TMC Cardiac Rehab fundraiser is the most successful yet

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After having some stents put in his heart, Derek Rowsell was enrolled in TMC’s Cardiac Rehab – an environment in which clinical staff monitored his heart rhythm and physiological responses while making sure he was properly executing his exercise plan under the umbrella of safety and close supervision. Lucky for him, after his procedure, the great medical insurance he had through his employer picked up a good chunk of the tab. For many others, the bills that come in are added stress at the absolute worst time.

Each visit costs upwards of $250 for cash-paying patients. Typically, insurance picks up about 80 percent of the tab, but oftentimes patients are still required to fork over a hefty co-payment. Many patients still have to come up with $45 for each visit. Multiply that by the 36 visits most patients need, and that’s more than $1,600 each patient has to come up with in order to complete the program. For many folks who are retired and on a fixed income, oftentimes it’s just not feasible.

“You’re already worried about how you’re going to recover. Then to have to figure out how to pay for cardiac rehab – some people really struggle,” Rowsell said. Now considered a phase III patient, he attends cardiac rehab two to three days a week to maintain the cardiovascular progress he’s achieved. He’s also part of Friends of Cardiac Rehab, a group of patients who use TMC Cardiac Rehab as well as families, friends and health professionals interested in cardiac rehabilitation services. Many are long-time survivors of cardiac disease and provide living examples of the benefits of maintaining healthy hearts through exercise, lifestyle changes and reduction of risk factors.

“Everybody in the FOCR group is a patient or a former patient. We’ve all gone through TMC Cardiac Rehab. We’re all aware of how important it is and how much it lifts you up emotionally. We’ve all chosen to stay here. When we come, we are among friends and have developed a culture of safely exercising with people we know,” explained Rowsell.

Three years ago, a group within FOCR formed a fundraising committee to specifically create a scholarship fund to help patients in need. Their idea for a family-friendly event: a bowling tournament.

Each year, it’s held at Lucky Strike Bowl on a Saturday in September.

This year, FOCR raised more than $5,000 from this annual event! In the three years since the bowling fundraiser started, FOCR has raised almost $11,500 dollars for the scholarship fund.

“Without their contribution, we absolutely would not have a scholarship fund,” said Mark Gaxiola, supervisor, Cardiac Rehabilitation. “The group is entirely made up of volunteers. Through their efforts and their compassion, they are able to help patients who have a real financial need. This year alone, 35 patients were able to receive a cardiac rehab scholarship.”

Patients who demonstrate a financial need can receive up to $500.

Rowsell added, “It’s all about more people and more involvement each year. Helping anyone is satisfying. But when you know you’re helping patients who really need it, you get a little extra gratification.”

Vital response: Why one family is especially grateful for TMC’s cardiac services

Nadine Huddleston TMC TAVR patient

Nadine Huddleston
TMC TAVR patient

When Nadine Huddleston was diagnosed with aortic stenosis 15 years ago, she didn’t think much of it.  She was pretty tired, but chalked it up to old age.  “My pastor told me, ‘Nadine – no one ever died from a heart murmur,’” she said.  Aortic stenosis is a narrowing of the aortic-valve opening that restricts normal blood flow to the entire body.  It can cause heart failure and shortness of breath.  It’s a common public heart problem affecting millions of people in the U.S.  And it can be fatal.

Sure, she thought about getting it fixed.  But that’s where it stopped.  “I asked my doctor what he would have to do to fix it, and he said they’d have to cut me open.  I was not about to have that done,” she said. 

In August of 2013, as she was preparing for knee surgery, her cardiologist grew increasingly concerned.  The surgery would have to wait.  Her aortic stenosis had gone from bad to worse.  Luckily for Huddleston, medicine had really advanced.  Open chest surgery was no longer the only way to treat her condition.  “I was between a rock and a hard place because I wanted to do it, but I was frightened.  So when I found out they could take care of the problem without cutting me open, I was all for it,” she said. 

Tucson Medical Center is one of 250 sites in the country to offer the transcatheter aortic valve replacement, or TAVR.  During the procedure, physicians replace the valve by placing catheters in a patient’s groin or under their breast, instead of opening up the chest. 

Huddleston had her surgery in February of 2014.

Gary & Kathie Brauchla

Gary & Kathie Brauchla

At 85 years old, she describes her quality of life as “pretty good.”  For her family, it was the second big bullet they managed to dodge the past couple of years.  Huddleston’s son-in-law, Gary Brauchla, suffered cardiac arrest in his sleep.  His wife, Kathie, performed CPR, saving his life.  Brauchla ran a 5k eight months later, and has made it his mission to spread awareness about the importance of CPR and AED training.  He also visits cardiac patients at TMC who are just starting their journey, and is very active with TMC’s cardiac rehabilitation.

Huddleston is taking it easy, and will start cardiac rehabilitation when her cardiologist decides the time is right.  And when she does, she’ll have at least one familiar face there to walk her through it.

