Page 14 - Christiana Care Focus February 2019

Members of the heart failure team for patient Miguel Denizac (center), including, from left, Franjo Siric, M.D.; Cathy Johnson, RN, CHFN; Susan Roberto, CMA; Craig Laing, MSN, ANP-BC; and Sourin Banerji, M.D.
It’s a Wednesday morning and Miguel Denizac arrives for a checkup with the team from the Heart Failure Program in Christiana Care’s Center for Heart & Vascular Health.
He smiles as he gives a high-five to Craig Laing, MSN, CRNP. Susan Roberto, CMA, a Cardiology team lead, comes from behind hAer desk for a hug. “It’s always great to see you, Miguel,” she says.
little more than a year ago, Denizac was frightened and upset. At age 33, he collapsed and was rushed to the hospital. “I couldn’t breathe. I felt like I was going to vomit,” he recalled, speaking through a medical
interpreter. “When they got me to the hospital, they couldn’t find a pulse. Right there, they found a problem with my heart.”
Denizac was diagnosed with cardiomyopathy, essentially a weak heart, sometimes with no known cause. He was in heart failure, a condition in which the heart can’t pump enough blood to serve the body’s needs.
It was hard for him to understand. A native of Puerto Rico, Denizac speaks only Spanish. Back home, he had been diagnosed with bronchitis and other lung problems, but not heart disease.
12 CHRISTIANA CARE HEALTH SYSTEM
“With younger patients, receiving a diagnosis of heart failure hits them like a ton of bricks,” said Niya Jones, M.D., MPH, a cardiologist who specializes in advanced heart failure. “Understandably, it can be a very difficult diagnosis to accept.”
Denizac’s best hope for survival was a left ventricular assist device or LVAD, a battery-operated mechanical device that takes over the job of the left side of the heart. But he was reluctant to cooperate with his care. To receive an LVAD implant, patients must be able to follow treatment plans and care for the device.
“I resisted. I wouldn’t take my medicine. I didn’t want nurses in my room,” he recalled. “I was not an easy patient.”
One of Denizac’s greatest barriers to care was language. To break down that wall, the Heart Failure team partnered with Language Services, which provided qualified medical interpreters during his appointments.
Roberto became his advocate. She believed that Denizac could overcome his resistance and do well managing his LVAD.
Teamwork with