Fall/Winter 2014

Horse trainer survives heart attack at fairCaregivers work together seamlessly to save his life.By Maraline Kubik

Shake Danny Trent’s hand and you know immediately that he’s a working man, a hard-working man. His hands are worn, rough with calluses that come from 50 years training horses.

His face lights up when he talks about the horses he’s trained, especially Haha, the colt who won race #6 at the Canfield Fair.

Haha also won races in two other cities, but it’s Danny who may be the biggest winner. He survived what many people don’t — a heart attack that rendered him unconscious moments after settling Haha into his stall at the fair.

Danny, a resident of Delaware, Ohio, went to fill a bucket of water for his horse and doesn’t remember what happened next. What he does know is that if it weren’t for a team of healthcare providers who worked together seamlessly, he wouldn’t be around to talk about it.

He suffered a massive heart attack just outside the speed barn at the fair and collapsed.

“I been short of breath every once in a while, but I’d just sit down,” he says, explaining that he didn’t know

he had a heart condition. “I don’t go to doctors,” he says.

Two security guards saw him go down and rushed to help. They called for paramedics and started CPR. When paramedics arrived two minutes later, Danny had no pulse, no respiration. They shocked him

twice with an automated external defibrillator, started an IV and performed a 12-lead EKG.

The EKG transmitted critical information about Danny’s condition

to doctors in the emergency room at St. Elizabeth Youngstown Hospital, speeding his diagnosis so treatment could begin as soon as he arrived.

When the ambulance arrived at St. E’s, Danny was immediately taken to the cardiac cath lab where Dr. Wahoub Hout, a cardiologist/interventionalist, performed a cardiac catheterization that determined he needed heart bypass surgery. Danny had blockages in three of his major heart arteries.

The following morning Dr. Jeffrey Fulton, a cardiothoracic surgeon at St. E’s, performed a triple coronary artery bypass on Danny’s heart.

“I was afraid, but I knew I had to have it. I wasn’t going to walk out alive if I didn’t,” Danny says. Then, his voice rising and eyes opening wide, Danny adds, “These are one heck of doctors here on this hospital staff – they brought me back alive. Not too many people survive what I went through.”

Danny was released from St. Elizabeth Youngstown Hospital the Saturday after his surgery with plans to rest. “I can visit my horse; I just can’t do no work,” he smiled, grateful to be alive.

Danny Trent holds a teddy bear that all open-heart surgery patients receive. Patients hold the bear against their chests to help ease pain.

Heart to HeartYour resource for heart health

Proudly wearing matching red T-shirts, employees and friends of Mercy Health Youngstown raised a substantial sum for the American Heart Association when they participated in the annual Heart Walk this fall.

2 Heart to Heart Fall/Winter 2014

New Valve Clinic at St. Elizabeth Offers Team Approach to Patient CareSt. Elizabeth Youngstown Hospital is enhancing the care of heart patients by taking a team approach to their care. Thanks to a new Valve Clinic and new approach to care, patients can have their heart valve problems diagnosed during a single trip to the hospital.

“Historically, Mercy Health Youngs-town, formerly Humility of Mary Health Partners, has been the first to bring new cardiac procedures to the Mahoning Valley,” says Mariann Pacak, RN, MHHS, director of cardiac services at St. E’s. “With our new Valve Clinic, we’re once again bringing a first-of-its-kind service to the tri-county area.”

At the Valve Clinic, patients are seen by cardiologists and cardiothoracic surgeons who work collaboratively with other heart specialists and primary care physicians. The healthcare team uses echocardiograms and other tests necessary to accurately and quickly diagnose patients’ heart valve diseases.

NEW EQUIPMENT PINPOINTS

FAULTY SPOTS IN HEARTS

St. Elizabeth Youngstown Hospital recently installed new equipment in its cardiac catheterization (cath) laboratory that can more accurately pinpoint the location of problem spots within the arteries of your heart. Cardiac (heart) catheterization is a diagnostic procedure that uses special X-rays to view the arteries and chamber of your heart.

Catheterization helps doctors diagnose heart conditions like coronary artery disease, defective heart valves or congenital defects and provides important information about your heart’s ability to pump blood.

