The Rhythm Section

March 2013

Me nded

Hearts “inspiring hope

By Lois Wagner

“

of Citrus County Chapter 367 in heart disease patients and their families.”

We All Have a Story; Art McKinney’s Story Life Goes On

I want people to know that heart surgery is not a prescription for death,” Art McKinney says. “Sure, you have to adjust your life. I can no longer run up 3 flights of stairs; I take the elevator. But it’s amazing what you can still do after a heart procedure, and I’m qualified to say that.”

Art, who was recently named Publicity Chairman for our Mended Hearts chapter, came to Florida by way of Boston and New Hampshire in 1987. After his arrival here, he worked for ICC and then The Chronicle in Sales and Circulation, where he became Circulations Director.

Art’s heart history began in 1997 when he had surgery for a carotid artery. In 2002, he experienced quadruple bypass surgery; in 2010, aortic valve replacement; and in 2011, a stent insertion and another bypass.

Art’s heart adventure continues. Art’s heart surgeon, Dr. Kim, recently referred Art to a heart specialist at the Heart Institute in Leesburg. Dr. Kim is concerned about a micro valve repair and wants to avoid another surgery since Art has so much scar tissue. Dr. Stark, who looked at Art’s heart via his esophagus, indicates that Art definitely has a problem with a valve not entirely closing, causing a significant jet into the upper chamber of the heart.

“...You don’t have to sit in a chair and wait for the Maker to call you...

When Art came to Florida he lived in Citrus Hill for ten years. He moved to Inverness in 1996, just 2 minutes from the bike trail where he’d ride 20 to 35 miles in a day. He’s now down to 10 miles.

He’s still doing what he enjoys but at an easier pace. He continues to walk an hour every day, but he hasn’t been going to the gym 5 days a week since the micro valve problem was identified.

“Although I’ve had a lot of work done on my heart,” Art says, “I’m still very mobile. I have no symptoms except shortness of breath, but that may be from COPD.” So you can see that Art speaks with authority when he advises, “You don’t have to throw in the towel. Participate in life.

You don’t have to sit in a chair and wait for the Maker to call you. Work at enjoying life. I can still do a massive amount of things. We were on a cruise in January, and we plan to go on another in April.”

Art says he first heard of Mended Hearts from Dr. Kim and Marylou when he had his valve replacement in March of 2010. The organization was just beginning. After he and his wife attended their first meeting, they took out a family membership. “I appreciate the positive atmosphere at the meetings. Seeing others with heart experiences allows us to grasp the miracles doctors have worked. However, we, the patients, are a part of it. We have to work on being well and being positive. A heart attack changes life, but there’s still a lot of living left to do.”

Chapter Board Members President: Millie King 637-5525 Vice President: Jackie Popomier Secretary: John Onder Treasurer : John Hoffmeister

The Rhythm Section Staff Editor: Rick Hosea Staff Writer: Lois Wagner Photographer: Bob Ellison

If you have a story or event to put in the Rhythm Section please contact Rick Hosea at (813) 892-4309 or richosea@gmail.com, or Lois Wagner at jwagner117@tampa bay.rr.com

M

ended Hearts is a national non profit organization formed to give heart patients, their care givers, families and friends support to help understand heart disease; causes, treatment and preventative measures.

Our local chapter meets the second Friday of each month.

Meetings start at 10 am and end around 12 pm. Any one interested is invited to attend our meetings. We meet in the Gulf Room of the Old Historic School House adjacent Citrus Memorial Hospital in Inverness.

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By Lois Wagner

Marylou Speaks Candidly about Cardiovascular Disease at February MH Meeting

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Marylou

So what is cardiovascular disease,” Marylou Magrino asked her audience at the Mended Hearts meeting in February. “The heart doesn’t get enough oxygen. It’s the Number 1 killer, resulting in about a million deaths a year. About 42% of all deaths in a year are attributed to heart disease….Because we are living longer, every minute of every day, someone dies of heart disease.”

Marylou 34 years of nursing and her position with Citrus-Ocala Heart and Vascular Institute as Dr. Kim’s nurse provide her with the knowledge and information to discuss the various surgeries performed at Citrus Memorial Hospital: cardiovascular, thoracic, and vascular.

Especially those who smoke are susceptible to aneurisms, as are people with hypertension. “You don’t feel them,” Marylou said.

“They are found by tests - often when people receive testing prior to surgery for another reason.”

Most of the time, the damage can be repaired with stents, but an aneurysm too close to the kidney still requires open repair. If a patient shows signs of a rupture, a Cat Scan is required immediately.

Plaque in the artery of the leg (PAD) can cause an aneurysm there.

Patients MUST walk to force the blood to flow in the legs. “Tell your doctor about any leg pains,” Marylou cautioned. Shortness of breath is another symptom she warned about. “If you can’t walk a mile and you find yourself getting too tired, this is another indicator of a problem. A 5- minute warm up is important before walking because walking is exercise.”

Pressure indicates heart pain. Be able to describe the pain: sharp, dull, with motion, etc.

