A Healthier Heart
Frequent checkups can help patients with a serious cardiac condition stay on top of their health.
About two years ago, Doug Runge, 60, of Little and a member of RWJBarnabas Health Medical Silver was hospitalized at Monmouth Medical Center (MMC) for congestive heart failure (CHF), emphysema—a lung condition that causes shortness of breath—and chronic obstructive pulmonary disease (COPD). When he was discharged, his primary care physician and nurses recommended that he enroll in MMC’s Healthy Lives Program, in which patients with heart failure and COPD are closely monitored to reduce their risk of being re-admitted to the hospital. Today, Doug comes to the hospital every two to four weeks for blood work, lung function tests and medication checks.
“It’s very helpful,” says Doug. “The nurses are warm and make me feel at ease. They talk to me on the same level, which makes my situation easier to understand.”
Recently, Doug was having trouble sleeping due to difficulty breathing. One of the Healthy Lives nurses prescribed a respiratory treatment that has helped him get a good night’s sleep and greatly improved his quality of life. “I feel like I’m on top of my health, even though I have a progressive disease,” says Doug. “I can manage my symptoms much better.”
Hospitalization is common for patients with heart failure. About 83 percent of patients are hospitalized at least once, and 43 percent are hospitalized at least four times, according to a study published in the Annals of Translational Medicine. CHF is an advanced form of heart failure and has the highest readmission rates.
Over the past decade, strict guidelines have been developed to help doctors manage patients with CHF and keep them out of the hospital, says Isaac Tawfik, M.D., Chief of Cardiology at MMC Group. Patients need to take medication, follow a strict diet, exercise regularly and weigh themselves daily. “They’re supposed to call us if their weight fluctuates by more than three pounds,” he says. “If they retain excess water, they’re more likely to require hospitalization.”
The Benefits of Routine Monitoring
The Healthy Lives Program employs four Nurse Practitioners (NPs) with more than 20 years of experience working with cardiology patients. The NPs perform stress testing, check patients’ medications and lab results, and visit them at their homes. They also educate patients about heart failure.
“We want patients to understand why we ask them to do things,” says Denise Yaman, DNP, APN, CHFN, the Healthy Lives Program coordinator. “If they understand, they’re more likely to comply and end up with a better health outcome.”
While the NPs can monitor patients remotely through telemedicine, it’s beneficial for patients to come to the office for checkups.
“In-person appointments enable us to examine patients; we can check for leg swelling, signs of water retention and breathing problems and intervene early to prevent hospital readmission,” Yaman says. “We can also listen to patients’ hearts and check for valve problems.”
During an office visit, a patient can be checked for related disorders, such as kidney failure. “Blood work can tell us if a patient has kidney disease and needs diuretic medications,” says Dr. Tawfik. “If a person is retaining an excessive amount of fluid, he or she can be given intravenous diuretics in the office and avoid a visit to the Emergency Department.”