FEBRUARY 2019
American Heart Month OMC Foundation’s annual Heart Luncheon planned
Understanding CPR, plus upcoming training seminars
Getting a good night’s sleep instrumental in heart health
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February 6, 2019
American Heart Month February 2019
KNOW THE SIGNS
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HEART ATTACK SYMPTOMS CAN BE DIFFERENT FOR WOMEN Although chest pain is a main sign for both women and men, women are more likely to experience the following: • Pain in the shoulders, neck, jaw, upper back or arms. • Unexplained dizziness, light-headedness or fainting, sometimes accompanied by palpitations. • Shortness of breath or trouble breathing without chest discomfort. • Clammy sweating that feels like stress-sweating. • Stomach pain, abdominal pressure or nausea • Unusual weakness, fatigue or inability to perform simple activities.
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If you or someone you know is experiencing these symptoms, call 911 and say, “I think I (or whomever) is having a heart attack,” so EMTs can come prepared.
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CARDIOLOGY
DAVID TINKER, MD | CARDIOLOGY CLINIC
The health of our community is fueled by the health of our people. That’s why delivering excellent care drives everything we do. Jefferson Healthcare is expanding and enhancing cardiovascular services to provide a wider array of treatment options and exceptional heart care. Right here at home.
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There is no heart more special than yours.
Vulnerability and the Heart of Resilience 4
February 6, 2019
American Heart Month 2019
Peninsula Daily News and Sequim Gazette
By Kristin Halberg, transformation guide and owner of The Dream Hatchery
R
esearch professor Brene Brown said in a Super Soul Sunday interview with Oprah Winfrey that while she was conducting her research on joy, she interviewed a man who shared the following: “My whole life I never got too excited, too joyful about anything. I just kind of stayed right in the middle. “That way, if things didn’t work out, I wasn’t devastated, and if they did work out, it was a pleasant surprise.” He went on to say, “In my 60s. After 40 years of marriage, I was in a terrible car accident, and my wife was killed. The second I realized she was gone, the first thing I thought was I should’ve leaned harder into those moments of joy, because (my practice of suppression) did not protect me from these feelings.” Brown calls this practice of suppression “losing our tolerance for vulnerability.” She said this causes us to try to dress rehearse tragedy so that we can beat vulnerability to the punch. Does this sound like you? Do you withhold your joy or excitement, squash or numb your pain or constantly look over your left shoulder waiting for the other shoe to drop when you start to feel joy? If you answered yes, you, too, have potentially lost your vulnerability free card,” there are ways to both learn to be fully present to life and to become more emotionally tolerance for vulnerability. resilient. In fact, being fully present to life is one of the key THE HEART OF THE MATTER Vulnerability is at the core of all emotions and feelings. traits found in emotional resilience. Emotionally resilient people can “roll with the punches” and adapt to adversity To feel at all is to be vulnerable — and human. As Brown said in her book “Daring Greatly,” there is no without lasting difficulties. Less resilient people have a “get out of vulnerability free card” in this game of real life. harder time. According to researchers, emotional resilience is partly Life itself is about vulnerability. related to factors that are not under your control, such as The good news is that although there is no “get out of genetics, but the key traits of resilient people can be learned. They include: • presence • emotional awareness • perspective • a spiritual connection • recognizing the efficacy of asking for support and nurturing close connections • a sense of humor • optimism • perseverance • cultivating an internal focus of control In my experience, the heart of resilience comes from the ability to master this key group of inter-active traits: presence, emotional awareness and perspective. To be fully present to life means to bring your awareness fully to each moment and notice the thoughts, feelings and the tangible sensory data existing in each moment. Emotional awareness means you learn to differentiate between your thoughts, your feelings, the sensory data and the meaning your mind then assigns to this information. Once you have distinguished this difference, it becomes easier to shift your perspective, realizing that often the meaning your mind made of the data is not the true meaning, but rather a (perhaps plausible, but often inaccurate) story based on past or future fears.
