Dr. Alexander Chudnovsky, director of Cardiac Rehabilitation Services at Howard County General Hospital, with (from left): Prasobha George, RN; and exercise physiologists Suzanne Jeffreys and Brett Goldberger. Dr. Chudnovsky is a cardiologist with Cardiovascular Specialists of Central Maryland in Columbia.
February is American Heart Month: Exercise to Tone Your Heart!
American Heart Month is a good time to remember how important exercise is for heart health. No matter what age you are or stage of life you are in, some form of exercise is beneficial for most people.
Alexander Chudnovsky, M.D., a cardiologist on staff at Howard County General Hospital (HCGH) and medical director of the hospital’s Cardiac Rehabilitation Program, wants you to know that exercise is for everyone, regardless of age or cardiac health status. The heart is meant to be used!
No Cardiac History?
Exercising doesn’t just tone the muscles in your arms, legs and core, it strengthens the heart muscle. According to the American Heart Association, physical activity helps prevent the nation’s number one and number four killers: heart disease and stroke. “When you exercise regularly, the heart becomes conditioned and uses oxygen and energy more efficiently,” says Dr. Chudnovsky. “To condition the heart, you should exercise at least four times a week and raise your heart to your target heart rate for 20 to 30 minutes during exercise.”
What is your target heart rate? 220 – your chronological age x 0.8 = your target heart rate.
The Cardiac Patient In general, most cardiac patients benefit from exercise. Those with coronary artery disease and congestive heart failure can benefit significantly from cardiac rehabilitation offered in a clinical, monitored setting. You should discuss a cardiac program with your physician. HCGH offers many cardiac rehabilitation options to help those who have recently experienced a heart attack, angioplasty, stable angina, coronary bypass surgery, irregular heart rhythms, heart failure or transplant or valve surgery. Call 443-718-3000 for more information.
“Exercise can induce the heart to grow new blood vessels to supply areas of the heart that may have been affected by prior cardiac events,” notes Dr. Chudnovsky. “In addition, regular exercise can help reduce blood pressure, increase good cholesterol (HDL) and reduce bad cholesterol (LDL), improve glucose metabolism for those with diabetes and support weight loss.”
Before You Start: According to Dr. Chudnovsky, if you are planning to start exercising and you are not conditioned and have cardiac risk factors that include diabetes, smoking, high cholesterol, high blood pressure and/or a family history of cardiac events, you should see your cardiologist or primary care doctor before you put your heart under the stress of physical activity.
Monday, Oct. 20, 3:30 p.m. – 5:30 p.m. Blood Pressure Screening at Glenwood Branch. Free, walk-in blood pressure screening and monitoring offered by Howard County General Hospital: a Member of Johns Hopkins Medicine. No registration required.
Monday, Oct. 20, 3:30 p.m. Superfoods at Miller. Some foods promote health and longevity better than others. Licensed nutritionist Karen Basinger names these powerhouses and how to best use them. Register online or by calling 410.313.1950.
Tuesday, Oct. 21, 9 to 11:30 a.m. Diabetes Screening & BMI. Free. Held in Howard County General Hospital’s Wellness Center. Meet with an RN for a glucose blood test, BMI measurement and weight management information. Immediate results. Fasting eight hours prior recommended.
Monday, Oct. 27, 5:30 p.m. to 9 p.m. Adult, Child and Infant CPR/AED in Howard County General Hospital’s Wellness Center. Cost is $55. This course will teach the skills needed to clear an airway obstruction, perform cardio-pulmonary resuscitation (CPR), and how to use an automated external defibrillator (AED).
Saturday, Aug. 16, 10 a.m. – 12 p.m.Ask A Master Gardener. Discuss gardening questions and concerns at the Glenwood Branch. University of Maryland Extension – Howard County Master Gardeners. Also offered at the Miller Branch Saturday, Aug. 16, 10 a.m. – 12 p.m. and Aug. 18 7 – 8:30 p.m. No registration required.
Saturday, Aug. 16, 10 a.m. Compost Demonstrations. Master Gardeners discuss and demonstrate composting on a drop-in basis at the Miller Branch. Free bins provided for Howard County residents. University of Maryland Extension – Howard County Master Gardeners. No registration required.
Saturday, Aug. 16, 11 a.m. Crop Swap. Do you have an abundance of vegetables from your garden? Let’s crop swap! Bring homegrown produce to trade for something new and delicious at the Miller Branch. Share growing tips and favorite varieties. Families welcome. Leftovers donated to the Howard County Food Bank. Set up from 11 – 11:30 a.m., swap from 11:30 a.m. – 12 p.m. Registration is required. Register online or by calling 410.313.1950.
Monday, Aug. 18, Blood Pressure Screening at Glenwood Branch – a Well & Wise Event. Free, walk-in blood pressure screening and monitoring offered by Howard County General Hospital: A Member of Johns Hopkins Medicine. Also offered, Tuesday, Aug. 12, 1 – 3 p.m.
