Healthy Lifestyles Online – February 21 Edition

LeConte’s Healthy Lifestyles is a health and wellness publication printed twice a month in local newspapers serving Sevier County and South Knoxville. And here online! We hope you find this information healthful.

Table of Contents

‘Bridge Back to Life’
Do You Have a Heart for Rehab?
Happy Birthday, LeConte Medical Center!
Cardiac Calcium Scoring Could Save Your Life
Nurses Receive Silver Lamp Award
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‘Bridge Back to Life’
Cardiac Rehab Helps Patient Shed Defibrillator

The day a nurse strapped a wearable defibrillator around Ken Conner’s chest was the day that the 55-year-old Sevierville man realized just how serious his heart problem was.

Diagnosed with congestive heart failure (CHF) and cardiomyopathy (abnormal heart muscle), his heart was functioning at only 10 percent efficiency. “The doctor said I could’ve dropped dead at any second,” Conner recalled of his visit last July when he saw his doctor about a nagging cough and chronic fatigue. “I was terrified.”

Not only did his doctor order a stent placed into Conner’s heart, he also ordered him to wear an external defibrillator and begin cardiac rehabilitation at LeConte Medical Center three times a week for 12 weeks.

At the three-month mark, Conner, now 35 pounds lighter, returned to his doctor for a follow-up. “I was told my heart was now functioning at 35-40 percent and getting stronger,” Conner said, adding that he no longer needed a defibrillator. “It was kind of like running a marathon and crossing the finish line. I literally shouted in the room.”

Conner’s success didn’t surprise exercise physiologist David Zerrlaut, who said he has seen some patients actually improve their heart function to as much as 65 percent.

“Ken came into rehab wearing a defibrillator so I knew his heart function was weak even before I interviewed him,” said Zerrlaut. “His heart function was only 10 percent. I had worked before with patients wearing defibrillators and a lot of them felt like this was a death sentence. But Ken proved it’s not. It can be overcome.”

“I was determined that it wouldn’t be a death sentence for me,” said Conner, whose father died at 55 of a massive heart attack. “Faith has a lot to do with it because I had a lot of people praying for me. Support is really important. If you don’t have that support, you need to go find it.”

Much of Conner’s support came from the cardiac rehabilitation team who custom-tailored a medically supervised program of exercise and diet for him.

With electrodes attached to his body, a heart monitor around his neck and the defibrillator’s four-pound battery pack hanging from his side, Conner trudged onward three times a week – sometimes with so much zeal that the staff had to slow him down.

“Each person has their own specific needs, and we try to make sure that we’re not pushing them too hard,” said Zerrlaut. “Most of the time we had to slow Ken down, and say, ‘You need to slow down – your heart rate is too elevated.’ So we have parameters that we follow to not only make it safe, but effective at making the heart stronger.

“Patients who come in wearing a defibrillator are just like everyone else – whatever they put into the program is what they’ll get out of it,” said Zerrlaut. “We can’t always guarantee the results, but we can give the best recipe possible. That is through, first and foremost, following the doctor’s directions, medications, diet and exercise, and a willingness to work and put yourself through it. Ken did all that.”

While Conner “graduated” from the LeConte rehab program Dec. 22, he emphasized that CHF is a chronic, progressive condition and he must remain vigilant with his exercise and diet. He is now eating only healthy foods, has reduced his sodium content to 2,000 milligrams a day and tries to walk a minimum of four miles a day.

“Life is too short,” said Conner. “If you ever have a situation where you are told to proceed with cardiac rehab, do it! Don’t give up, push forward. Like one of the staff told me: You have a rebuilt engine, and you have to take care of it, pace yourself, but keep moving and listen to it. You can’t just push through the gate and think life is like it was before. It’s not. Day by day, listen. Monitor your progress. Get positive feedback from the healthcare workers regularly. The staff with LeConte Cardiac Rehab are first class and care for their heart patients. If you quit, you are only quitting on yourself.”

Zerrlaut agrees. “Cardiac rehab is a jumping off point to change your habits, especially with exercise,” he said. “I’ve worked in this field for years, and there are a lot of patients who come in with the mentality of, ‘I’ve done my 36 sessions. I’m done. I don’t have to exercise again.’ But that’s not how it works – it’s meant to be a lifestyle change.”