FIND UNDERSTANDING
To begin to understand the heart of resilience, start with this practice: Inner Sanctuary Tool: Drop your awareness into your heart and breathe a little more deeply than usual. Continue to breathe this way for at least five breaths, keeping your awareness in your heart. Repeat this practice 15 to 20 times a day, 10 to 20 seconds at a time. This practice — seemingly quite simplistic — begins to balance your autonomic nervous system and helps you to create a small pause between the stimulus (the situation causing you to avoid vulnerability) and your response to it. Typically you will notice a difference in your ability to be present to whatever arises in a few short weeks. Once you have mastered this step, the next key practice is to begin to differentiate between the tangible sensory data of any given situation, your thoughts about it, your feelings about it and the meaning your mind makes of that combination. Our minds often jump to conclusions and worst-case scenarios designed to protect us from vulnerability. To recognize how often we tend to jump to false conclusions, watch a formulaic movie, soap opera or sitcom. Learn to shift your perspective to remind yourself that vulnerability is part of the human experience, and see the gifts in small ordinary moments of beauty and connection. Kristin Halberg is an artist, writer, teacher, coach and intuitive guide who blends the healing power of nature with expressive arts, science and mystical traditions to create transformational change. Her company, The Dream Hatchery, catalyzes women’s return to belonging and wholeness, and guides deep transformation in the areas of self-belief, relationship, wellness and purpose. Learn more at thedreamhatchery.com.
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OMC Foundation’s annual heart luncheon set American Heart Month 2019
Peninsula Daily News and Sequim Gazette
February 6, 2019
Submitted by Bruce Skinner, executive director of the Olympic Medical Center Foundation Olympic Medical Center Foundation will present the 12th annual Red, Set, Go! Heart Luncheon, presented by the Jamestown S’Klallam tribe, on Friday, Feb. 22. The event begins at 11:30 a.m. at Vern Burton Community Center, 308 E. Fourth St., Port Angeles. Anyone interested in sponsoring or attending the event can contact the Foundation office at 360-417-7144. Individual tickets are $60. Last year, a record 320 people attended. “We encourage you to attend this wonderful event,” said committee chair Karen Rogers. “We have sold a record amount of sponsorships and, therefore, 100 percent of all money raised at the luncheon will go toward local cardiac service care. “To date, we have raised over $379,000,” she added. Those who have delivered their personal “survivor” stories at previous events will be the special honorees at the event, and one or two will speaking as a representative of the group. Dr. Kara Urnes of Olympic Medical Heart Center and Dr. Kira Long, a vascular surgeon with Swedish Vascular Surgery, also will be speaking on the topic of heart health education.
EDUCATION AWARENESS
In 2008, Olympic Medical Center Foundation launched a three-year campaign to raise awareness about the critical issue of heart health for women on the North Olympic Peninsula. The campaign was so successful that the Foundation decided to host an annual event. The educational lunch promotes that the key to eradicating this disease is education. “The purpose of our event is to inspire women to become more educated to improve their heart health,” Urnes said. “Many women are surprised to learn that heart disease is the number one killer of women.” In the first 10 years, the event has raised money to
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heart-healthy foods
to work into your diet Courtesy of clevelandclinic.org
PHOTO BY MEGAN KRUEGER
Attendees of the 2017 Red, Set, Go! Heart Luncheon converse at the Vern Burton Community Center in Port Angeles. This year’s heart luncheon is slated for Friday, Feb. 22. benefit patients through the Olympic Medical Center’s cardiac program and save lives, according to OMC officials. Proceeds from the events also have allowed the Foundation to partner with local agencies to launch a community-wide Automated External Defibrillator (AED) program. An AED is a lightweight, portable device that delivers an electric shock through the chest to the heart. The shock can potentially stop an irregular heartbeat (arrhythmia) and allow a normal rhythm to resume
1 Fish high in omega-3s, such as salmon, tuna, mackerel, herring and trout.
2
A handful of healthy nuts, such as almonds or walnuts.
