Becoming a patient—even under the best of circumstances—is a difficult journey. Often, patients and their families never learn much about their condition, what caused it, or how to prevent it from happening again. This is where national guidelines and proven medicines come in. One of the goals of this book is to give you all that and more. In addition, this book includes many crucial questions you should ask BEFORE you go home, so you’ll have the best chance to stay on the road to recovery.

In researching and writing The Essential Guide to Prescription Drugs for the last decade, and working with The Mended Hearts and my advisory board to create this book, I’m convinced that the best colleague any doctor can have is a more informed patient. While the events that led you here may have been confusing and even scary, the important thing is that you are in the right place now. And from this moment on, you and your family have the opportunity to make changes that may help you. Research tells us that when both patients and their families become involved in the hospital, it’s not only more likely that proven medicines will be started—it’s far more likely that they’ll be used and continued.

You didn’t become a heart, stroke, or blood vessel disease patient overnight. It is a long journey and, surprisingly, one that starts when we are children. Risk factors such as blood pressure, cholesterol, fats from unhealthy diets, and those fats that our bodies manufacture can combine with damage in blood vessels to silently threaten your life. Whether you have Unstable Angina, an NSTEMI (Non-ST Segment Myocardial Infarction) or STEMI (ST Segment Myocardial Infarction) heart attack, a stroke, or Peripheral Artery Disease—please remember these are all words that describe the same disease process showing up in different parts of the body.

Let’s face it. Life changes after a heart attack. From now on, you’ll be a heart patient. While it isn’t always easy, becoming a patient doesn’t have to be a lonely journey. Involving your family—tapping their strength and support when you go home after a heart attack, stroke, or new diagnosis—creates a “safety net” that is rarely equaled. Even before you leave the hospital, family members can ask questions that you may have forgotten. Your support system will work best when both you and your family have clear information about your condition, treatment, and goals. This treatment may include starting proven medicines BEFORE you go home from the hospital—and continuing them in ways that give you the best chance at avoiding worsening disease or even death from a second heart attack or stroke. 

Becoming well again means making smart choices. After more than 20 years in health care, I’ve learned that research always leads to emerging science, and science that stands up to time often becomes the accepted way that medicines are used, called guidelines. This book was written with expert guidance from my editorial advisory board and from Mended Hearts in order to more clearly tell you and your family about national treatment guidelines—giving you the power to make smart choices, to help drive your own destiny, or successfully coach a loved one. It is OK to ask your doctor questions and to team up and think together about guidelines, the medicines that most experts recommend, and why or why not they might be the right ones for you.

Guidelines in the broadest sense are simply a road map, a way that experts suggest that things should be done. Oddly enough, even though they are developed by recognized experts and reviewed by objective organizations, guidelines are often simply not followed. For example, most women die from heart disease. This is a fact; yet time and time again, doctors, nurses, and pharmacists do not take the time to ask simple questions about heart disease risk or family history. Frighteningly, even after a heart attack, underuse of recognized medicines (a “treatment gap”) and underuse or lack of communication of information (a “knowledge gap”) can be a lethal combination for women.

Hope for the future comes from getting things on track. Whoever you consider to be your “family” or your coaches, the time has come to get them on board with your treatment and care. This book is meant to give you good information to talk to your doctor, nurse, and pharmacist about. When you put yourself at the center of care and utilize the strength of your family, great things are possible. Learn from this book, and then speak up.
In every section, you’ll find checklists of questions to ask your doctor, nurse, or pharmacist BEFORE you go home. Ask for yourself, for your loved ones, and for your friends. There are even checklists in this book to copy and take to your family doctor, heart doctor, and other specialists after you go home. Request (politely but firmly) that they be added to your medical chart, and talk about them at every office visit. Stay involved in your care as time goes on. Remember, your best chance of preventing worsening disease, a second heart attack, or second stroke comes from working together as a family to start and keep taking proven medicines over time. Great things are possible. Find out, speak up, and mend your heart.

No claim is made that all known actions, uses, side effects, adverse effects, precautions, guidelines, or interactions for a drug or condition are included in the information provided in this book. Talk to your doctor before making any changes, additions, or deletions to the medicines that you already take. This book contains information about guidelines, medical conditions as well as medicines—but is NOT medical advice. Although diligent care has been taken to ensure the accuracy of the information provided during the preparation of this book, the continued accuracy and correctness are ever subject to change relative to the dissemination of new information and guidelines derived from drug research, development, and general usage.

Funding for development of this book was provided through an unrestricted educational grant to Mended Hearts from the Bristol-Myers Squibb/Sanofi Pharma ceutical Partnership to develop a guide for heart patients focusing on making the most of medications. Development, content control, and other matters relating to this book were accomplished by the author, publisher, and advisory board, wholly independently of the Bristol-Myers Squibb/Sanofi Pharmaceutical Partnership. No part of this book may be reproduced, stored in any retrieval system, or transmitted, used or communicated in any form or by any means without prior written permission from the Medicine Information Institute, Inc. Use this book in ever improving health.

James Joseph Rybacki, Pharm. D.

Medicines and Your Family. Copyright © 2004 by The Medicine Information Institute. All rights reserved. For information, address The Medicine Information Institute, 8133 Elliott Road, Suite 212, Easton, MD 21601