Cardiovascular disease is a disease with a mortality rate that ranks 1 in 5, which is considered very high, making patients with this disease need close care and from professional and experienced medical personnel.
From the previous episode, we got to know one of the important treatment centers of Thammasat University Hospital, which is a center that everyone has heard of quite often, the 60th Birthday Anniversary Dialysis Center of Her Royal Highness Princess Maha Chakri Sirindhorn. One thing that makes us realize is that even though kidneys deteriorate with time and the number of years that increases every day, it would be better if we take care of them so that they last a little longer than before, it’s not too difficult to do.
Now, the admin will take everyone into the working period of medical personnel where every second is as valuable as if their lives are hanging by a thread. But the lives in question are not their lives, but the lives of the patients. The admin will take everyone to get to know the Thammasat Heart Center and the Cardiac Intensive Care Unit (CCU) from Dr. Winit Longlaleng, a professional nurse with special expertise and advanced practice in cardiovascular disease, and Dr. Rewadee Udom, head of nursing in the Cardiac Intensive Care Unit (CCU), Thammasat University Hospital.
“A deadly killer called heart disease.”
Statistics from the World Health Organization show that 7.2 million people, or 12.2% of all deaths, die from cardiovascular disease. In Thailand, there are approximately 37,000 deaths per year, with 2 deaths per hour. It is also ranked in the top 5 diseases with the highest mortality rate every year in global surveys.
“The symptoms are as tight as if an elephant had stepped on it.”
A symptom that you can clearly observe yourself to see if you are at risk of having heart disease or not is chest tightness. The tightness will occur very frequently. Sometimes it may spread to the neck, to the left shoulder. In some cases, it may be the right shoulder, but most of the time it is the left shoulder. Some people feel so tight that it radiates to the back. Some research studies say that it is as tight as if an elephant is stepping on your chest. The feeling of tightness in the chest, sweating, palpitations, sitting or lying down, or stopping breathing does not help. If you have these symptoms, go see a doctor immediately.
“Gastric disease makes you overly optimistic and diabetes makes you barely feel it.”
Some people in the elderly group, especially women, will have less sensation. Sometimes they feel a lump under their epigastric region, so they think that it might be gastritis. But when they actually get checked, they find out that they have acute coronary artery disease. Or having a chronic disease like diabetes will make them feel less about heart disease symptoms. Don’t diagnose the disease yourself. Sometimes heart disease seems easy to see, but sometimes it doesn’t tell us anything at all.
“It doesn’t hurt to see a doctor. Whether you get sick or not, at least you’ll be sure.”
You have to know how to observe yourself. Don’t think that your chest tightness or epigastric pain is only due to stomach disease. Many people have made the mistake of thinking this way. If you have stomach disease, take medicine and wait a while and your symptoms will improve. But if you take medicine and it still happens frequently, or you have sweating, shortness of breath, or palpitations, you have to know that it is not normal and you should go see a doctor. Other symptoms occur only for each person, but the main symptom that everyone has is chest tightness.
“Being physically fit doesn’t mean you can’t get heart disease.”
People who take good care of their health and exercise regularly have a lower risk of heart disease because they are healthy. But it does not mean that they do not have the right to have heart disease. Because heart disease can occur from many factors, for example, genetics, problems with the heart enlarged for no reason, for example, genetics, or problems with the heart enlarged for no reason, etc. Athletes who exercise and fall down, no matter how strong you are, do not trust this disease.
“We have to be patient-centered.”
Thammasat Heart Center and Cardiac Intensive Care Unit (CCU) is one of the centers that is now a COE or Center of Excellence, a Center of Excellence in Cardiovascular Disease. It is one of the five centers of Thammasat that is very famous. Therefore, when working, personnel do not work at a single center. There is a committee for developing the quality of patients with cardiovascular disease, including a large committee for internal medicine. Therefore, all personnel work in connection with many departments, focusing on the patient as the center. All personnel are people who rotate and connect with each other to help patients in the center as best as possible.
“Treatment of heart disease is not just for cardiologists.”
In treating heart disease patients, many parties are involved. We have to plan the work systematically because we cannot let the patients go without any advice. We have to give advice on food and behavior. If the patient has any abnormalities, such as being overweight, having too much fat, or being very thin and looking malnourished, we will have nutrition specialists come in to help look at the patient’s food. Or if the patient has symptoms of weak arms and legs, which is common in the elderly, we will find a team of physical therapists to give advice on stimulating them to stand up, walk, and sit. Many teams of personnel are ready to help the patient.
Coordination with CCU
CCU stands for Cardiac Care Unit, a unit that takes care of heart disease patients. We will take over the care after the procedure because it is considered that patients after a heart attack are like injuries that require treatment, which the heart center will perform the treatment. After that, there is monitoring, which is the duty of the CCU. Each patient will be in a separate room. There are 20 beds in total, 8 of which are in the critical area. There are another 12 beds in the critical center that will be monitored through monitors.
“One thing nurses can do is provide education.”
Providing advice to patients, relatives, and primary caregivers, first assess who the caregivers are. Currently, most patients are elderly. If we give advice to the patients directly, they may be forgetful, so we have to give advice to relatives and primary caregivers as well. The purpose of providing knowledge is how to prevent patients who have recovered from relapse, and to be able to return to live with their families as normal as before.
“It feels good, it feels like a nurse is near him.”
Due to COVID-19, there are some problems with visiting because sometimes the hospital cannot allow relatives to come and listen to the guidelines for patient care when the patient returns home. Therefore, technology has been introduced to help by having patients download the CCU TUH application via QR code and then come and chat with the admin who is waiting to reply to the chat. How are you doing when you get home? Have you taken your medicine? Have you taken care of your wound well? Can you do it? There is a follow-up with the patient all the time, which has received very good feedback from users. They take pictures and send them to tell them how they are doing or what foods they can eat. This helps make patients who have returned home feel at ease.
“I want patients to have the best quality of life possible, without illness or suffering.”
In the term of the cardiac intensive care unit, it does not only mean taking care of critically ill patients. We also look at patients who have passed the critical stage, whether they have passed the critical stage and are dying or near death. There is palliative care and end-of-life care. Thammasat Thammarak Center is a team that comes to help with the pain and suffering that must be treated. In some cases, relatives must be called in to talk about if this continues, the patient will suffer. In the end, what do the patient need? What do the relatives need? How much do the center need in the final stage? So that they can take them on the right path.
Conclusion
Heart disease patients who arrive early can receive treatment early, increasing the chance of returning to a normal life. If the heart muscle is deprived of blood or dies, it is like a dead brain. There is no revival. Therefore, time is life. If you have severe chest tightness, go to the hospital immediately. You must start taking care of yourself. Observe yourself. Health check-ups are important. At least once a year, if you have the opportunity to have an ECG or an echocardiogram, that is a good opportunity. At least you can see the problems with your heart. If you know early, you can solve the problems early. This will have a positive effect on our health.
“We believe that every second is valuable to patients. In a split second, if we do not help in time, the patient may die. And if we help quickly, it means we increase the patient’s chances, giving the patient another chance to live.”
With love and care “Jai” | Thammasat University Hospital
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