3 Berries are chock full of heart-healthy phytonutrients and soluble fiber. Try blueberries, strawberries, cranberries or raspberries.
following sudden cardiac arrest. All proceeds raised at the educational Red, Set, Go! Heart Luncheon will again benefit local patients with heart disease. Funds from the luncheon will go toward the purchase of state-of-the-art diagnostic treadmills. “We invite all the women in our community to join us at our inspiring luncheon,” Rogers said. “Once again, we are raising money for something that will save lives.”
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A 4-ounce glass of red wine (up to two for men and one for women per day) can help improve good (HDL) cholesterol levels.
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Try marinated tofu in a stir-fry with fresh veggies for a heart-healthy lunch or dinner.
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Red, yellow and orange veggies, such as carrots, sweet potatoes, red peppers and acorn squash, are packed with carotenoids, Flaxseeds contain omega-3 fatty acids, fiber fiber and vitamins. and phytoestogens to boost heart health. Fruits, such as oranges, cantaloupes and papayas, are rich in beta-carotene, potassium, Dark beans, such as kidney or black beans, are high in fiber, B-vitamins, minerals and more. magnesium and fiber.
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Understanding, managing AFib with doctor’s help 6
By Laura Foster, special sections editor & MetroCreative Palpitations of the heart or uncomfortable sensations in the chest can be distressing. Thoughts of a heart attack might come to mind, and that anxiety can only exacerbate the situation. While a heart attack might be the first thing people think of when experiencing chest discomfort, atrial fibrillation might be to blame for such feelings. Atrial fibrillation, also called AFib, is a quivering or irregular heartbeat that can lead to heart-related complications. “Atrial fibrillation is an electrical problem of the heart where the normal pacemaker of the heart stops working,” said Olympic Medical Center’s Dr. Kara Kurtz Urnes, who specializes in cardiology, nuclear cardiology and echocardiography. “And the reason it does that is the pacemaker of our hearts is located in the upper chamber of the heart, and if there are processes that affect the health of that atria, such coronary artery disease, even just age (or) high blood pressure, the upper chambers can get bigger but they also become more electrically unstable. “And so what can happen is the pacemaker stops working, and every heart cell in the upper part of the heart starts to beat on its own, and that’s fibrillation.” According to Heart
American Heart Month 2019
Peninsula Daily News and Sequim Gazette
February 6, 2019
Rhythm Society, there are three types of AFib: • Paroxysmal fibrillation: Occurs sometimes and then stops. AFib stops by itself and the heart returns to normal rhythm. AFib might last for seconds, minutes, hours or days before the heart returns to its normal rhythm. • Persistent AFib: Does not stop by itself. Medications or a special type of electrical shock (called cardioversion) is used to help the heart return to normal rhythm. If no treatment is given, the heart will stay out of rhythm. • Long-standing AFib: Cannot be corrected. Medications and controlled electrical shock cannot help return the heart to normal rhythm. The American Heart Association said that at least 2.7 million Americans are living with AFib. Although treatable, without proper diagnosis, AFib can lead to blood clots, stroke and even heart failure. When the heart is working normally, it contracts and relaxes in a beat. When a person has AFib, the upper chambers of the heart, called the atria, beat irregularly. They quiver and do not move the blood into the ventricles in an effective manner. This irregularity can cause pooling or clotting of blood. Should a clot break off and enter the bloodstream, particularly in an artery leading to the brain, a
THE HEART
stroke can occur. “The type of strokes caused by atrial fibrillation — called embolic strokes — are caused by having clots that form in the heart that go to the brain,” Urnes said. “The clot starts in the heart and goes north toward the head. That’s caused because when people have atrial fibrillation, they also have problems with how the upper chamBlue components indicate de-oxygenated blood pathways and red components bers of the heart squeeze.” indicate oxygenated blood pathways. Wikimedia Commons
RISK FACTORS & SYMPTOMS
you seem to be stuck there, we think it’s actually a gradual progression that Many people with AFib the person gets it intermitexperience no symptoms at tently for short amounts of all and are unaware they time then they begin to get have it until it is discovit intermittently for longer ered during a physical periods of time and at some examination. point they just stick in it,” “One way people describe Urnes said. it as just an irregular For those who experience heartbeat or skip heartpersistent symptoms over beats,” Urnes said. time, The Mayo Clinic lists As a person ages, his or her risk for AFib increases. these as some of the more common: “The younger you are, • Palpitations, which the less heart disease you can be sensations of a fliphave, the less likely it’s flopping in the chest or going to be atrial fibrillation because atrial fibrilla- even a racing feeling. • Fatigue. tion runs with more struc• Reduced ability to tural heart problems,” she exercise. said. • Lightheadedness. “Age is definitely a risk • Chest pain or shortfactor.” ness of breath. AFib is more common • Dizziness and weakamong people with clogged ness. arteries or diabetes and may develop following TREATMENT valve surgery. A proper diagnosis from It also is more common a physician is needed in people with coronary before treatment can begin. heart disease. An examination might Stress, too, can be a include an EKG or ECG, major factor in triggering which will show the heart’s AFib. “Even if the first time we electrical activity as line see you in atrial fibrillation tracings on paper.
