Peter Tuttle had experienced chest pains before. The 55-year-old retired Cleveland Heights-University Heights elementary school teacher dismissed those situations as consequences of morbid obesity and physical inactivity. A lifetime of bad eating habits had packed 280 pounds on his 5-foot-10 frame and put him on eight medications to control high cholesterol, high triglycerides, high blood pressure, Type 2 diabetes and gout.
His weight problems were rooted in a "heavy fat, major carb kind of diet" during childhood. Any efforts Tuttle had made in the past to control his weight — he lost 100 pounds at one point — were obliterated whenever he returned to his habit of large meals.
So Tuttle didn't think to call 911 when a sensation he compares to "a real kick to the chest" interrupted an attempt to shovel his driveway after a March 9, 2014, snowfall. He only casually mentioned it during a routine physical the following day. Tests revealed he'd suffered a heart attack — the result of an 85 percent blockage in his left anterior descending artery.
Nine days later, under local anesthesia and a sedative, Tuttle watched Cleveland Clinic doctors place a stent in the blocked artery. Only then did he realize the severity of his condition.
"I had whipped up a will real fast and handed that to my brother," he says. "I wasn't sure whether I was going to leave that room alive."
Dr. Leslie Cho, head of preventive cardiology at the Cleveland Clinic, made it clear a stent wasn't a solution. He needed cardiac rehab, a program of nutritional counseling and supervised exercise in a hospital.
"We put [patients] on an exercise stress test," Cho says. "We figure out what their current functional capacity is, and based on their current functional capacity, we design a program that will improve [it]."
Tuttle began rehab sessions three times a week. Nutritionists taught him to eat properly portioned meals of lean meats and fish, low-starch vegetables and low-sugar fruits.
"From the beginning, my weight started to come off," he says.
Tuttle has lost 55 pounds. He'd like to drop another 25. He now only has a trio of medicines to control diabetes, cholesterol and blood pressure along with a baby aspirin. And he is off injection insulin.
The recent retiree once exhausted by an after-work grocery run now rides a recumbent bicycle and walks on a treadmill every day. He describes himself as a human Energizer Bunny. "Now I just go on and on."
Starting in March, Peter Tuttle worked out during rehabilitation sessions every Monday, Wednesday and Friday. He dusted off his home treadmill, purchased a recumbent bicycle, and began duplicating his workouts at home on the days he wasn't exercising at the hospital. "Part of doing cardiac rehab is so that [patients] can get the confidence to do it on their own," says Dr. Leslie Cho, Cleveland Clinic's head of preventive cardiology. Here's a look at Tuttle's fitness routine.
Ride a recumbent bike for 20 minutes at a resistance of 45 watts.
Walk on the treadmill for 7 minutes at 2 miles per hour and 25 percent grade. Three-minute cooldown. *Increase by one minute every time until you reach 18 minutes.
After three months of increased cardio, Tuttle was able to add light weight-training. "Skin was starting to hang everywhere," he says.
One set (20 reps) of chest and leg presses. *Increase weight from 15 to 30 pounds on the chest-press machine and from 177 to 250 pounds on the leg-press.
One set (20 reps) of tricep and bicep extensions, and hamstring curls. *Use 5-pound free weights for the tricep curls and 5-pound ankle weights for the leg extensions and hamstring curls, gradually using heaver weights reaching 15 pounds.
Although Tuttle yearns to increase his time on the bike and treadmill, the experts overseeing his progress advise against it. "They've talked to me about [damage to] knees and hips," he says.