Tag Archives: The Nebraska Medical Center

Alzheimer’s Disease

December 10, 2015 by

Caring for a loved one with Alzheimer’s disease can be both physically and emotionally demanding. “As the disease progresses, the amount of care the Alzheimer’s patient requires rises dramatically, as does the toll it takes on the caregiver,” notes Daniel Murman, M.D., neurologist at The Nebraska Medical Center.

While there are things you can do to better prepare yourself for the caregiver role, the thing to remember is that Alzheimer’s progresses differently in each person, as do the caregiver circumstances and ability to cope with the disease.

 “I remember noticing changes in my wife for about a year but I couldn’t put my finger on it,” says Allan Schur, husband of Sharon Schur, who was diagnosed with Alzheimer’s in 2005 when she was just 54 years old. “It took my daughter, who hadn’t seen her for almost a year, to step in and tell me that she needed to be seen by a doctor.”

The most difficult part about being a caregiver is dealing with and managing guilt, notes Schur. “No matter how much you try, no matter how much you do, you cannot change the course of what is always a terminal disease,” he says. “There are no ‘survivor’s walks’ for Alzheimer’s.”

Schur also recommends starting each day as a new day and not dwelling on the past or thinking about what might have been. “The most important day in the life of a caregiver is today,” he says.

While it may sound contradictory, Schur says it is also important to be proactive. “Early in the disease you have to teach your loved one new tricks before they need to use them and while they have the capability to learn.” For example, there are phones where you can insert pictures of a child, friend or caregiver on large buttons so the user can press the picture of the person he or she wants to dial. “By the time I realized my wife needed this type of phone, it was too late to teach her how to use it,” says Schur.

Schur adds other tips. “Early in the disease, note the places you like to go and which ones have family restrooms. This will help you later when your loved one may need assistance.”

Participation in a support group is vital. “You can learn from the successes and failures of other caregivers,” says Schur. “You will be reminded that others are walking down a similar path and learn new coping mechanisms. You will see that you are not alone and that’s a pretty big deal some days.”

And lastly, be proactive about their care, stresses Shur. “I reached a point where I realized that if I continued with this 24/7 job, my loved one would outlive me. Tour facilities while you can and well before you need to place your loved one in a long-term facility.”

“Alzheimer’s is a long and emotional process, and caregivers should not feel guilty about seeking outside resources to assist them whenever possible,” says Dr. Murman. He suggests using resources such as the Alzheimer’s Association and the local Agency on Aging.

Visit the Alzheimer’s Association at alz.org to learn more.

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CPR Essentials

December 12, 2014 by

According to the American Heart Association (AHA), for every minute a cardiac arrest victim goes without life-saving CPR and defibrillation, the chances of survival decreases 7 to 10 percent. Learning the basics of CPR is especially vital for seniors.

The statistics are frightening: About 92 percent of sudden cardiac arrest victims die before reaching the hospital.  “But if more people knew CPR, more lives could be saved,” says Jennifer Redmond, executive director of the AHA. “Immediate CPR can double, or even triple, a victim’s chance of survival. What most people don’t realize, is that almost 80 percent of cardiac arrests occur at home. So most likely, the life you save will be that of a loved one.”

Several years ago, the AHA issued guidelines for hands-only CPR, hoping that this would encourage the use of CPR among bystanders.

“Hands-Only CPR is recommended for use by people who see a teen or adult suddenly collapse in an “out-of-hospital” setting such as at home, at work, or in a park,” explains Redmond. “In a national survey, Americans who had not been trained in CPR within the past five years said they would be more likely to perform hands-only CPR than conventional CPR on a teen or adult who collapses suddenly.”

However, there are times when conventional CPR with rescue breathing may provide more benefit than hands-only CPR. The AHA recommends CPR with a combination of breaths and compressions for all infants up to age 1; children up to puberty; anyone found already unconscious and not breathing normally; any victims of drowning, drug overdose, collapse due to breathing problems, or prolonged cardiac arrest.

To administer chest compressions correctly, place the heel of your hand in the middle of the chest on the breastbone between the nipples. Put your other hand on top of the first with your fingers interlaced. Compress the chest at least two inches at a rate of 100 compressions per minute.

Haysam Akkad, MD, an interventional cardiologist at The Nebraska Medical Center, stresses the use of hard, fast chest compressions, which keeps the blood circulating to vital organs. “You want to see the chest wall moving up and down,” he says. He also recommends that you always start CPR immediately and then call for help. Chest compressions should continue until help arrives. If an AED is close by, use that instead of CPR, he says.

