Surviving a Heart Attack: Why Care in the First Hours is Critical

February 1, 2020

February is Heart Disease Awareness Month!

In the United States, about 790,000 people have a heart attack each year. With numbers like that, it’s likely that you, or someone close to you, will have a heart attack during your lifetime. Luckily, many people survive heart attacks and go on to live fulfilling lives. And the odds for this happy outcome are far higher among folks who recognize they’re having a heart attack and get the right care, right away.

Protect yourself and your loved ones by understanding what causes this health crisis and how prompt treatment can save a life.

What is a Heart Attack?

Your heart has the tough job of pumping blood and oxygen through the coronary arteries all along your body. A heart attack happens when plaque builds up in your arteries over time and blocks the flow of blood. Without blood bringing oxygen to the heart muscle, the area of your heart supplied by that artery begins to die.

This is the moment when quick medical care is critical: A blockage that’s re-opened in two to three hours will cause far less damage than one left untreated for five or six hours.

Know Your Risk and Prepare for the Worst

As with most diseases, there are risk factors for heart disease you can influence with treatment or lifestyle change, and others you cannot. Some factors such as your age, gender and family history can’t be changed. However, others can be better managed to help reduce your risk for heart disease and heart attack, including your:

Alcohol or Tobacco Use
Blood Pressure
Diabetes
LDL (Bad) Cholesterol
Physical Inactivity
Stress Level
Weight

Both your family history and certain lifestyle choices should be reviewed with your doctor at each well visit — especially at your annual physical. These routine checkups are designed to provide an opportunity for you and your doctor to determine your risk for certain diseases and conditions, put a screening plan in place, discuss any health changes and create a plan for any needed lifestyle changes.

What to Do If You Suspect a Heart Attack

If you suspect you or a loved one is having a heart attack, call 911, where you’ll be taken to your local Emergency Room to get expert help right away. People who get to the hospital quickly have the best chance for survival. They also have a better recovery, since opening the blocked artery as soon as possible means less heart muscle dies.

The key to getting the help you need, when you need it, is recognizing the signs of a heart attack.

While the most classic symptom is sudden severe chest pain, not all heart attacks give such a clear signal. In fact, many heart attacks are silent, causing few or no symptoms at all.

Heart attack symptoms can begin gradually or suddenly, and may be mild or severe. You or your loved one may experience:

Cold Sweat
A Sense of Impending Doom
Nausea, Stomach Pain or Heartburn-Like Symptoms
Pain, Pressure, Squeezing or Other Discomfort in the Chest
Pain Radiating From the Jaw, Neck Shoulders or Arms
Shortness of Breath
Unusual Fatigue

It’s especially important to know these symptoms if you or someone you love is at higher than average risk for a heart attack.

In addition, women can have more subtle heart attack symptoms that are easily mistaken for other health conditions, such as anxiety. These include:

Dizziness
Heartburn or constant indigestion
Nausea
Pressure between your shoulder blades
Rapid heart beat
Trouble sleeping
Unexplained extreme fatigue that can last for days

Every Moment Counts

It’s smart to work at lowering your heart attack risks, so you can avoid this frightening and dangerous health crisis. In the meantime, remember the symptoms of heart attack and call 911 if you think you or someone nearby is having one — even if you’re not sure.

Pemi-Baker Community Health’s Home Care team will be by your side as soon as you return home; helping you recover and regain independence day by day.

