Better Health - February 2021

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| SUNDAY, FEBRUARY 21, 2021

Heart failure affects

over 3 million women in the United States, and the sad fact is that

heart

disease

leading cause of death for women

is the

in the nation.

Keith O’Connor

She remained stable for a while until a few years later Heart failure affects over 3 when a medication she was million women in the United taking made her heart condiStates, and the sad fact is that tion worse. heart disease is the leading Nay was referred to Baycause of death for women in state Medical Center’s Heart the nation.

Failure Program, where after Jaime Nay and her sister further treatment, the care Christie Muscaro-Asselin team discussed the possibility both survivors - only know too of an LVAD (left ventricular well about heart failure. assist device).

It wasn’t until Nay’s daughAn LVAD is a mechaniter was born in 2010 that her cal pump that is surgically health problems began. implanted inside a patient’s She had a beautiful daughchest to help their heart do its ter, Kailey, and celebrated her job. birth. However, for Nay, her LVADs are used for what pregnancy triggered sympis termed as “destination toms of cardiomyopathy, a therapy” – used as long-term disease of the heart muscle, treatment for heart failure. Or, which can be hereditary as as in Nay’s case as a “bridgein her case or acquired. The to-transplant therapy,” during condition makes it hard for which patients are placed the heart to deliver blood to temporarily on the LVAD the body and can lead to heart until a heart for transplant failure. becomes available. Baystate Two years after her daughMedical Center has the only ter’s birth, Nay’s symptoms LVAD program in western worsened.

“My whole body felt extremely weak. I was tired and I could tell that my heart didn’t feel normal, it felt as if it were flipping and fluttering a lot,” Nay, 39, said.

After an echocardiogram and a visit with her primary care doctor, the West Springfield woman learned the unfortunate news.

“My primary said to me, ‘Are you sitting down? I’m sorry to tell you that your heart is functioning at only 20 percent,’” she said.

As a result, Nay was given medicine to address her symptoms, which for heart failure often includes breathlessness, swollen legs and feet, and a bloated belly.

Special to The Republican

Massachusetts and it was approved in 2016 by The Joint Commission.

“When doctors told me about the LVAD, I was totally against it. I was willing to let myself die and live out my life the way I was….without the hassle of surgery and putting my family through all that stress,” Nay said.

“It was my family who finally convinced me to have the surgery. I got really sick a couple of times and was hospitalized. Finally, my doctors told me that I would be dead in a couple months without the LVAD,” she added, noting that in addition to Kailey, she has a significant other, Jonathan, and a son, Christopher.

And, she listened to them, eventually consenting to the surgery which was performed at Baystate Medical Center by cardiac surgeon Dr. David Deaton.

“One of the things I told

Jaime was that it wasn’t just about herself…..but about her family and to think about what she would be doing to them if she wasn’t here for them,” said Muscaro-Asselin, 48, of West Springfield.

Nay has a history of cardiomyopathy in her family. Her sister and mom both have the disease as well. But she never thought that her sister would soon be facing the very same decision.

“Jaime and her sister have a familial mutation in the TTN gene which put them at risk of heart failure,” said Dr. Mara Slawsky, medical director of the Heart Failure Program at Baystate. She noted the mutation weakens the heart muscle so that it can’t pump blood properly around the body.

“Heart failure is a common disease in the Western world which is sometimes familial and other times the result of other factors such as a heart

attack or coronary artery disease. Only in the past several years have we become more aware that there is a significant genetic component to the disease,” she added.

Dr. Slawsky noted that both women were placed on milrinone, an intravenous drug that is a short-term treatment for life-threatening heart failure. It works by relaxing the muscles in the blood vessels to help them dilate, which lowers blood pressure and allows blood to flow more easily through your veins and arteries.

“Milrinone gave my sister almost another year before needing the LVAD, however, it didn’t work as well for me and within two months I was scheduled for the surgery,” Muscaro-Asselin said, who is married with two children, Matthew and Ann-Marie, and who also provides a home for her son’s friend, Tim. Now both sisters are enjoying life as well as the additional time they have been given with their families. And they would recommend the procedure to anyone asking.

“I’m still here and doing things with my family and that keeps me going. It’s all been worth it,” Muscaro-Assellin added, noting she is working hard at losing weight so that she can be placed on the heart transplant list.

And, for Nay, her life got even better when last year on June 9, as the coronavirus raged on, she received a call from her doctor.

