Scott Webb (Host): Heart disease is way too common in America and today I'm speaking with Samantha Feltner. She's a Cardiac Nurse Practitioner practicing at Franciscan Health and she's here today to explain what a holistic approach to heart disease prevention means and how it could benefit all of us.

 This is the Franciscan Health Doc Pod. I'm Scott Webb. Samantha, it's so nice to have you here today. I was just saying that we're going to talk about a holistic heart disease prevention, a holistic approach, if you will. And that may be a little bit different than folks have had before or heard before, or experienced before. So what does that mean exactly holistic approach and what does that mean to you?

Samantha Feltner, NP: So a holistic approach is more than just medicine. So we could include heart, mind, soul, body, just embracing all parts of a person that goes into their wellness, their health, and really takes every part of themselves to make sure that they are on the way to their best self. To me, that means that they can take care of themselves in the best way possible.

They can use moving and getting their bodies moving. They can use their mind; meditation or prayer if that is what they want to use to really get themselves into a mindset of being healthy. Using their culture and their family values in order to get themselves into that mindset of health and wellness.

Host: Yeah, that's interesting. So a healthy, not just a healthy body, right? A healthy body, mind, soul. love it. I'm looking forward to this conversation. We hear, and I speak with a lot of medical experts, Samantha, so I hear a lot about the importance of diet and exercise for heart health and maintaining a good healthy weight. But so when we think about obesity then, or even just maybe 10 to 20 pounds overweight, how does that extra weight impact our health?

Samantha Feltner, NP: So being overweight, having that extra weight on the body can cause extra stress on the heart. So with each pump, there may be extra pressure that the heart has to use in order to get blood to the other parts of the body. Now there is research that people specifically with weight around the middle of their body, they are at increased risk for heart disease.

 The extra weight along with if they are not eating well, they are not moving their bodies, not having that physical activity with exercise, but also just not getting up and walking around in their daily lives. It can lead to more strain on their heart that causes high blood pressure, high cholesterol, Type 2 diabetes that can all lead to a higher risk for heart disease.

Host: Yeah. And of course, most of us do carry that extra weight around the middle, right? And you talked about stress there. Let's talk about the impact of stress on our hearts.

Samantha Feltner, NP: Absolutely. So stress is really a big thing for us. You know, we have short term stress that may help us in our, you know, daily life a little bit of stress that helps us get a project done because we need to focus a little more. But when we have an ongoing long term stress, that can take an emotional and physical toll on us, on our bodies, on our minds, but really on our spirits, on our souls as well.

You know, we can start having symptoms that go beyond just a daily thing. We can have anxiety, depression that may set in, we can start getting irritable. We can start having trouble sleeping. We can start having even physical symptoms like having headaches, a lot of kids, and adults too can start having upset stomachs.

Reflux is really a big symptom with stress as well. You know, you see a lot of people taking, Tums or something like that to help with their acid that they keep getting because they're just so stressed from it. Also tension. A lot of people hold tension in their shoulders and even just the sleeping, it can cause you just to feel drained throughout the day and just all of the activities that you need to get done throughout the day at work, your focus is just less than it should be. So, all of these things place more stress on the heart and can cause some major problems for you, for your body in general.

Host: Yeah. And you touched on sleep there. And I know a lot of us just struggle to get enough sleep. When I was younger, I could sleep for so long, 10, 12 hours without breaking a sweat. Now, you know, I wake up at 6:30 in the morning and just desperately wish it was more like 8:30. But how much sleep? Yeah. How much sleep do we actually need?

Samantha Feltner, NP: So, generally, the recommendation is about 7 to 9 hours of sleep each night. Now, I don't know about you, but I don't usually get nine hours of sleep. I try to get close to seven hours of sleep. Now, kids, babies, teenagers, they all need more than that, of course, because they're growing bodies, they're growing minds, but as adults, we need sleep.

That is our body's reset time. And it's really important for our, especially our minds, but also it does affect our heart as well. And our hearts are affected. Sleep helps in the healing and repair of our blood cells, our tissues, our blood vessels, but it also can help our immune system to help us stay healthy. Anytime we have poor sleep,

it puts us at higher risk for that high blood pressure, the cardiovascular disease that we were talking about, high cholesterol, and so it is so important for us to really try and get that sleep. Now, I know that a lot of us, like I said, don't get that sleep, but there are ways that we can try and get more sleep.