The spikes and dips in the tracings are called waves. An EKG will determine if the heart is pumping correctly. Once AFib is diagnosed, managing risk factors and restoring a heart to normal rhythm becomes the priority. “The two types of treatment we often call ‘rate
control versus rhythm control.’ Rate control is just leaving a person with atrial fibrillation — either intermittent of continuous — and just making sure their heart rate stays not too fast when they have it,” she said. AFIB continued on Page 9 >>
What is your CHADS-VASc score? Add up the points for your risk factors and share the results with your cardiologist. Points Risk factor 1 Congestive heart failure 1 High blood pressure 2 Age 75 or older 1 Diabetes 2 Stroke or mini-stroke (prior) 1 Vascular disease (heart or peripheral artery) 1 Age 65-74 Male = 0; Female = 1 Sex Your score: Source: Health Monitor Network
American Heart Month 2019
Peninsula Daily News and Sequim Gazette
GETTING A GOOD NIGHT’S SLEEP
Advice to take to heart By Laura Foster, special sections editor
When we get those good days in, we feel well rested and ready to take on the world. When those bad days happen, we Getting a restful seven or eight hours of drag our feet and slog through our workdays, aiming and hoping for another good sleep is always at the top of our daily day. to-do lists. This general number of sleep Through all this, we home in on how hours has been touted over and over again our sleep affects our mental and physical by doctors, healthy living articles, talk health. shows, family members, friends and coDo we feel awake the next day, or is workers, to name a few. We have our good days — where we are everything a bit hazy? Do we have the strength and energy to mindful to turn off our phone and TV make dinner, or are we ordering takeout? screens and let our brains power down to Sleep affects more than just our brain appropriately prepare for sleep — and we have our bad days — where we fall asleep and our muscles and joints; it makes all the difference in our heart health. on the living room couch with the TV on Olympic Medical Center’s Dr. Usha and still in our work clothes.
Reddi, who specializes in sleep medicine, said the number of hours of sleep an individual needs can change over a lifetime. “It is a range. It is not a set number.” she said. “Some (people) are short sleepers, needing five to six hours. Some need more, like eight to 10, to be their normal self. “Children need a lot of sleep, about 10 to 13 hours. (But) as we get older, we settle down to the range of six to eight.” A 2011 “European Heart Journal” review of 15 medical studies involving almost 475,000 people found that short sleepers had a 48 percent increased risk of developing or dying from coronary heart disease in a seven to 25-year follow-up period (depending on the study) and a 15 percent greater risk of developing or dying from stroke during this same time. Interestingly, long sleepers — those who averaged nine or more hours a night — also showed a 38 percent increased risk of developing or dying from coronary heart disease and a 65 percent increased risk of stroke. When we look at the sleep-heart connection, Reddi said, we need to look at the broader scope of the function of sleep. “Sleep is a continuum of our day,” she said. “When there is normal sleep, it protects the heart. When there is a dysfunction of sleep, such as sleep apnea, there is a risk factor for cardiovascular disease.”
