Elvin Hammer is 81 years old and lives with two chronic conditions: diabetes and heart failure. In January, during his second stay at the hospital in five months for heart failure, he made a decision that would ultimately change his life – he became the first patient enrolled in Floyd Memorial’s new Heart Failure Outpatient Clinic.
The clinic, which opened in December of 2007, offers one-on-one consultation with experts who provide personalized therapy and develop individual treatment plans to improve the patient’s quality of life and reduce their chances of hospitalization due to heart failure.
Marla Estes, advanced registered nurse practitioner, was the first to meet with Elvin and his wife, Irene. “The goal of our first initial meetings was to keep Mr. Hammer out of the hospital. I saw him one week after being discharged from the hospital and his legs were swollen and he had what he described as a rattling in his chest. Once we got him over the hump and out of danger of being readmitted to the hospital we started working on his individual treatment plan.”
Initially, Estes and a registered nurse from the Heart and Vascular Center’s Cardiac Rehab Department focused on educating both he and his wife about factors such as sodium and fluid intake that increase the onset of symptoms. They also helped the couple to develop a clear understanding of all of Elvin’s medications, what they were prescribed for and when to take them.
“Diet is a huge learning curve for many of our patients,” said Estes. “Many think a lowsalt diet means not adding additional salt to your foods, but it really involves analyzing your diet and being able to identify foods that are already high in sodium.”
According to Hammer, the diet has probably been the hardest part. “My wife cooks all of our meals, so she is easing off of starchy foods, holding back on sodium and finding lower fat meal options.” Mrs. Hammer added, “Because he is diabetic, he can’t have sugar either so meals have been difficult.”
One of the most important components of the clinic is keeping the patient’s cardiologist informed. Cardiologist Mark Bickers, MD, referred Hammer for the program. “Dr. Bickers knows Mr. Hammer’s situation very well and we have been able to work as a team to improve his health,” said Estes. “This program is a collaborative effort and it is very important to the patient that we keep their referring physician up-to-date on their progress.” Estes is now seeing Hammer every two weeks compared to the once-a-week initial visits. “I am really impressed with him. He has done so much better since his last visit.”
And Hammer’s feeling toward the staff is mutual. “The staff is A-1. They were super in the intensive care unit and they are super here. I even called Marla one weekend and she was very nice and willing to help me out even though she was off.”