Sudden cardiac arrest is a leading cause of cardiovascular death and is not the same as a heart attack. Sudden cardiac arrest occurs when electrical impulses in the heart become rapid or chaotic, which causes the heart to suddenly stop beating.  A heart attack occurs when the blood supply to part of the heart muscle is blocked. A heart attack may cause cardiac arrest. Currently, only about 41 percent of cardiac arrest victims get CPR from a bystander.

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Keeping Mind and Body Active

April 5, 2014 by
Photography by Bill Sitzmann

Mike Egger, 66, has always enjoyed tinkering around the garage, maintaining his cars and lawn equipment and doing just about anything mechanical. Since he developed Parkinson’s disease some 20 years ago, these are some of the things he still enjoys most in life, but they also serve another purpose. They help keep his body and mind active—essentials in helping control the symptoms of Parkinson’s disease.

Parkinson’s is a progressive disorder of the nervous system that advances slowly and affects movement, muscle control, and balance. It is the second most common nervous system disorder after Alzheimer’s disease.

It is estimated that as many as 3 to 4 percent of the population will develop Parkinson’s symptoms during their lifetime and the risk is even higher in Nebraska. “While we don’t have a cure for Parkinson’s, we continue to make progress in diagnosis and treatment,” says John Bertoni, M.D., Ph.D., neurologist and director of the Parkinson’s Clinic at The Nebraska Medical Center. “We are continually learning more about the disease and there are many new treatments coming down
the pipeline.”

People may have Parkinson’s for many years before it becomes apparent, notes Dr. Bertoni. Some of the more subtle early-stage symptoms include: loss of sense of smell, thrashing in sleep, depression, loss of facial expression, excessive sleepiness during the day, constipation, shortening of one’s steps, and a diminishing arm swing when walking. Other symptoms include slowness, rigidity, and tremors at rest.

Mike and his wife, Mary, believe that Mike probably had Parkinson’s disease for about 10 years before he was actually diagnosed.  “I had noticed a change in his gait, one of his arms wasn’t swinging much anymore, and he had developed a slight tremor in one of his hands,” she says. The signs were so slight, however, that she attributed them to an old injury caused by falling off a horse.

As the symptoms became more pronounced, Mike saw a doctor and was diagnosed at age 50 with Parkinson’s. “The disease progressed so slowly at first that I barely noticed it, or maybe I was in denial,” he says.

Initially, Mike took medications to help control his symptoms. Most people with Parkinson’s can get significant control of their symptoms with medications and a combination of other therapies including occupational therapy, speech therapy, nutrition counseling, support groups, and
regular exercise.

Medications can help alleviate problems with walking, movement, and tremors by increasing the brain’s supply of dopamine. In Parkinson’s disease, certain nerve cells (neurons) in the brain gradually become sick. These neurons are responsible for producing the chemical messenger dopamine. A reduction of dopamine levels causes abnormal brain activity, which can lead to the symptoms of Parkinson’s disease.

“Recent studies have revealed that people who are not over-treated with medications do the best in the long run,” says Dr. Bertoni. “We have also found that those who take an active role in their own care, who exercise regularly, stay engaged, and participate in support groups, do the best in managing the disease and living a relatively healthy, active, and quality life.”

Mary, who is the president of the Nebraska chapter of the American Parkinson’s Disease Association (APDA), says that the organization offers more than 20 support groups throughout the state for both Parkinson’s patients and their caregivers.

As Mike’s disease continued to progress, he eventually had to quit work. The medications also became less effective, and the side effects of the drugs grew to become worse than the symptoms themselves, a common problem among people who have been taking medications for many years.

When Parkinson’s disease patients stop responding to medications, a surgical procedure called deep brain stimulation may be considered. Deep brain stimulation involves implanting an insulated wire into a target area of the brain. The lead is connected to a small pulse generator implanted beneath the skin, which generates mild electric pulses to the brain to reduce Parkinson’s symptoms, including tremors.

Mike had the procedure performed nearly two years ago and says it has essentially eliminated his tremors. His biggest challenges include trying to walk steadily and maintaining his balance. Aside from that, Mark says, “I still do everything now that I’ve always done, but I don’t do them quite as well and not as fast.”