SLEEP APNEA
More than 18 million American adults have sleep apnea. According to the National Sleep Foundation, obstructive sleep apnea is a sleep disorder in which breathing is briefly and repeatedly interrupted during sleep. The “apnea” in sleep apnea refers to a breathing pause that lasts at least 10 seconds. Sleep apnea, a chronic disease, can cause fragmented sleep and low oxygen levels in the blood. For people with sleep apnea, the combination of disturbed sleep and oxygen starvation can lead to hypertension and heart disease, among other problems. In sleep apnea, the airway often collapses, blocking airflow. The person wakes up multiple times a night, gasping for air. The body releases the stress hormone epinephrine (also called adrenaline) which, over time, can raise blood pressure and contribute to heart problems, including arrhythmia, stroke and heart failure. Obstructive sleep apnea (OSA), the most common form of sleep apnea, occurs when the muscles in the back of the throat fail to keep the airway open, despite efforts to breathe.
February 6, 2019
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OSA is associated with obesity, which also is a major risk factor for heart disease and stroke. Another form of sleep apnea is central sleep apnea (CSA), in which the brain fails to properly control breathing during sleep. CSA is far less prevalent.
RED FLAGS
For those who are concerned about their quality of sleep, Reddi said there are several red flags to look out for regarding sleep apnea. “You can do everything right, but you’re still experiencing poor sleep. That could be red flag that your quality of sleep is not good,” she said. Other red flags include: • Severe snoring. • Gasping for air in the middle of the night or experiencing a “drowning” sensation. • Waking up frequently to use the bathroom. • Waking up with a headache. • Severe daytime sleepiness. • Weight gain. • Night sweats. If you experience any of these symptoms, Reddi suggested getting tested for sleep apnea.
GETTING BETTER SLEEP
Whether you have sleep apnea or aren’t sleeping well here or there, Reddi said we need to take a look at all aspects of out lives and make sure they are conducive to healthy sleep patterns. Food choices, lifestyle choices and gadgets all play a role in our sleep cycles. “Making sure there are at least two to three hours between an evening meal and bedtime ensure that gastric emptying has happened,” Reddi said. She also urges people to avoid alcohol two to three hours before bedtime and to avoid rigorous exercise at least an hour and a half before bedtime. Turn off electronics, as the blue light emitted from them influences melatonin levels. Set — and stick to — a set bedtime and wake-up time. “It can vary by an hour or so, but not by three or four hours,” she said. And, Reddi added, “Spend less time in bed. Use it for only sleep.” This will allow your mind to associate your bed with only rest, thus allowing for a more restful sleep cycle. For more information, Reddi recommends visiting the following websites: sleepfoundation.org, CDC.gov and NIA.gov.
Jefferson Healthcare working to help community with wellness resolutions 8
February 6, 2019
American Heart Month 2019
Peninsula Daily News and Sequim Gazette
By Amy Yaley, director of marketing and communications of Jefferson Healthcare
T
he New Year brings resolutions from many to make a fresh start or continue on the path to better
health. Similarly, Jefferson Healthcare in Port Townsend continues to intensify its commitment to community well-being by opening the Jefferson Healthcare Wellness Center. The center is dedicated to supporting individuals on their personal journey of improved health. Self-care is an important part of illness prevention. The new center is a space freshly renovated for the mission of illness prevention through education, empowerment and movement. Staffed by physical therapists from Jefferson Healthcare’s Rehabilitation Services, the wellness center allows instructors to show participants how to harness their own healing power to improve quality of life. Rehab staff understand proper body mechanics, personal limitations and can adjustment instructions based on an individual’s strengths.