Aneurisms can occur in the lungs, as well as in the heart. An aneurysm in the heart causes a big blood swirl and the blood to clot.

Heart surgery may consist of implanting a pacemaker, a small computer that goes into action when the heart needs assistance.

Since it is battery operated, the battery must be checked every 3 months and must be monitored by a cardiologist. Following that surgery, a patient waits six weeks to raise the arm and will have scar tissue.

Following bypass surgery, patients should have periodic stress tests, either treadmill or chemical. The plaque that causes heart disease does come back! The residue from the chemical test remains in the system anywhere from 3 days to 3 months. Five sites are available for this procedure.

If a flight is planned in the near future, Marylou suggested getting a note from the technician that administered the stress test to avoid problems with airline security. Obtaining a copy of a patient’s operation report or wearing a bracelet indicating the medications or health issues a person has are other precaution so that health care providers have handy access on the person to pertinent information when needed.

Artrial fibrillation causes blood clots. The symptoms should be taken seriously. The earlier this problem is attended to the better.

Extreme heart rates cause strokes. A defibrillator may be implanted in cases if needed.

Cardiomyopathy results from infection or alcoholism. The heart enlarges and doesn’t have the pumping capacity, and the person becomes a cardiac invalid.

Children with congenital heart disease are being identified and receive heart repair. Also some adults who find that they have had this disease all their lives are now having their hearts repaired. Identifying problems like heart murmurs early is important because the window of opportunity for repair closes when a person becomes high risk as the murmur enlarges or the person ages.

Marylou concluded by stating, “Mind, body, and soul are connected; you can’t treat one without the other.”

Marylou’s Nurses Commandments: A must for dealing with cardiovascular disease

      

Take one day at a time.

Share you concerns with your healthcare provider.

Join a Support Group (Mended Hearts is a good one).

Stay active.

Seek help for depression.

Know your medications, keep a list with you at all times.

Keep an angina diary– date, time started, how long it lasts, was nitro taken, was there relief?  Pray and or Meditate often.  Keep a copy of your procedure and carry it with you to a new Doctor or to your primary care physician for the first follow-up.  Think prevention–Diet, exercise, if you smoke-STOP, follow Dr.’s orders.

SPEAKER FOR MARCH: Dr. Karen Fisher Phar.D. Pharmacist at Citrus Memorial Hospital

Mark Your Calendars!

W

e will be having a Bake Sale on March 22, 2013 at the cafeteria entrance at CMH. We will also have a Chinese auction, Spring Basket (made by Diane Hogue), Three Handmade Afghans (handmade and donated

by Aline Castonguay) and a Wall Hanging Quilt of Fish (Donated by Faye Clark).

Hint: For the raffle tickets bring your name & address labels and stick them on the tickets, then you just have to add you telephone number, lot easier then writing all the information.

For more information and or to volunteer to help or bake call Call Dianne Hogue (352) 341-4063

CMHS Awarded Chest Pain Center Accreditation

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By Rick Hosea

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s most of you probably know Citrus Memorial Health Systems has recently received accreditation by the Society of Chest Pain Centers (SCPC). This has been a two plus year process with more than 400 hospital wide protocols documented to meet the rigorous standards set forth by the SCPC. As of February 11, 2013 CMHS joined the 12 percent of hospitals nationwide to have full chest pain accreditation with pci. “Our survey was done on December 21 and we were told that we would be recommended for accreditation but we didn’t know for sure until February 11” CJ Hosea, manager of CMHS cath-lab, says with pride. Out of 5795 hospitals nationwide only 631 have accredited chest pain centers.

CMHS is the 61st accredited chest pain center in Florida.

I recently sat down with C J Hosea manager of the Cardiac Cath Lab of CMHS. CJ was also co-chair of the committee relegated to the task of bringing CMHS compliant with the accreditation protocols. “We have been working very hard over the last two years with EMS, the ER, ER physicians, cardiologists, cath-lab, surgery, pretty much hospital wide, to establish proven protocols set forth

by SCPC that will standardize the care of patients with cardiovascular disease and heart attacks” said CJ. “One of the criteria that have to be met is a ‘door to balloon time of 90 minutes’. That is the time a patient enters the ER to the time oxygenated blood is supplied past the blockage to the heart. This 90 minuet door to balloon time must be met at least 90% of the time.” This is one of the measures CMHS easily meets.

CMHS has also established a chest pain unit. This is a 25 bed unit where patients admitted through the ER will go for evaluation. A select group of physicians rotate through the chest pain center and follow SCPC protocols to test patients through a stress test or cath or other means to determine the cause of the chest pain and the proper treatment. The patient can usually go home within 48 hours.

What this means to the community is that CMHS is able to tap into resources to find the best evidence based practice nationally and bring those same practices to the community. So we in Citrus County can receive the same excellent quality of care found in any other accredited chest pain center in the nation. “What is exciting about our accreditation” says CJ “is that our accreditation is with PCI which is percutaneous coronary intervention. This means in addition to just taking care of your chest pain we also do the intervention at our facility. Not all accredited facilities do the interventions.”

