HeartBeat
Pacific
NEWSLETTER
Volume 18 Number 2
December 2004
"POST-OPERATIVE CARDIAC CARE" by Dr.
Vicki Bernstein, MD
Thank you for asking me to contribute to the Pacific Heartbeat
Newsletter. As everyone knows there are four hospitals in British
Columbia that do open heart surgery. The three hospitals in
Vancouver are the Vancouver General Hospital, St. Paul's Hospital
and Royal Columbia Hospital; the fourth hospital is in Victoria and
that is the Royal Jubilee Hospital. It takes a very experienced and
skilled team required to treat patients with advanced heart disease
who undergo open heart surgery. The team is made up of surgeons,
anaesthetists,
cardiologists,
critical
care
nurses
and
physiotherapists. There are also other very important members that
make it possible for the ward to run smoothly and they are the
social workers and pharmacists.
I am the cardiologist that directs the care of all the patients that
undergo surgery at the Vancouver General Hospital and I would
like to share with you my daily work in running this unit. As you
will see it is a very demanding but rewarding job, which I enjoy
despite the many challenges that each day brings. My morning
starts with a brief discussion with the nursing supervisor as to the
problems encountered by the previous evening staff. They inform
me of the number of patients needing discharge provided that they
are medically stable and it is possible to get them home. As you can
understand there has to be flow in the system and if cardiac surgery
ICU cannot transfer patients to the. ward then it may be difficult to
get the patients from the operating room into the ICU. Thus there
are occasions when our bed situation is so tight that surgeries have
to be cancelled and this is done always with great regret.
Part of the morning is getting the discharge books and
prescriptions ready for patients who are ready to leave the hospital.
This is an important task as the books are taken home by the patient
containing documents outlining the procedures, medications and
latest investigations that have occurred during the hospitalization.
This book gives the family doctor and referring cardiologist much
of the information that they need to continue care of the patient
after discharge. Some drugs that were taken prior to surgery are
discontinued for a variety of problems, mainly due to low blood
pressure and sometimes due to renal impairment.
Thereafter a full ward round takes place where all patients are
examined and new orders are written. The
most frequent problems that are encountered early postoperatively
are arrhythmias and heart failure. Arrhythmias (palpitations),
mainly atrial fibrillation is very common and can occur in up to
30% of patients undergoing bypass surgery and as high as 60% in
patients undergoing valve replacement with or without bypass
surgery. This can be treated very effectively with the administration
of intravenous medication, usually beta blockers and occasionally
calcium blockers and Digitalis.
The next challenge is that of patients who develop heart failure
during surgery. This is not unexpected in many situations where
heart function has been reduced prior to the surgery. The
cardiologist's role is to institute diuretics and medications to help
support the heart. Ward rounds on 16 - 20 patients usually take 4 to
5 hours. I then go to my office where I do an afternoon of outpatient office practice and return after that to the ward to check for
any new arrhythmias or answer some of the concerns that the
nursing staff may have.
I have an important message to anyone who has undergone
open heart surgery: I would not be doing an adequate job as a
cardiologist if I don't try to persuade many patients to change their
life style. Open heart surgery is not curative as some surgeries can
be. It is really palliative care especially in those who have coronary
artery disease. Surgery definitely improves quality of life and in
some cases increases life expectancy but it does not mean that drug
therapy can be discontinued and even more importantly risk factor
modification ignored~ It is imperative that those that still smoke
quit, weight loss is very important and would help the diabetic
patients to improve glucose control and it also assists in good blood
pressure management and reduction in cholesterol. Unfortunately
coronary artery disease continues even when improvement in risk
factors is undertaken. However, the progression of coronary artery
disease affecting other coronary vessels or the bypass grafts
themselves may be reduced by aggressive medical therapy with the
use of the statins, ACE inhibitors and risk factor modification.
I send a personal message to all the wonderful volunteers who
I see on the ward giving their valuable time encouraging and
counselling the patients in the unit. They should all be
congratulated and sincerely thanked for their time that they devote
to this important service.
Happy Christmas and New Year to you all and I hope
everyone remains healthy and do not give us too many further
challenges.
net. You all know who you are, and it wasn't me!
As you know, your golf committee is always looking for new
This will be the last time I have the honour to wish you all, as venues throughout the province. We have decided to keep the
president, a Happy Holiday Season and a very good New tournament on the lower mainland for 2005, possibly at
Year in 2005.
