@ FAST FACTS ABOUT HEART VALVES
4 Each of your FOUR HEART VALVES opens and closes to keep blood flowing correctly.
The AORTIC AND MITRAL VALVES are the two most commonly affected by heart valve disease. Source: American Heart Association
SUMMER 2018
Cardiac Valve Center team keeps blood moving The heart pumps about 2,000 gallons of blood every day through a system of valves within the heart. But sometimes those valves don’t work like they should, triggering symptoms and health problems that need to be treated. If you have a problem with one of your heart’s valves, the experts at the Mercy Cardiac Valve Center can help. The Cardiac Valve Center isn’t an actual place. It’s a concept of treatment that puts the patient first.
IN THIS ISSUE
2
KNOW PRESSURE Get to the heart of the new blood pressure guidelines.
4
WEIGHT-LOSS SUCCESS Support makes the difference.
Deon W. Vigilance, MD
— Continued on page 2
KEEP YOUR HEART HEALTHY A primary care provider can help. Visit mercyhealth.org/ find-a-doctor.
Is your blood pressure too high? LEARN ABOUT THE NEW DEFINITION OF HIGH BLOOD PRESSURE You may have heard about a big change in how high blood pressure is diagnosed, and it could affect you or someone you love. “High blood pressure now starts at a lower number than before,” says Richard H. Hunn, MD, a cardiologist with Mercy Cardiology at Mercy Fitzgerald Hospital. “So some people who didn’t have high blood pressure in the past could have it now.” It’s important to know what your
Category
Top number
Normal
Bottom number
Less than 120
and
Less than 80
Elevated
120 to 129
and
Less than 80
High blood pressure stage I
130 to 139
or
80 to 89
High blood pressure stage II
140 or higher
or
90 or higher
Higher than 180
and/or
Higher than 120
Hypertensive crisis
Cardiac Valve Center — Continued from front page “The patients are seen in our regular offices,” explains Deon W. Vigilance, MD, a cardiothoracic surgeon at Mercy Fitzgerald and a member of the team that treats valve problems. Other physicians on the team include Richard H. Hunn, MD, and Eddy Mizrahi, MD. “The only thing that’s different for valve center patients is that they see the cardiologist, the surgeon and our valve coordinator all at the same time,” Dr. Vigilance says. This team approach means you don’t have to return multiple times to see each specialist.
2
More @ Mercy Summer 2018
Valve troubles Hearts have four valves. Each valve keeps blood flowing through the heart in the proper direction— opening to let blood flow forward, closing to prevent blood from flowing backward. “In general, one of two things can go wrong with heart valves,” Dr. Vigilance says. “Either they’re leaking, which is called regurgitation. Or they become blocked, which is called stenosis.” The most common symptom of valve problems is shortness of breath. Other symptoms can include: • Swelling in the legs • Chest pain • Light-headedness • Fainting, or feeling faint • Overall fatigue Valves can either be surgically
blood pressure is because high blood pressure can be dangerous to your health— Richard H. especially if it’s Hunn, MD not treated and controlled. “In time, it can raise your risk for many serious conditions, including heart attacks, strokes and kidney disease,” says Dr. Hunn. At left are the new blood pressure categories from the American Heart Association. If your blood pressure is not where it should be, ask your doctor how you can improve it by adopting healthy habits, taking medicines or doing both.
repaired or replaced. Depending on the specific problem, the surgery can be open—performed with a long incision—or minimally invasive, in which surgery is performed through small incisions. Heart valve disease can lead to serious problems, such as heart failure. “And that’s one reason why we developed the valve center,” Dr. Vigilance says. “We can try to fix these valve problems earlier, before someone develops heart failure. And we do that as a team.”
WANT TO KNOW MORE? You can read more about the Cardiac Valve Center at mercyhealth.org/valvecenter/patients.
Treating cardiogenic shock Mercy Fitzgerald is one of the first hospitals in the country to adopt a new treatment strategy that helps boost survival
NEXT-DAY CARDIOLOGY
When you need to see a cardiologist ASAP Let’s say you have shortness of breath and a little bit of chest pain. You’re worried something may be wrong with your heart. You may have: •• Shortness of breath •• Chest pain •• Palpitations •• Loss of consciousness or light-headedness So you go to the emergency department, and the physician says you’re not in immediate danger, but you should be evaluated by a cardiologist soon. Normally, it might take weeks to get an appointment with a heart specialist. But not at Mercy Fitzgerald Hospital, where you’re able to see a cardiologist the next day—or even possibly that same day— after you or your doctor call for an appointment. It’s part of a new speedy access cardiology program at the hospital. “This access program ensures a new patient will get an
Martin J. O’Riordan, MD
appointment with a cardiologist on the same day or the next day after the patient or a referring physician calls,” says Martin J. O’Riordan, MD, Cardiovascular Service Line Director for Mercy Health System. “We wanted to offer prompt evaluation for patients who need a cardiac assessment.” The next-day program was started in 2017 so that patients could see cardiologists without delay, Dr. O’Riordan says. A quick appointment can be requested for any patient who experiences cardiac symptoms but is found not to be having a heart attack.