Monday, Aug. 18, 2 p.m. Infectious Diseases. Learn about infectious diseases, how they are spread, and how disease detectives work to find and stop their spread using medical technology and nanotechnology at the Savage Branch. Participate in mock disease outbreaks around the globe to learn to identify and handle some of the most dangerous diseases, select the right medical or nanotechnology methods, and develop a communication pack to let others know. Being an Infectious Disease Detective has never been more fun! Ages 11-18. HiTech is funded in part by a National Leadership Grant for Libraries from The Institute of Museum and Library Services. Visit hclibrary.org/hitech_events. Registration is required. Register online or by calling 410.313.0760. Offered again on Aug. 19 at 2 p.m. , Aug. 20 at 2 p.m., Aug. 21 at 2 p.m., and Aug. 22 at 2 p.m.
Monday, Aug. 25, 7 p.m.I’m Going to be a Big Brother or Sister. In partnership with Howard County General Hospital: A Member of Johns Hopkins Medicine. A Well & Wise class. Come to the Central Branch to prepare for the arrival of a baby in this class for new siblings. Enjoy stories, activities, and bring a favorite doll or stuffed animal to practice holding your baby. Resources for parents, too. Families; 30 – 45 min. Ticket required.Limited space; tickets available at Children’s Desk 15 minutes before class.
Tuesdays and Thursdays, Sept. 16 to Nov. 6, 6:30 – 8 p.m.Healthy Weight Connection. Kick-start individual lifestyle changes, including diet and exercise, to help you reach a healthier weight. Receive personalized guidance from a certified dietitian. Various nutrition topics and gentle yoga. Class held in the Howard County General Wellness Center. Cost is $195. Register online or call 410-740-7601.
Monday, Aug. 4, 6:30 p.m. Move with Games at Elkridge Branch – a Well & Wise Class. Exercise while competing with friends on the Wii or XBox Kinect. Healthy snack provided. Ages 11 – 17. No registration required.
Monday, Aug. 4 & 18, 3:30 p.m. – 5:30 p.m. Blood Pressure Screening at Glenwood Branch – a Well & Wise Event. Free, walk-in blood pressure screening and monitoring offered by Howard County General Hospital: a Member of Johns Hopkins Medicine. Also offered, Tuesday, August 12, 1:00 p.m. – 3:00 p.m. at Elkridge Branch. No registration required.
As we approach Mother’s Day, our gift to you is a primer on heart disease and women. According to the National Heart, Lung and Blood Institute (NHLBI), one in four U.S. women dies from heart disease.
Coronary heart disease, or atherosclerotic cardiovascular disease, occurs when plaque builds up in artery walls, narrowing them and making it harder for blood to flow through. If a blood clot forms, the blood flow can stop and cause a heart attack.
Signs and Symptoms
“Women tend to think of themselves as caregivers, but they also need to be care getters,” stresses Lili Barouch, M.D., a Johns Hopkins cardiologist on staff at HCGH. “Women should not ignore their symptoms, even if they don’t seem typical, because women with heart disease get a wider variety of symptoms than men. Although ‘classic’ heart disease symptoms include chest pain radiating down the left arm at rest or with exercise, women may only experience more atypical types of chest discomfort such as squeezing, burning or tightness, or even have no chest discomfort at all. Their ‘chest pain’ may feel like indigestion or acid reflux, nausea, cold sweats or they may only have shortness of breath. Women and men with diabetes often do not experience chest pain due to diabetic nerve damage; rather, they may just feel short of breath, nauseous and sweaty. If you aren’t sure, or if you sense something is wrong, see your doctor.”
“In general, women have the same risk factors as men, but they may affect women differently from men,” says Dr. Barouch. “There are several risk factors for heart disease—including those you can’t control and those you can.”
Age and menopause. Estrogen provides women with some protection before menopause, so women who are 55 and younger have a lower risk compared to men. However, the risk for heart disease increases in both men and women after 55.
Women who undergo early menopause (before age 46) are at an increased risk.
Family history. Your risk for heart disease increases if your father or a brother was diagnosed with heart disease before 55 or if your mother or a sister was diagnosed with heart disease before 65. A family history of stroke—especially a mother’s stroke history—also can help predict the heart attack risk in women.
Preeclampsia during pregnancy, which occurs when women have a rise in blood pressure and excess protein in the urine.
High cholesterol and triglyceride levels
High blood pressure
Birth control pills
Weighing In on What Matters Most
“It is more important to be fit than thin. Even if you don’t lose weight, exercise improves cardiac efficiency and lowers blood pressure, blood sugar and cholesterol,” says Dr. Barouch. “Start by exercising at least three days a week and see what you can do comfortably. Don’t push yourself to exhaustion, or you will not sustain it. Pick a moderate exercise that you enjoy; once it becomes a habit, increase your time until you get to the goal of 30 minutes or more of exercise each day.”
According to NBLHI, inactive people are nearly twice as likely to develop heart disease compared to those who are physically active. In addition, a lack of physical activity can worsen other heart disease risk factors.
