Dressed in red, staff in the Department of Cardiology at Nassau University Medical Center took part in the go Red for Women campaign on Feb. 3. go Red for Women was initiated by the American Heart Association in 2004 after statistics revealed that more than 500,000 women die from heart disease each year, claiming more lives than any other disease, including cancer.

To raise awareness and promote a heart healthy lifestyle, cardiology staff members gathered in the lobby at NUMC and offered free blood pressure screenings.

Staff members and a heart disease survivor also spoke about their experiences. Guest speaker Sylvia Martin said she was diagnose with congestive heart failure at NUMC after a car accident last October. “I was going to the doctor all along,” she said,” but nobody every detected it.”

Martin’s road to recovery was slow and she was at NUMC for nearly two months due to injuries sustained during the car accident, but eventually agreed to undergo surgery and a defibrillator was inserted on Jan. 27. The electronic device will constantly monitor her heart rhythm and will help her heart beat normally. “I can see by the spring I’ll be blossoming again,” Martin said.

Some staff members also attended a videoconference with the Long Island Jewish Medical Center, who offered a special presentation for go Red for Women.

During the conference, numerous specialists discussed the importance of making proactive heart-healthy choices, including Dr. Jennifer Mieres, senior vice president of North Shore LIJ’s Office of Community and Public Health. “Remember to make a promise to yourself beginning today,” she said. “Most importantly, listen to your body. if something is different, if you’re not feeling right, if you’re a little bit out of sorts, do not just write it off.”

Mieres told the audience to start with small steps like making a more colorful plate by adding vegetables, laughing for at least ten minutes each day, walking more and getting at least seven hours of sleep each night. “Making that commitment out loud will ensure sustainability on the road to heart health,” she said.

Administrative Director of Cardiac Services at NUMC Lorinda Bauer said that most women don’t pay attention to their bodies and emphasized that men and women do not present with the same symptoms. She said the most common heart attack symptoms in women are indigestion, exhaustion, anxiety, back pain and jaw pain. She added that women should know their baseline cholesterol and blood pressure and have a routine electrocardiogram, EKG, performed each year.

If you’ve never heard of palliative care, you’re not alone. In a recent survey, only 24 percent of people said they were familiar with the term. Palliative care isn’t nearly as well known as, say, hospice care; in fact, people often confuse the two. its use is growing fast, however, and 59 percent of hospitals with more than 50 beds now have palliative care programs. Hospitals like this type of care because it appears to be cost-effective and may improve health outcomes. Patients — once they know about it — like it because it can make them feel better.

The goal of palliative care is simple: Improve the quality of life for people who are dealing with serious chronic or life-threatening medical problems. People with diseases such as cancer, congestive heart failure, HIV/AIDS and kidney failure often have tremendous problems with pain, shortness of breath, fatigue and nausea, among other symptoms. especially in a busy hospital, it’s challenging to keep these patients comfortable and pain-free and to help them deal with the difficult medical and personal decisions they may face. That’s where palliative care comes in.

Specially trained palliative care teams, which typically include a doctor, a nurse, a social worker and a spiritual counselor, focus on relieving pain and managing symptoms. They coordinate a patient’s care among different providers, if necessary, and help patients and their families determine care goals and make treatment decisions. If a patient is nearing death, the palliative care team can offer emotional and spiritual support.

‘more comfort’

Palliative care — from the Latin “palliare,” which means “to cloak” — grew out of the hospice movement that began in the 1970s. “We showed that you don’t have to die in pain,” recalls Michael Levy, director of the pain and palliative care program at Fox Chase Cancer Center in Philadelphia. “you can have more comfort and function, and attend to the anticipatory grief work that helps the patient and the family.”

As hospice care became more established, policymakers and clinicians realized that seriously ill patients, even when not facing death, could benefit from better pain and symptom management and other palliative care services. Today, hospice care is at one end of the spectrum of palliative care. but while hospice is generally offered to people who are expected to live six months or less, palliative care can be provided in conjunction with curative treatments. many patients who receive it aren’t expected to die anytime soon.

After Andre Chervin began a series of radiation sessions in 2008 to treat a cancerous mass in his throat, he caught a virus that causes severe diarrhea and was admitted to Mount Sinai Medical Center in New York for a week. while there, Chervin was in extreme discomfort because the radiation treatments had dried up his saliva, making his mouth and throat so dry that he couldn’t swallow.

“It was horrible,” says Chervin, now 83. “you cannot eat; you can only drink.”

The palliative care team visited him and set him up with a spray bottle that contained artificial saliva that he could spray into his throat. the liquid didn’t taste pleasant, but at least it allowed him to swallow.

Patients are sometimes confused and alarmed when the palliative care team comes to their room, says Donna Nolde, palliative care program manager for Chandler Regional Medical Center and Mercy Gilbert Medical Center, both near Phoenix.

When members of the team introduce themselves, they immediately clarify that they’re not hospice workers. “you have to do it quickly or you lose them,” she says. “They think, ‘There’s something wrong with me!’ “

Although palliative care is still a relatively new field, research is beginning to show benefits. A study published last year in the New England Journal of Medicine found that lung cancer patients who received palliative care had better quality of life, were less depressed and lived longer than those receiving standard care.

Palliative care is cost-effective as well. A study in the March edition of Health Affairs found that Medicaid patients at four New York state hospitals who received palliative care on average incurred nearly $7,000 less in hospital costs per admission than Medicaid patients who didn’t receive palliative care. this study supports the results of a 2008 Archives of Internal Medicine study of non-Medicaid patients at eight hospitals that showed average savings of about $1,700 for those who survived a hospital stay and $4,900 for those who did not.