~by Anna Swanson

Heart Health and Shoveling Snow

December 18, 2019

Now that the first snow of the year has fallen, it’s a good time to think about safety with snow shoveling and using a snow blower. This is especially important for Senior citizens as well as those with a history of heart disease and/or heart related health conditions. Those of us living in and around the Plymouth, NH area will get plenty of chances to practice snow removal, since we average around 73 inches total snowfall annually. That’s over 6 feet of snow!
What are the health risks related to shoveling? A recent report from Harvard Medical School found the following:

Most heart related health issues due to shoveling were noted in men. Studies have not found a link between heart attack and snow shoveling for women.
The deeper the snow, the more men were admitted to hospitals due to near attack. If snowfall totals were 8” or more, there was a 16% increase in hospital admission from heart attack compared to days with no snow.
Fatal heart attacks were 34% more common after snowfall of at least 8”. Also, the longer it snowed, the higher the rate of heart attack.
These findings were not strictly limited to heart attacks from shoveling the snow-there may be other factors related to heavy snowfall that trigger heart issues, such as trying to walk thru deep snow, or pushing a car stuck in snow.

What is it about snow shoveling, or even pushing a large snow blower that creates these risks? Doctors who have investigated the problem have identified several factors:

Snow shoveling requires forceful use of arm muscles. Many people are not used to using their arms so aggressively, and this creates strain on their circulatory system.
This type of activity is known to cause rapid increase in pulse rate (how fast the heart beats) and blood pressure. For people with heart disease, their system may be unable to cope with sudden increases of that nature.
Working outdoors in cold weather may cause blood vessels to constrict (tighten up), depriving blood flow to the tissues and forcing the heart to work even harder to keep up with the demand of lifting heavy shovelfuls of snow.
In most cases, people do not take the time to warmup their muscles, as you would prior to working out. Typically, we just grab the shovel, head out the door and start flinging snow. The heart and lungs have no chance to prepare for the workload.

So what can people do to prevent a problem with winter snow removal? The American Heart Association and the Harvard Medical School list the following safety guidelines:

Pace yourself! If you start to tire or become short of breath, take a rest break. If you were exercising and started to fatigue, you would rest before continuing-why not do the same with snow shoveling?
Avoid eating a large, heavy meal right before going out to clear the driveway-the stomach and GI tract require extra blood flow to digest that meal. Shoveling lots of snow in addition can add stress to the heart muscle.
If you smoke, please do not smoke while shoveling, it will deprive your muscles of needed oxygen.
Push snow rather than throw or lift it whenever possible.
Avoid shoveling heavy wet snow. While a cubic foot of fluffy snow may weigh as little as 5.2 lbs., a cubic foot of wet snow can weigh over 12 lbs.
Take smaller shovelfuls and avoid using large shovels-a large shovel might seem attractive (I’ll get done quicker) but you’ll be lifting a lot more weight with each shovelful.
Make sure to dress warmly enough to avoid hypothermia. When he was in high school, my son used to shovel our driveway in shorts and a t-shirt. Being a bit older, I would never try that! Also some people find inhaling lungful’s of cold air very hard on their breathing. Wear a kerchief or snow mask to help warm the air you breathe while shoveling.
For folks who have had a prior heart attack, known heart disease, or multiple risk factors for heart disease, one simple recommendation is – don’t shovel the snow! These folks may best reduce the chances of a problem by getting a snow blower, hiring a plow truck or a neighborhood kid to do it for them.

Regardless of how much snow we get this year, we at Pemi Baker Community Health hope all the people living in our part of NH have a healthy and safe winter.

~by Ernie Roy, DPT

Pemi-Baker Community Health Recognized as a ‘We Honor Veterans’ Partner

November 11, 2019

It may surprise many people to learn that 25 percent of those who die every year in the U.S. are Veterans. To help provide care and support that reflect the important contributions made by these men and women, Pemi-Baker Community Health (PBCH) has become a national partner of We Honor Veterans, a pioneering campaign developed by National Hospice and Palliative Care Organization in collaboration with the Department of Veterans Affairs.

As a We Honor Veterans Partner, PBCH will implement ongoing Veteran-centered education for their staff and volunteers to help improve the care they provide to the Veterans they proudly serve. The nation is seeing many of the Veterans who served in World War II and Korean pass away—and the number of deaths of Vietnam Veterans is beginning to rise.

