Heart Health: Bridging the gap – CHF 360 program helps patients improve on their own

”Get back, Loretta!”
– Paul McCartney, “Get Back” 1969

“Get better, Loretta!”
– Wise Regional CHF 360 team, 2015

Growing up in the 1960s and ’70s, Loretta Harris no doubt heard that Beatles line a million times.

But it was the second line – a day-in, day-out, rousing chorus of “Get better!” combined with lots of skilled help – that helped get her back on her busy feet after a heart attack last September.

Loretta is a shining example of the effectiveness of Wise Regional Health System’s CHF 360 – a comprehensive follow-up program designed to help patients with congestive heart failure (CHF) stay on the road to recovery once they get out of the hospital.

For Harris, it started slowly – as most heart attacks do. The 59-year-old Chico resident noticed arm pain last September while she was working.

“I didn’t pay it any attention, and then I thought, ‘You know, they say that might be one of the signs of a heart attack.’ But I ignored it,” she said.

The next day at work, she had indigestion throughout the day – another sign.

“I never have indigestion,” she said. “But I drank orange juice, and if I’m going to get it, that’s what would give it to me. So I was kinda blaming it on that.”

At home that evening, she shared her symptoms with her husband, Dewey, who advised her to take her blood pressure and take an aspirin.

The blood pressure was a little high, but not alarming. So she took an Aleve instead.

“That night it just got a little worse, and my blood pressure was up a little,” Loretta said. “But I went on to work the next day.”

Then she called her daughter, an LVN, and went over her symptoms.

“She said, ‘You’re going to the doctor. I’m on my way down there to get you right now,'” Loretta said. “She brought me to the hospital, and sure enough …”

All Hands on Deck

ALL HANDS ON DECK – A big team had a hand in fixing Loretta Harris’ heart. Shown in one of Wise Regional’s two cardiac cath labs are (from left) Wanda Villard, MSN, NP-C, coordinator of the CHF 360 program; Polly Jones, RN, BSN, the RN for CHF 360, patient Loretta Harris, and Dr. Jason Finkelstein, M.D., F.A.C.C, cardiologist with Advanced Heart Care in Decatur, who implanted the stent in Harris’ blocked artery. Messenger Photo by Joe Duty

SLOW HEART ATTACK, QUICK TREATMENT

Tests in the ER revealed a heart attack was underway, due to 95 percent blockage in one of her coronary arteries. Soon, cardiologist Dr. Jason Finkelstein was standing at her bedside telling her she needed a stent to open that artery.

“Dr. Finkelstein said, ‘My team’s still here. Would you like to go ahead and do this?’ and that scared me because it was all happening so fast,” Loretta said. “My daughter goes, ‘Do it!’

“I’m glad I did.”

Prior to her trip to the ER, Loretta was a pretty heavy smoker – from one to two packs a day, depending on whether she was working.

“I quit the day I came into the hospital,” she said. “I don’t regret it. I smell everything now. Everything tastes different – I have food that I don’t even like anymore, now that I can taste it.”

Along with coronary artery disease, Loretta was suffering from congestive heart failure (CHF) – a condition in which the pump function of the heart falls behind, leading to fluid overload in the lungs. That leads to shortness of breath and swelling in the abdomen and legs.

“It’s a chronic disease similar to diabetes,” said Wanda Villard, MSN, NP-C and coordinator of the CHF 360 program at Wise Regional. “We can’t always cure it, but we can always manage it.

“In Loretta’s case, the pump function was affected by a lack of oxygen,” she noted. “That’s what caused the pump to not function well. So because Dr. Finkelstein could fix the plumbing, and get her heart oxygen, and then we gave her the medicines to support it, her heart pump got better.”

Loretta left the hospital a few days later. Even with the stent, her heart was still so weak she was given a “life vest” – an automated external defibrillator built into a vest that she wore 24 hours a day – to detect any abnormal heart rhthym and shock it back into proper rhythm if necessary.

She never got a shock, and by following up through CHF 360, she was able to ditch the vest by Christmas.

“I came and visited with her while she was still up in CCU,” Villard said. “Her heart function had been affected from the heart attack, so we enrolled her in the CHF 360 program, got her a blood pressure cuff and scales and all the educational materials, and then I started seeing her over in the clinic.”

Polly Jones, RN, BSN, worked in the cath lab before Villard snatched her away for the CHF 360 program.

“Loretta was very receptive to the program,” Jones said. “She called if she had questions, and she expected my phone calls. I spoke to her husband a lot on the phone – so it was very much a team effort between the two of them, and all of us. They were very involved.”

Mighty Women

MIGHTY WOMEN – Wise Regional’s CHF 360 team includes a lot of medical professionals who join congestive heart failure patients to help their recovery. Part of that team for patient Loretta Harris includes (from left) Holly Buckner, RN, cardiopulmonary rehab nurse; Susan Rector, director of cardiac rehab; Harris; Wanda Villard, MSN, NP-C, coordinator of CHF 360, and Polly Jones, RN, BSN, the nurse for CHF 360. Messenger Photo by Joe Duty

IT TAKES A VILLAGE

Dewey, a lifelong resident of Chico, was an integral part of his wife’s recovery.

“He’s my sweeheart,” Loretta said. “He was like my nurse when I couldn’t be with them. He told me he was proud that I didn’t give up, and I told him, ‘Well, I’m not going to give up!’

“He didn’t think I’d exercise, he didn’t think I’d give up smoking, salt, coffee – but I did,” she said.

“I love my family. It would probably kill them if I wasn’t around.”

Jones said battling CHF is very much like exercise and dieting – it’s hard to do it alone.

“It is helpful to have someone to encourage you,” she said. “It’s hard – you’re cutting out salt, cutting your fluid intake – it’s hard. You don’t think about it until you actually have to start applying it. It’s a lot to take in.”

Villard said they communicated with Harris so much that they easily recognized each other’s voices on the phone.

“We don’t even have to say who we are,” she laughed. “We’re on a voice recognition relationship.”

But she stressed that they welcome those calls.

“So often, I think people don’t want to bother the doctor,” she said. “They think, ‘Maybe I’ll just wait ’til tomorrow.’ We always encourage people, if you have a question, call us. This is all we do. You’re not bothering us. This is our job, to be your coach.”

CHF 360 starts when a patient is admitted, follows them through their treatment and for at least 90 days after dismissal.

It includes an array of resources including education, monthly support groups, transportation assistance, medication assistance including home and hospital delivery, a free blood pressure cuff and scales, a custom fitness plan created by cardiac rehab specialists, and continued testing.

The team has board-certified cardiologists, an interventional cardiologist, a board-certified cardiothoracic surgeon, a cardiac electrophysiologist, cardiac nurses, exercise physiologists and physical, occupational and respiratory therapists.

“Basically, we just try to find what are the barriers that are out there, that are keeping from getting the best care, and what can we do to help eliminate those barriers,” Villard said.

READMISSION RATE PLUMMETS

The program, which started in June 2013, grew to serve 222 people in 2014. Indications are, that growth will continue.

“Patients with congestive heart failure, their odds of readmission back into the hospital within 30 days are pretty high,” Villard said, citing the new medications, dietary and lifestyle changes.

“It’s almost too fragile of a state to go between office visits,” she said. “You go from the ICU where three or four doctors are looking at you every day, to going home, where you might see somebody every two or three weeks. So we bridge the gap.

“Polly calls, checks on vital signs, checks on weight. We can do little adjustments to medications. We do labs to follow up, to see how the body’s doing with medications – just to make sure when they leave the hospital they continue to get better.”

Nationally, about 25 percent of patients with heart failure are back in the hospital within 30 days. Wise Regional’s average was about 27 percent before they started CHF 360.

“We’re at 13 percent now,” Villard said. “It’s made a pretty significant impact on the number of patients coming back in for other complications. We try to catch those complications early, turn things around and give people resources.”

Loretta and her husband bought in completely and have achieved ideal results. She started working again about a month ago, a three-day-a-week job.

She’s grateful to be busy again, and now she faces life armed with an enormous amount of knowledge she didn’t have before.

“Now I notice any kind of little pain – anything,” she said. “If this happens again, I’ll let somebody know.”

And her exercise routine has become an inspiration for the rest of her family.

“I started exercising after about six or eight weeks,” she said. “I was a little slow getting started, but out where we live there are a lot of hills and my husband made some walking paths for me.

“I’d walk them, and he’d walk them with me,” she said. “He said if you can’t, just stop and rest. But I made me a goal and when I’d get on top of the hill, I’d celebrate.”

She has developed a deeper love for their land – and her addiction to walking has infected not only her husband, but also her kids and grandkids.

“Now, I can just walk anywhere I want to,” she said. “I think those hills, that rugged terrain, that helped a lot.

“I got them all walking.”

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Heart Health: 17th Annual Wise County Walk Across Texas

Through a modest increase in daily activity, most Americans can improve their health. WALK ACROSS TEXAS is a program that persuades and motivates people of all ages to make the most important change… to get started. It is a fun and flexible way to exercise. The program is simple, free and safe. All you need is a team of eight people to get moving, with one person being designated as the “team captain.” The team who walks farthest “across Texas” will win, but everyone who participates will take home a healthy habit – walking for fitness.

