Patients who have experienced life threatening events have much in common. Certainly anxiety and fear of recurrence are paramount. Several strategies can be employed to help our patients deal with these feelings. What can we as clinicians do? Take them surfing….
1. Regain control: When sick and in the hospital, patients lose all control. For most, this can be a frightening experience. Patients can regain control by becoming actively engaged in their post MI care. Data provides power. Data provides control. Educate patients on the medications you have prescribed and why. Let them know that ACE inhibitors, Beta blockers, Aspirin, and cholesterol lowering meds have been shown to reduce mortality and prolong life in the appropriate cardiac patient. Engage patients in monitoring medication effects such as maintaining a BP log, or charting their cholesterol response over time. Help them choose an appropriate surfboard and help them understand how the board is best suited to their needs. Tell them why and how the long board will help them stand up and ride the wave to shore.
2. Educate: When a life threatening cardiac event occurs to a patient, many have no idea why. Spend time explaining the physiology of the event to the patient and family after discharge during an office visit. Help patients understand the biology of the cardiac event and understand how and why it was treated in the way that it was. Through greater understanding, patients are less likely to rely on unreasonable and unhealthy coping mechanisms such as avoidance of activities associated with the cardiac event (such as walking in the mall). Help them understand how the wave forms, how it gains momentum and how to paddle in at the perfect time to ride to shore.
3. Coach: Enroll patients in appropriate cardiac rehab activities. By working with certified rehab personnel and exercising in supervised environments, patients are more likely to gain confidence. Track progress and discuss the gains that are made during an office visit. Provide encouragement even when the patient expresses difficulty with exercise and fatigue–help them get back up and ride the next wave after wiping out.
I am still sore from surfing this past week. But, I continue to get back up on the board and ride the waves. I find great peace and great pleasure in the ocean and on the board. Sometimes I wipe out, sometimes I get a few bruises. But I continue to surf. Let’s remember to keep our patients from avoiding things that may give them great pleasure. Just because a life threatening cardiac event is survived, doesn’t mean we have to stop living. Avoidance behaviors can be destructive. Help patients recover and get back up on their particular surfboard. Spend time educating, coaching and empowering your patients. Share as much data as you can. Help your patients learn to “Hang Ten”!