Despite its apparent cost-effectiveness, insurers typically don’t yet reimburse hospitals for palliative services beyond doctor visits and care related to hospice.

“Unless you have a health-care system or a large hospital funding the rest of the team, you really can’t provide (palliative) care,” says Michael Nisco, medical director of hospice and palliative care services at Saint Agnes Medical Center in Fresno, Calif.

When Martin Arnold’s 94-year-old mother was admitted to Saint Agnes last month, a blood clot in her leg had caused a systemic infection; her condition was dire.

When she arrived at the hospital, Arnold says, she was in tremendous pain, moaning and fidgeting. A member of the palliative care team visited her and gave her a morphine drip to ease the pain in her leg. She went to sleep and never regained consciousness.

“It was a total relief to the family to get her someplace where they were able to give her what she needed to keep her peaceful,” he says.

Most people with serious illnesses aren’t in the hospital, of course, and the future of palliative care lies outside acute-care facilities, says Diane E. Meier, Mount Sinai’s palliative care program director and the director of the Center to Advance Palliative Care, a group that helps hospitals and others develop palliative care programs. In the next decade, she expects to see palliative care emerge in individual physician offices, clinics and other community settings.

“That’s where most of the patients are,” she says, “and that’s where the need is.”

This column is produced through a collaboration between the Washington Post and Kaiser Health News. KHN, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health-care-policy organization that is not affiliated with Kaiser Permanente.

View the Bulletin’s commenting policy »

comments powered by Disqus

How are they related?

Where did you read that indigestion is a symptom of congestive heart failure? As far as I know, and I just looked in 2 of my med school textbooks, indigestion is not listed as a symptom of congestive heart failure. you can occasionally get loss of appetite and nausea due to fluid buildup, but even those aren't really common symptoms that we look for.

its not a symptom. its just so happens that indigestion causing an acid burn near the thorax region near the heart and heart failure is allso at pretty much the same region hence it is sometimes mistaken heart failure for indigestion.
stress in the heart can cause a build up of acid (feels like indigestion) but an indigestion usually doesnt cause a heart failure.

Last Updated: December 23. 2010 1:00AM Dr. Paul Donohue: your Health

Dear Dr. Donohue: my husband is 66 years old and has been diagnosed with hyponatremia. He has high blood pressure and takes medicine for it. He is also an alcoholic, eats very little and has lost a lot of weight.

Will you please discuss hyponatremia? I’m at my wits’ end because he looks so bad. He sees a kidney specialist, and I found “hyponatremia” on a piece of paper he brought home from the doctor.

J.B.

Dear J.B.: Hyponatremia (HI-poe-nuh-TREE-me-uh) is a low blood level of sodium. It’s not really an illness. It’s a sign of many possible disorders. something in the body has gone wrong and makes the body retain too much water or lose too much sodium (salt). Excessive sweating, drinking way too much water, burns, vomiting, diarrhea, adrenal gland abnormalities, pituitary gland problems, liver and kidney diseases, and congestive heart failure are some of the things that lead to a blood sodium drop.

A frequent cause, and perhaps your husband’s cause, is diuretics — water pills. They’re often used for control of high blood pressure. many of them induce a loss of sodium. This is corrected by adjusting the diuretic dose.

Most of the time the sodium drop isn’t that great, and no symptoms are generated. I have to believe that applies to your husband. his doctor would not have let him come home if his sodium level was too low.

dear Dr. Donohue: I have a Baker’s cyst behind my left knee. I have been told it can be cured when I have my knee replaced. However, that is impossible because of another physical condition. I can get very little information about this disorder. I was told to wear an elastic stocking, which I do and which seems to help. what is a Baker’s cyst? are there things I should be doing?

W.K.

dear W.K.: ever hear of bursas? They’re small, pancake-shaped affairs that are wedged between bones and tendons to prevent friction when the tendon rubs against bone. a Baker’s cyst is a swelling of a bursa behind the knee. It’s actually connected to the knee joint by a tunnel. The tunnel has a one-way valve that closes as fluid from the knee finds its way to the bursa. The bursa swells. The basic problem, most often, lies with the knee itself — arthritis, torn cartilage or other joint problems. Baker’s cysts are quite common.

What’s this about needing a knee replacement to fix it? That’s not true. a doctor can drain the cyst with a needle and syringe. often, the cyst reforms. Injecting cortisone into the cyst after drainage lessens the chance of recurrence. Elevation of the leg and a compression bandage are helpful. So are anti-inflammatory medicines if you can tolerate them. In stubborn cases, a doctor can surgically remove such a cyst.

Write to Dr. at P.O. Box 536475, Orlando, FL 32853-6475. Readers may

order health newsletters from rbmamall.com.

Subscribe to Detroit News home delivery and receive a SPECIAL INTRODUCTORY OFFER.

when he coughs up the blood it looks like hes coughing up his insides. im taking him to the vet in the morning but i wanna know what im up againts.

Oh! That's serious. Glad to hear you have an appointment with your vet in the morning.

If it is heartworm, treatment is expensive and depending how far it has progressed depends on the outcome. Whatever he has is not good.

could be a number of things, go to the vet expecting anything, they are the professionals, they are the ones you need to listen to!

well if he has heartworm and if he has had it for a long time he could be developing congestive heart failure… or he could have a tumor that is causing the blood… either way it is a serious problem and may not be somethign you want to hear… i hope everythign goes well