Team members report their daily mileage to the team captain, and the team captain reports the individual and team total miles on the following web address: walkacrosstexas.tamu.edu or to the Extension office at the end of each week by: telephone 940-627-3341, fax 940-627-8070 or e-mail khbrown@ag.tamu.edu.

Teams are not required to walk or ride together, although they may if they desire. Teams simply pool their mileage each week to work toward “walking across Texas.” Members may walk, jog, ride a bike, skateboard, roller blade, tread mill, swim, spin and/or run. A large Texas map showing the progress of teams will be in Texas AgriLife Extension, Wise County office, and at other various locations.

So dust off your walking shoes and prepare to join us in this 8-week journey beginning on March 2, and continuing through April 26.

Walk Across Texas is sponsored by Texas AgriLife Extension. We are looking for captains and team members. Please encourage organizations in which you are involved to participate in this endeavor.

Remember prevention works! Individuals can save a lot of pain, worry and money by avoiding health problems. I encourage you to join the Walk Across Texas Program today.

Call or come by Texas AgriLife Extension Service, Wise County office, located at 206 South State, in Decatur or call 940-627-3341 to pick up your Walk Across Texas Team Captain Packet.

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Heart Health: Stress & Your Heart Health

How do you react to a stressful situation?

Do you shut down or lash out? Take to unhealthy habits to deal with the pressure building up inside of you? How you handle life challenges can have a major impact on factors that have been proven to negatively impact your heart health.

Stress may affect behaviors and factors that increase heart disease risk, including high blood pressure, cholesterol levels, smoking, physical inactivity and overeating. So step back and take a deep breath – for your heart’s sake.

OVERALL BODY IMPACT

Bodies react to stress in different ways. You may experience a headache, back strain or even stomach pains if you’re stressed out. Your energy level can be greatly reduced and your sleeping patterns disturbed.

All of these factors can set off a chain of events that leads to a potentially compromised cardiovascular system.

When you’re stressed, your body releases adrenaline, a hormone that temporarily causes your breathing and heart rate to speed up and your blood pressure to rise. Depending upon how long you’re stressed, your body may experience this set of circumstances off and on for days at a time.

And although the link between stress and heart disease isn’t clearly defined by organizations like the American Heart Association, chronic stress may cause some people to depend on unhealthy lifestyle habits, like drinking too much alcohol, which can increase your blood pressure and may damage the artery walls.

DEALING WITH STRESS

Managing stress is a challenge, but a necessity if you hope to be a picture of good health. A few studies cited by the American Heart Association have examined how well treatment or therapies work in reducing the effects of stress on cardiovascular disease, and the results have shown positive links.

The best place to start when dealing with your stress is a qualified professional. Speak to your physician about how you’re feeling. They will be able to refer you to a specialist who can offer effective treatment or preventive strategies.

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Heart Health: Mental Health & Heart Health

The connection between mental and physical well-being is being researched at great lengths by the medical community.

Researchers are busy trying to find tangible connections between mental health and heart health.

Research shows there could be physiological links, the American Heart Association reports, between a person feeling down and their efforts in seeking relief from smoking, drinking or eating fatty foods.

The same biological and chemical factors that trigger mental health issues and could also influence heart disease.

DEPRESSION

While the American Heart Association states that there is no firm research linking stress to heart disease, there are signs pointing to it as an additional risk factor. Being stressed or unhappy can increase hormones like adrenaline and cortisol, which can both impact your blood pressure and heart rate.

You should monitor yourself and your loved ones closely, especially those dealing with rehabilitation and recovery from heart disease or stroke. The American Heart Association reports that having heart disease or a stroke can cause anxiety or depression, which can get in the way of rehab or other aspects needed to regain physical health.

An estimated 1 in 10 of Americans ages 18 and older report depression. The American Heart Association cites studies that show that up to 33 percent of heart attack patients end up developing some degree of depression.

WHAT TO DO

Start by discussing how you are feeling, both physically and mentally, with your healthcare provider. He or she will be able to help, or refer you to the most appropriate care or provide the best place to start.

It may take a combination of counseling and medication to help deal with depression. Patients may be taught methods of dealing with relaxing and relieving stress, including breathing exercises, meditation or a focus on healthier lifestyle changes.

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Heart Health: Home is where the heart {care} is

Bill and Dorma Gantt aren’t averse to long drives. For several years, it was 600 miles one way to visit their grandkids at San Benito, and until they moved from the Austin area to near Chico nine years ago, they were up here “almost every weekend” to see their other grandkids’ ballgames.

But when Bill had a heart flare-up recently, they decided to stick closer to home.

Comforting Hearts

COMFORTING HEARTS – Bill and Dorma Gantt hang onto a heart-shaped pillow Bill got after one of his procedures several years ago. He recently moved his heart care to Wise Regional. Messenger Photo by Joe Duty

“We had been using a cardiologist over in Denton, who had been recommended to us,” Bill said. “We really do like him – but it’s 110 miles round trip, and the older we get, the harder it is to make that trip.”

Bill and Dorma both have a history of heart problems, and both are diabetic. They had seen newspaper ads about the cardiac care program at Wise Regional Health System and decided that next time they needed cardiac care, they would give them a try.

“We had been talking in the last two or three weeks about looking over in Decatur,” he said. “I’d been reading about their upgrading their cardiac unit, and I was really impressed with it. We decided that pretty soon we’d go talk to somebody over there and find out about it.”

Then Bill hurt his shoulder moving some feed sacks. After the pain continued to get worse, his wife insisted that their son take him to the urgent care clinic in Bridgeport Sunday, Jan. 25, to get it checked.

“I just knew I’d damaged my shoulder,” he said. “They hooked me up to their various machines and just immediately called the ambulance and sent me to Decatur.”

The personnel at Bridgeport had detected a possible heart attack. As it turned out, Bill wasn’t having a heart attack – but he was having “serious heart problems.”

By bringing him to the clinic, the shoulder injury may have saved his life.

“When they got me into the ER in Decatur, they said, ‘We can send you on over to Denton, to your cardiologist.’ This was a cardiologist telling me that!” Bill laughs. “They had one right there when I got there.

“I said, ‘Well, no. I’d like to just stay right here.’ They said that was fine, and they went through the full procedure.

“They said, ‘We need to check you into the hospital. We’ve got some work to do.'”

Helping Hands

HELPING HANDS – Cardiologist Dr. Jason Finkelstein put three stents in one of Bill Gantt’s arteries at Wise Regional’s Cardiac Cath Lab. Messenger Photo by Joe Duty

Bill ended up in the cath lab, getting three stents placed in an artery by Dr. Jason Finkelstein, who joined Advanced Heart Care in August 2007. The shoulder may still need work, but the heart procedure was successful and Bill was up and around just a few days later.

“They had hoped to do the heart cath on Monday, but they were really, really busy,” Bill said. “It was Tuesday before they could get to it.”

Bill, a big, active man who retired after 36 years in research and development with Texaco Chemical in Austin, has had seven stents placed over the years – at hospitals in Austin, Round Rock and Denton. He had a quadruple bypass done in Denton a few years ago.

This was his first time to be worked on in Decatur.

“I was impressed with everything I saw,” he said. “Having done this in several hospitals, I know kind of what to look for. There was just a really caring atmosphere. I was never waiting for anything. There was always somebody available, and anytime I made a call, it was instant that I got some help.”

He has a visit scheduled Thursday with his family physician, Dr. Denise Casper, at her office in Bridgeport, and a follow-up appointment with Dr. Finkelstein next week.

“This was another thing that impressed me,” he said. “The day I got home, I got a call from my family doctor. Wise Regional had contacted her and told her what was going on, and my family doctor was making the appointment for me to go in this Thursday.”

Dorma noted that in one day at Wise Regional, four cardiologists came to check on her husband.

“I was impressed with the cardiology department,” Bill said.

Bill and Dorma have two sons. Spencer Gantt is a coach at Victoria and his wife, Jennifer, is also a coach. Matt Gantt works for Microsoft and his wife, Dalene, works for Simpson Boyd Powers and Williamson law firm in Bridgeport.

The Gantts, who celebrated their 56th anniversary two days after Christmas, make every effort to keep up with their grandkids’ sports and other activities.

With a little help from the folks at Wise Regional, they should celebrate a few more – and watch those grandkids continue to excel.

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Heart Health: Local Heart Care Resources

ADVANCED HEART CARE

2401 S. FM 51, Suite 200
Decatur, TX 76234
940-627-0044
www.advancedheartcare.com

Jason Finkelstein, M.D., F.A.C.C.; Bruce Gordon, D.O., F.A.C.C.; Trieu Ho, M.D., F.A.C.C., Electrophysiology; Irfan Hameed, MD; Cheryl Fostel, F.N.P.C.

EXCEL CARDIAC CARE

1502 S. FM 51, Suite B
Decatur, TX 76234
817-518-9005
Saritha Dodla, M.D., F.A.C.C.

Preventative, diagnostic, interventional and nuclear cardiology and electrophysiology

Services include ablation, ambulatory B.P. monitoring, angiojet, balloon angioplasty, cardiac catheterization, cardioversion, carotid angiography and stenting, coronary angiogram, echocardiogram, electrocardiogram, enhanced external counterpulsation (EECP), holter monitor, implantable defibrillator (ICD), intravascular brachytherapy, laser angioplasty, nuclear stress test, pacemaker, peripheral vascular angiography and intervention, SPECT scan, stenting, stress test and transtelephonic monitoring

TEXAS HEART AND LUNG

609 Medical Center Drive, Suite 2500
Decatur, TX 76234
940-626-2420
www.TexasHeartandLung.com
Arshad M. Yousuf, M.D., F.A.C.S., F.R.C.S.