WALKING THEIR WAY TO HEART HEALTH …

Heart Walk Participants Promote Physical Activity

Roughly 2,000 people participated in the annual 1.25-mile American Heart Association (AHA) Heart Walk in September. Sponsored in part by St. Elizabeth Health System, the event promoted physical activity while raising funds for the AHA’s cardiovascular research and

education programs. The Heart Walk is part of the My Heart, My Life program encouraging all Americans to take control of their health by changing the way they approach it.

The AHA’s goal is to reduce death and disability from cardiovascular disease and stroke by 20 percent by the year 2020. Put this lifesaving goal on your personal “to-do” list.

Eat your heart out, Los Angeles! Allen Amorn, MD, FHRS, has moved to Youngstown.

Formerly a member of a cardiology group in the Los Angeles area, Dr. Amorn is a staff physician at St. Elizabeth Youngstown Hospital, where he specializes in cardiac electrophysiology (which involves diagnosing and treating problems with electrical systems of the heart).

The move to Youngstown brings Dr. Amorn back home. He grew up in Canfield and graduated from Cardinal Mooney High School. “I have a strong family background in the medical field,” he says. “My father is a gastroenterologist, and my mother is an RN who worked at St. Elizabeth. I admired what they did and knew it was something I aspired toward.”

WHAT DREW HIM TOWARD

ELECTROPHYSIOLOGY

“During med school, I found myself enjoying cardiology,” he says. “Many of my mentors were electrophysiologists, and I realized that I enjoy offering patients a lifesaving service when they are in critical need. Thanks to electrophysiology, we can use minimally invasive procedures to dramatically improve the quality of patients’ lives.”

WHERE HE WENT TO SCHOOL

After earning a bachelor’s degree in combined sciences from Youngstown State University, Dr. Amorn earned his medical doctor degree from Northeast Ohio Medical University (NEOMED) in 2004. He served an internal medicine residency at Cedars-Sinai Medical Center in Los Angeles, a cardiology fellowship at Kaiser Permanente in the

Greater Los Angeles area, and an electrophysiology fellowship through the Heart Rhythm Society (FHRS) at Cedars-Sinai.

HOW HE RACKED UP AWARDS

Dr. Amorn was named among “The Leading Physicians of the World” by the International Association of Cardiologists, took honors as one of the “Top 10 Cardiologists” in Arcadia, California, and was listed among “Super Doctors® Rising Stars™” in a special section of Los Angeles Magazine.

WHY HE CHOSE TO PRACTICE

AT ST. ELIZABETH

“I think St. Elizabeth has developed a strong foundation for a heart program,” he says. “I have a lot of colleagues and friends here, and our hope is to build a world-class cardiovascular program with new services and treatment options.”

WHAT SERVICES HE OFFERS

Dr. Amorn treats cardiac arrhythmias, including atrial fibrillation (Afib) and ventricular tachycardia (VT). He implants pacemakers and defibrillators, manages cardiac resynchronization therapy (CRT) and performs advanced catheter ablations.

HOW HE FIXES PROBLEMS

THAT STUMP OTHERS

“In the Los Angeles area, my colleagues and I handled arrhythmias that other doctors didn’t want to deal with,” notes Dr. Amorn. “I had one patient in particular who was especially grateful. She was only in her 30s and had an arrhythmia caused by an extra electrical pathway to the heart. A number of her family members had died from this heart abnormality, and she was scared.

“During a single, two-hour procedure, I totally cured her arrhythmia and simultaneously reduced her risk of sudden death,” he says, “She’ll never need a repeat procedure.”

HOW HE IMPROVED HIS

LIFESTYLE

“In LA, I spent far too much time driving, but in Youngstown, I have a better lifestyle, as well as family support for our young children.”

Dr. Amorn’s wife, Alicia, is a family medicine physician. The couple has a baby and a toddler. “I spend as much time with the kids as I can,” says Dr. Amorn. “I’m also an avid golfer and do a regular exercise routine three to five days a week.”

Heart to Heart Fall/Winter 2014 3

Meet Dr. AmornHeart Specialist Focuses on Building World-Class Program at St. Elizabeth

“ I enjoy offering patients a lifesaving

service when they are in critical need.

Thanks to electrophysiology, we can

use minimally invasive procedures to

dramatically improve the quality of

patients’ lives.”