“He asked me what I was doing and then blurted out, ‘How would you like to get a new heart today?’” Nay said, before immediately heading to Brigham and Women’s Hospital in Boston, where she received the transplant later that day.

“What I’m really looking forward to is to be able to go swimming now that I don’t have the LVAD attached to me anymore. But, I’ll be waiting for the warmer weather, there will be no polar plunges for me,” she laughed, noting she “misses her Baystate family” now that her care as a transplant patient continues in Boston.

Risk factors for heart disease in both women and men include high blood pressure, high LDL (low-density lipoprotein) cholesterol, stress, and smoking. Several other medical conditions and lifestyle choices can also put people at a higher risk for heart disease, including diabetes, being overweight or obese, eating an unhealthy diet, physical inactivity, and drinking too much alcohol.

“Good heart health begins at a young age. Work with your primary care provider, who can help you with lifestyle changes to mitigate your risk factors,” said Dr. Slawsky.

For more information on Baystate Health’s lifesaving cardiac capabilities, visit baystatehealth.org/heart.

Jaime Nay, right, and her sister Christie Muscaro-Asselin, both heart failure patients, enjoyed a pre-pandemic day of shopping at Holyoke Mall last January. (PHOTO COURTESY OF BAYSTATE HEALTH)

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The effects of

caffeine on the

Indulging in a morning cup of coffee is a beloved ritual for millions of people across the globe. The rich, bold flavor of coffee has created devotees in all corners of the world, all the while laying the foundation for a lucrative market.

body In its recent “Global Coffee Market - By Product: Global Industry Perspective, Comprehensive Analysis and Forecast 2020-2026” report, Zion Market Research estimated that the global coffee market is expected to reach $155.64 billion in annual revenue by 2026. Though the flavor of coffee is what compels many people to pour that morning cup o’ Joe, others crave coffee in the mornings because of the jolt it can provide at the dawn of a new day. Caffeine is responsible for that jolt, and devoted coffee drinkers, and individuals who prefer other caffeinated beverages, may have come to rely on the boost caffeine provides to kickstart their day.

Researchers have studied the effects of caffeine on the human body to great extent.

Many studies have concluded that modest consump-

tion of caffeine is safe for healthy adults. In fact, the Mayo Clinic notes that up to 400 milligrams of caffeine per day, which is just about the amount of caffeine in four cups of brewed coffee, appears to be safe. But adults may want to learn more about the effects of caffeine on their bodies as they try to determine just how much they should consume each day.

· Caffeine and the heart

According to the Heart Foundation NZ, most studies that examined the potential correlation between heart disease and coffee intake found no association between the two. In fact, the Heart Foundation NZ points out that plant sources of caffeine like coffee provide a host of other compounds and nutrients,

including antioxidants, that can positively affect heart health. However, the online medical resource Verywell Mind notes that the stimulant effect of caffeine speeds up the heart rate.

Healthy adults who drink coffee or other caffeinated beverages in moderation likely won’t have to worry about their heart rates after consuming caffeine, but people who are prone to anxiety may be vulnerable to panic reactions if they consume caffeine.

supplement echinacea can increase the concentration of caffeine in the blood, · Caffeine and potentially exacerbating medications the unpleasant effects of Adults currently taking caffeine intake. certain medications or supAdults who consume plements should speak with caffeine should always do so their physicians about any in moderation and only after potential interactions begiving due consideration to tween those substances and the many ways that caffeine caffeine. For example, the can affect their bodies.

Mayo Clinic notes that mixing caffeine with the herbal can disturb daytime alertness and performance.

· Caffeine and sleep

Caffeine consumed during certain times of day may interfere with a person’s ability to get a good night’s rest. The Mayo Clinic notes that even small amounts of sleep loss

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Heart Heart palpitations, chest pain, shortness of breath light-headedness and fainting.

These could be symptoms of a serious medical condition.

By Cori Urban

SPECIAL TO THE REPUBLICAN

“Many heart rhythm problems are caused by heart attacks, heart valve problems and occasionally genetic abnormalities that a patient may have been born with,” explained Dr. John P. Marenco, president of Pioneer Valley Cardiology and chief of the Division of Cardiology and president of the medical staff at Mercy Medical Center in Springfield. “Many of these conditions are rooted in poor diet, excessive alcohol use or sedentary

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Left: Elie Semaan, MD, Chief of Vascular Surgery, in the catheterization lab at Mercy Medical Center. (HOANG ‘LEON’ NGUYEN / THE REPUBLICAN)

&Vascular

invasive procedures and operative interventions. “Our goals are patient specific but include improvement of lifestyle and limb salvage,” Semaan explained. “Once a patient has been medically optimized, they may require further intervention. This may include a same day outpatient procedure such as an angiogram in which we take pictures of the artery, find and open blockages.”