DIAGNOSTIC AND INTERVENTIONAL SERVICES

Cardiac procedures include bypass surgery, valve repair and replacement, congenital heart surgery, aortic surgery, atrial fibrillation surgery and hypertrophic cardiomyopathy surgery. Minimally invasive procedures also are offered. Yousuf is one of only a few surgeons in North Texas performing the mini-sternotomy, a minimally invasive procedure for valve repair.

WISE REGIONAL HEALTH SYSTEM

609 Medical Center Drive
Decatur, TX 76234
(cardiology services on third floor)
940-627-5921
www.wiseregional.com/cardiac

Emergent, preventative and diagnostic services, cardiopulmonary service department, cardiac catheterization lab, critical care unit and cardiac rehab

As an accredited chest pain center (by the Society of Chest Pain Centers) and primary stroke center (by the Joint Commission), WRHS offers an advanced cardiovascular program that provides a full continuum of cardiac care, eliminating the need to travel great distances for high-quality cardiac care.

The medical staff includes board-certified emergency department physicians, board-certified cardiologists, interventional cardiologists, a board-certified cardiothoracic surgeon, a cardiac electrophysiologist as well as respiratory therapists, exercise physiologists and cardiac nurses, all trained in using the latest treatment strategies.

SERVICES/PROCEDURES

WRHS offers noninvasive calcium screenings, consultations, diagnostic stress testing, interventional cardiology, stress echocardiograms, electrophysiology, nuclear cardiology, EKG, therapeutic hypothermia, hypertension treatment, coronary stent and Pacemaker implementation.

CARDIOPULMONARY SERVICE DEPARTMENT

The cardiopulmonary service department provides inpatient and outpatient diagnostic testing for those with heart and lung disorders.

CARDIAC CATHETERIZATION LAB

Cardiologists and radiologists perform diagnostic catheterization/angiography of the heart arteries in the only cardiac cath lab of its kind in the county. These specialized studies of the heart help physicians determine how to handle the repair of coronary blockages, which methods to use, and the need for more aggressive intervention, such as bypass surgery.

The Cardiac Catheterization Lab at WRHS also offers catheterization procedures via the radial artery, an approach that increases patient comfort and decreases the risk of complications.

CRITICAL CARE UNIT

The critical care unit at WRHS provides individualized, continuing specialized care to patients who’ve had a heart attack or major cardiac surgery with the most up-to-date monitoring and testing equipment. Care is one-to-one, nurse to patient ratio, the first 24 hours of a patient’s stay in CCU after bypass surgery.

CARDIOPULMONARY REHABILITATION PROGRAM

WRHS offers a cardiopulmonary rehab program for those who have been diagnosed with heart disease, have recently had heart surgery (stent, bypass, open heart) or have COPD (chronic obstructive pulmonary disease), asthma or symptomatic lung disease.

Nurses, exercise physiologists and respiratory therapists organize scheduled exercise and education sessions on how the heart and lung function, ways to decrease stress levels and how to choose healthy diets.

Classes are Monday, Wednesday and Friday at several times throughout the day. Each class lasts approximately one-and-a-half hours, and the program is generally 12 weeks. However, the duration of the program, and class times, are flexible.

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Heart Health: Bad vs. good cholesterol

In the fight between LDL vs. HDL cholesterol, which type is winning within your body?

Cholesterol is transported through your bloodstream by carriers called lipoproteins, which are characterized in two ways: low-density lipoprotein (LDL) and high-density lipoprotein (HDL). These are what make up the total cholesterol count you receive from your doctor, as well as one-fifth of your triglyceride level.

LDL (BAD CHOLESTEROL)

Considered bad cholesterol because it contributes to plaque, LDL cholesterol can clog arteries and make them less flexible. This condition is known as atherosclerosis.

A heart attack or stroke can occur if a clot forms and blocks a narrowed artery. Another condition, peripheral artery disease, can develop when plaque buildup narrows an artery supplying blood to the legs.

HDL (GOOD CHOLESTEROL)

HDL cholesterol helps remove LDL cholesterol from the arteries, carrying away the bad cholesterol from the arteries and back to the liver, where it is broken down and passed from the body.

The American Heart Association states that one-fourth to one-third of blood cholesterol is carried by HDL. A healthy level of HDL cholesterol may protect against heart attack and stroke, while low levels have been shown to increase the risk of heart disease.

TRIGLYCERIDES

Another type of fat, triglycerides work to store excess energy from your diet. High levels of triglycerides in the blood are associated with atherosclerosis, and many people with heart disease or diabetes also have high triglyceride levels.

Heightened triglycerides can be caused by obesity, physical inactivity, cigarette smoking, excess alcohol consumption and a diet very high in carbohydrates.

Additionally, underlying diseases or genetic disorders are sometimes the cause of high triglycerides. People with high triglycerides often have a high total cholesterol level, including a high LDL cholesterol level and low HDL cholesterol level.

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Heart Health: Know the signs of a heart attack

Each year, approximately 1.2 million Americans suffer a heart attack, and nearly one-third of these individuals die, many before they reach the hospital.

People often dismiss heart attack warning signs, such as chest pain, and think they merely have heartburn or a pulled muscle. The result is that many people wait too long before getting help.

Recognizing early symptoms is the best way to treat and stop the heart attack process. Frequent signs of a heart attack include:

  • Chest discomfort. Most heart attacks involve discomfort in the center of the chest. The discomfort lasts for more than a few minutes or it may go away and come back. The discomfort may feel like pressure, squeezing, fullness or pain.
  • Discomfort in other areas of the upper body. This may include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
  • Shortness of breath may occur with or before chest discomfort.
  • Other symptoms may include breaking out in a cold sweat, nausea or light-headedness. Treatments are most effective when they occur in the early stages of chest pain.

Heart attacks are often viewed as a man’s problem when, in fact, more women in the United States die of heart disease each year than men. Women often experience signs and symptoms that are different from those that men experience. This is because smaller arteries may be blocked in women; whereas, men often have blockages in the main arteries.

Heart attack signs in women that can go unnoticed include:

  • Pressure, fullness, squeezing pain in the center of the chest, spreading to the neck, shoulder or jaw
  • Light-headedness, fainting, sweating, nausea, or shortness of breath with or without chest discomfort
  • Upper abdominal pressure or discomfort
  • Lower chest discomfort
  • Back pain
  • Unusual fatigue
  • Unusual shortness of breath
  • Dizziness
  • Nausea

If you have chest pain or other heart attack symptoms, call 911 and seek medical attention immediately.

*Information provided by Wise Regional Health System

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Heart Health: Understanding blood pressure numbers

You may know your blood pressure numbers, but do you truly understand them?

Typically recorded as two numbers written in a ratio, such as 117/76 mm Hg, your blood pressure measurement is a vital one that can alert physicians of an issue going on with your body, specifically your heart.

The American Heart Association recommends a blood pressure screening at your regular healthcare visit or once every two years if your blood pressure is less than 120/80.

THE NUMBERS

Systolic: The top number of your blood pressure reading represents the pressure in the arteries when the heart beats, or when the heart muscle contracts. This is the higher of the two numbers.

Diastolic: The lower of the two numbers, this bottom measurement records the pressure in the arteries between heartbeats, which is when the heart muscle relaxes and refills with blood.

Typically more attention is given to the top number as the major risk factor for heart disease, especially for people over 50 years old. This systolic figure generally rises steadily with age because of many factors, including plaque buildup and increasing stiffness of larger arteries.

HEALTHY MEASUREMENTS

A normal blood pressure reading, defined by the American Heart Association, is less than 120/80. Numbers that may signal a warning sign for a heart issue are measured and defined as the following:

Prehypertension: 120-139/80-89

Hypertension Stage 1: 140-159/90-99

Hypertension Stage 2: 160 or higher/100 or higher

Hypertensive Crisis (Emergency Care Needed): Higher than 180/Higher than 110

DEALING WITH HIGH READINGS

A single high reading does not necessarily mean that you have high blood pressure. However, if readings stay at 140/90 or above over time, your doctor will likely recommend a treatment program that may include lifestyle changes and prescription medication.

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Life-saving tool: AEDs are being used locally to keep hearts beating

Life-saving tool: AEDs are being used locally to keep hearts beating

LIFESAVERS - Decatur firemen Eli Nobles (far left), Brandon Peyton (center) and Jed Boyd (far right) received the Lifesaver Award for their part in the successful rescue of heart attack victim John Conrad of Bridgeport last September. Conrad (second from left) and firefighter Brandon McGar (second from right) made the presentation. Decatur policeman Robert Cain (not pictured), who was the initial first responder, also earned the award. Photo courtesy of Rick Wallace/On-Fire Photography by Rick

Newark home remodeler Samuel Gary isn’t sure why he was lucky enough to survive a 2009 heart attack.

