Heart Care
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How to Manage Heart Failure
Blog
Heart failure occurs when the heart muscle can’t pump enough blood to meet the body’s needs. Signs and symptoms of heart failure include:
Shortness of breath.
Swelling in the legs, ankles and/or belly.
Sudden weight gain.
Fatigue.
Jennifer Brown, MD, cardiologist and heart failure expert with Anne Arundel Medical Center, focuses on helping patients learn how to manage this disease. “Heart failure is one of the top reasons patients are admitted to hospitals across the country, and the number-one reason patients are readmitted to the hospital within 30 days after discharge,” Dr. Brown stresses.
While most of the time heart failure cannot be cured, it can be managed. Dr. Brown recommends a four-pronged approach.
See Your Cardiologist
“If diagnosed with heart failure while in the hospital, the most important thing you can do to keep from being readmitted is see your cardiologist within seven to 10 days post-discharge and as advised after that,” Dr. Brown says. Follow-up visits with a cardiologist are critical, since medications started in the hospital are often adjusted after discharge to optimize symptoms.
Take Your Medications
Not taking your medications as directed will likely lead to ER visits. Medications for heart failure — as well as other chronic conditions such as high blood pressure, high cholesterol and diabetes — should be carefully managed. “The heart is negatively impacted when other disease states are not well controlled. For example, poorly controlled diabetes, uncontrolled hypertension and untreated sleep apnea can all worsen heart failure,” says Dr. Brown. “Many patients misunderstand how connected the body is.”
Adopt a Healthy Lifestyle
Lifestyle changes and self-management can go a long way toward improving your symptoms and overall quality of life. Dr. Brown recommends:
If you smoke, quit.
Manage fluids, drinking no more than 2 liters daily.
Weigh yourself daily. Sudden weight gain can signal fluid retention. Contact your cardiologist if you gain 3 pounds in one day or 5 pounds in one week.
Choose a heart-healthy diet. Limiting sodium is especially important for people with heart failure.
In addition, staying active, getting enough sleep and avoiding heavy alcohol consumption and other drug use can reduce symptoms and prevent hospitalization.
Manage Depression
“It’s common for cardiac patients to experience depression, and when left untreated, patients may lose motivation to exercise, eat a heart-healthy diet, take their medications … and the list goes on,” Dr. Brown says. “If there’s any question of depression, making sure it’s treated appropriately is critical.”
Heart Health 101
Your best defense against heart failure is prevention. Anne Arundel Medical Center offers Heart Health 101, a free class that delivers all the information you need to achieve a healthy heart for life.
The class helps you understand:
How the heart works.
Causes of heart disease.
How to manage heart disease risks.
Symptoms that something is wrong.
Diagnosis and treatment for heart disease.
Early heart attack warning signs for men and women.
Register for the next Heart Health 101 class on August 15 at 6 pm.
Medical school taught Dr. Brown how to treat heart failure. But her mother-in-law’s experience with it taught Dr. Brown how to care for people with heart failure. Read Dr. Brown’s inspiring personal story.
Find out how you can get involved in bringing cardiac surgery to AAMC.
Author
Jennifer Brown, MD, is a cardiologist and heart failure expert with Anne Arundel Medical Center.
Orthopedics, Patient Stories
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Spine surgery brightens future for high school student
Blog
After numerous setbacks, Hope Lomvardias thought she was out of options.
In the spring of 2015, Hope was a 17-year-old Archbishop Spalding junior who was excitedly touring colleges around the Northeast in preparation for applying in the fall. However, during the long car trips, she started experiencing intense low back pain, as well as leg pain and numbness. Her mother, Karyn, an infusion nurse at Anne Arundel Medical Center, became increasingly concerned.
“When we would stop the car, Hope could hardly stand up because she was in terrible pain,” explains Karyn. “And, it just worsened. I knew something was wrong, because I’ve had my own cervical spine issues, and I recognized nerve pain.”
Because of Hope’s young age, her healthcare providers were reluctant to diagnose a spinal disc problem. Eventually, Hope had an MRI that confirmed a large herniation in the disc in the lowest part of her spine, between L5 and S1 — an unusual diagnosis at her age. She began conservative treatment options that included medication and physical therapy.
“During all of this, Hope started her senior year of high school,” recalls Karyn. “It really created problems because she was in excruciating pain.”
Hope was able to make arrangements with the school to use the elevator and a rolling backpack, although she hated having to do things differently than her classmates. When Hope was younger, she wore a brace to treat her scoliosis, and she didn’t like feeling different again. However, she had little choice.
Next Steps
The medication and physical therapy did not offer Hope the relief she needed, and school was getting more difficult.
Her parents gave her the option of taking placement tests and going straight into college. But Hope did not want to give up her high school experience, including graduating with her class and going to prom. She continued on with physical therapy, while searching for other treatment options.
Hope then met with Roy Bands, MD, an orthopedic surgeon at The Spine Center at AAMC. Dr. Bands had treated both Karyn and Karyn’s father for spine issues, and now Hope would be the third generation to see him.
“Hope had a degenerative herniated lumbar disc, which in someone her age, we believe is primarily genetic,” says Dr. Bands. “She has a strong family history of this, including her mother and grandfather.”
At first, Dr. Bands recommended Hope continue physical therapy so he could monitor for any improvement. “Unfortunately physical therapy did not improve her condition, so we then discussed her surgical options.”
According to Chad Patton, MD, medical director of The Spine Center at AAMC, “Our philosophy of care is patient-centric from beginning to end. It’s important to exhaust conservative treatment options before surgery is considered.”
Better Images, Better Outcomes
The Spine Center at AAMC recently added the O-arm 3-D imaging system, which can improve patient safety and outcomes during complex spinal procedures.
Chad Patton, MD, medical director of The Spine Center at AAMC, is shown in front of the new O-arm 3-D imaging system.
“The O-arm captures full 360-degree 3-D images of a patient’s spine, giving us precise anatomical views,” explains Chad Patton, MD, orthopedic surgeon and medical director of The Spine Center at AAMC. “In real time, navigational software can show us where our instruments and implants are in relation to the patient’s anatomy without having to take additional x-rays during the surgery. Not only does this dramatically decrease the radiation exposure to the surgical team, but it also improves patient safety and ultimately allows us to tackle more complex surgery here at AAMC.”
According to Dr. Patton, AAMC’s investment in O-arm technology is one additional way the hospital provides the highest quality care possible.
A Surgical Solution
Although Hope was hesitant to have back surgery, she also recalls how badly she was hurting. “One time it got so bad right before surgery that I even thought ‘if only I can have my leg amputated’ because I couldn’t stand the pain,” she remembers. “The pain was that bad.” By that point, Hope was ready for surgery.
“The surgery to repair a herniated disc involves opening the spinal canal and shaving off the herniated portions of the disc. It’s called a laminectomy and discectomy,” explains Dr. Bands.
Hope had surgery over the Christmas break to minimize her time away from school, and she emerged in a much better place both physically and mentally.
“Immediately after the surgery, I felt so much better,” says Hope. “It was amazing. I felt like I had my old leg back. I was basically pain free. I’m so glad I decided to have surgery.”
Now, Hope has returned to her life as an active teenager. Dr. Bands cleared her to play sports again if she’d like. Plus, Hope was accepted to Johns Hopkins, where she plans to study history in the fall.
“Hope is a perfect example of how back surgery can make significant improvement in your life,” says Dr. Bands.
Author
Roy Bands, MD, is an orthopedic surgeon at The Spine Center at AAMC.