Allen Amorn, MD, FHRS, electrophysiologist, St. Elizabeth Youngstown Hospital

Think it’s too hard to lose weight? Maybe you first need to lose the negative attitude. You can shed pounds if you adopt a positive attitude and commit to changing your lifestyle. Instead of looking to fad diets, pills or other quick fixes, follow the sensible advice below from the medical experts at St. Elizabeth Youngstown Hospital.

If you’re overweight, it is important to lose weight because those excess pounds place you at higher risk for heart disease, stroke, high blood pressure, diabetes and additional health problems. Unfortunately, nearly 70 percent of adults in the United States are either overweight or obese and nearly 13 million (about 17 percent) of American children ages 2 to 19 are obese.

“Even if you lose only a few pounds, you can gain cardiovascular benefits, says cardiologist Kwon Miller, D.O. “Losing weight is really about gaining a new lifestyle. It’s about exercising more, eating fewer fats, sugars and other bad foods and eating more healthy foods. And it all starts with educating yourself on what’s healthy and what’s not.”

To learn more about healthy eating, we turned to Karen Hahn, registered dietitian at SEHC. “In order to lose excess pounds, people need to think in terms of living a healthy lifestyle,” she says. “They’re not going on a diet; they’re going on a lifelong journey toward health.

There are all kinds of tricks people can use to help them along their journey.”

Before we list these tricks, let’s talk about weight loss in general terms. Although you may have heard many of these weight-loss tenets before, they bear repeating.

GENERAL TIPS• Pay attention to your body. Think

about how awful you can feel when you overeat. Then imagine having the will power to stop eating before you get stuffed. Eat slowly while drinking plenty of calorie-free liquids (like water) in between bites. As soon as you start to feel satisfied, push away your plate and push yourself away from the table.

• Eat several small meals a day. Rather than gorging yourself (and stretching out your stomach) with a couple large meals, consume at least three meals a day. It is better to eat several small meals throughout the day than to eat just a couple big ones.

• Wait before eating again. If you still feel hungry or unsatisfied after a meal or snack, wait at least 10 minutes before having more food. Start an activity (like walking, reading or cleaning) that distracts you from eating. When you divert your attention from food, it is likely that you can forget about your craving.

• Drink plenty of calorie-free fluids. You may actually be more thirsty than hungry. Fill your stomach with water, tea or coffee (minus sugar and cream).

• Opt for low-fat foods. Choose lean meats, low-fat or nonfat cheese and skim or 1% milk rather than higher fat items. If a recipe requires a fat, use a “good fat” like olive oil rather than butter or lard.

• Consume plenty of fiber. Since it expands, fiber makes you feel fuller. So eat an abundance of high-fiber cereals and other whole grains, fruits, vegetables and other high-fiber foods.

• Cut back on sugar. Avoid regular sodas, cut back on juices and learn to enjoy your coffee and tea without sugar.

• Limit alcohol intake. Try to restrict yourself to no more than two or three beers or glasses of wine per week.

• Eat only in designated areas. Keep all food in the kitchen and eat only in a chosen spot, such as at the table. Do not eat in the car or bedroom or in front of the TV.

FOOD PREPARATION TIPS

• Plan meals in advance.

• Use healthy cooking methods, such as:

1. Baking, broiling, roasting or boiling without adding fat. Do not fry foods.

TELL YOUR WEIGHT TO ‘GET LOST!’

Safeguard your heart by following reliable weight-loss advice from medical experts

4 Heart to Heart Fall/Winter 2014

2. Using nonstick cooking sprays or cooking with wine, broth or fruit juice rather than butter or oil.

3. Cooking with low-calorie foods instead of high-calorie ones. For example, substitute 2% milk for cream or applesauce for oil in baked goods.

4. Preparing only what you need for one meal – so that you’re not tempted to eat leftovers.

5. Putting away leftovers for future meals and storing them in opaque containers that you cannot see through.

6. Avoiding cooking when you are hungry. A good idea is to cook and refrigerate your next meal immediately after finishing a current one.

7. Making fruits, vegetables and other low-calorie foods a part of each meal.

8. Drinking water while cooking.

MEALTIME TIPS

• Drink a glass of water before eating and continue to drink plenty of water during a meal.

• Use small dishes. You can mound less food on small plates and in bowls, glasses and serving spoons. At the same time, you can trick yourself into thinking you’re eating more (since your small dish will look fuller).

• Fill your plate with correct proportions. Imagine that your plate is divided into four equal parts. Fill one part with meat, one with a starch like rice, potatoes or pasta, and the other half with non-starchy vegetables like lettuce, broccoli and green beans.

