Robert R. Cawley, D.O.
Dover, NH 03802
Heart failure is a leading cause of hospitalization in people over 65, but patients will do better in the long-term if they can stay out of the hospital. Wentworth-Douglass Hospital’s Heart Failure Clinic was created with this goal in mind – providing patients easy access to specialized clinicians and resources to help them stay healthier.
Q: What is heart failure?
AO: Heart failure is an often-misunderstood condition. Simply put, when you have heart failure it means your heart is losing its ability to pump blood efficiently. This often happens because the heart muscle either weakens or stiffens, and this affects the heart’s ability to pump enough blood supply to meet the body’s needs. Classic symptoms of heart failure include shortness of breath, trouble breathing while lying down, swelling in the feet, legs, and stomach, a general feeling of fatigue, and exercise intolerance.
Q: How do you approach caring for a patient with heart failure?
AO: Heart failure is a serious condition that often gets progressively worse over time, but there are steps we can take to relieve symptoms to improve quality of life, slow the progression of the disease, and help patients live longer.
When we first see a patient with heart failure, the most important aspect of our approach is understanding the cause of their heart failure. If you can understand the root cause, you can treat it more efficiently. This requires teamwork from the cardiologists, nurses and primary care physicians, as well as commitment from the patient.
We have well-established medications for the treatment of heart failure. Over the past five years, we have also had very exciting improvements in the field and our medication options have broadened. For instance, when we see patients with diabetes and heart failure, we work closely with our medicine and endocrinology colleagues to get our patients on some relatively new diabetes medications which control blood sugar and improve heart failure at the same time.
We have an excellent cardiac rehabilitation program at Wentworth-Douglass and our experienced physical therapists help our heart failure patients regain their strength to have a healthy lifestyle. Most of our heart failure patients enjoy participating in this comprehensive and very beneficial program.
Q: How does the Heart Failure Clinic at Wentworth-Douglass help patients?
AO: When you have heart failure, regular office visits with expert providers are very important. The Heart Failure Clinic supports this goal in helping our patients with education, symptom management and improving their overall comfort. The clinic’s team includes dedicated Heart Failure Nurse Navigator Hilary Niesuchouski, RN, who is available to answer questions and coordinate appointments. Pam Levesque, APRN, a nurse practitioner specialized in heart failure helps patients manage their symptoms, adjust medications, and collaborate with our expert cardiologists. I feel lucky to work along with an outstanding team.
Our goal is to prevent the need for advanced medical and surgical therapies in our heart failure patients. But for patients who do need that level of care, through our collaboration with Massachusetts General Hospital, we have expert support from the Corrigan Minehan Heart Center’s Advanced Heart Failure Program. The Mass General team is only a phone call away and are a great resource, when it’s needed.
To learn more about the Heart Failure Clinic, please call (603) 609-6417.
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