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In 1999, Louis Phillippi's heart was so weak that he was not expected to live more than two years.
But Phillippi said that when the years passed and he did not die, he began exercising regularly and eating healthful foods. Today, at 65, he is living with heart failure, which kills about 250,000 people nationwide annually.
``I guess you could say I'm a dead man walking,'' the Fort Worth, Texas, man said.
Heart failure, the heart's inability to pump enough blood through the body, is often viewed as a death sentence.
After diagnosis, less than 50 percent of patients live five years and less than 25 percent live 10 years, according to the Heart Failure Society of America. In recent years, specially designed heart-failure clinics have appeared across the country, providing a comprehensive approach to treating the condition and improving patients' outcomes.
Cardiovascular disease is the leading cause of death in Texas, with more than 55,000 deaths annually.
An estimated 900,000 people nationwide are admitted to the hospital for heart failure annually and about one-third of them are readmitted within 90 days, said Dr. Tehreen Khan, a Fort Worth cardiologist who directs the Plaza Medical Center of Fort Worth's Heart Failure Clinic.
That's partly because they are not educated and not micromanaged,'' she said.That's where the heart-failure clinic comes in.''
The physician-directed, nurse-run clinics are based on the simple strategy of offering immediate access to a care provider, said Dr. Clyde Yancy, a University of Texas Southwestern Medical Center associate professor of internal medicine.
At Plaza Medical's clinic, patients are educated about medications, diet, fluid intake and exercise. They learn to deal with the disease, which can cause blood and fluid to back up into the lungs and build up in the feet, ankles and legs.
Most of all they have access to someone who can answer their questions, said Joyce Putman, educator and nurse practitioner at the clinic.
We do a lot of hand-holding,'' she said.But that's really important to them at this time in their lives.''
Almost all of the patients experience fear, said Rana Lambdin, Plaza's Heart Failure Clinic manager.
Most of the time they hear the words `heart failure' and figure, `I'm done for,' '' she said.It can be scary because all of a sudden, they can't breathe.''
One of the clinic's goals is to reach heart patients before serious problems require hospitalization.
``You can't prevent heart failure, but you can stall it,'' Lambdin said.
When Phillippi came to the clinic, he had a history of cardiovascular disease. Only 30 percent of his heart was working, two arteries were 100 percent blocked, two were 90 percent blocked and one was 80 percent blocked.
My left ventricle is blown out as big as a balloon, and some time in the future it is going to burst,'' he said.I'll be dead before I hit the ground.''
He is not a candidate for a heart transplant or other surgery, but he is learning how to cope. One of his most pressing concerns was dizziness, a side effect of one of the drugs he takes. At the clinic, he experimented with taking the medication at different times to avoid the dizziness.
That simple change, along with regular exercise and diet, has made all the difference.
Thirty years ago, heart failure was seen only as a flow problem and was treated by decongesting the system, but new therapies have improved the outlook for patients, Yancy said.
We don't look at heart failure as failure anymore but rather success,'' he said.With the right medicine, we can dramatically improve a patient's outcome and decrease the risk of death due to heart failure by 50 percent.''
Five years after he was diagnosed with heart failure, Phillippi said he still tires easily but can go fishing and recently opened three home-based businesses. He credits the nurses at the Heart Failure Clinic with helping him to enjoy life again.
``I wouldn't be here without them,'' he said.
Heart failure occurs when the heart's pumping power is weak, causing a buildup of fluids in the lungs and other tissues.
Symptoms include shortness of breath, fatigue and weight gain caused by fluid retention.
Risk factors include coronary heart disease, smoking, high cholesterol levels, hypertension, diabetes and obesity.
SOURCE: National Heart, Lung and Blood Institute
(ONLINE: For more information about heart failure, go to www.hfsa.org or www.americanheart.org.
c.2004 Fort Worth Star-Telegram