“It wasn’t anything I did, or how good I was,” he said recently. “But the good Lord brought me back for some reason, and I’m very, very thankful I got to see my grandkids grow up.

“I’ve got 16 of them and six great-grandkids.”

Heart disease is the No. 1 killer of Americans, responsible for nearly one out of every four deaths (595,444 of 2,465,936, 24.1 percent) in 2010, according to the most recent data available from the Centers for Disease Control and Prevention.

Yet interviews conducted in recent months suggest that if a heart attack is unavoidable, Wise County is a pretty good place to have one, thanks to the availability, skill and resources of area first responders and hospitals.

“Our [emergency] response time in Wise County is awesome,” said Billy Newsom, athletic trainer at Bridgeport High School. “Mr. Dillard [Charles Dillard, Wise County Emergency Medical Service administrator] does a great job.”

Gary’s life was saved by volunteers with the Newark Fire Department who responded to a 911 call at his home.

Chief James Edgemon, Assistant Chief Jerry Taylor, 1st Capt. Mark Killough, 1st Lt. William Terry and 2nd Lt. Justin Davis used both cardio pulmonary resuscitation (CPR) and an automated external defibrillator (AED) to restore the man’s heartbeat and breathing before an ambulance took him to Wise Regional Health System’s cardiac catheterization lab in Decatur.

In late September, first responders from the Decatur Police Department, Decatur Fire Department and county EMS also used CPR and AEDs to save the life of John Conrad of Bridgeport when he had a heart attack at Decatur’s Walmart store.

The addition of the AED to the first responders’ lifesaving toolbox has made a big difference in the number of happy reunions like the one Gary had two years ago with the Newark firemen who received Lifesaver Awards for their actions.

“When you see something like this, it makes you feel good about what you do,” Taylor, the Newark assistant chief, said at the 2009 ceremony. “We do this job for a reason.”

A 2008 survey published in the Journal of the American Medical Association showed that fewer than 5 percent of those suffering cardiac arrest lived to be discharged from a hospital.

But a Medicare study showed survival rate for cardiac arrest when CPR is administered was as high as 18 percent.

CPR is considered a first step in treatment of people who have had a heart attack, which occurs when blood flow to a part of the heart is blocked.

CPR acts to preserve brain function until further means are taken to restore spontaneous blood flow and breathing.

Defibrillation, a common treatment for irregular heartbeats, relies on electrical therapy to “shock” the heart back into normal rhythms. The use of CPR and AEDs in the first few minutes after collapse can result in long-term survival rates as high as 50 percent, according to a handout from the Decatur Fire Department.

One study found that two-thirds of the AED “saves” were performed by a layperson.

“I was an EMT for years,” Newsom, the Bridgeport trainer, said. “When you carried in a defibrillator, it was a big deal. (Now) a layperson can pull an AED out of the cabinet and use it. It’s awesome to me how user-friendly they are. They have voice prompts that tell you everything you need to do.

“Technology is amazing. Remember how the original computers were the size of rooms? Now we have ones the size of watches. It’s the same with AEDs. The idea they’d make it portable so that anybody could use one blows me away.”

Newsom and the Bridgeport school district were recently the recipients of a new AED donated by North Texas Sport and Spine.

“With the latest stories about AED resuscitation coming out of Azle and Frisco, it seemed the right thing to do,” said Robert E. Stapp, chief executive officer and managing partner of the Decatur business. “There is a strong medical presence here in Wise County and our community should benefit from this resource.

“I hope this story will spur additional AED donations throughout North Texas along with sports medicine education,” he said.

In September, an AED and quick-thinking adults saved the life of a 13-year-old boy after he collapsed during a seventh-grade football game in Azle. A few weeks later, two teachers at a Frisco middle school used an AED to save the life of a 12-year-old student who collapsed from sudden cardiac arrest.

Stapp said he contacted principals at both Decatur High and Bridgeport High to offer an AED donation.

“Bridgeport indicated that an AED would be a great addition to their new gym and overall sports program as they had already exhausted their grant funds,” he said “We were delighted to sponsor this donation to Bridgeport ISD to protect students and staff alike.”

At a school board meeting in Alvord near the end of September, trustee Vic Czerniak asked district nurse Cheryl Clark, in light of the highly publicized Azle incident, how Alvord ISD was equipped for AEDs.

Clark proudly responded that Alvord, with about 750 students enrolled, owns 10 AEDs, which she said was “probably more than any other district in Wise County.”

“Two of these were purchased through the state grant program, one was donated by TASB (Texas Association of School Boards), and three were donated by local companies,” she said. “The rest were purchased by our district.”

The AEDs are allotted with one per campus and two at the high school, one in each gym, one in the field house and one in the weight room.

“We are fortunate to have as many as we do,” she said, “but there is always room for another. All of our coaching and UIL staff are trained annually, as required by law. Many of our faculty and staff at each campus volunteered to be trained each year.”

AEDs cost anywhere from $1,100 to $2,500 each, according to local first responders. Clark said Alvord’s AEDs require $400 batteries, and defibrillator “smart” pads, which have a short shelf life, cost $80 to $100 apiece.

“This is of great cost to the district, but there is never a doubt that we will cover this expense,” she said. “Our school board funds this unquestionably.”

A state law, enacted in 2007, required all Texas schools to have AEDs on each campus, at each sports competition and “available” for each sports practice.

Newsom, the athletic trainer for Bridgeport schools, said that prior to the state law requiring AEDs, he took a suggestion from then-Bridgeport High Principal Kenneth Thetford and applied for a grant designed to provide AEDs for use in rural school districts.

“We were denied, because the response time (of first responders) is so great here,” the trainer said.

Bridgeport ISD, with more than 2,200 students, now has seven AEDs. Like the much-smaller Alvord, though, it has never had to use an AED.

“They (AEDs) are great devices to have,” Newsom said. “But you want them to collect dust. If you’re using them, something bad has happened. But if someone has a cardiac event, this is the best thing to have.”

A study by University of Washington researchers of high schools equipped with AEDs found the survival rate for sudden cardiac arrest was an impressive 64 percent – and nearly two-thirds of the people rescued were adults.

Another Texas law requires that all state buildings have AEDs on site.

All of Wise County government buildings are equipped and so are patrol cars for the sheriff’s deputies.

“We actually did get a $68,000 state grant administered by the (North Texas) Council of Governments in 2010,” Sheriff David Walker said. “The county put defibrillators in all the county buildings. Then we got enough to put AEDs in every patrol car that we have.

“Obviously, we’re not paramedics or EMTs, but we do have some who work for us who do carry an EMT or paramedic license. If you’re in the right place at the right time, they (AEDs) are useful. A lot of times an ambulance is on the way, but if we need to use it, we’ll have it.”

The Decatur Fire Department has a program called “Community Heart Savers” that conducts monthly CPR and AED training for those who live in the city and the fire department’s response district, or who work within these areas.

To register or seek more information, call (940) 627-3199, visit the station at 1705 S. State St., or email dbennett@decaturfd.com.

Community Heart Savers has also been instrumental in getting AEDs installed in city-owned buildings. City employees are required to be CPR and AED certified.

“We’ll reach out to anybody in the county to teach CPR and how to operate AEDs,” said Deroy Bennett, deputy chief of prevention for the Decatur Fire Department. “We’ve been successful in getting a few businesses and churches that regularly have large groups of people to purchase AEDs.

“There’s no law that businesses have to have them, just as there’s no law for them to report to us that they have them,” Bennett said. “But we try to help them wherever we can.”

Besides the Decatur Fire Department, Wise County EMS also offers CPR and AED training. Dillard, the EMS administrator, said all 38 of his employees are certified to train the public on CPR and AEDs.

Newsom, the Bridgeport athletic trainer, said all Texas athletic trainers have to be certified as AED and CPR instructors, too.

“We have to be able to instruct other people in how to use them,” he said. “I taught my son how to use it when he was 10 or 11. That’s how easy they are.”

AED DONATION - Susanne Boston (left) and Robert Stapp (far right) of North Texas Sport and Spine present a new automated external defibrillator (AED) to Bridgeport High School recently as school nurse Linda Green, athletic trainer Billy Newsom and Principal Jaime Sturdivant accept for the school. Submitted photo

AED: HOW IT WORKS

What’s small but powerful, lightweight but strongly recommended and can save you from America’s No. 1 killer?

The answer is an AED, which is short for an automated external defibrillator.

The machine is designed specifically for the first person to respond to a victim of sudden cardiac arrest, and not only can it restore a victim’s heartbeat and breathing, it’s also easy to operate.

“Remove clothing from chest,” is the first instruction you hear from the AED version sampled by the Messenger at the Decatur Fire Department, a 4.5-pound plastic box 4 inches high, 8 inches wide and 9.5 inches long.

“Connect electrodes” comes next. A diagram shows where to attach the electrodes (on either side of the heart).

The AED does it all from there, advising “Please do not touch the patient,” “Analyzing now,” and “Heart rhythm shockable” or “Heart rhythm not shockable.”

If a shock is what’s needed, the machine will provide one, with no need to touch the machine. If the situation is “not shockable,” the AED will prompt the rescuer to “Continue with CPR.”