While a definitive cause for Parkinson’s has not been found, a combination of factors may play a role, notes Dr. Bertoni. These include aging, having an inherited gene, and exposure to environmental triggers. Some speculate that the relatively higher incidence of the disease in Nebraska may be due to exposure to farm chemicals.

Despite some of the daily challenges of dealing with Parkinson’s disease, Mike continues to maintain a positive attitude. “I figure there are many people who have worse things than me,” he says. “I just try to roll with it and stay positive.”

The APDA assists people throughout the state. Visit parkinsonsne.org or call 402-393-2732 for additional information.

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Young and Surviving Cancer

May 25, 2013 by
Photography by Bill Sitzmann

It was just eight weeks after Amberly Wagner-Connolly had given birth to twins when she received the devastating news that she had breast cancer. She was just 29.

“I knew that life as I knew it would never be the same,” she recalls. “I was so shocked. Why me? Why would I have these beautiful kids and then so soon after find this out?”

As it turns out, the experience has come to be one of the most positive things that has happened in Wagner-Connolly’s life. It also became the springboard that put her goals in motion.

“It has helped guide me in my life and my career,” she says. “It opened my eyes to how much worse things could be and inspired me to do more with my life. Through cancer, I realized that I wanted to go into public health where I can help others. I know I am a better mom, friend, teacher, nurse, wife—everything. All of my roles have been affected in a positive way because of [cancer].”

On March 1, Wagner-Connolly celebrated her four-year anniversary of being a cancer survivor, and while she has managed to make it a positive in her life, she acknowledges that it was also one of the most difficult and trying times in her life.

“It has helped guide me in my life and my career. It opened my eyes to how much worse things could be and inspired me to do more with my life.” – Amberly Wagner-Connolly, survivor

The number of young adults who are diagnosed with cancer is very low, usually less than 5 percent, depending on the cancer, says Margaret Block, M.D., a medical oncologist at Nebraska Cancer Specialists. But for those who do receive the disturbing news, it can be a very emotional and stressful journey.

Like many young cancer patients, Wagner-Connolly experienced the challenges and emotional turmoil common among people her age. She struggled with the shock of being diagnosed at such an early age; she feared not being around to see her children grow up; and she grew weary from juggling two tiny twins and a four-year-old daughter when she could barely take care of herself.

Her family and friends and people she didn’t even know became her biggest supporters. Her husband worked nights and was able to help as much as he could during the day. Her mother and mother-in-law also provided help when they could and were there for emergencies.

Her co-workers at The Nebraska Medical Center held a fundraiser for her. Several friends of her sister who work at Lincoln Financial Group also organized a fundraiser/auction and raised more than $6,000 to help her with her medical bills.

This touched Wagner-Connolly greatly and was a turning point that helped her keep fighting. “It made me see the good in the world,” she says. “When complete strangers reached out to help me, I became determined that I had to do something with my life to make an impact like they had for me.”

“The number of young adults who are diagnosed with cancer is very low, usually less than 5 percent, depending on the cancer.” – Margaret Block, M.D., medical oncologist with Nebraska Cancer Specialists

Determined to not let her surgery and chemotherapy treatment slow her down, Wagner-Connolly was able to continue her master’s studies, finishing on her target date. She also kept a challenging work schedule as a nurse at The Nebraska Medical Center.

Being able to maintain some control over other parts of her life was important to her mental well-being. There were days during her six-month chemotherapy regimen when she felt as if she couldn’t go on. “I just had to take it day by day,” she recalls. “I did a lot of reality checks.”

Having goals—such as seeing her children grow up, completing her master’s degree, and wanting to live to make a difference in the world—fueled her will to keep fighting.

“Amberly did an amazing job,” says Peggy Jarrell, LCSW, OSW-C, a licensed clinical social worker and a certified oncology social worker at Nebraska Methodist Hospital, who worked with her during her treatment. “Motherhood can be stressful enough…put cancer on top of that, and you have a lot to deal with. [She] was able to maintain her own and still stay active in the outside world.”

Jarrell says it’s very important for cancer patients to establish a good support network of people and friends who can help them through this period. She also recommends having a designated support person who can accompany them at appointments and act as their second set of ears. Many hospitals now provide nurse navigators to help patients “navigate” the health care system.

Stacy Patzloff, RN, BSN, a certified oncology nurse navigator at Alegent Creighton Health, says nurse navigators work closely with the patient and the cancer support team to make sure everything is coordinated. They’re there to attend appointments with them and to act as a support person who is available 24/7.