Sometimes patients require bypass of the blockage or removal of the plaque causing the blockage for the best result. Those patients will be given an operative option.”

Ultimately, the patient plan is customized to their needs and the patient makes an educated decision that suits their life,” Semaan said.

The division sees about 3,000 patient visits a year and still has openings for new patients.

Peripheral arterial disease is becoming more prevalent; it has multiple risk factors that include age, smoking, diabetes and hypertension.

“Our population is aging and

Above: John P. Marenco, MD, President of Pioneer Valley Cardiology and Chief of the Division of Cardiology and President of the medical staff at Mercy Medical Center in Springfield. (SUBMITTED PHOTO)

that trigger the rapid rhythm in the heart are cauterized.

“Patients may need blood thinners to prevent stroke,” he said. “For patients with congestive heart failure, they might need an implantable defibrillator to shock the heart out of severe abnormal rhythms which would otherwise be fatal.”

He places between 100 and 200 in patients annually and does an equal number of catheter ablation procedures.

“Pacemakers are placed for abnormally slow heart rhythms that cause fatigue, dizziness or fainting,” he explained, adding that implantable defibrillators are placed in patients with severe heart problems that put the patients at risk for sudden death or “for patients who suffered a cardiac arrest and survived in order to protect them in the future from reviewing events.”

The general prognosis for these conditions varies, but with current treatments even the most serious conditions can most often be treated in a way that maintains a reason-

devices (the device can be tested right from the home automatically). “We now have implantable heart monitors to better detect causes of arrhythmia and fainting,” he added.

Marenco attended medical school at Georgetown University and did his medical

residency and cardiology fellowship at Tufts University.

Semaan earned a medical degree from St. George’s University and did general surgery training at Maimonides Medical Center. His vascular surgery training was done at Boston University Medical Center.

Both he and Marenco encourage persons with undiagnosed symptoms to see their primary care provider to determine if they should see a specialist.

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Atrial fibrillation is the most common arrhythmia seen in his department; it is a common cause of emergency room visits.

Atrial fibrillation is treated with medications or a procedure called catheter ablation where critical areas that trigger the rapid rhythm in the heart are cauterized. “Patients may need blood thinners to prevent stroke.”

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diabetes is becoming more prevalent,” the doctor said.

Symptoms of a vascular problem include pain in the buttocks, thighs or calves when walking, pain in the toes at night, an ulcer or breakdown of the tissues in the foot and sensation changes in the foot.

For Marenco, atrial fibrillation is the most common arrhythmia seen in his department; it is a common cause of emergency room visits.

Atrial fibrillation is treated with medications or a procedure called catheter ablation where critical areas

able quality of life.

Since Marenco began practice in the cardiology field in 1998, there have been many advances in the field: There have been major discoveries and technology breakthroughs in treating atrial fibrillation including new alternatives to blood thinners (anticoagulants) such as the Watchman device, a small device implanted into the heart that stop clots from forming. There has been the development of leadless pacemakers (no wires) and remote monitoring of pacemaker and defibrillator

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lifestyle.”

As an electrophysiologist, Marenco treats cardiac arrhythmias, evaluates causes of fainting and palpitations and places pacemakers/implantable defibrillators.

He is one of many doctors at the medical center who work with heart and vascular patients.

Dr. Elie S. Semaan is chief of vascular surgery at Mercy Medical Center, focusing on total vascular care of patients. With regard to peripheral vascular/arterial disease, this includes medical optimization, minimally

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Preventive healthcare

and the pandemic Procrastination is not typically considered a good thing. But as the world spent much of 2020 confronting the COVID-19 pandemic, putting certain things on hold became part of the new normal.

In an effort to reduce infection rates, public health officials with the Centers for Disease Control and Prevention and the World Health Organization urged people to limit their in person interactions with people outside of their own households. As a result, many of the things people do on a regular basis, including seeing their physicians for wellness visits, were rescheduled.

It’s understandable that many people postponed preventive care and wellness visits during the pandemic, but it’s also potentially dangerous. For example, researchers with the Health Care Cost Institute found that childhood vaccinations declined by roughly 60 percent in mid-April 2020 compared with 2019. Other screenings and preventive exams, including mammograms, pap smears and colonoscopies,

also declined by significant percentages during the pandemic compared to the previous year.