Burnaby Mountain Golf Course, but we have a few more
I became president of the Pacific Open Heart Association
proposals to look at. What do you think?
after the Annual General Meeting in February, 2001. I have
Our heartfelt thanks go out to our hole sponsors without
thoroughly enjoyed the position. I was blessed with a very
whom it would be difficult to put on this annual celebration:
effective Board of Directors to work with, and as a result I
Brown Bros. Ford (Vancouver), G &: F Financial Group
think we can look back on a number of worthwhile
(Burnaby), Garton &: Harris (Lawyers, Port Coquitlam),
achievements like an expanded visitation program and the
Heart &: Stroke Foundation (Vancouver), North Shore Credit
formation of the Sun Run Zippers team Of course the Board
Union (Burnaby), Pharmasave (Ocean Park), ScotiaMcLeod
continues to be proud of the teams of visitors who provide
support to open heart surgery patients at Vancouver General, (White Rock), UniPHARM Wholesale Drugs (Richmond) .
Perhaps I had better explain something here. The idea of this
St. Paul's and Royal Columbian Hospitals. ,
However I plan to step down after the 2005 AG.M. and tournament is not to make a lot of money (strange, you say)
become an active past president. It is in the best interest of but to show that there is good life after open-heart surge~ and
any organization for a different person to occupy the chair to gather together as many Open-Hearters as possible so as to
every few years. I started my term as president with a few share our experiences and our successes. I know there are
ideas that I wanted to pursue. Nothing would have been more golfers out there so please ask us for a 2005 Golf
possible without a hard working Board. In addition, the Board Tournament Package and come and join us next year. Also, I
had the sense to convince me that some of my "good" ideas want to thank all those who donated prizes which were
were not really worth the effort, and to substitute some others enjoyed by all.
A brief note to mention the passing of Jim Tough. 2004 would
that made more sense.
.
- For the third year we are the grateful benefactors of a have been his 19th POHA golf tournament. He was
donation of money from the Founders' Cup Foundation, This remembered and missed.
foundation is made up of a group of community minded The members of the golf committee are looking forward to
individuals, who sponsor a very successful golf tournament meeting all POHA golfers, both current and new, in 2005. In
each year and donate the proceeds to worthwhile the meantime, seasons greetings and stay in good health.
organizations. Their Board has been impressed with the Swing easy, hit hard.
Geoff Mook -- kddgm@telus.net
POHA support role- and especially the fact that all of our
Moe Pitcher -- 604-683-1514 or 604-738-6629
work is performed by unpaid volunteers who bear any
expenses themselves. These donations have eased the pressure
on our Treasury, and allowed us to further expand our
services. Five members of the ~O.H.A golf committee served
as volunteers at the Founders Cup Tournament including
myself, Moo Pitcher, John Pistawka, Ed Wittal and Patti
Bronson
I want to take this opportunity to thank you for the privilege
of serving as president of the ~D.H.A. and I want to wish all
the best to the new Board that will be formed in 2005.
Mike Martin
PRESIDENT.S MESSAGE
POHA GOLF
One of the hardest things to write is an article for a golf
tournament when it rained all day; However despite the
weather, I think most people I talked to enjoyed the POHA's
20th annual golf tournament. We had 52 golfers and 73 for
dinner -- you all deserve a medal.
I'm not going to mention all the winners: who won the longest
drive, nearest to the pin, low gross, and low
(Left to right) Cullis Lancaster, Lloyd Williams, John McCuaig, Dick
Weller.
Pacific Open Heart
Zippers
PACIFIC OPEN HEART ZIPPERS
Calling all runners, walkers, amblers, or just anyone looking for a
bit of healthy exercise, fun and food. The 21st Vancouver Sun Run
is coming up on April 17, 2005, and we are looking for people to
join our Pacific Open Heart Zippers team. Sun Run 2004 was the
first time POHA entered a team in the Corporate Team Challenge.
We didn't have a lot of time to organize, but we were able to enter
18 participants, 7 of whom were open-hearters, the rest being family
and friends.
This year we'd like to at least double the size of our team. Here's
some information for you to consider:
The SunRun is a 10 kilometer course through downtown
Vancouver, Stanley Park and the west end, over the Burrard Street
and Cambie Street bridges, ending at BC Place Stadium.
YOU GO AT YOUR OWN PACE, and do your own distance. Our
most enthusiastic participant this past year, Reg Phillips, who now
has done 10 SunRuns (and is 77 years young), has figured out the 3
and 5 kilometer distances, for those who may want to do a shorter
walk/run, rather than the full 10 km.
The Vancouver Sun publishes an excellent training schedule in
January which can be used to prepare for the event.
You should have the blessing of your doctor or Cardiac Rehab
program before you embark on a training regime if you haven't been
walking or running since your open-heart surgery.