“Motherhood can be stressful enough…put cancer on top of that, and you have a lot to deal with.” – Peggy Jarrell, licensed clinical social worker and certified oncology social worker with Nebraska Methodist Hospital

Support is key, agrees Dr. Block, whether it’s family, friends, a support group, or seeking the help of a psychologist or psychiatrist. Exercise can also be a good thing and may help you get through chemotherapy with less fatigue, she notes.

Other tips that may help young patients get through treatment and recovery include:

  • Don’t be afraid to ask for help from others.
  • Take time for yourself if you’re having a bad day.
  • Eat a healthy diet. Seek the nutrition advice of dietitians on staff at the hospital where you are receiving treatment.
  • Take care of your physical well-being. Programs like Alegent Creighton Health’s Image Recovery program provide cancer patients with wigs and helps them deal with hair, nail, and skin problems that are unique to cancer patients.

Today, Wagner-Connolly is very active in a number of projects to help other young victims of cancer. She started the group Survivors Raising Kids for young parents who need help with childcare during treatment and recovery. She is on the board of Camp Kesem for kids who have had a parent with cancer. She is also a nursing instructor at Clarkson College where she teaches public health and is pursuing a doctorate in global health.

“I know how lucky I am,” she says. “I want to make a difference in this world. No one should have to face cancer and certainly not a young mom.”

And for those who do, Wagner-Connolly is committed to easing that journey.

Smoking Cessation Aids

March 25, 2013 by
Photography by Bill Sitzmann

The old saying “third time’s the charm” didn’t work so well for Laura Adams when it came to quitting smoking.

“Every time I quit, I’d be good for about six months,” she says. “Then I’d get stressed about something and decide to have just one. Well, once you start up again, it’s all over. It’s an all-or-nothing thing.”

Adams is not in the minority. Most smokers will try quitting multiple times before they are successful. There’s a lot more to smoking than meets the eye, say local smoking cessation experts. “There’s an addiction to nicotine, the actual habit, and the emotional dependence that all need to be addressed,” says Laura Krajicek, a smoking cessation coordinator for Nebraska Methodist Health System.

A smoker for more than 20 years, smoking had become a crutch for Adams. “It helped me deal with daily stresses,” she explains. “When I had a cigarette, that was my relaxation time, my ‘me time.’ Coffee, cigarettes, and break time all went together. It was hard to have one without the other.”

Adams knew that it wasn’t a “pretty habit,” nor one she was proud of. With a campus-wide no smoking policy at her place of employment, Alegent Creighton Health Immanuel Medical Center, Adams would have to “sneak” to an off-site parking lot to smoke. To mask the nasty smoke odor, she would slip on a different coat, pull her hair back in a ponytail, wash her hands, and coat herself with body spray before returning to the office. “It was an embarrassing addiction,” she recalls.

“When I had a cigarette, that was my relaxation time, my ‘me time.’” – Laura Adams, former smoker

When Adams learned about Alegent Creighton Health’s smoking cessation program, Tobacco Free U, she decided this might be the extra push she needed to help her quit for good. The program focuses on the use of group or individual counseling in combination with a smoking cessation aid such as nicotine patches, nicotine gum, or medications.

According to the Cochrane Review, an internationally recognized reviewer of health care and research, combining counseling and medication improves quit rates by as much as 70 to 100 percent compared to minimal intervention or no treatment.

“Success rates rise drastically when you combine the two,” says Lisa Fuchs, a certified tobacco treatment specialist at Alegent Creighton Health. The counseling portion helps people tackle the behavioral addiction, and the smoking cessation aids help with the nicotine addiction.

Which smoking cessation aid is recommended depends on how heavy a smoker, health conditions, as well as what seems to be the best fit for that person’s lifestyle, notes Fuchs. These aids are most successful in individuals who have been counseled on how to use them appropriately. The most common aids include:

Nicotine patch – The patch is a long-acting therapy that delivers a steady dose of nicotine over a 24-hour period and is designed to curb a person’s cravings for nicotine. This may be appropriate for very heavy smokers. The dosage is gradually lowered to wean a person off the nicotine habit.