“If you’re doing CPR, it has a timer that will tell you how long you’ve been doing compressions,” firefighter Brandon McGar explained. “It’ll also have a beat, so you know when to do compressions.

“If the shock doesn’t help, we’ll do CPR all the way to the hospital,” he said.

Deputy Chief Deroy Bennett marvels at the technology.

“AEDs weren’t even available to lay users 15 years ago,” he said. “A layperson couldn’t read an EKG strip and determine when defibrillation is needed. To have a unit that is programmable to analyze heart rhythms is really something.”

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Test predicts potential for heart disease

At an early age I learned about heart disease as my father had his first heart attack at 42.

Just 10 years later, at 52, he suffered a fatal heart attack.

Richard Greene

Out of that tragedy, I decided to change my life, hoping to avoid such a fate at a relatively young age.

Recently, at Wise Regional Health System in Decatur I received a calcium screening test to gauge my risk for coronary heart disease and to see if the choices I’d made in my life were helping avoid a possible heart attack.

The test conducted in the radiology department identifies calcium deposits in the coronary artery.

“It’s basically looking to see what’s in your heart and see that there’s no blockage,” said Damian Morales, a CT tech at Wise Regional.

Cardiologist Bruce Gordon of Advanced Heart Care in Decatur said the test is an effective way to identify patients at risk for heart attacks.

“We know from decades of research that the stress testing that we use to assess risk is far from a perfect study,” Gordon said. “You could have a stress test that is normal and have 50 percent blockage in all three main arteries.”

He pointed out that almost half of heart attacks are in patients with minor blockage, and they may not show any symptoms.

“In 50 percent of patients, the first symptom is death,” Gordon said. “The key is to identify problems early and prevention.”

Around the time of my father’s death I was 21 and going through college potato phase. My weight ballooned to 230 pounds.

To shed some of the 60-plus pounds that I had put on during college, I decided to start running. One morning, I left my apartment in Denton and tried to run a mile. I got to the end of the trail and doubled over out of breath. Shamefully, I walked home a little disappointed. But the next morning, I woke up and did it again.

Within a year, I ran my first 5K, completing it without walking. Two years later, I completed my first marathon, slimming down to 175 pounds.

At age 33 and 15 marathons later, I felt like I’d done the best I could to keep my ticker healthy. But this was the true test.

Admittedly, I was a bit nervous to undergo the screening. Who likes to face their mortality and realize something is wrong? But finding out at my age would give me time to correct it with diet and other lifestyle changes.

I am a bit younger than the typical patient that has the screening.

“At 40 and above the heart starts slowing down, and there’s more potential for plaque buildup,” Morales said. “That’s why it’s good for 40, 45 and above. But family history brings up the risk. Finding out the risks at a young age is helpful.”

Gordon said people with a family history of heart disease, that smoke or have other contributing conditions such as diabetes, hypertension or high cholesterol should consider having the screening performed at an earlier age.

The CT scanner used for the screening is a large, box-like machine with a hole or short tunnel. You slide into the tunnel for the scan. Prior to this, electrodes are attached to your chest.

“It takes pictures at 360 degrees in between heartbeats,” Morales said. “Calcium or objects look white and the black is air. We’re trying to detect the calcium buildup in the artery of the heart.”

The calcium is calcified plaque that starts forming in childhood, according to Gordon.

“It’s inflammation in the arteries, and that inflammation leads to the buildup of plaque,” he said. “As the scar from the inflammation matures, calcium starts to develop. That’s the hardening of the arteries. It shows up on the CT scan.”

The screening is simple, patients do not need a prescription, and there’s no invasive IV or need to fast. You are asked not to ingest caffeine the day of the screening. The cost is $99.

“It’s a great type of test that’s going to change how we practice medicine,” Gordon said. “It’s cheap. You don’t need a prescription, and there’s no IVs. It also gives you an enormous amount of information.

“Our bodies are like a black box, and this opens the black box,” he said. “Within minutes, you’re looking at X-rays of the heart. It’s imaging the blood vessels, and it’s definitive. You get to see the disease.”

As Gordon said, within minutes I was looking with the techs at images of my heart on the screen. And fortunately, I didn’t see any of the white deposits.

Within days, I received my results with a perfect score of 0, meaning that for my age and gender, I currently am at a very low risk for coronary artery disease. No other abnormalities were found.

Scores can range from 0 to up into the thousands, and the higher the number for your age, the more care is needed.

“If you had a 30-year-old and an 80-year-old with scores of 100,” Gordon said. “In the 80-year-old, there’s a good chance that they are developing calcium in their arteries. But if the 30-year-old has a score of 100, they will want to watch it closely.

“Experts say if the score is over 400, you are several times more at risk for a heart attack,” he continued. “That is the cutoff. Those patients will be watched closer with more frequent doctor visits and closer monitoring of their blood pressure and cholesterol. They will be more motivated to change their lifestyle.”

After the screening, patients with elevated risks can make lifestyle changes, including increasing exercise, changing to a healthier diet and taking medication as prevention of a heart attack.

While my score came back at zero, Gordon said it’s not a free pass to quit trying to maintain healthy habits.

“If it comes back a 0, the patient has an excellent prognosis if they maintain a heart-healthy lifestyle,” he said.

He warned there still may be soft plaque that has not calcified. The key is early detection and prevention, with which this technology assists.

“People need to be informed,” Gordon said. “People and primary care doctors need to be educated that this technology is available.”

For information about the screening, visit the Wise Regional Health System website, www.wiseregional.com. To schedule an appointment, call (940) 626-1232.

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Wise kids lead the way in fundraising for heart health

SHOOTING FOR A CAUSE - Macy Sugg of Alvord Elementary concentrates on making a basket during Hoops for Heart 2011. Submitted photo

Some of the youngest Wise County citizens have contributed $198,585 over the last three years to the American Heart Association.

Wise County has the highest event average in North Texas for the AHA’s Jump Rope for Heart and Hoops for Heart events. These events provide an opportunity for school-aged children to raise money that funds children’s heart health research.

Participants gather donations and commit to jumping rope or playing basketball at the event organized by their physical education teacher. Students also spend class time learning about their hearts and how to keep them healthy.

Alvord Elementary School is one of the top 10 fundraisers in Texas for schools that participate in Jump Rope and Hoops for Heart. It’s No. 15 in the nation. Students raised $16,382.98 last year.

“I feel it is so important to promote the value of living a heart-healthy lifestyle,” said Alvord coach Rhonda Enis. “Through participating, we honor those in our community who have been affected by heart disease and stroke.”

“Jump Rope and Hoops for Heart also promotes community service by teaching kids how they can help others.” she said. “The students here at Alvord Elementary have learned jump-rope and hoop skills by participating each year while learning how nutrition and physical activity can help them live longer, healthier lives.”

Rann Elementary in Decatur is a top 10 fundraiser in the state for Jump Rope for Heart. Its students gathered $14,634.03 in donations last year.

“My message to the kids is – we have to take care of the heart we have, and we need to do our part to help others have a healthy heart,” said Rann coach Kasi Elder. “Jump Rope for Heart is a fun and kid-friendly program that teaches jump-rope skills, the importance of physical activity and community service.”

She also pointed out that the money raised by area school children helps fund potentially lifesaving research and the development of educational materials that teach the importance of heart health and staying fit.

Like many organizers of Jump Rope and Hoops for Heart events, Elder has a personal connection to heart disease.

“My father died instantly of a heart attack at 57, and my mother has had heart problems off-and-on since she was 10 years old,” she said. “I never knew either of my grandfathers because they both died very young of heart attacks. I also have had students and parents of students with heart problems.”

Bridgeport Intermediate and Bridgeport Elementary also excelled in fundraising, donating $13,390.90 and $11,518.42.

SCHOOL FUNDRAISERS

Other Wise County schools that participated last year:

Hoops for Heart

  • Chico $6,200

Jump Rope for Heart

  • Young Elementary $5,169.86
  • Boyd Elementary $2,438.32
  • Carson Elementary $2,196
  • Boyd Intermediate $1,687.61

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Cool treatment saves lives

HANDFUL OF SUPPORT - With the help of her family, including daughter Tammie Avara of Bowie (hand on left), Alice Beasley has survived and continues to thrive after two cardiac arrests. She has another daughter, Pam Foti of Shawnee, Okla., and son Rodney McGee of Bowie. Messenger photo by Erika Pedroza

Cats are said to have nine lives for their ability to defy death in threatening situations.

After surviving two cardiac arrests and withstanding a lengthy list of medical ailments, Alice Beasley, 65, of Bowie mirrors the relentless traits of the feline species.

Since her second cardiac arrest, where she underwent a therapeutic hypothermia procedure at Wise Regional Health System in Decatur, Beasley has not only been surviving, but thriving in her “third life.”

“Overall, I’ve felt better since I came out of the hospital after the induced hypothermia,” she said. “It’s a great service to offer. I’m here because of it. I can’t remember a whole lot, but I’m here.”

THE LUCK OF A LADYBUG

TWO-TIME SURVIVOR - In addition to surviving two cardiac arrests, Alice Beasley, 65, of Bowie deals with emphysema, diabetes, hernias, high blood pressure and a list of about a dozen allergies listed in a medical alert bracelet. Messenger photo by Erika Pedroza

Despite the misfortune of going into cardiac arrest twice within four years, the incidents happened in the best possible place.

