Genesis Heart Hero Handbook by Genesis Health System

HEART

HERO HANDBOOK

Real stories, real people and real tips for protecting those you love.

TABLE OF CONTENTS.

3 Introduction

Leading the Region in Heart Care

The Heart Basics

Heart Facts and Figures

Women and Heart Disease

Take Charge of Your Life

Steps to a Healthier Weight

Tips for Healthy Eating

Serving Size

Healthy Options for a Happy Heart

Get Screened

Get with the Guidelines

35足足

You Can Do It!

INTRODUCTION. If you’re interested in finding information about your heart or saving a friend’s heart, this handbook is for you. Within these pages, you’ll be able to determine your risk factors for heart disease; learn the signs and symptoms of a heart attack; and where to seek advice through many of the Genesis heart programs. In addition, you’ll read real heart stories from real patients. This Heart Hero Handbook is designed to help you understand and take action against heart disease. You’ll learn how to reduce your risk for heart disease through an active and healthy lifestyle. The booklet is intended for general information and educational purposes and should not be used to make healthrelated decisions without the involvement of your health care practitioner.

HEART HERO

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CONTINUE ON TO BECOME A....

LEADING THE REGION IN HEART CARE. For over 40 years, the Genesis Heart Institute has provided leadingedge heart care and demonstrated a commitment to clinical excellence and quality care. The Genesis Heart Institute is a multidisciplinary association of cardiologists, cardio-thoracic and vascular surgeons who collaborate on the best approach to manage and treat cardiovascular disease. The Institute brings together the most talented professionals across the many medical disciplines to bring added value and expertise to the Quad City region. Through the Institute, patients have access to the most advanced devices, drugs, treatment protocols and research. It links regional clinicians driven by excellence in patient care. CARDIOLOGY SERVICES AT GENESIS Genesis Health System touched many hearts in fiscal year 2011, with:

• 712 Cardiovascular Operations • 9,978 Cardiac Catheterization Lab Procedures • 61,718 Cardiac Rehab Visits • 60,783 Non Invasive Heart Tests

Genesis Medical Center (GMC), Davenport is the lead center for the health system’s heart care services. It provides a full array of cardiac services, including open-heart surgery, interventional cardiac catheterizations, and diagnostic testing. Other locations for heart care include the GMC, Illini Campus in Silvis, Ill., and GMC, DeWitt in DeWitt, Iowa. GMC, Illini Campus, upgraded and renovated its $1.5 million Cardiac Catheterization Lab in 2007, advancing to a new level of care and now offers elective and emergent angioplasty. At GMC, DeWitt, a partnership with area cardiologists allows patients to see their cardiologist much closer to home. The hospital also provides a wide variety of cardiac testing, including echocardiograms, stress testing and holter monitoring.

The Davenport, DeWitt and Illini campuses also have instituted a heart attack alert response system to enable the rapid unblocking of arteries for patients in the midst of a heart attack. Heart attack response times rank among the best in the nation. In 2010, the Genesis average door to-balloon time was 57 minutes -- far faster than the 90-minute standard of care set by the American College of Cardiology. The hospital also became the first in the Quad Cities to launch Induced Hypothermia, a therapy aimed at improving outcomes for adult patients surviving cardiac arrest. Genesis has received national recognition for providing high quality patient care and is the only provider in the region to earn the following acknowledgments: • Thomson Reuters has named Genesis as one of the Top 50 Cardiovascular Hospitals in the country • BlueCross and BlueShield recognizes Genesis as a Blue Distinction Center for Cardiac Care

• Genesis earned UnitedHealthcare’s Center of Excellence for Cardiac Care.

To find a physician, call 563-355-9191 or visit www.genesishealth.com

THE HEART BASICS. A quick primer on words and phrases you may hear from your health care practitioner: WHAT IS CARDIOVASCULAR DISEASE? Cardiovascular disease, also known as heart disease, includes diseases of the heart and blood vessels. This includes stroke, peripheral vascular disease, coronary heart disease, hypertensive disease and others. Heart and blood vessel problems develop over time and occur when arteries that supply blood to the heart or brain slowly become clogged from a buildup of cells, fat and cholesterol. This buildup is called plaque. When the blood flow becomes blocked by extensive amounts of plaque or a blood clot, a heart attack or stroke could result. Coronary artery disease (CAD) is the term used to describe disease of the arteries that feed the heart muscle. Itâ&#x20AC;&#x2122;s the most common form of heart disease. WHAT IS A HEART ATTACK? A heart attack occurs when the blood supply to the part of the heart muscle called the myocardium becomes severely reduced or stopped. If the blood supply is cut off for more than a few minutes, muscle cells suffer irreversible injury and die. Disability or death can result, depending on the extent of heart muscle damage. WHAT IS SUDDEN CARDIAC ARREST? Sudden cardiac arrest is caused by an electrical problem in the heart. It begins as a dangerously fast heartbeat that accelerates and makes an ineffective pump, unable to supply the body and brain with oxygen. About 95 percent of cardiac arrest victims die before they get to the hospital. WHAT IS PERIPHERAL VASCULAR DISEASE? Peripheral vascular disease (PVD) includes diseases of blood vessels outside of the heart and brain; itâ&#x20AC;&#x2122;s often caused by a narrowing of the vessels that carry blood to leg and/or arm muscles.