MAKE AN APPOINTMENT For more information about the next-day cardiology program or to schedule an appointment, call 610.586.4100.
Surviving a heart attack is no small feat. But it’s just the beginning for survivors who go on to have a condition called John J. Finley, cardiogenic shock. MD Cardiogenic shock, which can be fatal, occurs suddenly when the heart can no longer pump enough blood to the body. But at Mercy Fitzgerald Hospital, those with cardiogenic shock now have a better chance at living. John J. Finley, MD, is an interventional cardiologist at Mercy Fitzgerald, which was one of the first hospitals in the country to adopt a new set of treatment best practices tested in a Detroit pilot program. Hospitals in the pilot program were able to boost cardiogenic shock survival from 50 percent to nearly 80 percent. How? By taking a more aggressive approach to diagnosis and treatment, Dr. Finley says. That means doctors begin looking for evidence of shock earlier. If they find that a patient’s heart is showing signs of trouble, they begin to treat the problem right away. One treatment option is to place a device in the heart to help it pump enough blood. The device, an Impella heart pump, is delivered to the heart on the end of a slender wire (catheter) inserted in a blood vessel in the groin. “At Mercy, we’re trying to implement best practices and be on the forefront of cardiology practice,” Dr. Finley says. “We want to give someone with cardiogenic shock the best chance of recovery and survival.” That’s bringing new hope to those with a condition that, until now, has often been fatal. mercyhealth.org
3
SUPPORT every step of the way
THE BARIATRIC PROGRAM AT MERCY FITZGERALD HELPS ENSURE
Linda Keller-Doyle
Prashanth R. Ramachandra, MD, FACS
4
Bariatric surgery can be a life-changer. It can help you lose a lot of weight if you’re obese, and it can drastically improve your health. But the surgery isn’t easy, and you need a lot of physical and emotional support—before and after the procedure—to achieve success. And that’s exactly what you’ll get if you decide to have bariatric surgery at Mercy Fitzgerald Hospital. You won’t be making this journey alone—you’ll have an entire bariatric team by your side. Think of them as your personal partners to better health. “We give patients complete, compassionate care,” says Linda Keller-Doyle, Bariatric Program Coordinator at Mercy Fitzgerald. “We make it very personal.” Some bariatric programs might hand patients a list of tests they need to schedule before their surgery. Linda and her staff make the appointments for you. Not only that,
More @ Mercy Summer 2018
they’ll call to remind you when the tests are scheduled. The surgeons are part of the compassionate care package too. By the time your surgery is complete and you’re ready to go home, you’ll have the personal cellphone numbers for your surgeon, for Linda and for a dietitian. And you’re encouraged to call or text anytime you need help. “It’s above anything by far that I’ve seen in healthcare,” Linda says. “And I think it speaks volumes about our program.”
Healthy outcomes are a priority Weight loss is not the first topic discussed with new bariatric surgery patients. “We talk about disease resolution,” says Prashanth R. Ramachandra, MD, FACS, Mercy Bariatric Surgeon. “That is our big focus. I tell them, ‘Your diabetes is going to go away, your
Am I a candidate for bariatric surgery? Bariatric surgery is best for people who haven’t been able to lose weight and keep it off with diet and exercise. To be eligible for the surgery as an adult, it’s important to meet one of these three criteria, says Prashanth R. Ramachandra, MD, FACS, Bariatric Surgeon at Mercy Fitzgerald Hospital: You have a body mass index (BMI) of 40 or above. You have a BMI of 35 or above and a serious problem linked to obesity, such as type 2 diabetes, heart disease or sleep apnea. You are 100 or more pounds overweight. Call 1.855.LESS YOU (1.855.537.7968) for a free, private, one-on-one bariatric surgery consultation.
