Cardiac Rehab Paves Way to a Healthy Heart
Sandy Ogle is an active woman who admits her Type A personality keeps her on the go. She and her husband have a small business, Top Notch for Kids, making polar fleece caps and mittens for children. They have a website and travel to craft shows to sell their wares. Sandy “retired” after working for Xcel Energy for 19 years and CESA 12 for seven years.
She was watching her grandchildren when she developed such a pain in her shoulder that she called her husband and asked him to watch the kids so she could lie down. “I was simply in a world of hurt. It was like I hit my funny bone really hard. It was a terrible, sickening ache. I realize now that must be when I had a heart attack,” said Ogle.
Sandy thought she had hurt her shoulder lifting or pushing boxes. It would go away but it also came back. One day she had to walk up a hill and she wasn’t so sure she would make it. “I often walk with my niece. There were times I had trouble keeping up and when I would swing my arms the pain in my shoulder would act up,” said Sandy.
Sandy’s health has always been good. She maintains a proper weight and her everyday life provides a good amount of exercise. She was diagnosed with a heart murmur in her mid-thirties. When she went for her routine physical, she told her doctor she felt great. At the very end of her visit she said, “I do have shoulder pain that comes and goes.”
Dr. Mark Belknap, internal medicine specialist with Essentia Health Ashland, wanted to hear more. After Sandy described the time with her grandchildren, walking with her niece and walking up hill, Dr. Belknap ordered a stress echocardiogram, a test that performs a stress test and ultrasound of the heart almost simultaneously. The results were abnormal; at some point in the past Sandy had a heart attack.
Dr. Belknap referred her to Essentia Duluth where she underwent a left heart catheterization. It was discovered that her right coronary artery was completely blocked. How did she function at all? Her coronary collaterals circulation took over the job. Sandy calls it her own personal miracle.
Collateral circulation is a process in which small, and normally closed, arteries open up and connect two larger arteries or different parts of the same artery. They can serve as alternate routes of blood supply.
Everyone has collateral vessels, at least in microscopic form. These vessels normally aren't open. However, they grow and enlarge in some people with coronary heart disease or other blood vessel disease (such as in the case of stroke). While everyone has collateral vessels, they don't open in all people.
When a collateral vessel on the heart enlarges, it lets blood flow from an open coronary artery to an adjacent one or further downstream on the same artery. In this way, collateral vessels grow and form a kind of "detour" around a blockage. This collateral circulation provides alternate routes of blood flow to the heart in cases when the heart isn't getting the blood supply it needs. Lack of adequate blood flow is called myocardial ischemia.
Physicians advised Sandy to treat her condition with medication and exercise. She entered Phase Two Cardiac Rehabilitation at Memorial Medical Center. “The nurses are so upbeat and wonderful at their jobs. It’s fun going there. They are very observant and so compassionate. I couldn’t ask for a better place to be,” said Sandy.
“It isn’t just about exercising in Rehab. I talked with Sue Sederholm, a social worker, about stress; Jennifer Kupczyk, a pharmacist, about medication, and Theresa Hoyles and Rebecca Crumb-Johnson, registered dietitians, about diet,” said Sandy.
She explains that she does have angina once in awhile, which is chest pain or discomfort that occurs when an area of the heart muscle doesn't get enough oxygen-rich blood. Angina may feel like pressure or squeezing in your chest, or just shortness of breath. The pain also may occur in shoulders, arms, neck, jaw, or back. Angina pain may even feel like indigestion. Angina isn't a disease; it's a symptom of an underlying heart problem.
“When it happens, I stop what I am doing and it goes away right away. Once you’ve had that pain, you know it when it happens,” said Sandy.
“There are no heart problems in my family, my blood pressure has always been perfect and I’ve always been very energetic. For the most part I didn’t think twice about the pain in my shoulder. I’m very grateful that Dr. Belknap was on his toes. He is very meticulous in his care,” said Sandy. “I am also grateful I can follow a monitored exercise and medication program here at Memorial Medical Center. I don’t know what we would do without this hospital,” said Sandy.
To learn more about the Cardiac Rehabilitation Services at Memorial Medical Center, click here.
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