The entry fee as part of the team is $32/ until the middle of
February, and afterwards $37. The fee includes a T-shirt sporting
our very own "Zippers" logo on it.
As we did last year, we will plan on a post-run brunch at the Shark
Club or another nearby grazing facility to meet other team members
and swap stories.
We welcome POHA members, any other open-hearters, and any
friends, family members, or others who are interested in supporting
our Zippers team.
If you wish to join the Pacific Open Heart Zippers at the Sun Run
on April 18, or would like more information, please contact Kathy
McAuliffe by-email at kathmC@shaw;ca or call the POHA
telephone number, 604436-9005.
Betty Topp and John Pistawka
2004 DON TOPP TROPHY
We should thank the family of Don Topp for initiating, years ago,
this trophy; It is awarded each year to a person who has donated a
great deal of time and effort, for the good of the Pacific Open Heart
Association. The Board of Directors appreciate this means of
recognizing a worthy individual each year.
This year the award was made to John Pistawka. John has been an
active member of the P.O.H.A. since the time when we were a
branch of the First Open Heart Association which continues to
operate out of Victoria. John was one of the people who
spearheaded the formation of the P.O.H.A. as a separate entity
when we became registered as a non-profit society under the
Society Act of B. C. At that time he was on the first Board of
Directors. He returned to the Board four years ago, when we had a
desperate need for people to fill that role.
John, often accompanied by his wife Eunice, was an active visitor
for many years. He is an ardent golfer and has played in nearly
every one of our 20 golf tournaments. In addition he has been a
regular member of the golf committee. Again, Eunice has attended
most tournaments and worked hard at each one.
The Board wishes to congratulate John as a deserving recipient of
the Don Topp trophy and to thank both he and Eunice for all their
diligence in supporting the P.O.H.A year after year.
(Left to Right) Stan Vyse,
John Pistawka,
John Sutherland, Nina
Henriksen, Mo Pitcher
P.O.H.A. ANNUAL MEMBERSHIPS ARE DUE
The membership fee of $10.00 is now due to cover the
period from January 1 to. December 31. Please complete
the application form and mail it or bring it with you to the
Annual General Meeting on February 19th, 2005
~
Coming Soon...
The POHA will soon be providing "Live" answering on our
phone line 604-436-9005. In addition our website will be
updated early in 2005.
DONATIONS TO THE P.O.H.A.
The following points may be useful to members and non.
members alike:
As a registered non-profit society, any donations made to the
Pacific Open Heart Association will be acknowledged by an
official receipt and are tax deductible.
P.O.H.A is listed as recognized recipient of donations by the
United Way. Donors can direct that their donations be
sent to the Association and a receipt will be issued by
the United Way.
If you are puzzling over where to send your charity dollars
please be assured that any donation you send the P.O.H.A
will be placed directly into the operation of our visitation
program.
--- -~ ~
€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€~
VOLUNTEER VISITORS NEEDED
In order to keep our visitation program working efficiently in
Vancouver General, St. Paul's and Royal Columbian Hospitals the
P.O.H.A. always have a need for new volunteer visitors. If you are
able to spend 2 to 4 hours each month to visit patients in one of the
hospitals, please phone Mike Martin at 604-535-3195. He will be
happy to tell you more about this very rewarding opportunity to.
give support to fellow heart patients.
"Even if it's a little thing, do something for those who have need of
a person's help something for which you get no pay but the
privilege of doing it. For, remember, you don't live in a world all
your own. Your brothers are here too."
-Albert Schweitzer Nobel Peace Prize Winner, 1952
MEMBERSHIP REQUEST
Name
Address
City
Postal Code
Phone
I am interested in becoming a volunteer visitor: Yes
I am interested in other volunteer opportunities with POHA: Yes
Please send me a Golf Tournament Package
Membership Fee is only $10.00 per year.
Membership: Jan 1 to Dec 31
HEART TRANSPLANT HOME SOCIETY
SPRING FUND-RAISER
LOCATION: LEGENDS PUB (Corner of Buswell
and Cook Roads in Richmond)
DATE: Feb. 12th, 2005
TIME: 7:00PM
COST: $15 which includes a meal and a glass
of beer, to be followed by an auction of
house wares, furniture and artwork
ENTERTAINMENT: 9:00pm
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~<
~
PACIFIC HEARTBEAT NEWSLETTER
is published by the P.O.H.A.
P.O. Box 3979 MPO, Vancouver; B.C. V6B 3Z4
'Telephone: 604-436-9005
Editor: Bill Turpin Assistant Editor: Mike Martin
The POHA acknowledges the generous support of the
Founders Golf Cup Foundation in the production of this
newsletter.