WHAT IS CAROTID ARTERY DISEASE? Carotid artery disease occurs when the carotid arteries that carry blood to the brain are blocked by plaque. This prevents the brain from receiving enough oxygen-rich blood and may lead to a stroke. WHAT IS AN ABDOMINAL AORTIC ANEURYSM (AAA)? This is a weakened part of a major artery that carries blood to the legs and other areas of the lower body. The ballooning of this weakened area is a serious condition. If the force of the blood flow is too much for the blood vessel, it could rupture (burst) like an overinflated inner tube. The risk of rupture increases with the size of the aneurysm. This is often a fatal condition. WHAT IS HEART FAILURE? Heart failure is a condition in which the heart cannot pump enough blood to the body’s other organs because the heart muscle is damaged or overworked. Heart failure may be a result of: • Coronary artery disease • Heart attack • High blood pressure • Heart valve disease • Cardiomyopathy • Congenital heart disease (heart or blood vessel defects present at birth) • Infection of the heart valves • Infection of the heart muscle WHAT IS A STROKE? Lack of blood flow to the brain due to a blood vessel rupture or blockage leads to a stroke. The resulting brain damage may be very serious, causing: • Paralysis, numbness or tingling on one side of the body • Confusion, difficulty speaking or understanding • Loss of vision in one or both eyes • Difficulty walking • Drooping of one side of the face WHAT IS ATRIAL FIBRILLATION? Atrial fibrillation is rapid irregular electrical activity of the upper chambers of the heart, called the atria.

WHAT IS METABOLIC SYNDROME? An association between certain metabolic disorders and cardiovascular disease is termed metabolic syndrome. The main features of metabolic syndrome include insulin resistance, hypertension (high blood pressure), cholesterol abnormalities, and an increased risk for the blood to clot. Individuals are most often overweight or obese. Insulin resistance refers to the diminished ability of cells to respond to the action of insulin in promoting the transport of the sugar glucose, from blood into muscles and other tissues. If you have multiple risk factors for heart disease, talk with your health care practitioner to determine ways to lower your risk. HOW IS METABOLIC SYNDROME DEFINED? Any three of the following traits in the same individual meet the criteria for the metabolic syndrome: 1. Abdominal obesity: a waist circumference more than 40 inches in men and more than 35 inches in women. 2. Serum triglycerides 150 mg/dL or above, or taking medicine for high triglycerides. 3. HDL cholesterol 40 mg/dL or lower in men and 50 mg/dL or lower in women, or taking medicine for low HDL cholesterol. 4. Systolic blood pressure of 130mgHg or higher, or diastolic pressure of 85mmHg or higher, or taking medicine for high blood pressure. 5. Fasting blood glucose of greater than or equal to100 mg/dL or above, or taking medicine for high blood glucose. HOW COMMON IS METABOLIC SYNDROME? Metabolic syndrome is quite common. Approximately 20-30 percent of the adult population in industrialized countries have metabolic syndrome. It is estimated that approximately 47 million adults in the United States have it. As is true with many medical conditions, genetics and the environment both play important roles in the development of the metabolic syndrome.

Genetic factors influence each individual component of the syndrome, and the syndrome itself. A family history that includes Type 2 diabetes, hypertension, and early heart disease greatly increases the chance that an individual will develop the metabolic syndrome. Environmental issues like lack of regular physical activity and progressive weight gain also contribute significantly to the risk of developing the metabolic syndrome. Adults who continue to gain five or more pounds per year raise their risk of developing metabolic syndrome by up to 45 percent. While obesity itself is likely the greatest risk factor, others factors of concern include:

• Women who are post-menopausal • Smoking • Eating an excessively high carbohydrate diet • Lack of activity (even without weight change)

WHY SHOULD I KNOW ABOUT METABOLIC SYNDROME? Metabolic syndrome is worth caring about because it’s a condition that can pave the way to both diabetes and heart disease, two of the most common and important chronic diseases today. Metabolic syndrome increases the risk of Type 2 diabetes (the common type of diabetes) anywhere from 9-30 times over the normal population. That’s a significant increase. Although studies vary, the metabolic syndrome appears to increase the risk of heart disease 2-4 times that of the normal population. The term “metabolic syndrome” is a way of identifying individuals at high risk for the development of heart disease and diabetes. Intuitively we all know that obesity, high cholesterol, and hypertension are bad omens. We also know that insulin resistance precedes Type 2 diabetes, and can itself be an important condition meriting treatment.

BE YOUR OWN

HEART HERO 9

Everyone reading this handbook knows someone who is overweight, hypertensive, or has cholesterol levels that are “a little high.” It may be a brother, sister, parent, neighbor or even yourself. The main point to understand is the importance of treating the risk factors before heart disease develops. Lifestyle changes can be addressed at a doctor’s office. The other 99.999 percent of the time, they need to be addressed in the real world. We need to start having healthier food options readily available. We need to make time during the day to take a walk. We each need to surround ourselves with people who support our goals and needs. We need to be aware of our own heath, and to make whatever changes we can to improve it. The final take-home message is: • Find a walking buddy. • Take a walk during your work break, even if it’s just around the building. • Go to a health food store. • Look at what you feed your kids. • Urge your kids to go outside and play.

It all adds up. Preventing metabolic syndrome really means having a healthy lifestyle.