As a chest pain accredited hospital, Citrus Memorial has the processes in place to:

 Reduce the time from onset of symptoms to diagnosis and treatment  Treat patients more quickly during the critical window of time when the integrity of the heart muscle can be preserved  Monitor patients to ensure they are not sent home too quickly

and make sure they are receiving treatment for their condition in the most appropriate time frame

For more information about Citrus Memorial’s new chest pain accreditation or the Citrus Memorial Heart and Vascular Center visit www.citrusmh.com.

More Info on SCPC

T

he Society of Chest Pain Centers (SCPC) is an international not-for-profit organization committed to eradicating heart disease as the number one cause of death worldwide. Heart attacks are the leading cause of death in the United States, with 600,000 people dying annually of heart disease. More than five million Americans visit hospitals each year with chest pain.

SCPC’s goal is to significantly reduce the mortality rate of these patients by teaching the public to recognize and react to the early symptoms of a possible heart attack, reduce the time that it takes to receive treatment, and increase the accuracy and effectiveness of treatment.

In 2001, the Society of Chest Pain Centers established an accreditation committee to set up an Accreditation Process of Improvement for Hospitals with Chest Pain Centers. The Accreditation Process was based on the “Eight Key Elements of a Chest Pain Center” previously published in the American Journal of Cardiology.

The Eight Key Elements include

  

Community Education and early heart attack care EHAC Emergency Department Integration with the EMS

Emergency Assessment of Patients with Symptoms of ACS – Timely Diagnosis and Treatment of ACS



Assessment of Patients with Low Risk for ACS and No Assignable Cause for Their Symptoms

   

Process Improvement Personnel, Competencies and Training Organizational Structure and Commitment Functional Facility Design

After a hospital becomes accredited, the process cycle for improvement must be documented every three years in order to maintain active accreditation status. The Society of Chest Pain Centers process improvement accreditation and certification programs include:

   

Chest Pain Center Accreditation Heart Failure Accreditation Atrial Fibrillation (A-Fib) Certification Certified Chest Pain Coordinator Program

This information was taken from Wikipedia the Free Encyclopedia

Mended Hearts

Page 4 of Citrus

Don’t Forget to Renew Your Membership

March

8 FRI

22 FRI

12 FRI

County

Monthly Mended Hearts meeting 10 am in the Gulf Room at the Old Historic School House located adjacent to Citrus Memorial Hospital. Dr. Karen Fisher Phar.D. will be the speaker.

Bake sale and Basket Raffle and other good stuf. All kinds of goodies needed. Call Dianne Hogue (352) 341-4063

April Monthly Mended Hearts meeting 10 am in the Gulf Room at the Old Historic School House located adjacent to Citrus Memorial Hospital.

A

ny one wanting to become a member, see John Hoffmeister for forms and dues.

Members renewal forms with a self-addressed envelope are mailed to members from National headquarters. Please return forms and dues in the provided envelop which will, in turn, reimburse the local chapter.

Dues are, for individual $17.00, family $24.00 Also life time membership available. Lifetime individual is $150.00 and family $210.00.

Please be aware that membership is not required to attend our meetings and benefit from our guest speakers. Membership does give you the opportunity to become more involved in our chapter and on a national level depending on your serving interest. Plus you also receive the “Heart Beat” magazine full of all kinds of valuable information included in you membership.

Mended Hearts meets monthly on the second Friday in each month. Meetings start at 10:00 am. Everyone is invited. Meetings are held in the Gulf room located on the 1st floor of the old school house adjacent the hospital. Contact Cardio Vascular Services at 352-344-6416 Chili Bean-Stuffed Peppers Makes: 4 servings Serving size: 1 stuffed pepper

Prep 30 mins Cook 6 hrs (low) or 3 hours (high)

Ingredients:

Directions

 4 small to medium green, red, or yellow

Remove tops, membranes, and seeds from sweet peppers.

Chop enough tops to make 1/3 cup; set aside. If necessary, cut a thin slice from the bottom of each pepper so they sit flat. In a medium bowl stir together rice and undrained beans; spoon into peppers. Pour tomato sauce into the bottom of a 4-1/2-, 5- or 6-quart slow cooker; stir in reserved chopped pepper and onion. Place peppers, filled side up, in cooker.

sweet peppers

 1 cup cooked rice  1 15 ounce can chili beans with chili gravy  1 15 ounce can or two 8-ounce cans no-salt-added tomato sauce  1/3 cup finely chopped onion  3 ounces Monterey Jack cheese, shredded (3/4 cup)  Chili powder (optional) For Nutritional information and more great recipes go to

Cover and cook on low-heat setting for 6 to 6-1/2 hours or on high-heat setting for 3 to 3-1/2 hours.

To serve, transfer peppers to serving plate and cut in half, if desired. Spoon tomato sauce over peppers and sprinkle with cheese and, if desired, chili powder.

http://www.my.hearthealthyonline.com/recipe/

If you would like to share your heart healthy recipe please email to richosea@mendedheartsofcitrus.org.

Recipes should be similar in format as shown in the recipe above. Nutritional info would be helpful but not a requirement.

(Nutritional information was unavailable for this recipe)