MEDICINE&SCIENCE
More at their own care.
Heart failure occurs when the heart can’t pump enough blood and oxygen to support the body’s organs. It leaves patients breathless and weak. They also may gain weight and their legs, feet and ankles may swell. Smoking, eating too much salty and fatty foods, being obese and having a sedentary lifestyle all increase the risks for heart failure.
The condition afflicts 5.7 million U.S. adults, according to the Centers for Disease Control and Prevention. Half a million people are diagnosed with the condition each year. About half of people with heart failure die within five years, according to the CDC.
Freeman’s mother, Ethel Freeman, died of heart failure in 1987 at age 67.
“It makes it personal to me,” said Freeman who lives in Forest Park in Northwest Baltimore. “In those days, we didn’t know as much as we do now about heart failure.”
With medication, and a healthful diet and lifestyle, her patients may survive 30 to 40 years with heart failure. But they must limit the amount fluids they drink because too much fluid increases their body weight and requires their heart to work harder, Freeman said. Ignoring her orders leads to repeat “frequent flier” visits to the hospital.
Heart failure costs the nation an estimated $30.7 billion a year, according to the CDC.
“Every hospital or clinic across the nation has a problem with patients who have congestive heart failure being readmitted within 30 days,” Freeman said. “We need to come up with something to interrupt this cycle.”
She runs a weekly class to encourage heart failure patients to live healthier lives. The condition is especially common in aging and sedentary veterans, but a 39-yearold man arrived with the diagnosis this year.
“I’m working on him,” Freeman said. “It used to be over 65, but it’s hitting younger and younger, mostly because of their diet and lifestyle. Most meals used to be cooked in the home. Now with latchkey kids and both parents working, kids are eating in McDonald’s, and the kids are playing video games, and they’re not as active.”
The VA had supplied veterans who suffered congestive heart failure with monitors to track their blood pressure, fluids and exercise. These monitors submitted updates to doctors through landline telephones, but they weren’t practical for busy people with day jobs.
“They can’t be sitting at home attached to this machine,” she said. “I needed a mechanism to be able to capture some of the younger patients.”
Freeman’s app is being designed by Devin Harrison, an innovation coordinator with the VA. He estimates it will take one to two years. He’s also developing an app to help doctors treat patients with bedsores.
The heart app will be piloted at VA offices in Maryland then offered to veterans across the country. It will track diet, blood pressure, weight, exercise and medication, and send all the data to doctors for review. It also will empower patients to track their own habits.
“We need to make them active participants in their care,” Freeman said. “We can’t afford to be frustrated. We have to keep giving these patients information until we move them to a place where they buy in to what we’re telling them.”