HEART FACTS AND FIGURES. Nearly 2,300 Americans die of cardiovascular disease (CVD) each day, an average of one death every 36 seconds. CVD claims more lives each year than cancer, chronic lower respiratory diseases and accidents combined. Heart attack and its cause, coronary heart disease, is the single largest killer of American men and women. But there are steps to take that will help bring the number of these deaths down. Begin by learning the facts. LEARN THE WARNING SIGNS You can save a life by seeking immediate medical treatment before the heart muscle is permanently damaged. People who are treated within the first hour of exhibiting symptoms have an 80 percent chance of preventing muscle damage. Itâ&#x20AC;&#x2122;s important to understand that most individuals do not initially demonstrate the classic warning signs, such as chest pain. Pay attention to more subtle signs, such as indigestion, nausea or shortness of breath. Seek medical treatment as quickly as possible. Note the time your symptom(s) started. Youâ&#x20AC;&#x2122;ll be asked this later. Advances in heart attack treatment have led to reduction in the damage to the heart muscle, but only if treatment is started in the first few hours after symptoms begin. (See page 16 for more signs and symptoms.)

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More than 34 percent of people who experience a heart attack in a given year will die of it.

SEEK HELP IN AN EMERGENCY Cardiac arrest strikes immediately and without warning. Here are the signs: • Sudden loss of responsiveness (no response to tapping on shoulders). • No normal breathing (the victim does not take a normal breath when you tilt the chin up and check breathing for at least five seconds). Call 911. Do not drive, and do not ask someone else to drive you to the emergency room. FACTS TO REMEMBER 1. Denial or fear can delay treatment. 2. If an Automatic External Defibrillator (AED) is available, use it immediately. New technology has made AEDs simple and user friendly. Clear audio and visual cues tell users what to do when using an AED and coach people through CPR. A shock is delivered only if the victim needs it. AEDs are now widely available in public places such as schools, airports and workplaces. 3. Seek help immediately by calling 911 and requesting an ambulance (or tell someone else to call while you initiate use of the AED or begin CPR.) 4. Emergency medical technicians are prepared to handle escalating symptoms. 5. Effective bystander CPR, provided immediately after sudden cardiac arrest, can double or triple a victim’s chance of survival. 6. The most effective rate for chest compressions is 100 compressions per minute -- the same rhythm as the beat of the Bee Gee’s song “Stayin’ Alive.” 7. Studies have show that children as young as 9 years old can learn and retain CPR skills.

ACT PROMPTLY The American Heart Association states that 50,000 lives could be saved each year if cardiac emergencies were treated with greater urgency. The rate of survival decreases by as much as 10 percent with every minute that passes before a victim’s heart is shocked back into rhythm. As a result, less than 8 percent of out-of-hospital cardiac arrest victims survive. SIGNALS OF A HEART ATTACK Your body likely will have one or more of these symptoms: • Uncomfortable pressure, fullness, squeezing or pain in the center of the chest that lasts more than a few minutes, or goes away and comes back. • Pain that spreads to the shoulders, neck, jaw, back or arms. • Chest discomfort with lightheadedness, fainting, sweating, nausea or shortness of breath. LESS COMMON WARNING SIGNS OF A HEART ATTACK • Atypical chest pain, stomach or abdominal pain. • Nausea or dizziness (without chest pain). • Shortness of breath and difficulty breathing (without chest pain). • Unexplained anxiety, weakness or fatigue. • Palpitations (irregular heart beat), cold sweat or paleness. Not all of these signs occur in every attack. Sometimes they’ll come and go. Should they occur, get help immediately. If you notice one or more of these signs in another person, don’t wait.

Call 911 as soon as possible! © American Heart Association.

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Everyone can be a Heart Hero. Your friends and family may rely on your best judgment to save their lives.

WOMEN AND HEART DISEASE. #1 KILLER AMONG WOMEN MYTH: Heart attacks only happen to men. REALITY: Heart disease, stroke and other cardiovascular diseases kill more women than the next four causes of death combined. • One in three women have some form of heart and blood vessel disease. • Cardiovascular disease and stroke kill nearly twice as many women as all forms of cancer. • One in 30 women’s deaths are from breast cancer while one in every 2.8 women’s deaths are due to cardiovascular disease. • The death rate for stroke is higher for women than for men and is significantly higher for African-American women than for Caucasian women. USE OF ORAL CONTRACEPTIVES If you’re a female over age 35 and are considering use of oral contraceptives or hormones, talk with your health care practitioner about: • Your personal and family medical history. • Your risk factors for stroke, heart disease and cancer. • The safety and effectiveness of the various birth control methods and hormone replacement therapy. Smoking combined with the use of oral contraceptives greatly increases the risk of heart attack and stroke.

HARD FACTS • Women are counseled less about nutrition, exercise and weight control than men. • More women than men die yearly from cardiovascular disease, yet 25 percent fewer women than men have operations or procedures. • 63 percent of women who die from cardiovascular disease had no previous symptoms. • Many women and doctors do not recognize early signs of a heart attack. • Smoking by women causes 150 percent more deaths from heart disease than lung cancer. • Women who smoke are two to six times more likely to suffer a heart attack. • Use of birth control pills in smokers compounds cardiac risk. HEART HEALTH GUIDELINES FOR WOMEN More aggressive control of risk factors is needed: • Stop smoking. • Exercise at least 30 minutes for most days of the week. If you have trouble getting started, think about joining a Cardiac Rehabilitation Program. • Follow a heart healthy diet. • Control blood pressure, lipids and diabetes. Poor control puts women at a higher risk for Coronary Artery Disease (CAD). A combination of diet, exercise and medication may be necessary for optimal control. • Optimize psychosocial health. • Maintain a healthy weight.