The We Honor Veterans campaign provides tiered recognition to organizations that demonstrate a systematic commitment to improving care for Veterans. “Partners” can assess their ability to serve Veterans and, using resources provided as part of the campaign, integrate best practices for providing end-of-life care to Veterans into their organization. By recognizing the unique needs of our nation’s Veterans who are facing a life-limiting illness, Pemi-Baker Community Health & Hospice is better able to accompany and guide Veterans and their families toward a more peaceful ending. And in cases where there might be some specific needs related to the Veteran’s military service, combat experience or other traumatic events, PBCH will find tools to help support those they are caring for.

“We thank Pemi-Baker Community Health for partnering in the We Honor Veterans program,” says NHPCO President & CEO Ed Banach. “We Honor Veterans partners are committed to providing quality Veteran-centric care to the Veteran patients they serve. They understand how a Veteran’s military service, combat experience or other traumatic events, could impact their end-of-life experience.”

The resources of We Honor Veterans focus on respectful inquiry, compassionate listening, and grateful acknowledgment, coupled with Veteran-centric education of health care staff caring for Veterans. To learn more about We Honor Veterans or to support this important work via a secure, online donation, please visit www.wehonorveterans.org.
“VA shares a common goal with our nation’s hospices, and that is to provide the best possible care specifically tailored for Veterans, meeting their goals of care in their preferred setting. As we focus on working together and unite our services and skills, We Honor Veterans will channel our combined strengths directly to Veterans – wherever they are receiving care,” added Banach.

With 52 years of experience, serving over 900 clients from 18 towns in central and northern New Hampshire, Pemi-Baker Community Health is the home care provider of choice for Grafton County. Services include at-home healthcare (VNA), hospice and palliative care, on-site physical and occupational therapy and fitness memberships including a fitness gym and fitness classes in our 90-degree therapy pool. PBCH is located at 101 Boulder Point Drive, Suite 3, Plymouth, NH. To contact us please call: 603-536-2232 or email: info@pbhha.org Visit our website: www.pbhha.org and like our Facebook Page: @PBCH4

~By Anna Swanson

Pemi-Baker Physical Therapist, Matt Scagliarini Explains Taping

October 22, 2019

October is National Physical Therapy month and one of the most common questions we here from our patients is ‘what does taping do and can it help my injury?’ There are many kinds of tape used in the world of physical therapy. Some tape is applied to limit motion such as athletic taping but, in physical therapy we use tape to limit motion, increase motion and decrease swelling depending on its application technique. You may have seen tape applied to professional athletes or Olympians over the years and wondered what does that do? How could it possibly work?

Over the course of years as a physical therapist performing both manual therapy and exercise therapy interventions, it has become apparent to me that a great deal of what I do is targeting the nervous system, whether intended or not! I believe tape placed on a patient’s skin is just that, mostly a neurological input.
For years I think healthcare practitioners hoped and believed that taping techniques changed the way muscles move by pulling on them through the skin. If we think about this it really seems unfathomable that tape could create force changes in muscle tissue. So, I often half-jokingly tell my patients that “tape is tape on the brain. It can change your nervous system’s input to the brain about pain, swelling, muscle or joint position and allow it to respond with improved movement in that area.” I stop short of making claims that tape could actually pull hard enough to physically change a muscles ability to contract or markedly change joint position.

One thing I have positively seen with taping (as in the crisscross pattern) is reduction in swelling when applied to the affected area. So much so that visible changes in edema and bruising can be seen easily. In this case, the tape must be lifting the skin enough to allow the lymphatic system to drain more effectively or so it is believed.

The best part about taping is that it can be left on for up to 5 days helping to retain any affect your therapist is trying to achieve, it is inexpensive, it can be applied by the patient at home and very few patients ever report a negative side effect from its application. Ask your therapist if this could be beneficial to your treatment here at Pemi-Baker Community Health!

~By Matt Scagliarini, PT, DPT