“No one knows what the future is when they walk in here,” Conner added. “And although we don’t know the future when we walk out of the last class, it gives us a bridge to get us back to our life, whatever that looks like afterward. I think this program is top-notch, and I’m not just saying that – I’m proof of it.”

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Do You Have a Heart for Rehab?

Nationally certified by the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR), LeConte Medical Center’s cardiac rehab program seeks to safely restore physical fitness and function for people who have CHF or other serious cardiac events.

The key components of the program include medically supervised sessions of aerobic exercise, strength training and other activities. As you progress, the amount of your activity may also increase the staff seeks to help you regain and build your strength and endurance. Your progress is reported to your physician from beginning through the end of the program.

Each session is custom tailored for each patient in cooperation with his or her doctor, lasts 60 to 90 minutes and is held three times a week for 12 weeks. During the sessions, patients’ heart rhythms, blood pressure, heart rate and other indicators are monitored closely by staff.

Jay Jordan, a certified cardiac rehabilitation professional and team leader of the LeConte cardiac program, said a 2010 study noted that heart attack patients who attend all 36 sessions are 31 percent less likely to have a recurrent myocardial infarction. Meanwhile, other studies have shown that regular aerobic exercise can at least partly restore the heart’s ability to effectively function.

Still, only about 25 percent of the population eligible for cardiac rehab will start the program. Those who have had bypass surgery, heart attacks, stents, congestive heart failure, valve surgery or heart transplant are prime candidates for the program. That means 75 percent won’t attend, although studies have shown that at least 50 percent of those who do attend will fare much better at preventing another cardiac event.

“There are lots of reasons why people don’t come,” said David Zerrlaut, an exercise physiologist with LeConte. “Some just don’t want to come because they’re not used to exercise, or they say, ‘I can do that on my own’ or ‘It’s too far of a distance.’ You have to figure out what’s important to you.”

Most health insurance companies also recognize the value of cardiac rehabilitation and readily cover all 36 sessions, but check with your insurance company first. Cardiac rehabilitation requires a physician order and medical records/office notes to confirm the patient’s diagnosis and/or their cardiac intervention.

“We also have a scholarship program here that’s not really being utilized,” said Jordan. “If the patient doesn’t have medical insurance or they have a diagnosis that doesn’t qualify them by their insurance company guidelines, then they may be eligible for a scholarship that’s fully funded for 18 sessions.”

With cardiac rehab you get what you put into it,” said Zerrlaut. “If you’re willing to work and let us help you, you can make a lot of changes – positive changes – that will lead to better health and improved quality of life.”

For more information about Cardiac Rehabilitation at LeConte Medical Center visit www.lecontemedical center.com/cprehab or call (865) 446-8500.

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Happy Birthday, LeConte Medical Center!

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In honor of LeConte’s 7th birthday, you’re invited to bring
this ad to the Volunteer Gift Shop at LeConte Medical Center
and enjoy 25% OFF any one item.

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Cannot be combined with other discounts. Expiration: March 31, 2017

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Cardiac Calcium Scoring Could Save Your Life
Exam Available at LeConte Medical Center

LeConte Medical Center is always concerned about early detection and treatment of heart disease to prevent devastating or life-altering cardiac events.

Coronary artery disease is another name for heart disease. Coronary artery disease (CAD) is caused by a narrowing or blockage of the arteries that supply blood to the heart. CAD is easily detected by arterial calcium deposits and can be present long before a patient experiences chest pain or heart attack, allowing time for early treatment and prevention of heart attack. LeConte Medical Center is excited to offer coronary artery calcium scoring (also known as cardiac calcium scoring)  that provides a numeric score showing your risk of coronary artery disease.

LeConte Medical Center is the only location in Sevier County to offer coronary artery calcium scoring using the most advanced technology: an ultra-fast and accurate 64-slice CT (computer tomography) scanner.