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It’s up to you to seek information from your health care practitioner, the American Heart Association or visit www.genesishealth.com/heart

SYMPTOMS OF A HEART ATTACK • Chest pain • Pain in the left arm • Fatigue • Feeling breathless • Weakness/dizziness • Flu-like symptoms/loss of appetite • Nausea and/or vomiting • Feeling of anxiety • Back pain • Irregular heartbeat LESS COMMON WARNING SIGNS Women and men may share similar common warning signs, such as the squeezing feeling or pain in the center of their chest, but more often than men, women show some of the less common warning signs. MEN MORE OFTEN EXPERIENCE THESE SYMPTOMS: • Chest pain • Fatigue • Rest pain • Shortness of breath • Weakness WOMEN MORE OFTEN EXPERIENCE THESE SYMPTOMS: • Loss of appetite • Shortness of breath • Back pain • Nausea and/or vomiting • Irregular heart beat • Indigestion © American Heart Association.

REAL PEOPLE. REAL STORIES. Forget the heart attacks of Hollywood. Caryl Miller is living proof that a heart attack doesn’t always begin with crushing chest pain and end with a dramatic collapse onto the floor.

“Everyone thinks of the big chest pain, with pain radiating down the arm,” Miller says. “The morning of my heart attack, I felt like I was merely getting a terrible chest cold. I wasn’t in pain. I just thought, ‘Oh man, I’ve got a big one coming on.’’’ When she got up to refill her coffee cup, she became dizzy. The dizziness progressed, so she called for her husband, Scott, to help. “I got real dizzy and incoherent, and the room spun,” she says. “That’s basically all I remember until the ambulance got there.” Miller was in the midst of a heart attack. She was rushed to Genesis Medical Center, Davenport, where experts outperform national standards for rapid treatment of heart attack. At Genesis, cardiologist Jon Robken, M.D., implanted three stents to prop open the blocked arteries in the right side of Miller’s heart. With the help of a heart attack alert system, arteries are unblocked within an average of 55 minutes – far quicker than the national standard of 90 minutes. “I coded twice that day and received several shocks with the paddles to jumpstart my heart,” Miller says. “I was in the ICU for four days. When the nurses came to see me in my hospital room, they called me a Christmas miracle and said, ‘We can’t believe we’re talking to you. This is why we became nurses.’ A month later, I got two more stents.”

More than five months after her heart attack, Miller walked in the Quad Cities Heart Walk. Her family joined her – a daughter and her fiancé from Omaha and a son, daughter-in-law and two grandsons from Glen Carbon, Ill. In fact, she says she postponed a procedure to implant another stent, so she wouldn’t miss the walk. “Until I had my heart attack, I had no idea I had heart disease,” Miller says. “I’d just been to my family doctor for a check-up, and my blood pressure and cholesterol were fine. A week-and-a-half later, I’m being rushed to the hospital with a 100 percent blockage on the right side.” She wants to spread the word that heart disease is the No. 1 killer of women. “There has to be a reason why I survived after going through all that, and I’ll find out sooner or later,” she says. “If it’s to raise awareness of heart disease, then that will be plenty.”

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“Everyone thinks of the big chest pain, with pain radiating down the arm. The morning of my heart attack, I felt like I was merely getting a terrible chest cold.”

TAKE CHARGE OF YOUR LIFE! The next few pages give YOU an opportunity to take charge of YOUR life. Know your numbers, eat right, exercise and make the effort to be healthy! LOWER YOUR RISK OF HEART DISEASE AND STROKE Learn more about your risk factors and have regular check-ups. Reduce the risk factors you can control. You may need to: • Cut down on the amount and kinds of fat and cholesterol in your diet. • Stop smoking and avoid other people’s tobacco smoke. • Control high blood pressure. • Be more physically active. For example, use stairs instead of elevators! • Maintain a healthy weight. • Take medicine as your doctor prescribes it. TAKE ACTION IN YOUR COMMUNITY AND WORKPLACE • Ask for healthier food choices in grocery stores, restaurants and your company’s vending machines or cafeteria. • Insist on a non-smoking section in restaurants and other public places. • Request that your workplace be smoke-free. • Start a fitness walking club or exercise class. LEARN TO RELAX Find healthful ways to deal with situations you find stressful. Unhealthy responses to stress may lead to other risk behaviors like smoking and overeating. Get your friends and family to join you in a healthy way of life: • Make changes slowly in your family’s diet and exercise habits. • Share heart-healthy cooking tips and recipes with friends. • Suggest that your church, synagogue or community group hold a blood pressure or cholesterol screening. • Find a partner to exercise with you three or four times a week. • Turn off the TV and do something active as a family. • Help friends and family who want to quit smoking. © American Heart Association.