• Place serving dishes away from the table so that it is difficult to help yourself to seconds.

• Do not mix dressings into your salad. Instead, place dressings on the side and dip your fork into it before spearing a bite of salad.

• Sit in a different place at the table. This can help discourage you from slipping back into old habits.

• Make mealtimes special by using nice dishes, glasses and cloth napkins.

• Eat slowly. Cut one bite at a time, put down your fork between bites and take several one-minute breaks from eating during meals.

TELL YOUR WEIGHT TO ‘GET LOST!’

Safeguard your heart by following reliable weight-loss advice from medical experts

Heart to Heart Fall/Winter 2014 5

continued on page 6

• Enjoy fresh fruit as treats instead of rich desserts like ice cream, cake or pie.

• Leave a few bites of food on your plate after each meal to signify your control over food rather than its control over you.

• Remove your plate as soon as you finish eating.

• Toss out leftovers – unless there is a good use for them in a future meal.

SNACK TIPS

Snacking can actually help you lose weight – as long as you choose healthy low-fat, low-calorie snacks that satisfy your hunger and keep you from eating foods that are bad for you. Try to:

• Stock up on healthy snacks like fruit, low-fat yogurt, pretzel sticks, carrot and celery sticks, cucumber slices and broccoli and cauliflower florets. If you feel a need to dip raw veggies into something, try hummus, nonfat ranch dressing or yogurt-based dressings.

• Do not bring unhealthy foods into your home. No one in your family needs unhealthy foods.

• Have healthy snacks readily available. If you can easily reach for a healthy snack, you’ll be less likely to grab unhealthy ones like chips or cookies. Try keeping healthy choices in a special section of your refrigerator that’s easily accessible.

EMOTIONAL EATING TIPS

Some people rely on food as a coping mechanism to deal with boredom, stress or exhaustion. If you rely on food to deal with emotions, try these ideas.

• Talk with a supportive friend.

• Read inspirational quotes that help you resist eating.

• Take a relaxing bath or shower.

• Relieve stress by listening to music or a relaxation CD.

• Get outside and walk.

• Start doing something that keeps you from eating. Try activities like exercising, gardening, cleaning the house or painting.

SHOPPING TIPS

• Read labels. Avoid processed foods and foods containing numerous added ingredients like salt, sugars and fats.

• Choose fresh fruits and vegetables.

• Avoid excess sodium by buying low-salt canned goods.

• Shun fats by staying away from food products containing butter, oils, gravies or sauces.

• Steer clear of the “no-nos” like the candy aisle, bakery counter and ice cream freezer case.

• Limit sodium by purchasing foods with less than 300 milligrams of sodium per serving – unless your doctor says you don’t have to worry about sodium intake.

• Avoid foods with “bad fats” like trans fat and saturated fat.

• Educate yourself and do not believe that every food advertised as “healthy” is really good for you. For example, many low-fat foods contain large amounts of sugar.

Watch for more tips in the next Heart to Heart newsletter.

6 Heart to Heart Fall/Winter 2014

Weight-loss advicecontinued from page 5Got heart

attack symptoms?DON’T DRIVE! CALL 911 INSTEAD.Now there’s another reason not to drive your car to the hospital when experiencing heart attack symptoms. St. Elizabeth Youngstown Hospital has opened an additional electrocardiograph (EKG) receiving station in Andover, Ohio.

An EKG receiving station is an emergency department (ED) that can receive electrocardiograph (EKG) readings transmitted by emergency medical personnel (EMS providers). When a patient calls 911 with heart attack symptoms, an EMS squad arrives on scene and uses an EKG machine to record the electrical activity of the patient’s heart.

The EKG machine may be used in the ambulance or wherever the patient is located (such as the home, place of business or shopping mall). The EKG readings are then transmitted to the emergency department, where physicians determine if the patient is having a heart attack.

If the patient is, indeed, having a heart attack, then the squad transports him or her to St. E’s, which is a critical access hospital capable of performing cardiac catheterization and/or open heart surgery. While the EMS squad is en route, the staff assembles an expert heart team that is ready and waiting to provide appropriate care.

Speed is important because the faster the problem is resolved, the more heart muscle can be saved and the better the outcome for the patient.

