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Dave Garton’s once-boisterous life had become so limited he contemplated suicide. But he was so ill he didn’t think he would live long enough to kill himself, so he made funeral arrangements instead.
The former entrepreneur and self-proclaimed workaholic who “worked hard and played hard,” Dave was in the darkest of places. Poorly managed chronic obstructive pulmonary disease (COPD), heart failure and diabetes had converged to make every breath, every step, every task a hardship.
Physicians had given up on him, he said, “so I gave up too.”
Dave’s health plummeted in 2002 after suffering a heart attack. He owned two businesses at the time – a neon sign manufacturing business and a coffee shop. He had to give up both, kick-starting a deep depression. Anti-depressants contributed to massive weight gain, accelerating Dave’s spiral.
In 2007, a specialist said he needed a heart/lung transplant but that he wouldn’t survive it. Two years later he had an implantable cardioverterdefibrillator inserted to reduce his risk of dying if his heart stopped beating. And in 2018, he had three stents put in to open blocked arteries.
Finally, Dave was feeling better and was able to do more, but new problems emerged and again, he began slipping. He couldn’t climb more than two steps without sitting down. On the way upstairs to his bedroom, he once got stuck on the third step gasping for air, requiring paramedics to be called. In one month alone, Dave landed in the emergency department seven times. The burden on his partner-in-life, Wendy, weighed heavily upon him.
While Dave’s various health issues were all linked, each problem was being addressed separately. He credits a new family doctor for recognizing the coordinated care he needed and St. Joseph’s Health Care London for bringing it all together. Through the collaborative work of the heart failure, COPD and diabetes teams at St. Joseph’s Hospital, Dave has reclaimed his life.
This coming together of programs and professionals of various disciplines is part of a thrust at St. Joseph’s Hospital to improve quality of life by addressing the multiple needs of each patient. Program silos are coming down and care pathways are being redesigned and re-routed in what is called integrated care.
“It takes teamwork – across programs and specialties – to meet the needs of patients living with chronic conditions,” says Laurie Loveland, nurse practitioner with the COPD and Pulmonary Rehabilitation Program. “Every member of the team has an important role because they see the patient from a different perspective. We are creating connections and delivering care in new ways recognizing that patients are coming to us with more than one chronic disease. Patients tell you how grateful they are that it has all come together for them.
For example, care for COPD at St. Joseph’s now includes an opportunity for patients to join a classroom-based education program and a group exercise program with rehabilitation trainers. The fitness training begins with an eight-week intensive phase of sessions held at St. Joseph’s, followed by a six-month maintenance phase in partnership with the downtown YMCA. During their time in the exercise program, patients take part in skill building sessions with a social worker to better manage the anxiety and stress that often comes with COPD. Those with heart failure, heart disease or diabetes also see those nurses, educators and specialists.
“We work together to tease out the contributing factors to a patient’s condition and gaps in their care,” explains Mona GroenewegenBeukeboom, nurse practitioner with the Heart Failure Clinic. “Appointments are often made on the same day for a patient being seen in the COPD and Heart Failure clinics, and we will share test results so that only one test is needed, such as an ECG or blood work.”
The overall emphasis is on self-management, education and self-advocacy so that patients are not passive consumers of health care but rather an essential member of their care team, say Laurie and Mona. When patients are provided with the tools to manage their condition, they are better equipped to stay out of hospital and enjoy good quality of life.
Dave had resorted to spending his days on the couch watching TV when he was referred to the COPD program and offered pulmonary fitness training. “I thought there was no way I could exercise.”
Today, he is a healthy weight, back on the golf course, playing guitar and singing – something he didn’t have enough breath to do before. Stairs are no longer a problem and on scenic drives with Wendy, he can actually get out of the car rather than passively watch the world go by.
“I can’t believe what they helped me accomplish,” Dave says of the many teams and individuals involved in his care. “They not only made me understand the mechanics of what was happening, they gave me the skills and confidence to do what I needed to do. I feel lucky to be alive.”
Follow along with patient’s care at St. Joseph’s Health Care London.