Crossville Chronicle, Crossville, TN

February 7, 2013

Women urged to take charge of their health

By Heather Mullinix
Assistant editor

CROSSVILLE — Two Crossville women knew they needed to keep a close eye on their hearts and would eventually need surgery to correct abnormalities. Even so, both were surprised when those days came about.

Jennifer Tabor had been diagnosed with an aortic valve insufficiency when she was 15. The busy mother of five and director of Cumberland Medical Center's Senior Perspectives program had kept regular appointments with Dr. Vianney Villaruz for several years, but as her family grew and her commitments filled her calendar, she said she became lax about those regular appointments.

"One day, I noticed I needed to have my roots touched up," Tabor told the crowd at the annual Go Red for Women luncheon at CMC. "I decided to take a sick day and get my hair done and swing by the cardiologist's office for a quick check."

She was asked about shortness of breath and fatigue, both of which Tabor attributed to her busy life.

"He asked if my feet and ankles swelled. I said, 'Well, whose doesn't?'" she said.

More tests were ordered and the surgery Tabor had known she'd have to have "one day" was scheduled. At first, she wanted to delay the surgery until the summer when her kids would be out of school, but tests showed an aneurysm on her aorta.

"He said, 'No, we won't be waiting on that. We're going to schedule this around when you need it done,'" Tabor said.

Tabor encouraged women to take the time to take care of themselves and not to ignore symptoms.

"I thought it would never happen to me, and I knew for 20 years it was happening," she said.

She underwent aortic valve replacement at Vanderbilt Medical Center, choosing a bio-mechnical device that may one day need to be replaced but that would allow her to remain active and enjoy the activities she loves, such as skiing.

Her kids got her up and moving after the surgery, encouraging her to keep going. She then went to CMC's Cardiac Rehab program but worried about completing all 36 sessions. She found they were happy to work around her schedule.

Carolyn Steves underwent surgery in October to replace her aortic valve after years of watchful waiting. Since then, she is amazed at the changes she's seen in her own health.

"I no longer lose my breath when I walk down to the mailbox," she said. "I no longer have the chest pain or the pain in my left arm."

Steves' journey to heart surgery began 20 years ago with a misdiagnosis of mitral valve prolapse, followed by another cardiologist saying the tightness in her chest was just nuisance chest pain. After a move from Tampa to Sarasota, a trip to her primary care physician found her seeing another cardiologist for a possible heart murmur.

She didn't have a heart murmur. Instead, the cardiologist found her aortic valve was calcifying, a condition called aortic stenosis. It was the same condition her father had been diagnosed with in the 1980s.

The calcification would get worse over time, but medical innovations had developed new treatments that were advancing all the time. Steves' cardiologist suggested watching the condition closely and waiting on surgery until the disease had progressed.

As Steves was preparing to move to Tennessee in May 2012, she visited her cardiologist who told her the latest echocardiogram showed it was time to consider surgical intervention and recommended she find a cardiologist soon after her move. She found Villaruz. A heart catheterization in July confirmed it was time for the aortic valve to be replaced and Steves was referred to Vanderbilt Medical Center for the October surgery that replaced her valve with a bovine valve. Her mitral valve was also checked and was found to be normal.

After she was released from the hospital, she was referred to CMC's Cardiac Rehabilitation program.

"It's the best thing since Vanderbilt," Steves said. "The staff is phenomenal and I made a quick recovery."

They were happy to answer her many questions, which Steves believes is important when talking with physicians.

Dr. Amanda Grubb, hospitalist at Cumberland Medical Center and medical director of clinical effectiveness and medical affairs for the hospital, is also wife to Dr. Chad Halford and mother to Brooke, 2 and 1/2 years old.

"I love being a wife and a mother and a busy career woman, but let's face it, women are very good at taking care of others, but not so good at taking care of ourselves," Grubb said. "If you run full speed ahead without stopping for water, you lose momentum to finish the race."

Heart disease is the number one killer of American women, claiming a life every minute. In fact, more women die of heart disease than from all forms of cancer combined. Another 43 million women are living with heart disease. More women than men continue to be diagnosed with heart disease.

In 2004, faced with growing rates of women dying of heart disease, the Go Red for Women campaign launched to educate women and raise awareness of how heart disease affects women. More than 1.5 million women have joined the movement in the past 10 years, and 34 percent fewer women are dying of heart disease each year.

The American Heart Association offers Life's Simple 7, seven steps that can lead to better health and a reduced risk of heart disease. These steps include adding physical activity, managing weight, lowering blood sugar, quit smoking, eat better, control cholesterol and manage blood pressure. Though not one of the Simple 7, Grubb added stress management is also recommended.

"Stress takes a huge toll on our lives. It can cause aches and pains and headaches. It can cause ulcers in our stomachs. It can cause emotional instability, depression and irritability and fatigue," Grubb said.

Grubb recommended women find ways to deal with the stress in their lives through talking with friends and family for support, exercising, laughing, getting enough sleep and staying organized. Women should also come to accept there are some things they cannot change and try not to worry. Giving back to the community and slowing down also help reduce stress.

Small changes are recommended when implementing a healthy eating plan. Grubb said just adding two servings of fish each week can have dramatic impacts on health. Adding more fiber helps to control cholesterol. For activity, adults need to get at least 30 minutes of activity five days a week. These sessions don't have to be all at once, Grubb said, but combined daily activity of 10 minutes each would also make an impact.

A healthy diet and active lifestyle can help to control weight, which is important because obesity alone is a risk factor for heart disease. Grubb recommends becoming familiar with individual calorie needs by talking to a primary care physician or using numerous online resources. Women also need to take note of their Body Mass Index, calculated from body weight and height.

Women need regular cholesterol screenings because too much bad cholesterol forms plaques on arteries and veins and lead to heart attack and stroke. To help control cholesterol, add fiber to the diet and choose foods low in cholesterol, trans fats and saturated fats.

Lowering blood sugar can be achieved through reducing consumption of simple sugars, like those found in soda, candy and sugary desserts, and through adding regular physical activity to help the body respond to insulin. Those with diabetes should take their medication or insulin as directed.

A healthy blood pressure also key, with new recommendations calling for a blood pressure of 120 or less over 80 or less. Many people are unaware they have high blood pressure because they have no symptoms, but 90 percent of Americans will develop high blood pressure at some point in their lifetime.

Giving up smoking provides tremendous health benefits, and many take place soon after putting down the cigarettes, the lungs start to heal and are comparable to a nonsmoker after one year.

"Many people say they smoke because of stress, but smoking is going to add to stress by taking away good health," Grubb said.

The resources available at Go Red for Women, www.goredforwomen.org, can help women to make lifestyle changes that will reduce their risk of heart disease. Of those who joined the movement, 89 percent made at least one healthy change in their life, with 61 percent beginning to eat healthier, 54 percent starting exercising, 43 percent checking cholesterol and 37 percent losing weight.

To learn more, visit www.goredforwomen.org.