Download Sleep Apnea and its Treatment Devices Improve Patient Care

Medical Associates Clinic and Mercy Medical Center
WINTER
2010
Devices Improve Patient Care
Many heart failure
patients are
receiving special
pacemakers and
defibrillators
to protect their
heart rhythm and
improve their heart
Julie Ehlinger, ARNP function. Now
the newest devices
are also being used to help monitor a
patient’s condition. The FAST (Fluid
Accumulation Status Trial) study was
presented at the national meeting of
the Heart Failure Society of America
meeting that I attended recently in
Boston. This trial and others have
shown that following information from
devices can be more accurate than
weights in detecting fluid build-up.
Devices use the leads or wires
implanted in the heart to monitor
changes in heart rhythm, heart rate,
battery life, patient activity, and even
fluid levels in the chest. This information
can be obtained in the office as well as
from the patient’s home. From home,
the patient uses a special transmitter,
connected to the phone line. Some
transmitters can even gather information
from the device automatically while the
patient sleeps. The information can be
gathered at regular scheduled times,
or if the patient is noticing a concern
or symptoms. The information is sent
to a secure internet website for review
by a heart failure nurse. This is very
convenient for patients, and may decrease
the number of trips patients have to make
to the office for device checks. It gives
patients more freedom to work or travel,
as the monitor weighs about a pound and
fits easily into a suitcase. It also increases
peace of mind, as patents know that
their care providers have access to their
important heart information.
Heart Failure Education & Support Group
Sister Marie Barth will present
“The ART in HEART”
Wednesday, February 17
2:00 – 3:30 p.m.
Registration at 1:45
**New Location**
Mercy Medical Center, 6th Floor Auditorium
Call 584-3232 to register
Family and friends are invited to attend.
Sleep Apnea
and its
Treatment
Sleep apnea, a
condition where
a person stops
breathing for at
least ten seconds
repeatedly while
sleeping, is a
common problem
in people with
congestive heart
failure or CHF.
Mark Janes, MD
The main problem
in CHF is a weak
heart muscle. Up
to 60 percent of
those with CHF
may have sleep
Connie Wessels,
apnea. Usual
RN, MSN
treatment for sleep
apnea is decided by an overnight sleep
study called a polysomnogram. If
sleep apnea is found, the doctor will
order treatment usually called CPAP
(continuous positive airway pressure)
or BIPAP (biphasic positive airway
pressure). A mask is fitted that tightly
covers the nose, or nose and mouth,
and attached to the CPAP or BIPAP
device.
A recent study from Sweden showed
that a low calorie diet and weight loss
can decrease the symptoms of sleep
apnea in overweight people. The
study lasted for nine weeks and the
people who were in it saw their sleep
apnea drop from severe to moderate,
or moderate to mild or normal. At
the same time, heavy men in the
study who did not lose weight, saw
no change in their sleep apnea. The
Swedish study lasted only nine weeks,
but did show the possibility that sleep
apnea improves with weight loss. The
remaining question is of the long term
ability to keep the weight off.
As the New Year is here, another
reason to lose weight is that it could
improve your sleep and your heart as
well.
Pharmacy Updates
for a New Year and
a New Decade
Got Healthy Bones?
Bones need proper nutrition to stay healthy. While
calcium is critical to bone health, a variety of minerals,
vitamins and other components work together to make
strong bones.
The world of pharmacy changes very
quickly and there always seems to be a new
medication or new information about an
old medication. The year 2010 will be no
different.
Calcium
Brand Name
Generic Name
Anticipated Date
Calcium is 65 percent of
the weight of your bones.
Approximately 600-700 mg of
calcium move in and out of the
bones every day. If your diet
is low in calcium, your body
removes calcium from your
bones but does not replace it.
Choose three servings of high
calcium foods each day such
as low fat milk, yogurt, cheese,
fortified orange juice or fortified
soy milk.
Boniva
ibandronate
January 2010
Boron
Namenda
memantine
January 2010
Flomax
tamsulosin
March 2010
Cozaar
losartan
April 2010
This is a trace mineral that helps keep calcium from
being excreted in urine. Eating plenty of fruits and
vegetables will ensure you are getting enough boron.
Hyzaar
losartan/HCTZ
April 2010
Magnesium
Effexor XR
venlafaxine
extended-release
July 2010
Aricept
donepezil
November 2010
Here are a few hot topics and updates for
the New Year:
Sara Nicolaus, PharmD
•Many brand name medications are scheduled to be generically
available in 2010. Watch for their generic name and possible
price reductions at your pharmacy. Review the list below for
these expected changes.
•Many patients with heart failure are prescribed an angiotension
II receptor blocker (ARB) such as, Atacand, Avapro, Cozaar,
Diovan, Hyzaar, or Micardis. Two of these medications, Cozaar
and Hyzaar, are scheduled to be generically available in 2010.
• With the New Year also come price adjustments from drug and
insurance companies. Do not be alarmed if the price of your
prescriptions has increased or decreased.
Ask Your Pharmacist
We are here to answer questions you may have concerning your
prescriptions. It can be confusing with so many different names
and prices for medications. We can help you understand what
your prescriptions treat and how to use them.
Generic equivalent medications are just as safe and effective
as brand name medications. All generics go through the same
rigorous testing as brand name medications before they are
released.
Please be aware that generic medications come in different colors,
shapes, or sizes. Check your bottle for labels that indicate this
change, or ask your pharmacist if the medication looks different
than your last refill.
Sources: 1. Drugs@FDA Jan. 2010 2. Pharmacist’s Letter Oct. 2009
Mary Hampton R.D.
L.D. C.N.S.D.
Half of your body’s magnesium is found in bones.
Magnesium can take the place of some calcium in bone
if calcium supplies are low. Nuts and whole grains are
excellent food sources of magnesium as are beans, dark
green vegetables, fish and seeds.
Vitamin D
Vitamin D is unusual in that it can be made from
sunshine. However, in northern climates where we have
less sun exposure, most lack the vitamin D needed to
promote healthy bones. Heart healthy food sources of
vitamin D include fortified low fat milk and yogurt,
salmon and fortified whole grains. A daily multivitamin
containing vitamin D should be considered.
Salt
Excess salt intake causes calcium to be lost in the urine.
Limit daily sodium intake to 2000 mg per day.
Purple Cow Smoothie
This is an easy breakfast. Make it the night before, store it in the
refrigerator in the blender jar, and blend in the morning.
1 cup skim or fortified soy milk
1 cup calcium-fortified orange juice
1 banana
1/2 cup frozen blueberries
1/4 cup wheat germ
Place all ingredients in a blender. Blend on high speed until
pureed smooth. Serve immediately or refrigerate until ready
to serve, up to 12 hours. If you make it ahead, we recommend
blending quickly before serving.
Nutrition Facts: Calories 226, Protein 10 g, Fat 2 g, Saturated fat 0 g,
Carbohydrate 44 g, Fiber 4 g, Calcium 338 mg