The National Center for Chronic Disease Prevention and Health Promotion notes the power of preventive care is undeniable. In fact, the NCCDPHP points out that, while chronic diseases are among the most common and costly of all health problems, they’re also among the most preventable. Annual wellness visits and early detection efforts like routine screenings for at-risk populations can uncover problems before they escalate into something more serious. In addition, annual physicals, which are provided free of charge through many health insurance policies, provide great opportunities for doctors to advise patients on their overall health and how to improve it if exams and blood work turn up any red flags.

Visiting a doctor during the pandemic

As vital as preventive care can be, it’s understandable if people are hesitant to visit their doctors during the pandemic. But patients can take certain steps to calm their nerves about booking preventive care appointments during the pandemic.

· Schedule telemedicine appointments.

The number of telemedicine appointments has skyrocketed during the pandemic. While the transition from predominantly in-person appointments

to telemedicine might have been a reluctant and rocky one at the start of the pandemic, many doctors’ offices have since firmly established their telemedicine protocols. The Mayo Clinic advises patients who have not yet tried telemedicine to contact their doctors’ offices to arrange an appointment.

Herbs &spices that can

· Inquire about office procedures.

Doctors try to keep patients healthy, not get them sick. Various medical organizations, including the American Academy of Family Physicians, have provided thorough checklists to help physicians prepare their offices to welcome patients during the pandemic. Patients can ease their concerns by contacting their doctors’ offices and asking them about their pandemic-related protocols.

promote healthy hearts

A nutritious diet is a key component of a healthy lifestyle.

When paired with regular physical activity, a nutritious diet can help people dramatically reduce their risk for various diseases, including heart disease.

· Don’t hesitate to make requests.

There’s no such thing as being too safe from COVID-19, so patients can work with their doctors to calm their fears even further. Ask to pay copays over the phone and request that the front desk call you when the doctor is ready so you don’t have to sit in the waiting room.

Preventive care is an important component of health care, even during a pandemic.

According to the World Health Organization, ischaemic heart disease and stroke claim more lives each year than any other disease, annually accounting for roughly 15 percent of all deaths across the globe.

Many deaths caused by heart disease can be prevented, and eating a healthy diet is a great preventive measure that anyone can take.

Though some people may associate healthy diets with bland foods that lack flavor, people can incorporate various heart-healthy herbs and spices into their favorite dishes to make them more nutritious and flavorful.

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· Garlic

Garlic has long since earned its place on the kitchen spice rack. However, botanically, garlic is neither an herb or a spice but a vegetable. Regardless of how it’s classified, garlic is loaded with flavor and can be used to improve just about any recipe, all the while benefitting heart health. The United Statesbased health services provider Mercy Health notes that garlic can help lower blood pressure and reduce bad cholesterol levels.

· Cayenne pepper

· Turmeric

Garlic and even cayenne pepper may already be staples in many people’s kitchens, but that’s not necessarily so with turmeric.

A yellow spice often used when preparing Indian foods, turmeric has anti-inflammatory properties thanks to curcumin, the part of turmeric responsible for giving it its yellow color. Experts acknowledge that turmeric needs to be studied more to definitively conclude its effects on heart health, but WebMD notes that one small study indicated that turmeric can help ward off heart attacks in people who have had bypass surgery.

Few ingredients may change a recipe as quickly as cayenne pepper. The addition of cayenne pepper · Coriander can instantly make dishes A popular herb used more spicy. But cayenne across the globe, coriander pepper brings more than is sometimes mistaken for a little extra kick to the cilantro. Though the two dinner table. Healthline come from the same plant, notes that various studies cilantro refers to the leaves have shown that capsaicin, and stems of the coriander the active ingredient in cayplant, while the coriander enne pepper, can provide a in recipes typically refers host of health benefits. One to the seeds of that plant. such study published in the Mercy Health notes that British Journal of Nutrition coriander seeds may help found that adding capsareduce bad cholesterol and icin to a high-carbohydrate high blood pressure, both breakfast significantly of which are significant risk reduced hunger and the factors for heart disease. desire to eat before lunch.

Eating less can help people Heart-healthy herbs and more effectively control their body weight, which in spices can be added to various recipes, proving that turn reduces their risk for nutritious meals need not be heart disease. void of flavor.

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