Nicotine gum or lozenges – Gum and lozenges are short-acting therapies that deliver smaller doses of nicotine and can be taken as needed to curb the nicotine urge. Tom Klingemann, certified tobacco treatment specialist at The Nebraska Medical Center, recommends that smokers schedule the doses so that they maintain a steady state of nicotine in the body to avoid the nicotine cravings and temptation to smoke. In general, he is opposed to short-acting nicotine replacement therapies because “they keep people looking for a chemical fix even though they may not be smoking anymore.” They are also very expensive, and most people trying to quit can’t afford the $40 a week price tag they would cost if used appropriately.

e-cigarettes – These work by heating up a liquid nicotine substance that is inhaled as vapor. The product is not regulated by the Food and Drug Administration (FDA) and many still have a lot of chemicals that may not be any healthier than actual smoking, notes Klingemann. “These are not intended to help people quit but keep them addicted to nicotine,” he says.

Medications – The two primary prescription medications used for smoking cessation include Zyban and Chantix, with Chantix being the preferred of the two, says Fuchs. “Zyban is an anti-depressant and may be recommended for a person with mild depression to help with moodiness as well as decreasing cravings and withdrawals,” notes Fuchs. It is believed to work by enhancing your mood and decreasing agitation related to trying to quit.

Chantix is a newer drug and works by binding to nicotine receptors in the brain and blocking them so that nicotine can no longer activate those receptors, causing a person to get less satisfaction from smoking. At the same time, it also triggers a small release of dopamine, the reward neurotransmitter in the brain. It appears to be safe and quite effective, notes Klingemann. Krijicek says that her clients have seen the most success with this aid.

“Success rates rise drastically when you combine [counseling and medication].” – Lisa Fuchs, certified tobacco treatment specialist at Alegent Creighton Health

Adams used Chantix, which she said helped curb her nicotine urges. But what helped the most, she says, was to change the habits that she associated with smoking. For instance, instead of coffee and cigarettes in the morning, she reached for coffee and orange juice. Because she normally smoked while driving, she changed the route she drove to work. She also replaced the time she would have spent smoking with more positive habits like walking her dogs, running, bicycling, and swimming.

“Once I quit, I started making healthier decisions in other parts of my life as well,” she says. “I started eating better, drinking less caffeine, and exercising more. I feel better now.”

“For 90 percent of smokers, the addiction is behavioral,” notes Klingemann. “It’s all of the other stuff that drives the smoking addiction. Until you start changing your behaviors and routines, it’s really hard to quit.”

From Patients to Caregivers

February 25, 2013 by
Photography by Bill Sitzmann

Margaret Ludwick spends her days sitting in a wheelchair at a senior care center in Elkhorn. She never speaks. The only expressive motion involves her hands—she constantly puts her long, tapered fingers together like a church steeple. Her big blue eyes stare straight ahead but focus on nothing. No one can reach her anymore, not her daughters, not her husband.

Alzheimer’s, the most common form of dementia in adults 65 and over, robs even the most intelligent people of their brain and eventually destroys their body. There is no cure. There is no pill to prevent it. There’s not even a test to definitively diagnose it. Effective treatments have proven as elusive as the disease, itself.

“We do have medications that may help with symptoms in some patients, especially in the early stages of Alzheimer’s,” says Dr. Daniel Murman, a specialist in geriatric neurology at The Nebraska Medical Center. “But they don’t truly slow down the disease process.”

According to researchers, the number of Americans living with Alzheimer’s will triple in the next 40 years, which means 13.8 million will have the disease by 2050 (Chicago Health and Aging Project research as reported by nbcnews.com).

Awareness of symptoms is crucial for early intervention.

“Memory loss and changes in behavior are not a normal part of aging,” stresses Deborah Conley, a clinical nurse specialist in gerontology at Methodist Health Systems who teaches other nurses and caregivers about Alzheimer’s. “I would urge family members to take [their loved one] to a family physician first, seek as much information as possible, and start making your plans.” An assessment that includes the person’s medical history, brain imaging, and a neurological exam can result in a diagnosis that’s about 85 percent accurate for Alzheimer’s.

Ludwick, a registered nurse, who worked at Immanuel Hospital for years, never received an extensive workup.

 “I would urge family members to take [their loved one] to a family physician first, seek as much information as possible, and start making your plans.” – Deborah Conley, clinical nurse specialist in gerontology at Methodist Health Systems

“I first noticed something was wrong about 15 years ago, when Mom was 70,” explains Ludwick’s daughter, Jean Jetter of Omaha. “It was the day I moved into my new house. Mom put things in odd places, like a box labeled ‘kitchen’ would wind up in the bedroom. And she stood smack in the middle of the doorway as the movers tried to carry large pieces of furniture inside, and she just stared at them.”