 
Please click here to read more about TMC’s Structural Heart Program including the remarkable story of Bill Marvin, one of TMC’s first TAVR patients.

Tucson Medical Center – now a recognized Atrial Fibrillation Center of Excellence

Tucson Medical Center is the first hospital in Arizona to be awarded Atrial Fibrillation Certification by the Society of Chest Pain Centers (SCPC), an independent, nationally recognized accreditation authority.  TMC earned this distinction by meeting or exceeding a wide set of stringent criteria, demonstrating its expertise and commitment to quality patient care.  The SCPC also conducted an extensive and objective review of TMC’s atrial fibrillation, or a-fib program.

A-fib is the most common cardiac arrhythmia, with an estimated one in four adults developing it.  In some cases it can lead to stroke and possible death. TMC cardiac electrophysiolgist Dr. Lionel Faitelson says, “The one thing that needs to be emphasized is the link between a-fib and stroke – particularly in Tucson, where we tend to have a population that is a bit older.”

TMC cardiac electrophysiolgist Dr. Darren Peress says, “This certification means that TMC is providing a recognized standard of care.  All of the physicians here are providing the same level of care.  We’re all practicing in a way that’s evidence-based, and that’s been recognized as good medicine.  Patients should know that if they come here, they’re going to get a full range of good care.”

TMC’s protocol-driven and systematic approach to evaluating and managing a-fib patients allows physicians to reduce time to treatment.  It also allows them to stratify patients by risk to decrease their length of stay in the emergency department and the hospital.  “This certification means that the process itself – of getting the patient into the hospital, and out of the hospital, has some uniformity,” says Dr. Faitelson.

The SCPC is a non-profit, nationally recognized accreditation organization.  It focuses on transforming cardiovascular care by assisting facilities in their effort to create communities of excellence that bring together quality, cost, and patient satisfaction.  SCPC’s goal is to help facilities evaluate and manage the a-fib patient more effectively, improve patient outcomes, and educate patients and health care providers to more efficiently care for this disease.

TMC has already been endorsed by the SCPC as an accredited Chest Pain Center.

Cardiac Medical unit reopens after facelift

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Earlier this fall, TMC closed down Unit 500, Cardiac Medical, to give it a makeover.  Over the years, the hospital has been closing one unit at a time in order to update them.

Patients began occupying the unit on Monday.

“The patients have expressed their gratitude and everyone loves the work that’s been done,” said unit manager, Joyce Drozd. “It’s very exciting. The place still has that ‘new car’ smell; it’s all shiny and new.”

The work includes new flooring,  repainted and textured walls, renovated bathrooms, updated lighting and more. For the staff, new space was carved out of storage areas, the lounge was enlarged and a consultation room was included for doctors to speak with family.

And at the top of the walls visitors will see a stylized TMC heart, artwork of the TMC CardioVascular service line, spaced out every 10 feet. As a cardiac unit patients may be just getting back on their feet,  so staff wanted an easy way to measure a patient’s progress and to make sure they don’t overdo it.

Cardiac Care — In a Heartbeat

Pan Langseth

Pan Langseth was enjoying a night with her family when she suddenly felt very ill. Rushed to Tucson Medical Center, it took only minutes before she made it to the team that would save her life.

“We were celebrating birthdays and I suddenly felt like I was going to faint,” she recalls, “The next thing I knew I woke up in TMC.” Langseth had complete blockage in four arteries, but thanks to TMC’s rapid “door-to-balloon” time, she bypassed a wait at the emergency department and was promptly wheeled into the Catheterization Lab Suite.

“She presented with probably the worst initial clinical situation of cardiogenic shock and respiratory failure,” recalls cardiologist Dr. Marius Wagner. Given her unstable condition and realizing the need for quick intervention, the ED physician alerted the Cardiac Team, which was ready and in place. Within 30 minutes of her arrival, her artery was opened and the balloon pump in place to support her heart.

“She was discharged four days later!” Wagner says. “Just 10 years ago, a similar condition had a 95 percent mortality rate within the first day. Those who survived the initial hospitalization died of heart failure within the next six months.” Langseth has recovered and is back to playing golf with her friends and enjoying life.

The door-to-balloon time, a core indicator of a hospital’s quality of care, is measured from the moment a chest-pain patient comes through the hospital door to when they undergo angioplasty. TMC’s average is 65 minutes, compared with a national standard of no more than 90 minutes. Physicians know, when it comes to the heart, any delays in treatment increase the likelihood of damaged heart muscle. This is particularly important in patients who have suffered heart attacks – the first three to four hours are critical to heart salvage.

TMC’s Catheterization Lab Suite, or “Cath Lab,” is a sophisticated technical area equipped to perform total assessments of heart function, including evaluation of coronary artery disease, and electrophysiology procedures. It is expertly staffed by a team of cardiologists, registered nurses and technologists 24 hours a day, seven days a week.

“I have worked at TMC since 1983,” says Wagner. “The Cath Lab is the finest one in the city. I, for one, bring most of my patients here.”

