Thursday, March 28, 2013

Saving Time Can Save Your Heart Life

For about fifteen years, I was a volunteer firefighter and EMT.  When we responded to a medical call, it was not unusual for us to transport the patient to the appropriate hospital for further care.  This could be for a variety of causes, but many of these calls were for an apparent heart attack.

One of the things that we always did, if time permitted and we were at the patient's home, was to gather the medications that the patient was currently taking and take them with the patient so that the emergency doctors would have a more complete picture.  Some patients had these ready for us; for some others, we never found what they had taken that day.

There is a system which we now often see called "Vial of Life".  This consists of a magnetic sticker to place on your fridge and instructions to have you prepare a list of your meds and place that list in your fridge.  The EMTs know to look on your fridge, and if there is a sticker there, to look in your fridge.

You can use this or a similar system yourself and make it even better.  Here's how to do that:

1.    Take one of your empty pill bottles and put one pill, from that prescription, in that bottle.
2.    Do the same for all of your medications.
3.    Put all of the pill bottles, with at least one pill in each in a ZipLock Bag.
4.    Put your medication schedule in the same Bag.
5.    Put that Bag in a place where the EMTs can quickly find it. Your fridge is a good, common place that they can find quickly.
6.    Put a sticker on the outside of your fridge telling the EMTs that your meds are in the fridge.

It is so important for you, when you get taken to the emergency room (with your next heart attack), that they quickly know as much about you as they can.  This includes your medications. With this bag of your meds (and other information), it will dramatically reduce the time for them to know what to do to save your life.

The other thing you should add is the reference to your Road ID (http://www.roadid.com ).  


See our previous post for more information on the Road ID.

Emergency Identification for Heart Survivors


Until two-and-a-half years ago, I was fairly healthy.  I was still playing hockey twice a week, as I had for about sixty years.  I still skied, jogged, biked.  All the regular stuff.  Then, with any warning, I had 15 heart attacks in one day.  I had had about five of the attacks by the time the EMTs arrived but the attacks presented as a sharp pain in the left shoulder blade. The EMTs arrived and ran their tests.
 
They assured me, from their tests, that it wasn't cardio. And so, they took me to the nearest hospital but not the Heart Institute.  I apparently died a couple of times on the table, but they shocked me back each time. By the next morning, I was transferred to the right place and the repair work began.

Once I got back home and began rehab exercises, including riding my bike again (carefully), I was introduced to Road ID (http://www.roadid.com ) by my son.  It's a clever idea and answered a problem that I didn’t realize I had.  The problem was, if I did have another attack while on my bike (or doing anything else), I might not be able to explain my medical history and the meds that I was on.  Imagine the time lost once you arrive at a hospital if they don't know your history. They might think you had just a fainting spell or were intoxicated. Or you might be unconscious.

The Road ID has your medical information in one of two forms, either 1) on you as necklace tags or a bracelet or shoe tags and 2) available online on their website.  I couldn't decide which made more sense for me. I could see the benefits of each approach and decided to do both.

Now, I wear a lanyard around my neck whenever I am awake with two tags:

One tag has:
1) my name, age, city and phone number
2) my wife's name and phone number
3) my son's name and phone number
4) my daughter's name and phone number
5) a list of all the meds that I am on, and
6) the word HEART.

The second tag has:
1) my name, age, city and phone number
2) my wife's name and phone number
3) the toll-free phone number for all my medical information
4) the website, with serial number and pin number, for all my medical information.

I really don’t want anyone to have any doubts about my previous medical history nor my current meds .

The toll-free phone number and the website are both resources for the EMTs, physicians and cardiologists to get fast and easy access to your history.  There are templates to help you add your information and lots of free-form space. Mine has 18 pages of medical history and information relating to my heart.  And you can update the online information easily from your computer, as often as you like. No cost.

The cost for the tags is about $20-$25 and an ongoing annual fee, if you use the website for your information. I don't remember the annual cost but I think it's $10. It renews automatically which is why I don't remember the cost. But I remember that it's insignificant compared to saving valuable minutes saving your life. I think it's a great idea and I definitely feel more secure.

If you still need convincing, go to www.roadid.com and read some of the testimonials.

Sunday, January 27, 2013

Why the Cardiologist Recommended the Rehab Facility


Why the Cardiologist Recommended the Rehab Facility


I thought I was in good shape before my 'heart events'. I was playing hockey twice a week, skiing, biking, even walking. But, two years ago starting at 2pm while sitting in my car, I had the first of 15 heart attacks in nine hours.

I was in the heart institute for a week and lost the first 15 pounds of 41 that I eventually lost. In my last post, I talked about what the cardiologist told me (and my wife, who was there as my advocate) as we left the hospital. The staff there had set up several appointments for me for follow-on and continuing ancillary care. One of these was at the rehabilitation facility (hereafter called rehab). I wasn't sure that I needed/wanted to do that; it was for 'sick' people, or so I thought. I read about how important it was to get some exercise and to start by walking up and down in front of your house and gradually extend your distance. I could do that.

So, I tried to walk to the end of the block. I quickly developed chest pains. And, like most other first time heart patients, I 'knew' that I could die from that. So, I didn't exercise.

