SMART heart eases heart ache, targets cardiac patients' emotional well-being

Two years ago, 57-year-old Allus Brown underwent a simultaneous heart-kidney transplant and spent months in and out of the hospital after battling dilated cardiomyopathy, a condition that enlarges and weakens the heart. Now fully recovered, Brown is still in and out of Northwestern Memorial Hospital's Bluhm Cardiovascular Institute each week. Only nowadays when he visits, he's laughing it up, playing board games, and sharing accounts of his own struggles with heart disease as part of the Bluhm Institute's new and innovative program, SMART Heart, stress management and recreational therapy for heart patients. Brown says he thrives in his new role because it's one way he can give back and help others coping with the emotional aftermath of cardiac surgery.

"What I like most about being a SMART heart volunteer is that it truly focuses on being happy and doing things that can bring about happiness," says Brown, a Marine Corps veteran and former athlete.

According to Kim Feingold, PhD, director of Cardiac at Northwestern's Bluhm Institute, most cardiac programs only focus on the physical aspects of recovery following . But an emotional comeback is just as important.

"Few people recognize the significant psychological burden associated with heart surgery," she says. "Two out of five cardiac patients are clinically depressed, which makes them less likely to comply with recommended care and puts them at significant risk for complications, even death."

SMART Heart focuses on improving quality of life and the management of stress for cardiac surgical patients. The program incorporates games, movies, books and other entertainment activities into patients' hospital stays following heart surgery. The goal is to spark relaxation, laughter and enjoyment for these patients as a way to help fend-off the onset of psychological illnesses like depression, anxiety and stress, which are quite common among heart surgery patients compared to patients who have had other types of surgeries.

As Feingold explains, research shows that depressed patients are more likely to smoke, eat an unhealthy diet, remain inactive and consume alcohol. These unhealthy lifestyle choices are detrimental to physical recovery, as studies also show a direct correlation between psychological wellbeing and good health. This only underscores the importance of planting seeds for emotional recovery during a heart patient's hospital stay.

Every Monday night, Brown spends hours on a cardiac inpatient floor at Northwestern Memorial. First, he prepares his "SMART Heart cart" filled with books, DVDS, games and music. Then, he makes rounds to patient rooms, sometimes visiting 30 or more as he distributes the entertaining goodies. Brown often sits a while with patients, watching movies. And, you can always find him sharing a personal story of heart disease—something he says he is fortunate to do from the perspective of having "won his battle".

"If talking to patients and sharing my journey eases their minds about having a transplant or bouncing back after heart surgery, then I have done my job," said Brown.

Cardiac patient Brian Stringfellow agrees. During his hospital stay as he recovered from surgery, Brown wheeled by his room with the SMART Heart cart. Stringfellow says meeting Brown was a "welcome surprise."

"I worried that I might be a little bored just sitting in the hospital," Stringfellow says. "When you have down time, your mind wanders to 'what if this' and 'what if that.' Spending time with Allus and hearing about what he had to go through has given me strength to know I can do it too."

"Laughter can truly be the best medicine," adds Feingold. "While on the road to physical recovery, we know it's critically important to focus on emotional recovery. This program focuses on reducing the emotional backlash of surgery, which opens the door to educating patients about management of their disease and consequently improving cardiac outcomes."

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