“None of us are prepared for a family member or friend to have a stroke. We end up relying on the skills and experience of a whole team of people. It is phenomenal that HCGH has a designated stroke center just 10 minutes from our home. We got the best therapy from wonderful people who are a part of our community.” – Claire Cohen, Clarksville, Md.
The HCGH Stroke Program has demonstrated higher standards for care, thus increasing recovery for many stroke patients. The Maryland Institute for Emergency Medical Services Systems (MIEMSS) has designated HCGH as a primary stroke center for the State of Maryland, which means that our treatment of stroke patients is monitored and measured.
HCGH is ready to treat stroke, any time of night or day. A special protocol is initiated the moment Howard County Emergency Medical Services (EMS) calls the hospital with a potential stroke victim. While EMS transports the patient, the hospital team prepares. Within minutes of arrival at the hospital, a physician assesses the patient, blood is drawn for lab work and a CT scan of the brain is conducted.
Sobering National Stroke Statistics from the American Heart Association
Someone has a stroke every 45 seconds in the United States.
Only 20 to 25 percent of patients admitted to the hospital with a stroke arrive within three hours of the onset of symptoms, the “critical window” for treatment of certain strokes.
Less than five percent of patients in the United States receive thrombolytics, a critical treatment for some strokes.
Eric Aldrich, M.D., Ph.D., vice president of Medical Affairs and a neurologist who was instrumental in refining HCGH’s stroke program, believes that we must treat stroke according to the latest guidelines. A patient’s family can help ensure their loved one gets the best care. Dr. Aldrich explains, “I can’t emphasize enough the importance of calling 9-1-1 to get a head start on treatment. First responders begin treatment in the field and gather critical information about when the symptoms began.
“Our physicians can then diagnose and determine whether to administer thrombolytics, also known as tPA or clot-busting drugs. (Theses drugs are used in ischemic strokes, those caused by a blood clot, but not in hemorrhagic strokes, those caused by a bleed.) According to the National Stroke Association, carefully selected patients who receive these drugs within three hours from the onset of symptoms are 33 percent more likely to recover from their stroke with little or no disability after three months.” Dr. Aldrich adds, “Our focus is getting lifesaving, brain-saving care to patients within the critical three-hour window.”
(l. to r.) Susan Groman, RN, stroke program coordinator, laughs with Claire Cohen, Jose Maldanado and Jerry Cohen at a recent stroke support group.
Treatment at HCGH continues beyond diagnosis and acute care. According to Susan Groman, R.N. Stroke Program coordinator, HCGH encourages stroke patients to receive individualized rehabilitation services, including physical, occupational and speech therapy, for at least 24 months following a stroke. Stroke survivor, Jerry Cohen, began the program in 2010 and continues to benefit from what was learned from his therapists. “The team is excellent, they really know their business,” Jerry’s wife, Claire Cohen, says. “Best of all, physical, occupational and speech therapies are in one location, which makes scheduling back-to-back appointments easy. Transportation can be a huge issue, so convenience is key.” Today, Jerry is much improved. “The old myth was that after 18 months, there is little progress, but for everyone in this stroke group the progress continues,” says Claire. “We were told my husband would never be able to walk. He is walking. He came out of the hospital on a ventilator and a feeding tube. Now he can walk into a restaurant and enjoy normal food with family and friends.”
A monthly stroke support group is described by many patients and caregivers as an essential part of recovery. “The group is extremely helpful and is part of our routine,” Claire says. Group members are all ages and Claire notes that, like her, a number of caregivers are still working. Susan says; “Everyone is welcome, patients and caregivers alike.” Claire believes a diverse group is important. She says, “All strokes are different, they affect patients and families uniquely, but when you gather together in a supportive setting, there is much similarity. We discuss clinical trials, legal issues, home modification, transportation resources and how to find respite care. We share concerns and work together to find solutions.”
Education is also a part of the Stroke Program. Susan says, “We know that by teaching people the symptoms of stroke and the importance of calling 9-1-1 we can make a difference. Most of my patients wish they had called 9-1-1 sooner.”
Susan and her husband, cardiologist George Groman, M.D., have a commitment to stroke and emergency care in Howard County. Susan explains, “I’ve been an emergency nurse and a caregiver to aging parents and in-laws – so I know firsthand how valuable timely emergency treatment and rehabilitation are to a patient’s recovery and quality of life. Knowing this care exists can also give peace of mind to caregivers.”
Signs of Stroke Every minute counts, so act FAST when you see these signs:
Face – Droopy face on one side? Ask the person to smile.
Arms – Weak or numb arm? Ask them to raise their arms. Does one drift down?
Speech – Slurred speech? Ask them to repeat a simple sentence to see if they can.
Time – If the person shows any of these symptoms, call 9-1-1 immediately.
The HCGH Stroke Program recently received the American Heart Association (AHA) “Get With the Guidelines Stroke” Gold Quality Achievement Award. To learn more about our stroke support groups, call 410-740-7601 or visit www.hcgh.org/stroke.
Dr. Groman explains more about symptoms and treatment for stroke in these videos: