FAQ topics covered in this section:

General questions
Diabetes questions
Living Well With Heart Failure Program questions

GENERAL QUESTIONS ABOUT CARDIO RISK REDUCTION

If I already have heart disease, do I go to Cardiac Rehab or Cardiovascular Risk Reduction?

If you have recently been diagnosed with Coronary Heart Disease (blockages in your heart vessels) in the last twelve months, or if you have just had a heart attack or coronary artery bypass surgery, you will be eligible for our cardiac rehabilitation program.

If you have had angina and heart disease for more than a year but still need help getting your blood pressure, cholesterol, smoking, weight, or exercise program under control, the cardiovascular risk reduction program is for you.

Do I need my doctor’s approval to enter the cardiovascular risk reduction program?

Yes, you need to talk to your doctor about your participation. He/she will help you make the best decision for your health.

Will I need an insurance referral to participate in the cardiovascular risk reduction program or the diabetic education program?

If you have insurance that requires that you get a referral before you see a specialist, you will need a referral when you are seen here. Our administrative staff will help you obtain a referral. Your only responsibility will be to keep us updated if your insurance changes.

Will I have a co-pay?

If your insurance requires a co-pay with an  office visit, you will be responsible for this.

Sugar alcohols that are commonly found in foods are sorbitol, mannitol, xylitol, isomalt, and hydrogenated starch isolates. Because they have fewer calories than other sugars, they are often promoted as "diet" sweetners. But they still contain sugar and still affect your blood sugar.

High blood sugar (hyperglycemia) is the result of too much food, too little insulin, illness or stress. It happens when your blood sugar goes above 200 gm/dl, and can have a gradual onset. There are several symptoms and you may have some or none. Some common symptoms are extreme thirst, frequent urination, dry skin, hunger, blurred vision, drowsiness, nausea. If you have these symptoms, it is important you test your blood sugar. If your blood sugar is greater than 250 for several tests, call your doctor.

Low blood sugar (hypoglycemia) results from too little food, too much insulin or diabetes medication, or too much exercise. Hypoglycemia is when your blood sugar is less than 70 mg/dl and can happen suddenly, so it is important that you have some source of carbohydrate with you. The symptoms of hypoglycemia are shaking, fast heartbeat, sweating, dizziness, hunger, impaired vision, weakness, fatigue, headache, irritability. To treat a low blood sugar, drink a half cup of milk or orange juice or have several hard candies. Test your blood sugar. If the symptoms do not stop, call your doctor. Have a light snack such as a half sandwich and a glass of milk within 30 minutes of the symptoms going away,.

Yes, as long as you make healthy menu choices and plan accordingly.

I don't work a 9-5 job and can't arrange to eat breakfast, lunch and dinner in the same time frame as others. What shall I do?

Work with your medical team  to plan a food and medication regimen to keep your blood sugar in good control.

There are many different glucometers, or machines that test your blood sugar. Some have alternate sites to test, such as your arm. Many of the new machines have smaller needles and aren’t as painful as you may think. Talk to your medical team to find the best method for you.

It is important that you get all the information you can about diabetes and keeping yourself healthy. Make up classes are available if you miss one.

Can I bring my spouse or significant other to class?

Sure! Family and friends are welcome to listen and learn.

Most insurance policies in Massachusetts cover diabetes education but check with your insurance company to be sure.

LIVING WELL WITH HEART FAILURE

Who is eligible?

Anyone who has been diagnosed with heart failure.

Who is ineligible?

• A patient on dialysis.
• A patient in long-term care (excluding assisted living).
• A patient receiving hospice care.
• A patient with catastrophic illness that supercedes heart failure problems.
• A patient whose heart failure is well controlled but who requires frequent attention because of other health problems.

How can I participate?

You can refer yourself or members of your health care team can refer you.

Does my insurance cover this?

Yes, we accept all insurances. You will be responsible for any co-payments required (as you would be in your doctor's office.) You may also need a referral from your primary care physician if you have HMO insurance.

How can I make an appointment?

Please call our program at 978.354.2369.

If you are referred to the program assistant while you are still in the hospital, the heart failure nurse coordinator will meet with you before you leave. This session will include heart failure education, discussion of lifestyle management, and referral to the outpatient Heart Failure Clinic, if appropriate.

Where is the Heart Failure Clinic located?

NSMC Salem Hospital: Main 5^th Floor

NSMC Union Hospital: West Ground, across from Employee Health

What can I expect when I am seen in the Heart Failure Clinic?

You will meet one-on-one with the nurse practitioner who will assist you in managing your heart failure at home. A family member is encouraged to come with you, especially if he or she does the grocery shopping or cooking.

We will review the cause of your heart failure, medications to treat it and how to adjust them when needed. You will also learn how to recognize symptoms that need attention.

How often do I need to go to the Heart Failure Clinic?

The nurse practitioner will determine how often you need to be seen after your initial consultation. Most often your heart failure clinic visits are staggered in between your visits with your primary physician and cardiologist.

After each appointment, an office visit report is sent to your primary care physician and cardiologist.