CLASSES & PROGRAMS
The Jefferson Healthcare Wellness Center offers myriad special programs to keep your body and mind healthy. Ready, Set, Fit! is an eight-week exercise class that encourages participants to achieve personal fitness goals. Because classes are taught by a physical therapist, attendees will gain confidence in body alignment, position and
intensity of the exercise routine. This upbeat class features a blend of exercises, including cardio, yoga, dance, pilates, tai chi and agility training. Instructors guide movement and offer inspiration for a great workout. Tai Ji Quan for Better Balance is designed as an evidence-based fall prevention program for older adults and is great for individuals who are at risk for falls and those with balance disorders. Although origins can be traced to the contemporary simplified form of Tai ji quan, this class addresses common, but potentially debilitating, functional impairments and deficits. This specialized training approach is the culmination of a systematic series of scientific studies to improve results for participants. Dance for Parkinson’s classes are based on a set of principles, approaches and concepts that have been found to be particu-
larly beneficial for people with Parkinson’s. These weekly classes are “dancing for the sake of dancing” and place focus on the enjoyment of the creative and artistic aspects of dance. It’s also a great way to exercise! Exercise to Beat Back Pain utilizes movements to decrease, and even eliminate, low back pain. Classes draw upon, but are not limited to, exercise from the schools of yoga and pilates. They include simple core stabilization progressing toward dynamic core stabilization, as well as posture and body mechanics education. Classes are taught by licensed physical therapists who specialize in orthopedic physical therapy and the treatment of the spine.
MINDFULNESS
Stress reduction is an important aspect of self-care and is often overlooked as a culprit to other health issues. Many peo-
ple who practice stress reduction through mindfulness said they have an overall greater sense of well-being and improved coping ability. Reducing stress also can improve many health conditions, such as high blood pressure, diabetes and chronic pain. Mindfulness is one way of paying attention to thoughts, feelings and physical sensations as they are happening moment to moment. When practicing mindfulness, the breath is used with other thoughtful exercises to cultivate a greater awareness of triggers and stressors. The Mindfulness-Based Stress Reduction Program at Jefferson Healthcare teaches techniques to increases inner calm and looks at new ways to work with stress and stressful events — all in a supportive group setting. Educating the community to use their minds and bodies to improve the quality of life is important to Jefferson Healthcare; however, sometimes specialized, medically supervised care is needed. When patients have concerns about discomfort associated with their exercise routines, the diverse staff at Jefferson Healthcare Rehabilitation Services is a trustworthy and dependable resource. The rehab team has extensive experience with walkers, runners, cyclists, kayakers and anyone else who comes to them with pain and frustration. They know how to keep patients active and satisfied while looking for ways for them to rest and improve. WELLNESS continued on Page 9 >>
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AMERICAN HEART MONTH 2019 << AFIB from Page 6
“Rhythm control is trying very hard to keep the person in normal rhythm and doing that with medications. So we initially have to (look at) how many symptoms they have to decide on one or the other.” Doctors use a variety of medications to control heart rate, which might include beta blockers and calcium channel blockers. Medications to prevent stroke also might be prescribed. Anticoagulants, or blood thinners, help prevent the formation of blood clots, thereby lowering the risk of stroke. “The way we decide whether you need to be treated with blood thinners has to do with the risk factors that we call the ‘CHADS-VASc score,’ ” Urnes said (see info box on page 6). Anybody who has over two points has a high risk for stroke. This is when the
PeNINSuLa DaILy NeWS aND SeQuIM GaZeTTe
use of blood thinners is considered. Surgical intervention might be necessary if medications aren’t working. “There’s treatment with electrical therapies called ablations,” Urnes said. With ablation surgery, radiofrequency or cryoablation energy is applied via a catheter to sites where the pulmonary veins connect to the left atrium. Scar tissue forms, preventing abnormal electrical signals from reaching the atrium. When it comes to treatment after diagnosis, a new trend has emerged in the cardiology field. “The trend is to treat people a little earlier before things get bad in hopes that will prevent further progression (of atrial fibrillation,” Urnes said. Atrial fibrillation is a serious condition that requires treatment. Episodes can be managed and treated to help people live healthier lives.