Both times Beasley was at the clinic, Wise County Medical and Surgical, in Decatur. Both times she was treated within minutes of falling unconscious. Both times she survived.

“Thank God I was at the clinic,” she said. “If I had been at home, they would have had to call an ambulance to come all the way out here and then transferred me to Decatur. It’s truly a God thing. Sometimes I wonder why, but I know it’s not for me to question. He has a plan.”

The first time her heart stopped was in December, and it was due to an allergic reaction to an injection for an infection.

“I had taken each antibiotic before,” she said. “But the combination was almost lethal. As I walked out, my lips started to tingle.”

Beasley walked out of the examining room and to the front desk to say bye to her daughter, Tammie Avara, who then worked at the clinic.

“I told her about the tingling, and she told me to go back to have that checked out,” Beasley said.

Avara recalls the nurse running to the front to tell her that her mother had passed out and was turning blue.

“A nurse practitioner started CPR, breaking her ribs, which is what you’re supposed to do,” Avara said. “EMS arrived and transported her to the hospital, where she was kept for a few days and released.”

Almost three years later, April 3, 2011, Beasley visited the same clinic for a swollen ear.

She walked in, signed in and as soon as she sat in her chair, she fell unconscious, going into ventricular fibrillation.

“I was talking one second and out the next,” Beasley said. “That day is wiped out of my memory, but my sister (Marian Thomas of Bowie) was with me. I know what I know because of what she told me. But basically, I died at the clinic; my heart stopped beating for eight minutes. There were no symptoms whatsoever.”

Nurses began CPR and called 911. It just so happened the ambulance was stopped at the red light nearest the clinic, so they arrived in seconds, according to Avara.

“They used the defibrillator two or three times to get her heart to start beating again,” Avara said. “During the short ambulance ride across the street to Wise Regional, they used the paddles. Once they got her to the ER, they immediately recommended the hypothermia procedure.”

She was then transported to the cardiac care unit, where medical staff began cooling her body.

HOW IT WORKS

Because she was unconscious and in cardiac arrest, she was a candidate for the procedure, which has been in place at Wise Regional since 2010. It is used to lower the body’s temperature, and in turn, metabolism. This decreases the body’s need for oxygen, therefore preserving brain tissue to prevent brain damage.

“We want everyone to return to baseline functions at the very least,” said LeAnn Cummings, director of the emergency department at Wise Regional. “To do so, our goal is to keep the body temperature between 91 and 92 degrees Farenheit. Normally, it’s 98.6 degrees.”

To do so, nurses place leg and torso wraps hooked to a machine that pumps chilled water over the patient.

But because timing is key, paramedics are equipped with chilled saline and ice packs to initiate the cooling process in a timely matter, should they first come into contact with a cardiac patient like they did Beasley.

“You have up to four hours to initiate (the procedure),” Cummings said. “The sooner the body gets cooled, the better the success rate.

“That’s why we’re proud to be one of the few emergency rooms that initiate treatment before a patient hits critical care,” she said. “EMS and the ER have gotten on board with initiating, and we are seeing better results since doing so.”

Once the cooling process begins, medical staff hope to reach a desired body temperature in a set time frame before continuing with the treatment.

“Our goal is to get the body cooled within two hours and keep it cooled for 24 hours,” Cummings said. “Depending on the patient’s response, we start a gradual rewarming .2 to .25 degrees Celsius per hour. It’s a slow process that can take up to 12 hours. We can cool as fast as we want, but warming up is on the back end. You can really do some harm.”

Avara arrived at the hospital from Houston, where she and her husband, Rob, were doing prison ministry, at 11:30 the night of her mother’s second cardiac arrest that had occurred six hours earlier.

Avara immediately began praying over her unresponsive mother.

“After a while, her eyes came open,” Avara said. “She kept asking, ‘Where am I?,’ ‘What happened?,’ ‘Where is Bill (her husband)?’ She would ask the same questions every couple of minutes. But she was awake, and that’s all we cared.”

Relieved, Avara decided to head to the hotel to rest.

“On my way out, I asked the nurse to call us if anything changed,” she said. “Well, at 1:30 a.m. I get a call, and the nurse tells me that because she had been responding so well, they were going to start warming her back up – so many degrees every hour.”

Two days later, Beasley was taken off the ventilator, and she had a pacemaker put in the day before she was released. She spent 14 days in the hospital.

SUCCESS STORIES

Since the hospital began administering therapeutic hypothermia treatments a little more than a year ago, there have been 20 patients.

Beasley claims to be the 12th.

“I believe we were told only one person didn’t survive,” Avara said. “But I think that had to do with the severity of injuries and waiting too long to start the treatment. Otherwise, it has a great success rate.”

Beasley proudly boasts being one of the “better successes,” according to one of her physicians.

“The doctors said I responded better than anyone else,” Beasley said. “If I hadn’t, I probably would’ve been a vegetable in a nursing home.”

Since the incidents, Beasley has worked had to modify her diet, limiting her caffeine and fried foods.

However, she’s improved her quality of life to a greater extent.

“Since the treatment, I’ve quit smoking,” she said. “The doctor said the procedure helps detoxify the body. I’d tried quitting before, but I wasn’t successful. But I’ve never lit a cigarette since April 3.

“Before I went in, I was on oxygen 24/7,” she continued. “Now it’s just at night or during the day, if I need it. My lungs sound so much better. A lot of it has to do with not smoking, but it’s amazed me.

“I’ve really not had any issues with my heart since,” she added. “I’m dealing with other issues – emphysema, diabetes, hernias, high blood pressure, stage four chronic obstructive pulmonary disease – but my heart is fine. I go to the heart doctor every couple of months, and I have this monitor that checks my heart rate, heartbeat and sends that report every night.

“And there’s no brain damage, with the exception of some memory loss,” Beasley said. “But that’s one of the things they told me – that my short-term memory would be affected.

“Thankfully, that’s the only thing, and at least I can blame (memory loss) on that and not my age,” she said with a smirk. “God has been so good to me. Although my heart has stopped twice, I’ve been well taken care of and I’m still alive.”

ABOUT THERAPEUTIC HYPOTHERMIA

  • Wise Regional began using the treatment in October 2010
  • There have been 20 cases at the hospital, 18 of them successful
  • 45-79 age range

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Hospital stopover smoothes trucker’s road

It was mid-October, a little more than three months ago, and for James Simpson, it was good to be alive.

Then suddenly, in the span of a couple of hours, the Aurora truck driver was lucky to be alive.

After another week spent steering a trailer full of cargo up and down the nation’s highways and byways, Simpson, 48, had just made it back to town and the family he loves. He was attending church with his wife, Judy, when he had a heart attack.

“It was just crazy,” he recalled. “It was a burning sensation going through my arm up my chest. I thought it was heartburn. After church, I felt so bad, I didn’t talk to anybody and went straight home.

“I don’t even remember going home, to tell you the truth. When I got home, I wanted to lay down for a while. I had to get right back up because I couldn’t breathe.”

Simpson, who weighs 185 pounds, was having the worst kind of heart attack, one heart health professionals call a “STEMI.”

That stands for ST segment elevated myocardial infarction.

A myocardial infarction (often called an MI) is a heart attack, which occurs when a coronary artery becomes at least partially blocked by a blood clot, causing some of the heart muscle being supplied by the artery to become infarcted, which is medical speak for die.

There are two types of heart attacks, non-STEMI and STEMI, with STEMI being the worst.

In a STEMI, the coronary artery is completely blocked.

Not surprisingly, getting help in a hurry is important. Both the short-term and the long-term consequences of an MI are largely determined by how much of the heart muscle dies. If treatment is given within three or four hours, much of the permanent muscle damage can be avoided.

But if treatment is delayed beyond five or six hours, the amount of heart muscle that can be saved drops significantly. After about 12 hours, the damage is usually irreversible.

Simpson nearly blew it.

First, by not recognizing that his lifestyle of greasy truck-stop food, long hours in the cab of his truck and little exercise was making him a candidate for a heart attack.

Second, by not recognizing the signs. The classic symptom of an MI is an intense pain in the chest, often radiating to the jaw or left arm.

And finally, by not calling 911.

Simpson had his wife drive him the 13 miles to Decatur and the hospital emergency room. There, he waited his turn to be seen.

“He’s a good ‘What not to do’ example,” said Casey Rauschuber, coordinator of the cardiac care unit at Wise Regional Health System.

“You still get treated, but it’s a delay.”

In Wise County, calling 911 is important.

That’s because the heart-attack protocol at Wise Regional allows the paramedics and emergency medical technicians with Wise County EMS to make the diagnosis of a STEMI heart attack.

That, in turn, alerts the hospital and makes sure that a team of heart specialists is waiting to greet the patient when he arrives via ambulance.

“EMS will fax us an EKG (electrocardiogram) when they do it, and they call it (a STEMI) from the field,” Rauschuber said. “Typically, by the time they (the patient and ambulance crew) get here, everybody we need is here.”

Simpson complained of chest pains when it was his turn.

The ER staff recognized what was happening and started the steps to save the truck driver’s life.

