Living Well With Heart Failure: The Misnamed, Misunderstood Condition
Edward K. Kasper, MD; Mary Knudson
(The Johns Hopkins University Press, 2010)
The first part of this book’s title might sound like an oxymoron: "Living Well with Heart Failure"? The second part of the title explains it: Heart failure is misnamed and misunderstood—frequently by patients; not infrequently, even by physicians.
Mary Knudson, an award-winning writer who spent 17 years covering the medicine and science beat for The Sun, was flabbergasted in 2003 when she was diagnosed with heart failure. Her symptoms of shortness of breath and fatigue seemed to come on suddenly. After seeing one doctor after another who provided what she describes as "substandard treatment," she only grew more frightened and frustrated. None recommended the basic medications for heart failure—an ACE inhibitor or a beta blocker—apparently because she also has asthma. They evidently were unaware that many people with asthma can take a certain kind of beta blocker in moderate doses that won’t interfere with asthma medication. The third cardiologist she consulted repeatedly told her she needed a heart transplant.
Not until Knudson saw Edward Kasper, clinical director of Hopkins’ Division of Cardiology and a veteran expert in chronic heart failure and heart transplantation, did she finally receive all the medications recommended by the national guidelines, she says, and begin what has become her complete recovery.
Knudson realized that her experiences were not uncommon—and likely to occur among a growing number of Americans. Today, some 5.8 million people in the U.S. are living with heart failure, and the number surely will increase as the population ages.
Knudson and Kasper have collaborated closely on a book that will enable people to begin learning the basics of heart failure—its causes, symptoms, treatment, and challenges. Their book includes instructive case histories; advice on the patient-doctor relationship and on hospitals; additional sources of information; a chapter on exercise and another on nutrition and heart failure, written by Samantha Heller, a nutritionist who is a longtime friend of Kasper’s; and a lengthy appendix of medications.
"A well-informed patient is my best partner," Kasper writes in the introduction. Although he and Knudson say their book aims to help patients learn as much as they can about heart failure, it can provide useful information and guidance for physicians, too.
Taking Charge of Your Health: A Guide to Getting the Best Health Care as You Age
John R. Burton, MD; William J. Hall, MD
(The Johns Hopkins University Press, 2010)
Pioneering Hopkins geriatrician John Burton, 73, and his friend and colleague William Hall, 71, from the University of Rochester School of Medicine, both have aged gracefully while caring for the elderly. In their concise and user-friendly book, they strive to ensure that others in their age bracket manage to do the same.
As members of what Hall aptly describes as the "first generation" of leaders in what has become the field of geriatrics, he and Burton initially thought their book should be written for young physicians in training. Burton and Hall ruefully observe in the book that many physicians are just as prone as their patients to carrying myths about aging around "in their heads"—accepting, for example, the erroneous notions that elderly people can’t exercise or that an older person’s anemia is due simply to age.
While writing the book, however, Burton and Hall concluded that their audience instead should be older adults—readers who, like the patients they still see and their concerned families, are baffled by today’s ever-evolving health care system and sometimes ill-served by physicians who don’t understand the complex, frequently multifaceted issues that caring for the elderly involves.
For example, they note that longitudinal studies have shown that "all cases [of anemia] in older people are caused by underlying disease." They advise their readers to "challenge any health care provider who glibly attributes a new symptom or finding to age alone."
In 13 brief chapters, the 157-page, three-part book covers "The Older Patient in Today’s Health Care System," including the debunking of the prevailing myths about aging patients; "The Health Care System," including key programs and clinical settings for "we seniors"; and "Managing Your Health," with advice on medications, nutrition, and exercise.
The complexities of Medicare and Medicaid are explained; ways to select a primary care physician and make the most of appointments with these doctors or specialists are described; insights on selecting assisted living facilities, continuing care retirement communities, nursing homes, or other options are provided.
High-quality primary care is crucial for seniors, Burton and Hall note, and with the growing shortage in primary care physicians assuming crisis proportions as the population ages rapidly, the information in this book would be beneficial for physicians and laypeople alike.
Neil A. Grauer