WHAT’S YOUR EF? EF means “ejection fraction,” and the number represents the percentage of blood that is squeezed or ejected out of the heart’s left ventricle during each beat. Like cholesterol and blood pressure numbers, this number is a key indicator of your heart health. A normal ejection fraction is 55-65 percent. An EF of less than 40 percent indicates that the heart muscle has been damaged and is not functioning properly. The heart is less able to pump the blood necessary to meet the demands of the body. The result is a rise in pressure within the heart and lungs, leading to breathlessness, fluid retention and symptoms of fatigue and malaise.

50-75%

36-49%

35% & Below

Heart’s pumping ability is NORMAL

Heart’s pumping ability is BELOW NORMAL

Heart’s pumping ability is LOW

The primary concern of a low EF is the known correlation with sudden cardiac arrest. Knowing your EF and seeking treatment if it’s not at a safe level can help reduce the risk of sudden cardiac arrest, a condition that claims more than 335,000 American lives each year. It’s especially important to know your EF if you have: • Had a heart attack • High blood pressure that is not well controlled • Heart valve problems • Heart failure • A family link to sudden cardiac arrest Ejection fraction can be measured in many ways, but the most common method is with an echocardiogram, a simple test that uses ultrasound (sound waves) to take moving pictures of the heart. If your EF is too low, your practitioner can prescribe medications, devices, surgery or lifestyle changes. It’s important to follow a lowsodium diet, not use tobacco products, stay physically active, lose weight if you’re overweight, and limit alcohol.

KNOW YOUR NUMBERS Weight-related health risks are a serious problem. Your health care practitioner can help you fill out this chart. Use it to get a clear picture of where your risk factors stand and to set goals for getting your numbers to healthier levels. HDL “good” Cholesterol An HDL less than 40mg/dL is considered a risk factor for cardiovascular disease in men, while an HDL less than 50 mg/dL is considered a risk for women.

_______________mg/dL

Triglycerides When triglycerides are higher than normal (150 mg/dL or more), your risk of heart disease or stroke may be increased. If your triglycerides _______________mg/dL are 200 mg/dL or more, your health care practitioner may talk to you about your non-HDL cholesterol value. Your non-HDL cholesterol value should not be more than 30 above your LDL goal. Blood Glucose Levels When blood glucose levels are higher than normal, it means one has diabetes which also increases the risk of heart disease and stroke. _______________mg/dL • Normal fasting* plasma glucose = less than 100 mg/dL • Impaired fasting plasma glucose = 110 to 125 mg/dL • Fasting plasma glucose at which diabetes is diagnosed = 126 mg/dL or higher * Fasting plasma glucose is a measurement of glucose level in the blood serum taken in the morning before eating. Elevated Blood Pressure Blood pressure in excess of 130/80 mm/Hg increases your risk for heart disease, stroke and kidney disease. LDL “bad” Cholesterol Your health care practitioner will determine your LDL goal based on your number of risk factors and medical history. An optimal level of LDL is less than 100 mg/dL

_______________mm/Hg (systolic) _______________mm/Hg (diastolic) _______________mg/dL

Body Mass Index (BMI) A BMI of 30 or more is considered obese. (see page 22 to calculate.)

_______________BMI

Lifestyle I smoke OR live or work with people who smoke every day? I get less than a total of 30 minutes of physical activity on most days of the week?

________No ________Yes ________No ________Yes

I eat: At least 4.5 cups of fruit and vegetables each day Two or more 3.5 oz servings of fish per week Less than or equal to 36 oz of sugar-sweetened beverages per week Three or more 1 oz servings of fiber rich whole grains each day Less than 1500 mg of sodium per day

________No ________No ________No ________No ________No

________Yes ________Yes ________Yes ________Yes ________Yes

96 99 102 106 109 113 116 120 124 127

91 94 97 100 104 107 110 114 118 121

125 128 132

136 140 144 148 152

5’8” 5’9” 5’10”

5’11” 6’ 6’1” 6’2” 6’3”

143 147 151 155 160

150 154 159 163 168

138 142 146

100 104 107 111 115 118 122 126 130 134

157 162 166 171 176

144 149 163

105 109 112 116 120 124 128 132 136 140

115 119 123 127 131 135 140 144 148 153

119 124 128 132 136 141 145 150 155 159

165 169 174 179 184

172 177 182 186 192

179 184 189 194 200

151 157 164 155 162 169 160 167 174

110 114 118 122 126 130 134 138 142 146

186 191 197 202 208

171 176 181 193 199 204 210 216

177 182 188 200 203 212 218 224

184 189 195

26 27 28 Weight in Pounds 124 129 134 128 133 138 133 138 143 137 143 148 142 147 153 146 152 158 151 157 163 156 162 168 161 167 173 166 172 178

208 213 219 225 232

190 196 202

138 143 148 153 158 163 169 174 179 185

215 221 227 233 240

197 203 209

143 148 153 158 164 169 174 180 186 191

222 228 235 241 248

203 209 216

148 153 158 164 169 175 180 186 192 197

229 235 242 249 256

210 216 222

153 158 163 169 175 180 186 192 196 204

236 242 250 256 264

216 223 229

158 163 168 174 180 186 192 198 204 211

33 167 173 179 185 191 197 204 210 216 223

243 250 257 264 272

250 258 265 272 279

223 230 230 236 236 243

162 168 174 180 186 191 197 204 210 217

BMI Categories: • Underweight = <18.5 • Normal weight = 18.5-24.9

131 135 139

BMI HGT 4’10” 4’11” 5” 5’1” 5’2” 5’3” 5’4” 5’5” 5’6” 5’7”

STEPS TO A HEALTHIER WEIGHT.

