Isle heart patients won't find a rehabilitation program at a local hospital despite national guidelines. Hospitals have closed outpatient cardiac rehabilitation programs in the past 10 years because of reduced reimbursements.

“;Bottom line, it's a money issue,”; said Penney Sing, an exercise physiologist who runs a cardiac rehab program in the Honolulu Center for Physical Therapy in Nimitz Center. “;I'm really the only one left. Somehow I feel as though I have been handed a mission to hold cardiac rehab together, and I have done so for almost eight years.”;

Castle Medical Center's program outlasted the others because Adventist Health “;has a very strong mission for health prevention,”; said Ron Henderson, director of Castle's cardiopulmonary department.

He feels cardiac rehab saves lives, but after losing “;an incredible amount of money”; for 10 years, Castle's program closed in January.

“;It broke my heart that we had to close the program,”; Henderson said.

Hawaii patients with cardiovascular disease have gone from one cardiac rehab program to another as they've closed.

“;I still maintain I wouldn't be alive today if I hadn't had rehabilitation,”; said Bob Spangler, 80, who had a bypass in 1989. He went to cardiac rehab at Castle, then to the Queen's Medical Center. When that program closed in 2000, he went to the former St. Francis Medical Center.

“;The sisters said they'd never do what Queen's did and six months later, St. Francis closed,”; Spangler said. He then went to a cardiac rehab program operated by Sing at the All-Star Sports & Therapy Center in Iwilei.

Many doctors refer cardiac patients to fitness centers, but they don't get the monitoring rehab provides, Spangler said. Sing gives them three electrocardiograms in one day (before, during and after exercise) once a week and checks blood pressure and swelling regularly.

She ran the cardiac rehab program at Kapiolani Medical Center at Pali Momi in the late 1990s, which closed around 1999 when she went to the St. Francis program. The St. Francis program closed in January 2001, and she started the Iwilei rehab program with a Weinberg Foundation grant for equipment.

In 2003, she moved the program to the Nimitz Center when Arthur Senining invited her to join his Honolulu Center for Physical Therapy. About 30 cardiac patients use the cramped facility.

“;We have more equipment than most cardiac places in the nation because Arthur combined all his therapy training machines,”; Sing said. He also helps her clients, she said.

Senining said cardiac patients are unsure of what will happen if they go back to work: “;Penney gives them comfort, security and knowledge to go back to their lives.”;

Patients need a doctor's referral to participate in her program and she has sent letters and brochures to doctors describing it, Sing said. Yet, she said, “;doctors are slow to refer.”;

Donovan Young said he began hunting for a cardiac rehab program after an aortic aneurysm and valve replacement June 23 at Stanford University, but his local cardiologist didn't know of any.

“;My wife asked a girlfriend who works at Queen's and she said to come see Penney,”; the 52-year-old dentist said. “;I wish there were more locations and I wish the other doctors were more informed about the program.”;