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Daily steps key to heart health By MetroCreative Heart disease is a formidable foe. According the Centers for Disease Control and Prevention, heart disease accounts for nearly 25 percent of all deaths in the United States each year. Issues relating to the heart affect both men and women, and an estimated 15 million adults in the U.S. have coronary heart disease, the most common type of heart disease. Such statistics are disconcerting, but they can serve as a wake-up call that compels people to prioritize heart health. Fortunately, heart disease is often preventable and people can employ various strategies to reduce their risk. • Stop smoking right now. One of the best things to do to protect the
heart is to stop smoking. According to the American Heart Association, carbon monoxide is a harmful gas you inhale when you smoke. It decreases the amount of oxygen that is carried in the red blood cells. It also increases the amount of cholesterol that is deposited into the inner lining of the arteries which, over time, can cause the arteries to harden. This leads to heart disease, artery disease and possibly heart attack. • Eat healthy fats. When eating, choose polyunsaturated and unsaturated fats and avoid trans fats as much as possible. Trans fats increase one’s risk of developing heart disease by clogging arteries and raising LDL (bad) cholesterol levels. Read food labels before buying
<< WELLNESS from Page 8
anything at the store. • Keep your mouth clean. Studies show that bacteria in the mouth involved in the development of gum disease can travel to the bloodstream and cause an elevation in C-reactive protein, a marker for blood vessel inflammation. Brush and floss twice daily, and be sure to schedule routine dental cleanings. • Get adequate shuteye. Ensuring adequate sleep can improve heart health. One study found that young and middle-age adults who regularly slept seven hours a night had less calcium in their arteries (a sign of early heart disease) compared to those who slept five hours or less or those who slept nine hours or more.
• Adopt healthy eating habits. Changes to diet, including eating more fruits, vegetables, whole grains and lean proteins, can help you lose and maintain a healthy weight, improve cholesterol levels and reduce blood pressure — leading to a healthier heart. • Embrace physical activity. Regular moderate exercise is great for the heart. It can occur at the gym, playing with your pets or the kids, or even taking the stairs at work.
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Cardiac rehabilitation has three equally important parts: They also recognize no two patients are • Exercise counseling and training: alike and create customized plans for each Exercise gets the heart pumping and individual. strengthens the entire cardiovascular Not every patient — or every body — is system. the same. • Education for heart-healthy liv“It’s hard to see ailments affecting peoing: Education is the key to understandples’ quality of life,” said physical theraing how to manage cardiac risk factors. pist Brian Kura. “I love coming to work • Counseling to reduce stress: each day and helping people do what they Stress hurts the heart, and counseling want to do with their lives.” helps patients identify and tackle everyday sources of stress. HEART CARE Jefferson Healthcare consistently looks The Jefferson Healthcare Cardiac for ways to create a healthier community Rehabilitation Program is a medically through education and prevention. supervised course designed to improve There is a growing emphasis to create cardiovascular health for patients who health without increased spending. have experienced a heart attack, heart By incorporating strategies to address failure, angioplasty or heart surgery. the whole person, the health of the whole With the ultimate goal of reducing community can be improved. future cardiac events, the program uses Exercise, diet, disease and stress manexercise, heart-healthy education and agement are all avenues to efficiently stress management to get patients on the address community health issues. right track. Studies of a three-month medically Amy M. Yaley is the director of marketsupervised program consistently show the ing and communications of Jefferson advantages: Cardiac rehabilitation helps Healthcare. participants feel better, live a heartShe is a graduate of the University of healthy lifestyle and regain strength. It California San Diego. also can help prevent future cardiac Yaley has spent just over 25 years workevents and even death. ing in sales and marketing.
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The A-B-C (or is it C-A-B?) of CPR
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February 6, 2019
By Trish Tisdale, Clallam 2 Fire-Rescue
Every few years, cardiac arrest CPR guidelines are reviewed, studied and updated as necessary by the American Heart Association. For years, the emphasis in quality CPR, or cardiopulmonary resuscitation, was on having an open airway and providing rescue breaths. This led to the acronym A-B-C, which stands for Airway, Breathing and Circulation. In 2010, the American Heart Association changed standards to focus on compressions first. Gone was the trusty A-B-C sequence and now, in its place, there is C-A-B, which stands for Compression, Airway and Breathing. After using A-B-C for many years, why did the CPR standards change? One reason is that studies have shown cardiac arrest patients can actually go 4 to 6 minutes without rescue breaths; there is usually enough oxygen in the blood to supply the heart and the brain for several minutes. Compressions have been shown to be the most important step in performing CPR. After calling 911 and alerting responders, immediately start compressions. A second reason was that studies have shown that bystanders often hesitate to perform rescue breaths when performing CPR. How do I correctly position the airway? What’s the ratio between breaths and compression again? Where is there a barrier or mask? The change to C-A-B, as well as also advocating for compression-only CPR, would help simplify the process for people. When performing CPR, chest compressions are needed for blood to circulate and distribute oxygen throughout the body. Delaying chest compressions — even with just two rescue breaths — can reduce a patient’s chance for survival. To put it simply, when in doubt, do chest compressions.