As Ludwick’s behavior grew worse, Jetter begged her father, Thomas, to get her mother help.

“He didn’t want to hear it. He kept saying, ‘This will get better.’ He had medical and financial Power of Attorney. Dad worked full-time, and she was home alone. This went on for eight years.”

Ludwick’s steady decline rendered her unable to fix a meal or even peel a banana. She lost control of bodily functions. After she was found wandering the neighborhood on several occasions, Jetter was finally able to call Adult Protective Services and get her mother into an adult daycare program. After breaking a hip two years ago, Ludwick arrived at the Life Care Center of Elkhorn.

“This is such a sad, but not unfamiliar case,” says Conley, who began working with Alzheimer’s patients in the mid-’70s. “Even in 2013, people do not know what to do, where to turn.”

Dr. Murman adds, “There is still a stigma attached to Alzheimer’s. People don’t like to hear the ‘A’ word. But it’s much better to be open and specific about it.”

A specific diagnosis may rule out Alzheimer’s.

“Depression can mimic the symptoms of Alzheimer’s…symptoms like mistrust, hallucinations, apathy, social isolation,” explains Dr. Arun Sharma, a geriatric psychiatrist with Alegent Creighton Health. “But we can treat that. We can treat depression.”

Dr. Sharma helped establish a 22-bed, short-term residential facility called Heritage Center at Immanuel Hospital to better diagnose the reasons for a person’s memory loss. Once a patient is stabilized and receives a proper care plan, they can return home. The more doctors learn, the faster a cure will come.

“I see something exciting in the next five to 10 years,” says Dr. Sharma. “If we identify and isolate the protein believed responsible for Alzheimer’s, perhaps we can do a blood test to catch the disease early.”

 “There is still a stigma attached to Alzheimer’s. People don’t like to hear the ‘A’ word. But it’s much better to be open and specific about it.” – Dr. Daniel Murman, specialist in geriatric neurology at The Nebraska Medical Center

But what about a cure? With 78 million Baby Boomers coming down the pike—10,000 of them turning 65 each day—this country faces an epidemic. And what about the psychological, financial, and emotional toll on the caregivers, who are very often family members? They, too, feel isolated.

“It was an impossible situation for me. I couldn’t get her the help she needed,” says Jetter, who bore the brunt of the family crisis since her married sister lives in Dallas. “Now that Mom is at [the nursing home], I can take a breather and concentrate on Dad, who also has mental issues.”

In recent weeks, her father, Thomas, has been admitted as a permanent resident of Life Care Center of Elkhorn as well.

What about her own family?

“I have no one. No husband, no boyfriend. I mean, what boyfriend would put up with all this?” asks Jean, who’s been shuttling between one parent and the other for years, all the while trying to run her own business. The situation has obviously taken a huge personal toll.

Conley has two words for anyone facing similar circumstances: Alzheimer’s Association. The Midlands chapter has support groups, tons of information, and can gently guide the adult child or spouse. They even have a 24/7 hotline: 800-272-3900.

For anyone dealing with Alzheimer’s, that number could become a lifeline.

Surviving Heart Disease

January 25, 2013 by
Photography by Bill Sitzmann

As a young woman of just 38 years old, Dionne Whitfield didn’t fit the typical description of a heart disease patient. But there she was, standing in front of the cardiologist, still tired and breathless after undergoing a treadmill test, trying to grasp the news that she had three major blockages.

She didn’t hear much after that. All she could think about was that she didn’t want to become a mere statistic. That she still wanted to have a family and live to see her potential children grow up. What was going to happen to her, she thought.

One week later, in August of 2012, Whitfield was back in the hospital undergoing triple bypass surgery. Today, Whitfield is doing great, and with age on her side, she is determined to take control of her health and her life again.

Looking back, she knows now that her unhealthy lifestyle habits were bound to catch up with her eventually. At 352 pounds, she ate whatever she wanted, often grabbing fast food along the way. She rarely exercised, and she had settled for the fact that she was overweight and nothing was going to change that. She was also African-American, a population that tends to have greater prevalence of risk factors for heart disease than Caucasian women.

