Angioplasty guidance
When it comes to what happens next, Dr. Stephen Fort wrote the book on angioplasty
By Alison Delory
Imagine having to explain to each of the estimated 40,000 Canadians who suffer from cardiovascular disease their options and the risks involved.
Now imagine these same patients have read a comprehensive guidebook that gives them an overview of their symptoms and treatment alternatives.
The result would be better informed and ultimately healthier patients, says Dr. Stephen Fort, a cardiologist at Sunnybrook and Women's College Health Sciences Centre in Toronto.
He's written a book for patients called So You're Having Angioplasty.
"We wanted it to fit on a coffee table, not in a medical library," Dr. Fort says of the 176-page book, which uses simple language and includes quotes from patients, check lists, key points and a glossary of terms. There are also pictures of a cath lab and diagrams of blocked arteries, stents being inserted and angioplasty balloons.
It's not meant to eliminate the time doctors spend talking to their patients, but rather to make it more meaningful for both parties.
"Consultation with patients and their families before each procedure is necessary," says Dr. Fort, adding, however, that the book can help accelerate the consenting process.
The vast majority of patients find the concept of angioplasty easy to grasp, especially the way the balloon expands the artery, but what they don't fully understand are the risks, Dr. Fort says. These can include blood thinning and bleeding, strokes and, in about 1% of cases, the angioplasty patient will end up requiring bypass surgery.
When Dr. Fort was approached by publisher Dr. Helen Byrt (PhD) from Script Medical Press to write the first in a series of surgery guides for patients, he began to do library research. He found reams of articles filled with medical jargon and lots of literature that said "this option is best." Keeping in mind that each patient has individual needs and unique disease management goals, he says he tried instead to present all options without bias. The book also covers the pros and cons of bypass surgery and using medication alone to manage heart disease, Canada's number one killer.
Dr. Fort says it's difficult to strike a balance between educating patients and alarming them, but, "We have to be honest. Most patients realize they're at a crossroads and want to change their lifestyle."
Dr. Fort authored the book with his wife, Victoria Foulger, a former cardiac nurse and chartered herbalist. It includes the use of complementary therapies to reduce risk and for secondary prevention.
"It's easy to do angioplasty and then forget about the disease," says Dr. Fort, who instead stresses to patients they must also reduce their risk factors (obesity, smoking, lack of exercise) if they want their health to improve.
The book, which was launched in September, was distributed at the Canadian Cardiovascular Conference in Halifax in October by sponsors Eli Lilly Canada and JOMED Canada, a manufacturer of medical devices, including heart stents. It's now found in hospitals and is for sale online (www.whathappensnext.ca) and in major bookstores.
Readers also learn about the future of cardiac care, which Dr. Fort, an internationally recognized expert in interventional cardiology, cardiac imaging and intravascular ultrasound technique, describes in some detail. He says it will be relevant for at least two years as the specialty evolves.
—Alison DeLory is a desk editor.