Calculate your body mass index to determine if you’re at risk for obesity. Body mass index (BMI) is a measure of body fat based on height and weight that applies to both adult men and women: • Overweight = 25-29.9 • Obesity = BMI of 30 or greater

TIPS FOR HEALTHY EATING. GOAL/RECOMMENDATIONS

(BASED ON A 2000 CALORIE PER DAY DIET)

FRUITS AND VEGETABLES 4.5 cups or more per day

FISH Two or more 3.5 ounce servings a week (preferably oily fish such as salmon and mackerel, which are high in Omega-3 fatty acids

SUGAR-SWEETENED BEVERAGES Less than or equal to 450 kcal (36oz) per week

FIBER-RICH WHOLE GRAINS Three or more 1-ounce servings a day

RATIONALE Diets high in fruits and vegetables are associated with a lower risk of cardiovascular diseases as well as risk factors such as obesity and high blood pressure.

Eating fish is associated with lower risk of sudden cardiac death. Diets high in Omega-3 fatty acids may also help reduce triglycerides in some people.

Diets high in sugar tend to be high in calories and displace necessary nutrients from healthier foods. High sugar diets are also associated with obesity, and new research suggests a link with high blood pressure. Whole grains are high in fiber, which helps lower cholesterol, and contain essential nutrients, such as vitamins and minerals. Diets high in whole grains have been associated with a lower risk of cardiovascular disease and are helpful for attaining and maintaining a healthy body weight.

INSTEAD OF...

REPLACE WITH...

MILK GROUP Sweetened fruit yogurt Whole milk Natural or processed cheese

MILK GROUP Plain fat-free yogurt with fresh fruit Lowfat or fat-free milk Lowfat or reduced-fat cheese

MEAT GROUP Beef (chuck, rib, brisket) Chicken with skin Lunch meats (such as bologna) Hot dogs (regular) Bacon or sausage Refried beans

MEAT GROUP Beef (loin, round), fat trimmed off Chicken without skin Lowfat lunch meats Hot dogs (lower fat) Canadian bacon or lean ham Cooked/canned kidney or pinto beans

GRAIN GROUP Granola Sweetened cereals Pasta with cheese sauce Pasta with white sauce (alfredo) Croissants or pastries

GRAIN GROUP Reduced fat granola Unsweetened cereals with fruit Pasta with vegetables (primavera) Pasta with red sauce (marinara) Toast or bread (try whole grain)

FRUIT GROUP Apple or berry pie Sweetened applesauce Canned fruit packed in syrup

FRUIT GROUP Fresh apple or berries Unsweetened applesauce Canned fruit packed in juice or “lite” syrup

BE SOMEONE’S

HEART HERO 24

INSTEAD OF...

REPLACE WITH...

VEGETABLE GROUP Deep-fried french fries Baked potato with cheese sauce Fried vegetables

VEGETABLE GROUP Oven-baked “french fries” Baked potato with salsa Steamed or roasted vegetables

SOLID FATS Cream cheese Sour cream Regular margarine or butter

SOLID FATS Light or fat-free cream cheese Plain lowfat or fat-free yogurt Light-spread margarines, diet margarine

ADDED SUGARS Sugar-sweetened soft drinks Sweetened tea or drinks Syrup on pancakes or french toast Candy, cookies, cake, or pastry Sugar in recipes

ADDED SUGARS Seltzer mixed with 100% fruit juice Unsweetened tea or water Unsweetened applesauce or berries for topping Fresh or dried fruit Experiment with reducing amount and adding spices

SERVING SIZE. These quick reminders can help you get a feel for what a serving size looks like. With practice, you will be able to gauge them without measuring. 1 cup = a baseball 3/4 cup = a racquetball 1/2 cup = a scoop of ice cream 1/4 cup = one egg in the shell 3 oz = a deck of 52 playing cards 2 oz = a pair of dominos 1 1/2 oz = a 9 volt battery 1 oz = a pair of dice 2 Tbsp = a ping pong ball 1 oz = your thumb 1 tsp = a postage stamp 1 slice of bread = a CD case 1 piece of cornbread = 1/2 bar of soap 1 medium apple = the size of your fist 1 pancake = a CD TIPS FOR EATING OUT • As soon as you get your meal, split it in two and have half wrapped up to take home. • Instead of a whole meal, order an appetizer for a main meal. • Order dressings or rich sauces on the side and use sparingly or dip your food into it. • Avoid upsizing meals at fast-food restaurants. • Use smaller plates and bowls at self-service restaurants. • Buy smaller packages of snack foods. • Eat slower and savor your food. It takes about 20 minutes for your stomach to signal to your brain that you are full.

HEALTHY OPTIONS FOR A HAPPY HEART. GENESIS HEART FAILURE PROGRAM This program supplements physician’s care by providing clinical care, instruction and long-term follow-up. Patients are instructed on diet, including sodium restriction, physical activity, medication use, smoking cessation and signs and symptoms of heart failure. Genesis Visiting Nurse Association staff performs advanced cardiac assessments and provides therapy to homebound patients, reducing their need for hospital readmission. GENESIS HEART FAILURE OUTPATIENT CENTER The Heart Failure Outpatient Center’s mission is to improve the quality of life and to decrease hospital readmissions due to complications related to heart failure. Two types of visits are available to tailor treatment according to the needs of the person with heart failure. • Lasix Injection Visit: Nurse assessment, review of medications, clinical conditions, education, lab work. The patient is monitored for treatment effectiveness during their 1 to 1.5 hour visit one to two times weekly. • IV Infusion Therapy: Nurse assessment, review of medications and clinical condition education, lab work, administration and monitoring of infusion medication. The patient typically infuses four to six hours one to three times weekly.