“This has been a big eye-opening experience for me, and I don’t want to go back.” – Dionne Whitfield, heart disease patient

Whitfield’s attitude about her weight and health has done an about-face since then. Her attitude actually started to change with several warning signs shortly before the news of her blockages. In early January of last year, she learned that she was borderline diabetic. Concerned, Whitfield began attending group exercise classes and the pounds began to fall off. Motivated by her success, she began to make exercise a priority.

Then came her second warning. In July, she started becoming so short of breath that she could barely make the short walk from her office to the car. When things didn’t get better, she consulted with her doctor, who referred her to cardiologist Edmund Fiksinkski, M.D., at Nebraska Methodist Hospital, who performed the cardiac testing in which the blockages were found.

Whitfield’s surgery was performed by John Batter, M.D., cardiothoracic surgeon at Nebraska Methodist Hospital. After surgery, she underwent six weeks of supervised cardiac rehabilitation. Whitfield exercises on her own now but is still considered in a recovery phase for the next year and follows a moderate exercise program while her arteries heal.

“Dionne has done great,” says Susana Harrington, a nurse practitioner at Nebraska Methodist Hospital, who worked with Dionne throughout her recovery. “She really owned it and became more determined than ever to lead a healthy lifestyle.”

“This has been a big eye-opening experience for me, and I don’t want to go back,” says Whitfield. She continues to work out regularly, watches what she eats, and even reads labels now before putting food in her grocery basket.

She has also lost more than 72 pounds and is determined to double that. “I feel so much better now,” says Whitfield. “I’m not breathless now, and exercising is getting easier.”

 “She really owned it and became more determined than ever to lead a healthy lifestyle.” – Susana Harrington, nurse practitioner at Nebraska Methodist Hospital

What women need to learn from this is that the development of cardiovascular disease is a lifelong process and that prevention is a lifelong effort, says Amy Arouni, M.D., cardiologist at Alegent Creighton Health. Controlling your risk factors very early in life can help prevent the development of heart disease later. This includes quitting smoking if you smoke, maintaining a healthy weight, exercising regularly, eating a diet low in saturated fats with lots of fruits and vegetables, and watching your blood pressure and cholesterol. In fact, women can lower their heart disease risk by as much as 82 percent just by leading a healthy lifestyle, according to the National Institutes of Health.

Prevention is important because heart disease is the No. 1 killer of all women, claiming the lives of approximately a half million women each year.

The main difference between men and women is that women are more likely to develop heart disease in their 60s and 70s, about 10 years later in life than men.

That’s because after menopause, risk factors tend to rise in women, especially blood pressure and cholesterol levels and rates of obesity, says Eugenia Raichlin, M.D., cardiologist at The Nebraska Medical Center. Other risk factors such as smoking, diabetes, and family history also raise a woman’s risk.

“The longer you wait, the greater the potential to suffer significant damage to the heart.” – Amy Arouni, M.D., cardiologist at Alegent Creighton Health

The consequences of heart disease also tend to be more severe in women. For instance, “a greater number of women die of sudden cardiac death before their arrival at a hospital (52 percent) compared to 42 percent of men,” says Dr. Raichlin. “Women often require more hospitalizations compared to men, have lower ratings of general well-being, and limitations in their abilities to perform activities of daily living. As a result, heart disease in women presents a unique and difficult challenge for physicians.”

In addition to prevention, women should also be aware of the symptoms of heart disease and the subtle changes in their bodies, says Dr. Arouni. “Unlike men, women’s symptoms tend to be more vague and atypical and may include mild neck, shoulder, upper back, or abdominal discomfort; shortness of breath; nausea or vomiting; sweating; lightheadedness or dizziness; extreme fatigue and/or a jaw ache that travels down the neck,” she says. “Because the symptoms tend to be vague, oftentimes, women will stay at home and ride it out.”

This is one of the key areas where women go wrong. “Getting help quickly is critical,” says Dr. Arouni. “The longer you wait, the greater the potential to suffer significant damage to the heart.”

While the development of heart disease in a woman’s 30s is less common, it does happen, especially when other risk factors are involved such as family history, obesity, or diabetes.

Whitfield feels fortunate that she and her doctors took her symptoms seriously and that she sought help early on. Now, she hopes she can help other women avoid the same fate by taking control of their health at a young age. “I feel very grateful to my family and friends and to the doctors and nurses that helped me get through this,” she says. “When you’re young, you don’t think anything can happen to you, but now I know differently. I don’t take my health for granted anymore.”