1 2 3
WEIGHT-LOSS SUCCESS heart failure is going to go away, your knees and hips will feel remarkably better, and your sleep apnea will go away.’” But all those health benefits don’t happen unless the patient commits to a new way of life. They must exercise, they have to change their diet and eating patterns, and they often need to take vitamin and mineral supplements for the rest of their lives. It can be overwhelming, Linda acknowledges. But that’s why the Bariatric Program at Mercy Fitzgerald includes a support group. And it’s why Dr. Ramachandra continues to communicate with his patients for years. (He’s still in touch with his very first bariatric patient.)
dramatic that I sometimes don’t even recognize the patients anymore,” she says. For many people, the surgery totally transforms their lives. For example, Dr. Ramachandra tells of a woman who weighed over 550 pounds before he operated on her. “She was so heavy, she was turned down at other hospitals for surgery,” he says. “She was confined to a wheelchair when she came to us. Now, she is losing weight, looks healthy, and is out of the wheelchair and walking with a cane. “She told me, ‘The next time I see you, I won’t have the cane.’”
A sight to see
WANT TO KNOW MORE?
The weight loss most people experience after bariatric surgery is striking, Linda says. “The physical transformations are so
Go to mercybariatrics.org to learn even more about the Mercy Bariatrics Program. mercyhealth.org
5
Ask the Doctor DONNA RAZIANO, MD, CHIEF MEDICAL OFFICER OF MERCY HOME HEALTH AND MERCY LIFE, ANSWERS COMMON HEALTHCARE QUESTIONS
Q
What is an advance directive, and why do I need one?
A
An advance directive empowers you. It is a document that helps your family and doctors know your wishes about the care you would want if you were unable to decide for yourself. Why might that be important? Like many people, you may feel strongly about certain care choices that may be offered during a serious illness or at the end of life. An advance directive gives you the power to accept or reject medical treatment. By making your preferences known, others will know to respect those wishes too. The different types of advance directives are: A living will. It puts into writing what medical care is wanted—and not wanted—if your recovery isn’t likely. For example, you can say whether you would want to be on
6
a breathing machine or to have CPR to revive you. A medical power of attorney. This appoints a trusted person to speak on your behalf on medical matters if you are unable to make decisions. This should be someone who understands and respects your wishes. If you do write an advance directive, be sure to make multiple copies. Give one to the person you’ve chosen to make healthcare decisions for you and one to your primary care doctor. And bring a copy with you if you have to go to the hospital. The time to make an advance directive is before a crisis happens. They do not have to be complicated legal documents. Free standard forms are available from various organizations. You can find forms for Pennsylvania here: caringinfo.org/files/public/ ad/Pennsylvania.pdf.
It’s never too late to quit smoking When is the best time to quit smoking? Right now. In your 60s, 70s and beyond, breaking free of tobacco boosts your health. “If you stop lighting up, you’re likely to add years to your life, breathe more easily, have more energy and save money,” says Deborah Ludwig, Regional Director of Operations, Mercy Home Health. You’ll also: •• Lower your risk of cancer, heart attack, stroke and lung disease •• Have better blood circulation •• Have whiter teeth and healthier gums •• Stop smelling like smoke “What’s more, you’ll set a good example for your children and grandchildren,” Deborah says. If you’ve smoked around your family and friends, quitting helps protect them as well. That’s because secondhand smoke can cause serious health problems. In adults, it can cause heart disease and cancer. And in babies, it raises the risk of sudden infant death syndrome.
YOUR LIFE ON YOUR TERMS
Immediate benefits
Mercy LIFE helps all program participants arrange their advance directives through a team of licensed social workers and physicians. Your wishes, both medically and spiritually, can be discussed. To learn more about the Mercy LIFE program and its social services, call 215.339.4747.
“Within minutes after your last puff, your health will start to improve,” Deborah says. Here’s a timeline of what’s ahead in just the first year after you quit smoking: •• In 20 minutes, your heart rate and blood pressure will drop to more normal levels. •• In 48 hours, your nerve endings will begin to regenerate. You’ll be able to smell and taste better. •• In two weeks, your lungs will work better. •• In one month, you’ll cough less and be less short of breath. •• In one year, your risk of heart disease will be half of a smoker’s risk.
More More @ @ Mercy Mercy Summer Summer2018 2018
Take action now! MERCY LIFE IS THE BEST COMMUNITY HEALTH CHOICE Community Health Choices i s a new health insurance program coming in 2019 to residents in the Greater Philadelphia area. Information about the new health insurance program was mailed to the homes of Pennsylvania residents who qualify for both Medicare and Medicaid (Medical Assistance). Community Health Choices will give you the option to choose one insurance plan. You must choose one of the plans. If you do not choose a plan by January 2019, a plan will automatically be selected for you by the state of Pennsylvania. The insurance plans available are: • • AmeriHealth Caritas • • PA Health & Wellness •• UPMC Community Health Choices If you are eligible for the three health insurance plans listed above, you can also enroll in the Mercy LIFE program. Current members of the Mercy LIFE program do not need to enroll in the new Community Health Choices health insurance program. Members are already covered under
Give your teeth the care they deserve As you get older, it’s more important than ever to give your teeth and mouth lots of TLC. “That’s because your risk of cavities and tooth loss increases as you grow older,” says Donna Raziano, MD, Chief Medical Officer for Mercy Home Health and Mercy LIFE. One reason is dry
HAVE QUESTIONS? To learn more about the Mercy LIFE program or for more information on the new Community Health Choices health insurance program, visit mercylife.org/CHC or call 215.339.4524. Mercy LIFE’s health insurance and benefits.
