Next month, your doctor will be able to write you a prescription for exercise. Already some physicians write prescriptions for certain vitamins, minerals or herbal mixtures, but it's only recently that they have been able to fill out prescriptions for exercise and have professionals on-Island that will be able to fulfil them.

Thanks to efforts of the Bermuda Heart Foundation (BHF), two trainers have been certified in cardiac phase IV rehabilitation exercise.

Devrae and Susie Noel-Simmons completed a four-month programme with St. Catherine's Hospital, at the Wirral, in Britain.

The husband and wife personal trainers are now members of the British Association of Cardiac Rehabilitators and are on the UK register of advanced level exercise professionals in phase IV cardiac care.

When dealing with heart disease there are four phases of care. Phases one and two happen in the hospital and are centred on keeping the patient alive. Phases three and four are rehabilitative and centre on trying to get the patient back to living as normal a life as they used to as possible.

The couple explained in an interview with Body & Soul that their new certification enables them to carry out exercise programmes with patients at high risk for heart disease and 14 other conditions including high blood pressure, diabetes and obesity.

Doctors will simply prescribe a level of exercise for their patients and the personal trainers will be able to devise an actual routine.

According to the couple, until they returned to Bermuda with this certification a few months ago, doctors had nowhere on the Island to refer their patients, to help them regain strength and fitness.

Operating their own private company, International Fitness Pros, the Noel-Simmons are available to the general public with their new expertise. But they will also be an integral part of the BHF's new Cardiac Outreach Renewal and Education Centre (CORE) slated to open in late next month.

In that facility they will offer tailor made exercise programmes for their clients.

According to Simone Barton, Executive Director of BHF, patients at high risk for heart disease as well as those with heart disease, will be referred to the programme by their primary care physicians.

"People will have to be at a certain medical level before they can even come to us," she said. "They have to be, that's why you have the four phases of cardiac care.

"What you do in phase one and two is dramatically different from what you will do in phases three and four.

"By the time they are ready for three and four they will be appropriate for exercising at the level that we will see at the centre," she added.

Mrs. Noel-Simmons said in getting physician referrals, she and her husband will also learn of any other conditions their patients might have.

"If they have any other conditions we can deal with those in association and make sure that the goals that have been set for them (each patient) are correct and safe," she said.

In the case of patients with heart disease, cardiac workouts are the most important exercise according to Mrs. Noel-Simmons.

"The best thing for cardiac patients is cardio workout and then strength training. It's the heart and lungs that you want to get working," she said.

"But you have to take note of other factors like what their blood pressure readings are and what their cholesterol is," she added.

"The programme at CORE will be customised for each person. You cannot blanket this treatment because there are almost always other special factors involved.

"The person might have to go for an angioplasty or coronary bypass and they may be trying to avoid those things.

"All those conditions are serious, some more serious than others, and how we approach them from an exercise point of view, will differ slightly," she added.

Although only patients deemed by their physicians to be fit for exercise will be sent for the eight-week programme, Mrs. Noel-Simmons said both she and her husband expect to use heart monitors on many of the patients.

"What we will need to do is work with people at a certain target heart rate range once they get to that range," she said.

Bearing in mind that certain medications may mask the heart rate, she said working with heart rate monitors will be important.

But the couple will not only work with patients with heart disease, stressing the prevention end of cardiac care, they will also see people at high risk of developing the disease.

"If we can get to people ahead of time who are possibly at risk whether it's hereditary or by some other means, then we can get to solve the problem or at least curb it before it starts," said Mr. Noel-Simmons and exercise physiologist and personal trainer for more than 20 years.

With a family history of heart disease, diabetes and hypertension, Mr. Noel -Simmons is no stranger to the impact these conditions make on the everyday lives of Bermudians.

At the age of 35 he had heart surgery to mend a valve in his aorta, the main artery from the heart that pumps blood to the body. "When I had aortic valve surgery they told me that was it," he said.

"My rugby career was over, my personal training career was done and any athletics I wanted to do was done. I told them they obviously had never lived in Bermuda and that the costs required to live dictated that I had to work.

"There was no question about that. It was the only way for me to survive," he added.

"I was back up and running and playing rugby within six months of having major heart surgery. "

Proud of his own fight and determination he strongly believes that other locals simply need to be supported in order to succeed.

"It's a daunting thing if someone tells you, you have heart disease, you have high blood pressure or your sugar is high," said Mrs. Noel-Simmons. "Sometimes people need to have their hand held and have someone say 'don't worry we'll help you sort this out'."

The couple feel that they, along with the other support staff in the new CORE facility, can act as a caring team and make a real difference in the health of many locals.