Scuba instructor Dennis Maurer is undergoing what's described as "real-world" rehab following two recent heart surgeries.
"There was about an 80 percent blockage in one of the arteries," said Maurer, 60.
Instead of standard rehab, Maurer chose industrial athlete -- rigorous program designed to help heart patients get back to their physically-demanding jobs.
"Basically, we're trying to make the exercise prescription as close to real life as possible," said Tim Bilbrey, cardiac rehab manager, Baylor Heart and Vascular Hospital in Dallas.
They carry hoses up stairs, swing sledge hammers, shovel rocks, and even practice hitting dummies.
Firefighters, police officers, athletes, farmers and auto workers regain the strength they need by doing activities they do in their jobs.
"We believe that we need to see them at the level they are going to perform at their job or their sport," said Jenny Adams, senior research associate, Baylor Heart and Vascular Hospital in Dallas
A recent study found attending rehabilitation is associated with a 46 percent lower risk of death, but a recent study found only 14 percent of heart attack patients use rehab.
Adams said one of the problems is traditional rehab isn't personalized.
"We have a 90-year-old woman in here. In the old days, we would give her the same prescription that we would give a 30-year-old firefighter, and we just want to stop that," Adams said.
Every patient gets a different workout.
"After three months of working out and on rehab and after the surgery, I can walk on the treadmill. I can go up ladders. I can carry weights," Maurer said.
Standard cardiac rehab is very conservative. Patients ride stationary bikes, walk on treadmills, and lift very light weights. Adams believes the program at Baylor Hospital is the only one of its kind in the nation. It recently won the innovation award from the American Association of Cardiovascular and Pulmonary Rehabilitation.