Again, if you do not select one of the Community Health Choices health insurance programs, the state of Pennsylvania will choose one for you. You make the choice! Consider Mercy LIFE for you and
your family. Mercy LIFE provides seniors 55 and older with the support they need to continue living in their own home or with family. Mercy LIFE services help seniors remain independent, active and healthy. There are no out-of-pocket charges if seniors qualify for both Medicare and Medicaid or Medicaid only.
mouth—a common side effect of many medications. You’re also more likely to get gum disease, a bacterial infection in your mouth. “In its early stages, your gums may bleed and be tender,” Dr. Raziano says. Left untreated, this infection may eventually seriously harm your bones, gums and other tissues that support your teeth. You might even lose your teeth. The good news: There’s a lot you can do to help keep your teeth and smile healthy, especially if you follow these tips: •• See your dentist regularly—not just when you have a painful tooth. As
you age, the nerves inside your teeth become less sensitive. By the time a cavity hurts, it may be severe. Plus, regular visits can help your dentist find early signs of gum disease, as well as oral cancer, which is also more common later in life. •• Brush your teeth twice a day with fluoride toothpaste. Floss daily too. If your hands are stiff, try an electric toothbrush or a water flosser. •• Don’t smoke. It makes you even more vulnerable to gum disease. •• Speak up if your mouth is dry. Your dentist can help ease the dryness and protect you from cavities.
Make your own choice!
mercyhealth.org
7
FIND MORE DOCTORS, CLASSES, EVENTS, RECIPES & HEALTH TIPS:
Nonprofit Org. U.S. Postage PAID Harrisburg, PA Permit No. 66
Mercy Health System of Southeastern Pennsylvania 1 W. Elm St., Suite 100 Conshohocken, PA 19428-4108
mercyhealth.org Facebook “f” Logo
C MYK / .ai
facebook.com/mercyhealthphilly pinterest.com/mercyhealthPHL youtube.com/mercyhealthphilly
Find more @ mercyhealth.org
MFH
Learn about your risk for stroke AND
A stroke usually occurs when a blood clot disrupts the flow of blood to the brain. Without sufficient blood and oxygen, parts of the brain begin to die. That’s why stroke is always an emergency. Most strokes are preventable. One way to avoid a stroke is to know what puts you at risk for having one. Lorraine M. DiSipio, DO, a primary care physician at Mercy Medical Associates at Darby, talks about stroke risk factors and how you can lower them. What are the most common risk factors for stroke? ANSWER: Some of the most common risk factors for stroke include having high blood pressure or diabetes; a history of smoking; high cholesterol or certain heart conditions, such as atrial fibrillation; and being overweight or physically inactive.
Q
What can you do to reduce your risk for stroke? ANSWER: The first thing you should do is talk with your doctor and find out what your personal risk factors are. But in general, you
Q
should try to eat a Lorraine M. heart-healthy diet DiSipio, DO that is low in salt and saturated fat. You should also get regular exercise and maintain a healthy weight. And if you smoke, you should quit. What are common symptoms of stroke, and what should you do if you suspect you or someone else is having a stroke? ANSWER: The easiest way to remember the symptoms of stroke is with the letters FAST. F stands for facial weakness. Can the person smile? Or does their mouth or an eye droop? A stands for arms. Can the person raise both arms equally? S is for speech problems. Can the person speak clearly without slurring words? And T is for time. It emphasizes the importance of calling 911 right away.
Q
PRIMARY CARE CLOSE TO HOME Find a Mercy Physician Network provider near you by calling 1.877.GO MERCY (1.877.466.3729).
MORE @ MERCY is published as a community service for the friends and patrons of Mercy Health System. Information in MORE @ MERCY comes from a wide range of medical experts. If you have any concerns or questions about specific content that may affect your health, please contact your healthcare provider. Models may be used in photos and illustrations. If you would like to stop receiving this publication, please email IAtMercy@mercyhealth.org. 2018 © Coffey Communications, Inc. All rights reserved.