TMC has fostered a collaborative process among TMC cardiologists, heart surgeons and nurses – all working together to solve problems, improve quality outcomes and lower costs. “It is a unique environment. I think the collaboration encourages not only competition, which is very healthy, but also cooperation and learning from each other.”

Chest Pain Center wins national distinction for heart-saving protocol

When a patient comes to TMC with chest pain, a protocol goes into effect that ensures they reach the right physicians within precious minutes. It’s a heart-preserving, life-saving process, and a major reason TMC was named to the Thomson Reuters list of the nation’s top 50 cardiovascular hospitals for 2011.

“Patients presenting with chest pain will be assessed quickly for their immediate needs,” said Dr. Mark Goldberg, medical director of TMC’s Chest Pain Center, which was accredited in 2010 by the Society of Chest Pain Centers. “If the problem is acute, reaction time is rapid.”

The accreditation itself, which was essential to the Top 50 ranking by Thomson Reuters, proves TMC’s devotion to advancing patient care, especially in cardiac services. Heart disease remains the No. 1 killer of men and women in the United States. Chest pain can be enigmatic, but when it’s life-threatening, physicians know that time means both muscle tissue and life. In fact, the average time it takes a chest pain patient from entering the door to entering angioplasty at TMC is an impressive 65 minutes. The standard of care is 90 minutes.

“We work closely with EMS and are in communication when there is a 911 call for chest pain,” says Julie Ward, R.N., TMC’s chest pain center coordinator. “Some ambulance units are now able to fax EKGs here so we can activate the team prior to the patient’s arrival at the hospital to save even more time.”

For TMC, winning the accreditation for its chest pain center took synchronized work by cardiologists, nurses, pharmacists and hospital administrators. “Deciding to accredit the hospital as a Chest Pain Center meant that TMC, at all levels, was willing to put in the effort to improve systems vital for patient care,” says Goldberg.

Ward likens TMC’s goal for such an impenetrable system to that of the airline industry. “Airlines have taken the ambiguity out of their practices,” she says. “Everyone does the same thing, the same way, every time. And by doing this, they have made flying safer for thousands of people. We want to focus on that with heart care.”

Goldberg heralds the importance of a standard process. “Quality of care and outcomes improve anytime a hospital standardizes by implementing systems,” he says. “The prevalence of coronary disease makes it all the more important that diagnosis and treatment proceed in an accurate and timely fashion.”

The Path Back to Recovery for the Heart

Cardiac Rehabilitation Services at TMC

For professionals bent on improving the health of the community, it’s not enough to save someone’s life through angioplasty, bypass surgery, valve repair or stent replacement. Patients need a path back to recovery, and they need to learn how to maintain a healthy lifestyle that will keep their heart problems from recurring. That is the mission of TMC’s Cardiac Rehabilitation Program.

The 5,000 square-foot facility, located at the El Dorado Health Campus, offers state-of-the-art equipment – including treadmills, cross-trainers, recumbent bikes, row and Biodex machines – plus expert supervision and monitoring by a staff dedicated to helping cardiac patients move forward. “We provide a top-notch program from start to finish,” says Mark Gaxiola, supervisor of TMC’s Cardiac Rehabilitation Program. “Our goal is to first make sure the patient is safe. We utilize exercise and education as the primary interventions to improve the functionality of the heart and give the patient the ability to combat heart disease.”

Once authorized by a patient’s physician, cardiac rehabilitation can start in the hospital, as soon as the patient recovers from the acute phase of illness. Staff members educate the patient on coronary-artery disease, risk factors and important lifestyle changes. A prescription for home exercise and activities is also presented to the patient and family members at the bedside.

In the next phase, patients can attend one-hour exercise sessions at the El Dorado facility two or three times a week for up to 18 weeks. Sessions are vigorously monitored for heart rhythms and blood pressure, as the staff continues to tweak and adjust the intensity of each workout. Patients are ecstatic about their results, and many become life-long fitness enthusiasts.

A 2010 Mayo Clinic study of 2,400 stent-procedure patients found that cardiac rehabilitation reduced mortality rates by 46 percent! That’s results! “Improving patient health and quality of life through exercise is what our team lives for,” says Gaxiola. Unfortunately, while the services are beneficial, he says the El Dorado facility only sees about 30 percent of patients who could benefit. The problem? – Awareness. “I think the most important thing we can do as a department and hospital is to communicate the benefits and accessibility of cardiac rehabilitation services to our community and its physicians. We are here for you!”

Many patients who have seen the benefits firsthand have started a Friends of Cardiac Rehab program, under the auspices of the TMC Foundation. They help support the facility and bring more people through its doors. The group has already raised $30,000 for new equipment, and has a goal of putting a team together to ride in the annual El Tour de Tucson race. “They have supported us in so many ways,” says Gaxiola. “They volunteer their time and effort and help create awareness in the community for what we do and who we are.”


Tucson Medical Center | 5301 E. Grant Road | Tucson, Arizona 85712 | (520) 327-5461