My first appointment at the rehab facility was in a month. At my first appointment, they had me come in early to get the background, etc. There was a nurse and a physio in attendance and I explained what had happened and why I had not done any exercise for the past month. They wired me up and told me to walk around the track while they watched on their computer monitor. They said "Come in as soon as you have pains". I said "I'll see you in five". So I walked out on the track and developed pains in less than one circuit. When I went to see the monitor, they could not see anything wrong and said that was normal and not to worry about it. They did show me a confidence booster. "Put both arms straight up and, if there is a change in your chest pain, then it's not cardio". So, with that relief I went back onto the track and walked confidently for 45 minutes. And, I never looked backed.

The program offered at our heart institute is free for survivors and consists of sixteen sessions, two per week. They have a short, oval track and the regular gym machines (treadmills, bikes, elliptical trainers) and you are free to use whichever of these you want. There are 16 people in each session and you are free to use all of the facilities as you wish. There are medical personnel there at all exercise times and they take your vitals before each session.

After getting my confidence and learning what I could do, I eventually built up to my current level. It's been two years and I walk or bike for an hour per day and carefully watch all of the other risk factors (diet, stress, polluted air, meds, depression). Some say that I'm anal about how closely I monitor these things. I even photograph every meal so as to not miss any that I need to record for the next time.  My blood pressure (both arms) and pulse is amazingly low (but safely so). Even the cardiologist (also a survivor) is envious. I have not returned to hockey but I began skating and skiing again this winter and they both feel fine. I still make the same mistakes in those sports as before.

Is rehab important ? In my opinion, absolutely. Without that confidence boost, and the associated exercise value, I definitely would not feel as good as I do.

Thursday, January 24, 2013

What should your cardiologist tell you as you leave the hospital

Congratulations !  You will be leaving the hospital today and, although we enjoyed having you here, we don’t want to see you back.  Except, of course, for your visits to our rehab facility. I’ll get to that in a bit.

In the past, a heart survivor would be patched up, maybe receive a new transplant, maybe a bypass or some angiography and then sent back to live as they did before. Research over the years determined that survivors should change their lifestyle to increase their chances of not having another attack.  So, there are five things that you should address. These will become part of your new lifestyle.

These are:
1.    exercise – It is important for you to do regular exercise. This can be as little as walking for 30 minutes 3 times a week up to 60 a day every day.  In the rehab program, we will be able to determine how much and what activity you can do.
2.    diet – What you eat is important. You should be knowledgeable about the amount of sodium and fat that you eat.  The people in our nutrition program will help you to understand what this means and how to do it.
3.    stress – Stress is one of the things that is impossible to see but can have large effects on your body. If you are a stressed person, you may want to work on that.
4.    sleep – Sufficient sleep is necessary to help your body repair and to maintain itself. You should have 8 hours per night and a short nap 3 times a week.
5.    smoking – Smoking is bad for your heart and second-hand smoke is thought to be as bad, if not worse.
6.    depression - I would suggest a sixth thing cardiologists should discuss with their patients -- the risk of depression. More than half of all heart attack survivors suffer from depression after their heart attacks, and being depressed can increase their risk of a second heart attack two or three-fold! I think patients should be warned that this may happen and educated about potential signs of depression. It's also worth discussing with the survivor's family (similar to the counseling new fathers receive about how to spot post-partum depression).[this point is thanks to
Jen Thorson @jen_thorson on Twitter]

Stop these five things to greatly reduce your risk:

Smoking (or hanging around with smokers). Smoking is the most dangerous -- yet most reversible -- risk factor for heart disease. If you are under 40, quitting smoking and avoiding secondhand smoke today can lower your heart disease risk to that of a nonsmoker over time.

Eating trans fats. Synthetically created to extend the shelf life of baked goods and snack foods, trans fats can raise your level of LDL ("bad") cholesterol, too. Best bet ? Check the label for trans fats (also called partially hydrogenated oils) and avoid them entirely.

Adding salt. Eating a lower-salt diet can lower your blood pressure by five points, which for many people can mean one less prescription to buy. Most people consume as much as 3,500 mg of sodium per day. This comes mainly from processed food but also added at the table. You should aim for a maximum of 1,500 mg per day for at least the next year.

Gaining weight. You likely have lost weight while here. You need to keep that weight off and maybe even lose some more. In rehab and nutrition, they will advise you you’re your desired weight should be.  Processed food, oversized portions, snacking and a sedentary lifestyle have added inches to our waistlines and layers of risk to our hearts. Losing weight can help.

Giving up on medications. No one likes to take pills. But blood pressure, cholesterol, and diabetes medications will also reduce your likelihood of a heart attack. Talk to  your doctor about a medication regimen that will work for you, then stick with it. You want to be rigid consistent about your meds .

I want you to record your foods, daily, for at least three months, maybe even longer. You should record the numbers for everything you eat so that we can see how your body is responding to your new lifestyle. So record:
•    calories
•    sodium
•    cholesterol
•    total fat
•    sat fat
•    fluids
•    carbohydrates
•    potassium
•    protein

In some cases, you can get these numbers from the food packages. If not, search for them online.  Eating in restaurants will be a challenge, as it is difficult to get the numbers and there are some foods that you will have to avoid.  These include things like hot dogs, regular bread, canned soups, many pastas, ham, bacon, most condiments, soft drinks (especially power drinks).  But there are many things that you can have, like steak, beef, fish, some pastas, some cereals, most vegetables, most fruits, wine, beer, liquor.

We’ll set an appointment for one month and see how you are doing. The appointments have already been made for in the rehab facility and with the nutrition department.

I look forward to meeting you again in a month. Take care of yourself and I mean that.