Published on April 29, 2011

Living With Heart Failure

Genesis Heart Failure Outpatient Center treats and motivates patients

Two recent milestones show that Jack Hart has his life back.

After a two-year hiatus, he had the energy to go fishing again. He also took 25 pairs of pants in to be altered.

It has been five months since the November day that Hart first came to receive infusion drug therapy at the Genesis Heart Failure Outpatient Center, a little-known area on the fourth floor of the Genesis Medical Center, East Rusholme Street campus in Davenport.

Heart failure patient Jack Hart receives his
treatment of I.V. Lasix with the help of nurse
Andrae McMillan, RN-BC, at the Genesis
Heart Failure Outpatient Center.

Back then Hart of Davenport weighed 310 pounds -- much of that extra weight due to excess fluid in his body caused by congestive heart failure. He arrived at appointments in a wheelchair. He couldn’t walk across a room without becoming terribly short of breath, he says.

Today, the retired business owner is back to his “fighting weight” of 225 pounds, with the help of infusion drug therapy, medication and lifestyle changes like exercise and managing his diet and fluid and sodium intake. He gives credit to his new cardiologist Dr. Rafat Padaria and the I.V. drug therapy and support he received at the Genesis Heart Failure Outpatient Center.

“When I weighed over 300 pounds, I couldn’t walk down the hallway to the nurse’s station,” recalls Hart, 71, as he receives his twice-a-week infusion of Lasix. Lasix is prescribed to reduce fluid retention in people with congestive heart failure. “At home, I just kind of sat,” he says. “I couldn’t go fishing. I could hardly stand up.”

After more than 20 years of living with heart disease, Hart’s health had reached a low point. “I kept gaining weight and outgrew clothes like crazy,” he says. He was swollen and short of breath.

Improving quality of life

Heart failure, the progressive loss of the heart’s ability to pump blood, affects an estimated 5.7 million people in the U.S., with 670,000 new cases diagnosed every year. It’s a leading reason for hospitalization for people 65 and older, the American Heart Association says.

At the Genesis Heart Failure Outpatient Center, patients with heart failure can receive infusion drug therapy to support their heart function and ultimately improve their quality of life. Along with positive reinforcement, the center can administer inotropic agents to strengthen heart contraction; vasodilators to relax and dilate blood vessels; and, diuretics to remove excess fluid from the body.

With the help of nurses dedicated to heart failure treatment, patients also learn the importance of smoking cessation, physical activity, taking medication, monitoring their daily weight and restricting their fluids and salt.

Motivating patients

Early in his treatment, when good health seemed elusive, Hart’s nurse Andrae McMillan, RN-BC, searched for the one thing that would inspire her patient to make the lifestyle changes to bring him success.

“Jack was having a difficult time,” McMillan recalls. “He wasn’t happy. He wasn’t feeling good. I asked him, ‘What do you want to do most that will motivate you to get better?’ “

“I want to go fishing,” he answered.

In the gray and cold of winter, Hart continued his IV Lasix therapy while he dreamed of warmer days with a fishing pole in his hand. He thought of past fishing trips to Canada with his buddies and about the new boat in his shed that had hardly been used.

Four months later and 85 pounds lost, Hart came to the Genesis Heart Failure Outpatient Center one recent morning, and with great emotion in his voice, he announced: “Guess what? I went fishing!”

Heart failure reduces the ability of the heart to pump and deliver blood throughout the body. When this happens, the body holds onto water to compensate. The excess fluid eventually begins to seep into the body’s tissues, swelling the feet and ankles and filling the lungs and abdomen with fluid.

Because of excessive fluid retention, patients like Hart can gain 10 pounds over a weekend or 15 pounds over several days.

“Jack fought hard, and he earned it,” McMillan says. “It’s rewarding to see him reach his long-term goal and to go from being in a wheelchair, having no energy and huffing and puffing, to being able to do the things he loves.”

She adds, “We build relationships with these patients and families, and it helps improve outcomes. The patients are constantly accountable. They will admit if they went overboard at a buffet over the weekend; they know we’ll be able to see it on the scale. You can give them all the drug therapy in the world, but they need to be compliant on their end, too.”

Patients have hours to talk with each other during infusion treatments. “It’s like a support group, without the meeting,” McMillan says. “It’s a fun, morale-building environment. Our patients look at the successes of others and realize they can make changes and feel better, too. A success story like Jack’s brings hope to others and spreads like wildfire.”

Jack Hart looks forward to healthier days ahead, without the wheelchair.

“I went for a walk the other day with my daughter’s dog, and we walked a real distance,” he concludes. “ I didn’t come back huffing or puffing. My life has really changed.”