“Our 64-slice CT is an amazing piece of equipment,” explained Teresa Huskey, radiology manager at LeConte Medical Center. “The speed and accuracy of the images is an absolute benefit to our patients. We’re excited about this capability to provide cardiac calcium scoring as a tool for our patients and physicians. This technology will absolutely help save lives.”

Coronary artery calcium scoring (CACS) is a very effective way to tell you if you are at risk for heart disease.

Artery calcium scoring provides detailed computer images of your heart and arteries, and can show the presence, location and extent of calcified plaque in the coronary arteries – the vessels that supply oxygen-containing blood to the heart muscle. Calcified plaque results when there is a build-up of fat and other substances under the inner layer of the artery. This material can calcify, which signals the presence of coronary artery disease.

“This technology will absolutely help save lives.”

People with this disease have an increased risk for heart attacks. In addition, over time, progression of plaque buildup can narrow the arteries or even close off blood flow to the heart. The result may be chest pain, sometimes called angina, or a heart attack.

CT is one of the safest and most reliable examination methods available. CT works with an X-ray system that rotates around you, taking cross-section pictures of your body. These pictures are then converted by a computer into a complete picture, making a precise exam possible.

The images are analyzed to determine the amount of calcium present, and the findings are converted into a numeric cardiac calcium score.

Coronary artery calcium scoring cannot determine how blocked a particular artery is; however, it can accurately detect the presence of atherosclerosis and assess the subsequent risk of heart attack.

Cardiac Calcium Scoring Guide
Calcium Score	Implication	Risk of Coronary Artery Disease
0	No identifiable plaque	Very low, generally less than 6 percent
1–10	Minimal identifiable plaque	Very unlikely, less than 10 percent
11–100	Definite, at least mild atherosclerotic plaque	Mild or minimal coronary narrowings likely
101–400	Definite, at least moderate atherosclerotic plaque	Mild coronary artery disease highly likely, significant narrowings possible
401 or higher	Extensive atherosclerotic plaque	High likelihood of at least one significant coronary narrowing

The score does not benefit anyone who has already had a heart attack, coronary bypass surgery, or a coronary artery stent. These events already indicate the patient is at high risk.

“This calcium scoring screening is used mostly for middle-aged patients with some heart risk factors. Those who have extensive risk factors might likely be treated without testing. It’s the patients with one or two risk factors who should be screened,” said Stephen Dill, MD, LeConte Cardiology Associates. “This is an appropriate screening beginning at age 40 for men and 50 for women. Because coronary artery disease is so common, even without obvious risk factors it’s frequently present. It is the most common cause of death in both women and men, and it usually doesn’t cause any symptoms until there is a real problem. So by the time people become symptomatic, they usually have a very serious disease.”

Who should consider scheduling coronary artery calcium scoring?

If any of the following apply to you, then CACS may help:

• Men age 40 or older
• Diabetes
• Women age 50 or older
• High cholesterol
• Smoker
• High blood pressure
• Family history of heart disease
• Sedentary lifestyle

Coronary artery calcium scoring is quick and painless, generally taking 15 minutes or less to complete. There are no injected dyes or invasive procedures. The results of your scan will be reviewed by a radiologist, your cardiac calcium score will be determined, and the detailed final report will be sent to your referring physician’s office for review. The test is currently not covered by insurance, but costs only $125.

If the results of your exam indicate the need to be seen by a cardiologist, appointments with the physicians at LeConte Cardiology Associates will be available for your convenience.

A physician order is required to schedule this screening at LeConte Medical Center. Discuss  cardiac calcium scoring with your doctor to see if it would be a useful screening for you or a member of your family.

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Nurses Receive Silver Lamp Award

Congratulations to Anissa Adcox, RN, Surgery, and Donetta Sinard, RN, Critical Care, for being chosen as LeConte’s Silver Lamp Award winners for this year. The Silver Lamp Awards are presented by The Trinity Health Foundation of East Tennessee to enhance the skills of dedicated healthcare professionals.

The Silver Lamp Award acknowledges outstanding contributions of nurses in their areas of clinical expertise. The recipients receive scholarship funds in the amount of $2500 toward their continuing education. Adcox and Sinard were recognized at a banquet on Jan. 19, along with nurses from other area hospitals throughout the region.