A “landing place” to manage heart failure - Cape Cod Healthcare

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Published on March 27, 2017

A “landing place” to manage heart failure

Bill Wrenn isn’t one to whine.

“I resist complaining,” the 87-year-old said. “I tough it out.”

But in November, Wrenn, who lives in East Sandwich, had a reminder that he can’t “tough out” everything. A bout of pneumonia landed him in Cape Cod Hospital. The pneumonia was on top of cardiac issues that had been creeping up on him since a series of heart attacks and double bypass surgery 30 years ago.

That made him a candidate for Cape Cod Healthcare’s new Heart Failure Clinic for patients whose hearts are not working as efficiently as they should. Heart failure affects 5.7 million people in the United States and kills more each year than cancer, according to the U.S. Centers for Disease Control and Prevention.

Among other issues, patients tend to retain fluid because the heart isn’t pumping enough blood to the kidneys and other organs.

Symptoms can include lack of energy, shortness of breath, swelling of the extremities, and rapid weight gain. The goal of staff at the Heart Failure Clinic, led by medical director Elissa Thompson, MD and based at the Cape Cod Healthcare Cardiovascular Center in Hyannis, is to manage symptoms and help patients lead as high a quality of life as possible.

For Wrenn, a former Episcopal priest who worked as a counselor at Babson College, that means walking along the Cape Cod Canal with his wife, Barbara Peterson, checking his bird feeders or working in his vegetable garden, and taking drives around the Cape. The clinic is a place where he can be up front about how he’s doing.

A Safe Landing Place

Both Wrenn and his wife were surprised at first that the Heart Failure Clinic was not traditional post-cardiac surgery rehabilitation focused on exercise and diet. That’s a typical reaction, according to Shannon List, MSN, FNP, the Heart Failure Clinic’s nurse practitioner. Then patients begin to understand the purpose.

“We’re more a medical management program for patients with heart failure,” List said. “It’s a spot where they can be educated about diet and lifestyle changes in addition to receiving the appropriate medication adjustments to keep them compensated.”

Clinic staff, for example, work with Dr. Thompson and the patient’s own doctors to manage and adjust medication. The goal is “giving them the highest level of health for the longest period of time,” List said. “We give them a landing place to manage heart failure.”

Wrenn still sees his cardiologist and his other doctors. But about every six weeks or so, he sees Joanne Sandrey, RN, a case manager for Helping Hands, Cape Cod Health Network, a group operated by Cape Cod Healthcare. She checks on medications, diet and how his symptoms – lack of energy or shortness of breath, for example – are affecting his lifestyle.

“They ask the right questions, particularly about salt,” Wrenn said. “It’s very relaxed and informative.”

See Beyond His Stoicism

His wife, also an Episcopal priest, likes that Sandrey made a home visit and that the clinic is “solution-oriented.” She also likes staff that seem to see beyond Bill’s stoicism.

“You have to be honest,” she said, looking her husband in the eye. “He doesn’t fib,” she said. “He’s just always, ‘fine.’

Peterson likes the holistic approach and Sandrey’s concern about her husband’s quality of life.

“For example, she was saying if he wanted to be more active there was a medication they were able to try.”

Wrenn likes the atmosphere of the clinic.

“I guess the thing that’s immeasurable is that there’s not a sense of being rushed,” he said.

Wrenn considers the clinic a safe place where even he could complain, if he were so inclined.