PERFORMING CPR
One must perform 30 compressions to build up an adequate distribution of blood, called perfusion, to the heart.
American Heart Month 2019
Peninsula Daily News and Sequim Gazette
CPR/AED training set in Port Angeles
Clallam 2 Fire-Rescue holds first aid and CPR/AED training each month on Saturdays in Port Angeles. Trainings are held at the fire district’s administrative offices at 1212 E. First St. First aid classes are held from 8 a.m. to noon. CPR/AED classes are held afterward from 1 p.m. to 5 p.m. Of note, this is why adult CPR standards also Participants can enroll in both increased the number of consecutive compressions the first aid/CPR classes, or sign from 15 to 30 almost a decade ago. up for them individually. (Classes After only three seconds of stopping CPR, all might end earlier than 5 p.m., coronary and brain perfusion you built up will be depending on how the class prolost. gresses through the material.) When you resume CPR, you have to perform All classes are certified under another 30 compressions to rebuild perfusion. American Heart Association On adults, chest compressions should be at (AHA). least 2 inches deep and performed at a rate of at Cost for the combined first aid least 100 per minute. and CPR/AED classes is $65. Cost Compressions that are too shallow don’t propfor a half-day class (first aid only erly circulate the blood and oxygen; there will or CPR/AED only) is $55. Fees never be enough blood pressure to reach the brain include class materials and an adequately. If they are delivered too fast, one AHA eCard. (Students will need to risks not allowing enough blood to return to the print their own card). chest before the next compression. Registration and payment must CPR should be performed on a hard, flat surbe received prior to class to face, such as the ground. If a person goes into car- reserve place. diac arrest in a chair or in bed, move the patient Private classes are available for to the floor. groups of 10 or more. Online training also is available.
ADULTS ONLY
An important note to remember is that the C-A-B standard of CPR only applies to adult patients of cardiac arrest. Victims of drug overdose, drowning, asphyxiation, airway obstruction, trauma or respiratory failure still follow the old A-B-C sequence because the airway is the main concern in these patients. Those helping children should also follow the A-B-C sequence, as kids’ medical emergencies are typically respiratory and not cardiac related. With both A-B-C or C-A-B methods, early intervention the most important thing for a patient having a medical emergency. This means recognizing that the patient needs medical help and calling 911. CPR is just one step in the Chain of Survival (see sidebar). The patient must receive professional emergency medical care for their best chance of surviving cardiac arrest. Trish Tisdale is a volunteer EMT with Clallam 2 Fire-Rescue in Port Angeles. She has been an EMT since 2003 and also has served as a firefighter, rescue diver, fire investigator and wildland firefighter.
2019 CLASSES: • Feb. 9 • March 9 • April 13 • May 18 • June 8 • July 13 • Aug. 10 • Sept. 14 • Oct. 12 • Nov. 9 • Dec. 7 For more information about the in-person or online training courses, or to register, contact Heather Catuzo at admin@clallam fire2.org or 360-457-2550, ext. 200.
THE CHAIN OF SURVIVAL The American Heart Association’s Chain of Survival depicts the critical actions required to treat life-threatening emergencies, including heart attack, cardiac arrest, stroke and foreign body airway obstruction. The links within this Chain of Survival include: • Early access to the emergency response system. • Early CPR to support circulation to the heart and brain until normal heart activity is restored; • Early defibrillation to treat cardiac arrest caused by ventricular fibrillation; and • Early advanced care by EMS and hospital personnel.
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American Heart Month 2019
Peninsula Daily News and Sequim Gazette
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