GENESIS MEDICAL CENTER, DAVENPORT CARDIAC REHABILITATION PHASE III/IV PROGRAM This program helps heart patients with cardiac conditions and those at risk for heart problems maintain health and fitness. Professional staff with specialized training in cardiac rehabilitation and exercise physiology monitor exercise sessions. Cardiovascular, strength, balance and flexibility training are available at each session. Group educational classes are provided monthly. Family members and friends are welcome to join with a physician referral. Cardiac Rehabilitation Phase III/IV is located at the Genesis Heart Institute, 1236 E. Rusholme St., Davenport, IA 52803. For more information call, (563) 421-6991. GENESIS MEDICAL CENTER, ILLINI CAMPUS PULSE PROGRAM People Utilizing Life-Saving Exercise (PULSE) is an individualized, medically supervised exercise program that focuses on primary and secondary prevention of heart, or cardiovascular disease. The program assists the individual in maintaining or improving cardiovascular fitness while teaching important selfmonitoring skills to enhance a lifetime of exercise habits. The PULSE Program is offered at the Two Rivers YMCA, 2040 53rd St. in Moline. For more information, call (309) 762-0383. GENESIS SPARC PROGRAM • Our Stroke Prevention and Recovery Center offers aphasia and a stroke support group. • Speakers are available for community presentations. • Call (563) 421-3460 for additional information. STOP SMOKING • Let us help you stop smoking as quickly as possible and teach you the effective techniques for ending your physical and psychological addiction to tobacco. • Sign up for four, one-hour sessions by calling Genesis Medical Center, Davenport at (563) 421-1769. CLASS AND EVENT INFORMATION For information on classes and events, visit us at www.genesishealth.com/heart

REAL PEOPLE. REAL STORIES. Rose Dahlstrom had just finished breakfast and was getting ready for an outing with her daughter when she suddenly began to feel terrible.

“I had back pain, chest pain and pain radiating from my left arm and shoulder. I felt nauseous,” the resident of Carbon Cliff, Ill. “I wasn’t sure, but I thought I was having symptoms of a heart attack.” She did the right thing. She called 911, and was rushed by ambulance to the Genesis Medical Center, Illini Campus. She was in the midst of a heart attack and ultimately received two stents to open her blocked arteries in the hospital’s Cardiac Catheterization Lab. Today she realizes she had symptoms she shouldn’t have ignored. “I had a stroke the year before, which increased my risk of a heart attack,” she says. “I was taking medication for my cholesterol and high blood pressure. Yet, I had been experiencing headaches and a rapid heartbeat before my heart attack and did nothing about it.” Dahlstrom, who began her Cardiac Rehabilitation at the Larson Center of the Illini Campus, now exercises at the Genesis PULSE Program at the Two Rivers YMCA in Moline. “It’s very comforting to know that the program is medically supervised and that staff is monitoring you while you exercise,” Dahlstrom says. “I probably wouldn’t exercise at all if I wasn’t going there.”

GET SCREENED. q IS YOUR CHOLESTEROL LEVEL ELEVATED? Have your blood cholesterol level checked regularly starting at age 45. If you are younger than 45, talk to your practitioner to determine if you would benefit from having your cholesterol checked, particularly if you have diabetes, high blood pressure, heart disease, if you smoke, or if heart disease runs in your family. q IS YOUR BLOOD PRESSURE ELEVATED? Have your blood pressure checked at least every two years if it’s normal and more often if it’s not. High blood pressure is a reading of 140/90 mm/Hg or higher. Ideally maintain a blood pressure lower than 130/80 mm/Hg. q DO YOU HAVE DIABETES? Have a test for diabetes if you have high blood pressure or high cholesterol. These three risk factors often occur simultaneously and greatly increase your risk for heart disease. ARE YOU AT RISK FOR AN ABDOMINAL AORTIC ANEURYSM (AAA)? Men between ages of 65 and 75 who have ever smoked (100 or more cigarettes during lifetime) or who have a family history of AAA should be screened once for abdominal aortic aneurysm. This is an abnormally large or swollen blood vessel in the abdomen. Screenings are available by calling (563) 421-3200. These screenings also include an evaluation for peripheral vascular disease and carotid artery disease. COULD YOU BE DEPRESSED? Your emotional health is as important as your physical health. Take this short quiz to determine if you need to talk to your practitioner about being screened for depression: • Have you felt “down,” sad or hopeless over the past two weeks? • Have you felt little interest or pleasure in doing things?

GET WITH THE GUIDELINES. Basic recommendations from the American College of Sports Medicine and the American Heart Association. EXERCISE GUIDELINES FOR HEALTHY ADULTS UNDER AGE 65 Do moderately aerobic intense exercise 30 minutes a day, five days a week.

OR Do vigorously aerobic intense exercise 20 minutes a day, three days a week.