“I usually don’t go to the hospital for anything, but that night, if I didn’t go, I’d have been dead,” he said. “To me, that hospital’s top dog.”

A triage nurse is the first to see patients in the ER.

“When they roll in the door (to the treatment area) with chest pains, the first person who greets them is the tech that does the EKG,” Rauschuber said. “The results will be looked at by the triage nurse, and if they see ST elevation, they hand it to the ER physician. He calls the STEMI.

“They have a phone that alerts the interventional cardiologist on call for STEMI, and it alerts the cath lab (cardiac catheterization lab) team. From there, the cath lab and the on-call cardiologist will call back.”

In the meantime, the patient is prepped.

“The doctor informs him he’s having a heart attack. They go over consent forms. They will draw labs (blood samples) and do a chest X-ray,” Rauschuber said.

“Once he’s in the cath lab on the table, the physician will access the heart. He’ll go through an artery in the groin. He’ll take a look and deploy whatever stent device he needs to go with.”

A stent used in angioplasty works like a catheter in that it’s a tube placed inside a vessel. Made of wire mesh or plastic, a stent may include a balloon catheter that is used to push the clot outward to reopen blood flow. The balloon is deflated and removed but not the stent.

Upon completion of the procedure, the patient is transferred to the cardiac care unit, which is essentially an intensive care unit specially for heart patients.

“They’ll stay in the cardiac care unit for at least 48 hours,” Rauschuber said, “and if there are no irregular heart rhythms, they can go home.”

Simpson returned to his family, which includes two teenage boys at home, and was back driving his truck in just two weeks.

“People told me not to do it so soon, but I’ve got to. I’ve got to pay my bills,” he said. “But I don’t eat at truck stops now. They gave me a diet to live by, and I’m doing my darnedest to live by that. I stop by Walmart and get sandwich stuff and meals I can fix in the microwave.”

A fellow who had “never been sick a day in my life” before his heart attack, Simpson said he never was a big eater but isn’t eating as much as he used to since his scare.

“I’m just grateful for all the hospital did for me, that I didn’t leave my wife and kids,” he said. “That’s the thing I was worrying about: ‘Who would take care of my wife and kids?’

“If it wasn’t for my family’s support and the hospital that night, the doctors’ and nurses’ support, I’d have been dead.”

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Area heart health events and fundraisers

HEART HEALTH EXPO

  • 8 to 11 a.m.
  • Feb. 14, 2012
  • Decatur Civic Center

The Heart Health Expo will offer various screenings and live presentations on heart healthy ideas. Available screenings will include blood pressure, glucose testing, fitness assessments and a heart attack risk assessment.

Presentations will also be given on heart healthy cooking, women’s heart health, hereditary heart disease, AEDs and how to prevent a heart attack. Visitors will learn about exercises to do at work, new technology in heart care, weight loss surgery, the benefits of quitting smoking and how to identify symptoms of heart attacks and strokes.

Several Wise Regional departments will have booths, including the cardiac cath lab, emergency room, Fit-N-Wise, cardiac rehab, CCU, imaging, inpatient rehab, clinical care associates and Emergency Medical Services.

Discounts will also be given for the cardiac calcium screening.

TARRANT COUNTY GO RED FOR WOMEN LUNCHEON

Keynote speaker is Bill Weir, co-anchor of late-night television news program “Nightline.”

Heart attack survivor Renee Ticknor will also tell her story.

The Go Red for Women campaign is the American Heart Association’s national effort to increase awareness of heart disease – the No. 1 killer of women (and men) in America.

The American Heart Association uses the money raised to support awareness, research, education and community programs.

More than 21 percent is spent on research, almost 40 percent on public health education and 13 percent on educating health care professionals.

TARRANT COUNTY HEART BALL

The Heart Ball offers a time to celebrate the association’s work and mission, donors and volunteers and lives saved and improved.

Contributions make research funded by the American Heart Association possible, which provides breakthroughs, guidelines, training, advocacy and programs.

Giving fuels AHA research and programs designed to prevent heart disease before it starts and to help survivors thrive.

TARRANT COUNTY HEART WALK

The walk is a 5K with a mile turnaround for those who wish to walk a mile.

Money raised benefits the AHA, enabling the organization to put up-to-the-minute research into doctors’ hands so they can better prevent and treat heart disease among patients.

It also gets life-saving information to those who need it most. The organization shares information on how to eat better, how to recognize the warning signs of a heart attack and how to talk to a doctor about critical health choices.

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STEMI protocol saves time and lives

CATH LAB - Lacretia Miles, a nurse in the cardiac catheterization lab at Wise Regional Health System, pulls a gurney carrying a patient into the cath lab at the Decatur hospital as cardiovascular technologist Damien Morales CVT awaits their arrival. Messenger photo by Joe Duty

The ambulance crews for Wise County EMS play “beat the clock” every day when it comes to saving lives.

But they are time bandits when it comes to assisting people having heart attacks. Working with the heart specialists at Wise Regional Health System, they have found a way to steal back precious minutes that can make the difference between life and death.

It’s called the “STEMI protocol,” and it’s a valuable shortcut.

“If our medics are on a call and determine the patient is having a heart attack, we can notify the hospital it’s a STEMI, and they have their people ready when we get there,” explained Charles Dillard, Wise County EMS administrator.

A STEMI is a heart attack in which an artery to the heart is completely blocked, and it is considered much more life-threatening than a non-STEMI heart attack, where blockage is only partial.

“We can’t tell how much blockage there is until we get them up there (to the hospital) and get an MRI,” Dillard explained. “But we can definitely tell if a person is needing intervention. If we see there’s a blockage, we’re going to proceed like it is a STEMI until it’s proven otherwise.”

A STEMI call from Wise County EMS activates the “LifeNet” machine in the cardiac catheterization lab, which is essentially an operating room just for heart patients. The machine calls all the needed personnel, including the on-call cardiologist.

The EMS ambulances, each staffed by a paramedic and an emergency medical technician (EMT), are certified as mobile intensive care units. They can transmit electrocardiograms (EKGs) to the cath lab at Wise Regional.

“As soon as they see that (EKG), they know we’re transporting a STEMI patient, and they can start getting ready, start getting people down there that they need,” Dillard said. “We pull up to the emergency room doors and usually two people from the cath lab will meet us and escort us straight to the cath lab.”

Calling 911 is the most important thing, Dillard said.

“We can get an ambulance to you and as soon as we start treating you, we’re going to give you the same meds as the hospital,” he said. “We give medication to start dissolving the clots prior to getting (to the hospital).

“If you drive yourself to the hospital, you’re going to go to the ER (emergency room) and get checked out. However, if you say you’re having chest pains, they’ll start doing triage.”

The STEMI protocol is an exception rather than a rule for most ambulance operations.

“There are some others in the Metroplex who have a similar program,” Dillard acknowledged. “But most places, you have to see a doctor first (before being admitted to the cath lab).”

In order to earn the privilege, Wise County EMS employees have taken part in specialized training offered by the hospital’s cardiology staff and outside trainers.

“It’s a pride deal with us,” Dillard said, “that you have cardiologists and doctors that have that much trust in our paramedics.”

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Proper lifestyle prevents poor heart health

BACK ON BEAT - Susan Rector, manager of the cardiac rehabilitation program at Wise Regional Health System in Decatur, works with Jim Brown of Springtown (front) and John Conrad of Bridgeport. Messenger photo by Joe Duty

Three days a week recent heart patients pour into the workout area of Fit-N-Wise.

They range in age and appearance. Some can barely walk for more than a few minutes on a treadmill. Others are ready to go.

“We see heart patients that range from their 20s to their 80s,” Susan Rector said. “We work with a wide variety.”

Rector manages the cardiac rehabilitation program at Wise Regional Health System in Decatur.

“After someone has a heart procedure at the hospital, they are sent here,” Rector said. “We put them on a heart rehabilitation program.”

The patients all have something in common. They all suffered some type of heart trauma, be it a heart attack, congestive heart failure, bypass surgery, heart transplant or some other type of cardiac procedure, or they have heart disease. Afterward, they are sent to Rector and her staff to begin a three-month rehabilitation program. The program not only includes exercise, but also regulation of vital signs and education on how the heart functions and nutrition.

Most of the patients have something else in common. They could have prevented their current situation entirely. Only a small percentage of cardiac problems are genetic and unavoidable. Most can be tackled before they ever get started.

“A few of the cases we see are congenital, due to a hereditary factor, but you can even fight your genes to an extent,” Rector said. “But as long as people keep smoking, not exercising and eating at fast food restaurants, we have pretty good job security.”

It’s remarkable how basic it sounds to prevent traumatic, cardiac-related trips to the emergency room. It comes down to a few simple lifestyle choices:

  • 30 minutes of cardio a minimum of four times per week
  • incorporate fresh fruits and vegetables into a diet, staying away from processed and packaged foods
  • find a way to quit tobacco

Emergency procedures don’t cure the heart.

“A stent is just a Band-Aid,” Rector said. “But exercise can actually reverse heart disease. It’s sort of like a Roto-Rooter effect on your vessels.”

Although the cardiac rehab program lasts three months, patients are encouraged to continue the diet and exercise regimen for life. The cardiac rehab team at Fit-n-Wise boasts 60 percent of patients continue to practice lifestyle changes a year later.

