on a tablet.

Niemi said that Medicaid has been more open to telehealth services and covers all of the bills, but each patient is different.

His program does work in preventive care before people have a heart attack to catch early signs of heart disease. They also have pediatric patients.

Saltman experienced rehab three times and can’t imagine him setting up his vitals on his own. He thought it would be too complicated. He came into the program very negatively — but tried it anyway.

“But as it turns out — I was completely wrong,” he said. “I’m a big fan of it and it is somewhat better than cardiac rehab.”


telehealth, David Saltman, RecoveryPlus, Bainbridge Nursing and Rehabilitation Center, East Haven Nursing and Rehabilitaiton Center, Mosholu Parkway Nursing and Rehabilitation Center, Wayne Center for Rehabilitation and Nursing, Peter Niemi, Dr. Zhen Lei, Tim Bilbrey,