AND Do eight to 10 strength-training exercises, eight to 12 repetitions of each exercise twice a week. Moderate-intensity physical activity means working hard enough to raise your heart rate and break a sweat, yet still being able to carry on a conversation. It should be noted that to lose weight or maintain weight loss, 60 to 90 minutes of physical activity may be necessary. The 30-minute recommendation is for the average healthy adult to maintain health and reduce the risk for chronic disease.

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Children should be physically active for 60 minutes daily.

EXERCISE GUIDELINES FOR ADULTS OVER AGE 65 (OR ADULTS 50-64 WITH CHRONIC CONDITIONS, SUCH AS ARTHRITIS) Do moderately intense aerobic exercise 30 minutes a day, five days a week.

OR Do vigorously intense aerobic exercise 20 minutes a day, three days a week.

AND Do eight to 10 strength-training exercises, 10-15 repetitions of each exercise twice to three times per week.

AND

If you are at risk of falling, perform balance exercises.

AND Have a physical activity plan. Both aerobic and muscle-strengthening activity is critical for healthy aging. Moderate-intensity aerobic exercise means working hard at about a level-six intensity on a scale of 10. You should still be able to carry on a conversation during exercise. Older adults or adults with chronic conditions should develop an activity plan with a health practitioner to manage risks and take therapeutic needs into account. This will maximize the benefits of physical activity and ensure your safety.

REAL PEOPLE. REAL STORIES. Jeanne Stoltz of Bettendorf thought of every excuse in the book to explain away her symptoms of heart attack.

Her nauseous stomach was probably the flu. Her constant shortness of breath was the result of years of smoking, even though she had quit years earlier. Her shoulder ached and pain radiated down her arm but, then again, she had a bad left shoulder. Stoltz had survived an aneurysm four years earlier, and was a frequent sufferer of migraines. Her tolerance for pain already was high. To top it off, she had passed a stress test with flying colors just one year before. “Unlike many women, I actually had the classic signs of a heart attack. But what did I do? I totally ignored them and, despite my discomfort, went shopping with my daughter that day,” Stoltz says. “At that point, heart disease wasn’t on my radar.” Stoltz was in St. Louis visiting her children for Easter. She went shopping to help her daughter register for baby gifts. That “little case of the flu” wasn’t going to stop her from sharing the special milestone with her pregnant daughter. But the next day, when her symptoms persisted, she finally went to the Emergency Room and learned she had indeed suffered a heart attack. Three days later, she underwent a quintuple bypass to open blockages in her heart. Stoltz has this bit of advice for women: Don’t do what she did and ignore the symptoms of heart attack.

“When I finally went to the Emergency Room with my symptoms, the female doctor said I’d had a heart attack the day before and scolded me for not coming in sooner. She said, ‘If you had come to the hospital right away, you would have suffered less heart damage.’” After open-heart surgery, Stoltz now takes heart disease seriously. She participates in Genesis’ Phase IV Cardiac Rehabilitation and encourages her four grown children to pay attention to heart disease. Even though her own mother had a heart attack at age 67, Stolz always assumed she was immune because she led a healthier lifestyle. “Listen to your body,” she says. “I think women have a higher tolerance for pain, and that’s really a problem when it comes to seeing a doctor.” Being in a cardiac rehabilitation class with other heart patients can be a real motivator, she says. “Cardiac Rehab at Genesis gives you a real sense of comradeship. It makes a huge difference in recovery. Today, I have more stamina, better balance and feel like I’m in much better physical health.”

YOU ARE A

HEART HERO 34

YOU CAN DO IT. Start reducing your risk today by making healthy lifestyle changes: • Quit smoking and avoid other people’s tobacco smoke. • Exercise 30 minutes most or all days of the week. • Eat a healthy diet. • Drink alcohol in moderation or not at all. • Learn to relax and deal with situations you find stressful in a healthy manner. • Do not use illegal drugs. Drinking too much alcohol raises blood pressure, can cause heart failure and contributes to obesity. One drink is defined as one and one-half fluid ounces of 80-proof spirits, one fluid ounce of 100-proof spirits, four fluid ounces of wine or 12 fluid ounces of beer. Intravenous drug abuse leads to an increased risk of endocarditis (infection of the heart’s lining or valves) and stroke. Cocaine use is linked to an increased risk of fatal heart attack even in first-time users. Know your numbers. Maintain a: • Healthy weight. • HDL cholesterol level 40 mg/dL or greater for men and 50 mg/dL or higher for women. • LDL cholesterol level less than 100 mg/dL if other risk factors are present and less than 130 mg/dL if no other risk factors are present. • Triglyceride level less than 150 mg/dL. • Blood pressure less than 130/80 mm/Hg. • Fasting plasma glucose level less than 100 mg/dL. Involve your family, friends and co-workers in making healthy lifestyle changes: • Turn off the TV and do something active. • Use the nonsmoking section of public places. • Encourage others to become aware of their risk factors and help them to reduce their risk. • Ask your workplace to be smoke-free and offer healthy food choices.

Genesis will not exclude, deny benefits, or otherwise discriminate against any person on the grounds of race, color, creed, national origin, sex, lifestyle, social status, age, disability, ability to pay, source of payment, or existence of an advance directive. Interpreter services, auxiliary aids and communication tools are available in our patient care areas at no cost to patients and families with limited English skills or hearing and sensory impairments.