Heart to Heart Fall/Winter 2014 7

Go Nuts!ENHANCE YOUR HEART HEALTH WITH NUTS

As autumn ushers in colorful leaves and crisp air, squirrels begin gathering nuts. Maybe we could take a lesson from the squirrels. After all, nuts pack a powerful punch of omega-3 fatty acids, which are good for your heart.

Omega-3 fatty acids lower levels of low-density lipoprotein (LDL) cholesterol, otherwise known as the “bad” cholesterol that causes heart disease. In addition to reducing your risk of developing blood clots (caused by cholesterol that forms plaque), nuts are high in fiber, vitamin E and protein. They also contain plant sterols, which lower cholesterol, and L-arginine, a substance that appears to improve the health of artery walls.

Nuts are relatively inexpensive and easy to store. Consider packing a handful of nuts in your family’s lunches or taking them with you on trips. Although nuts are healthy, keep in mind that they are high in fat and should be consumed in moderation. Try using them as a substitute for saturated fats. For example, spread peanut or almond butter on bread instead of regular butter.

The American Heart Association recommends eating four servings of unsalted nuts a week. Select raw or dry-roasted nuts rather than those cooked in oil. A serving equates to a small handful of whole nuts or 2

tablespoons of nut butter. Although peanuts are actually a legume like beans — they also appear to be healthy for you.

Try our nut-enriched granola recipe below.

Nutty GranolaWith the holidays approaching, consider making heart-healthy granola. When placed in pretty containers tied with bows, it makes nice gifts. And eaten in moderation, this easy breakfast cereal or anytime snack can be good for you and your heart. Granola may be stored in air-tight containers for up to two months.

Preparation time: 10 minutes Total cooking and cooling time: 2 hours

Ingredients:

2/3 cup frozen unsweetened apple juice concentrate, thawed

1/3 cup canola oil

1/2 cup packed dark brown sugar

1 tablespoon ground cinnamon

1/2 teaspoon salt (omit if on a sodium-reduced diet)

5 cups old-fashioned rolled oats (not quick-cook)

1 cup toasted wheat germ

1 cup chopped walnuts

1/2 cup sunflower seeds

1 cup raisins

Directions:Preheat oven to 325°F after setting racks in the top and bottom thirds of the oven. Line two large baking sheets with aluminum foil.

Mix apple juice concentrate, oil and brown sugar in medium saucepan and bring to a simmer over medium-high heat, stirring occasionally. Remove from heat; stir in cinnamon and salt.

Toss oats, wheat germ, walnuts and sunflower seeds with juice mixture in a large bowl. Spread mixture evenly on prepared baking sheets.

Bake 15 minutes, stirring once or twice. Reverse sheets top to bottom and back to front and continue baking until lightly browned (about 15 minutes more) while stirring occasionally.

Remove from oven and place sheets on wire racks. Stir 1/2 cup of the raisins into each sheet of granola. Cool completely.

Yield: 9-1/2 cups

Nutrition per 1/2-cup serving: 262 calories, 11 grams fat, 0 mg cholesterol, 37 grams carbohydrates, 7 grams protein, 5 grams fiber, 67 mg sodium, 229 mg potassium

1044 Belmont AvePO Box 1790Youngstown, Ohio 44501-1790

Boost your health IQ by attending these free sessions

STROKE SURVIVORS’

SUPPORT GROUP

At monthly meetings for this group, stroke survivors and their families listen to educational speakers, ask questions, socialize and share feelings, issues and tips with one another. Some members have only recently experienced a stroke while others may have suffered a stroke (or multiple strokes) years ago.

For more information, including meeting dates, times and locations, contact Mary Ann Cashier at 330-480-2876.

HEART FAILURE

SUPPORT GROUP

This group offers patients and their families an overview of heart failure and what they can do to self-manage this chronic illness. Meetings are held at two locations:

• St. Elizabeth Youngstown Hospital 3 to 4 p.m. on the first Wednesday of each month. To register, call 330-480-3991.

• St. Joseph Warren Hospital Times and dates vary. For more information or to register, call 330-841-4327.

SMOKING CESSATION

PROGRAMS

By appointment. Please call 330-306-5010 between 8:30 a.m. and 8 p.m. Monday through Friday to schedule an evaluation at the tobacco treatment center located at St. Elizabeth Youngstown Hospital or St. Joseph Tod Avenue campus.