For some patients, their livelihood depends on reclaiming strength in their bodies and hearts.

“A lot of people in this area work in the oil field or on ranches,” Rector said. “They need to be able to lift 30 to 50 pounds or more on a regular basis. We help them achieve that.”

She added that local employers are good about allowing employees time to attend the rehab program.

Excuses plague the process of prevention like plaque in the arteries of the unhealthy.

“A lot of people go to the gym and expect to make up for 10 years of not exercising,” Rector said. “They expect to see results right away. But exercise is a lifetime goal.”

People cite a lack of time in the day. They want to watch television instead.

“Just put a treadmill in front of the TV,” she said. “Thirty minutes will go by before you know it.”

As for nutrition, time continues to play a role. It’s easier to eat out or microwave a packaged meal than prepare fresh foods. But imagine the time lost in hospitals and rehab once it’s too late for prevention.

For more information on prevention, visit the American Heart Association website at www.heart.org.

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Gender-specific symptoms indicate a heart attack

Heart attack symptoms are different in men and women, including everything from their severity to their onset.

Classic symptoms are severe chest pain and pain radiating through the left arm, but Dr. Jason Finkelstein, a cardiologist at Advanced Heart Care, said those symptoms are almost exclusive to men.

“Some women may not have symptoms,” he said. “With men, it’s more gradual symptoms before the heart attack, but with women, they don’t have pain prior to the heart attack; it’s during it.”

(See the graphic to the right for gender-specific symptoms.)

Finkelstein said he encourages everyone to “know their risk factors.”

“Those at higher risk are people who are diabetic and have higher cholesterol, sedentary people or those who don’t eat or sleep right,” he said. “Stay away from smoking.”

Finkelstein also said post-menopausal women and women who take hormone replacement therapy are at a higher risk.

“Usually women who are menstruating are really unlikely to have heart disease … it can happen, but it’s unlikely,” he said. “A lot of women are misdiagnosed when they are having a heart attack. It may be blown off as anxiety or stress.”

Finkelstein promotes a healthy lifestyle that includes a healthy diet, exercise and plenty of rest, but if someone is experiencing heart attack symptoms, they should get to the hospital as soon as possible.

“What we try to stress in the community is that you want to get to the hospital as soon as possible, because if it’s a clogged artery, you want to get it open as soon as possible,” he explained. “For every minute you delay in getting the artery open, your mortality increases by 1 percent.”

MAKE A DONATION

Donations to the American Heart Association fund research in our area.

Online:
donate.americanheart.org

Mailed:
American Heart Association
10900-B Stonelake Blvd., Suite 320
Austin, TX 78759

HEART DISEASE ORGANIZATIONS/RESOURCES

American Heart Association
www.heart.org

National Heart, Lung and Blood Institute
www.nhlbi.nih.gov

National Coalition for Women with Heart Disease
www.womenheart.org

Office on Women’s Health
www.womenshealth.gov

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Wise havens for heart care

ADVANCED HEART CARE

2401 S. FM 51, Suite 200 – Decatur
(940) 627-0044
www.advancedheartcare.com

Jason Finkelstein, M.D., F.A.C.C.; Bruce Gordon, D.O., F.A.C.C.; Donald D. Wurzburg, M.D., F.A.C.C.; Trieu Ho, M.D., Electrophysiology; Cheryl Fostel, F.N.P.C.

Preventative, diagnostic, interventional and nuclear cardiology and electrophysiology

Services include ablation, ambulatory B.P. Monitoring, angiojet, balloon angioplasty, cardiac catheterization, cardioversion, carotid angiography and stenting, coronary angiogram, echocardiogram, electrocardiogram, enhanced external counterpulsation (EECP), holter monitor, implantable defibrillator (ICD), intravascular brachytherapy, laser angioplasty, nuclear stress test, pacemaker, peripheral vascular angiography and intervention, SPECT scan, stenting, stress test and transtelephonic monitoring

WISE REGIONAL HEALTH SYSTEM
609 Medical Center Drive – Decatur
(cardiology services on third floor)
(940) 627-5921
www.wiseregional.com/hospital-services/cardiology

Emergent, preventative and diagnostic services, cardiopulmonary service department, cardiac catheterization lab, cardiac care unit and cardiac rehab

As an accredited chest pain center (by the Society of Chest Pain Centers) and primary stroke center (by the Joint Commission), WRHS offers an advanced cardiovascular program that provides a full continuum of cardiac care, eliminating the need to travel great distances for high-quality cardiac care.

The medical staff includes board-certified emergency department physicians, board-certified cardiologists, interventional cardiologists, a board-certified cardiothoracic surgeon, a cardiac electrophysiologist as well as respiratory therapists, exercise physiologists and cardiac nurses, all trained in using the latest treatment strategies.

SERVICES/PROCEDURES

WRHS offers noninvasive calcium screenings, consultations, diagnostic stress testing, interventional cardiology, stress echocardiograms, electrophysiology, nuclear cardiology, EKG, therapeutic hypothermia, hypertension treatment, coronary stent and Pacemaker implementation.

CARDIOPULMONARY SERVICE DEPARTMENT

The cardiopulmonary service department provides inpatient and outpatient diagnostic testing for those with heart and lung disorders.

CARDIAC CATHETERIZATION LAB

Cardiologists and radiologists perform diagnostic catheterization/angiography of the heart arteries in the only cardiac cath lab of its kind in the county.

These specialized studies of the heart help physicians determine how to handle the repair of coronary blockages, which methods to use, and the need for more aggressive intervention, such as bypass surgery.

CARDIAC CARE UNIT

The cardiac care unit at WRHS provides individualized, continuing specialized care to patients who’ve had a heart attack or major cardiac surgery with the most up-to-date monitoring and testing equipment. Care is one-to-one, nurse to patient ratio, the first 24 hours of a patient’s stay in CCU after bypass surgery.

CARDIOPULMONARY REHABILITATION PROGRAM
(940) 626-1732

WRHS offers a cardiopulmonary rehab program for those who have been diagnosed with heart disease, have recently had heart surgery (stent, bypass, open heart) or have COPD (chronic obstructive pulmonary disease), asthma or symptomatic lung disease.

Nurses, exercise physiologists and respiratory therapists organize scheduled exercise and education sessions on how the heart and lung function, ways to decrease stress levels and how to choose healthy diets.

Classes are Monday, Wednesday and Friday at several times throughout the day. Each class lasts approximately one-and-a-half hours, and the program is generally 12 weeks. However, the duration of the program, and class times, are flexible.

NORTH TEXAS COMMUNITY HOSPITAL
1905 Doctors Hospital Dr. –
Bridgeport
(940) 683-0300
www.ntchospital.org

AWARENESS AND HOW TO HELP

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American Heart Association campaigns

AMERICAN HEART MONTH

www.heart.org

February is American Heart Month, a time dedicated to raising awareness about the nation’s leading cause of death for both men and women.

GO RED FOR WOMEN

www.goredforwomen.org

Go Red for Women is a national campaign started in 2004 by the American Heart Association to increase awareness and dispel myths of heart disease in women – their No. 1 killer.

Cardiovascular disease claims the lives of nearly 500,000 American women each year. Yet, according to AHA, many women dismiss heart disease as an older man’s disease. Nearly 50 percent of American women don’t know that heart disease is their No. 1 killer and are unaware of their own risk factors.

The Red Dress is the national symbol for the movement.

NATIONAL WEAR RED DAY

Feb. 3, 2012

Americans are encouraged to wear red to show support for women and heart disease awareness the first Friday in February each year.

The National Heart, Lung and Blood Institute initiated the day in 2004 to give women a personal and urgent wake-up call about their risk of heart disease. It was also created to bring awareness to the Go Red for Women movement and promote the Red Dress as a national symbol.

YOU’RE THE CURE

www.yourethecure.org

Become an advocate of researching, treating and preventing heart disease by signing up to speak to lawmakers about the nation’s No. 1 killer – heart disease.

The American Heart Association provides an email alert system that directs you to legislative topics of the day and how to take action.

MY HEART MY LIFE

www.startwalkingnow.org

April 6, 2012

National Start! Walking Day is the first Wednesday in April.

The American Heart Association program encourages walking 10 minutes, three times a day to increase your life expectancy.

A companion to the AMA’s Heart Walk fundraiser, the My Heart My Life program offers information about healthier eating habits and exercise and tools to get you started.

BETTER U PROGRAM

www.goredforwomen.org/betteru

Go Red for Women BetterU courses provide guidance to help transform your overall health from the inside out.

The online nutrition and fitness program lasts 12 weeks and participants have access to a coaching tool, online journal and expert tips.

Each week, the program focuses on a different area of health and provides step-by-step guidance.

THE HEART TRUTH CAMPAIGN

www.hearttruth.gov

The Heart Truth campaign was created in 2002 after a meeting of women’s health specialists determined American women were not aware of the danger heart disease presented to them.

Sponsored by the National Heart, Lung and Blood Institute and partner organizations, it teaches women about heart disease and provides tools to help them take action against its risk factors.

Instead of presenting a ribbon as a token of awareness, the NHLBI introduced the Red Dress as the national symbol.

The Heart Truth logo is a trademark of HHS.

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