Now, I know in this world right now, our screens, our phones are so important to us and a lot of us use our phones all day long up until the time that we close our eyes. And so one of the things that we could do is to try to limit our screen time up until the time we go to bed. Another thing that we could do is to try using meditation or breathing exercises right at bedtime.

Try to get a more bedtime routine, like I don't know about you, but with my kids, we have a routine that we go through at night to try to get into that, okay, it's time to go to sleep. We need to settle down. We need to focus on getting ready for bed now. So it's just as important for kids as it is for adults, that we can get that mindset that

 it is time to rest and it is time for our bodies and our minds to rest.

Host: Yeah. And let's stay with sleep. Let's talk about sleepapnea, how it impacts our heart health and what can be done about it holistically. Like I know about, you CPAP and I know like the technology and the machinery, but how about holistically, how can you help?

Samantha Feltner, NP: There's a couple of things that can be done. There's actually therapies where you actually use specific positions that you lay in while you're sleeping. You can look those up. There are credible sites that you can find those at, or you can speak with your provider about sleep therapies and going to facilities. Weight loss is another good one that we can use.

Getting that weight off will help to decrease the amount of weight around the neck which is where a lot of the breathing mechanism that is obstructed during sleep. And then there are also some appliances that you can use within your mouth that can help hold open your mouth and your throat area to allow the breathing to continue and not have that stopping and starting.

Host: Sure. It does seem like there's so many benefits to just exercise and healthy living, healthy eating, as we're talking about today, yeah, healthy mind, healthy body. How about supplements, and whether or not those are things we should be interested in? And if so, you know, we're going to talk to our doctor about heart health. Which ones would you recommend?

Samantha Feltner, NP: So there, there's quite a few out there. Few that have been studied, that I am aware of. Fish oil, CoQ10, garlic, red yeast, rice, flaxseed. There are a few others that have been studied that may improve cardiovascular health. But here's the thing, with any herbal supplement or vitamin that you want to start, you have to talk with your provider. Some of these herbal supplements may interfere with a medication that you're already taking. So, in order to make sure that nothing is going to interact, may cause an issue; you have to talk with your provider before starting it. Garlic has been used for cardiovascular health, but it also can increase the risk of bleeding. So if someone is already on a blood thinner

Host: Right.

Samantha Feltner, NP: You do not want to start that supplement, so you really have to, you know, weigh the benefits and risks of any of those.

Host: Yeah, good to speak with our providers about how things might interact and Samantha, you know, we've all heard about using CBD, marijuana to help reduce stress, which certainly seems like a good thing. When you advise patients about this, what do you say and how does it impact their heart health?

Samantha Feltner, NP: CBD and marijuana is kind of one of those taboo subjects sometimes. We have patients that do say that, you know, it helps their stress levels, that kind of thing. But again, number one thing is that you would need to discuss it with your provider, whether it is actually beneficial for you.

The mode of transmission that you may be getting a smoke versus gummy or any number of ways that, you are able to get CBD or marijuana, the risks that come with that may not be beneficial to you, and so you would just need to check in. As far as specific to heart health, CBD and marijuana, there are not studies specific to heart health that give conclusive evidence that tell us one way or the other if they are good for your heart, not good for your heart. So, again, speak with your healthcare provider to know if those benefits are really outweighing the risks.

Host: Right. Yeah. Some good stuff to think about, just how we can help ourselves outside of traditional, maybe, you know, sort of medications and CPAP and things like that. Just give you a chance here at the end, if you had an opportunity and you do, just a, you know, piece of advice for patients, what would it be?

Samantha Feltner, NP: Just educate yourself. Know your personal risk, know your family risks, what your family risk of cardiovascular disease. Has there been strokes, has there been heart attacks in your family? Know how close of relatives they were. Was it your parents? Was it, you know, your grandfather, uncles? Just have an idea of what has been in your family so that you can know, what you need to do to try to prevent those things. Were they smoking? Were they, you know, obese?

Or could it be a genetic link? Also, other chronic conditions besides heart disease, just, knowing those things. Also, don't be afraid to speak with your provider about what you want for your own health. If you want to go for a more holistic approach to your health, then, talk to them, let them know.

If you want to avoid those medications, you want to go on a more natural health journey, advocate for yourself, speak up, and let them know what you want. And then just with that work together with your provider to make the best treatment plan and the best plan in general. We as providers want you to be healthy. We want you to live a healthy life because really it's your life. Live it well.

Host: Yeah, that all sounds right. And of course, you know, knowing family history is good and that's important. And really just as a patient, right, you have rights. And one of those rights is to speak up and to advocate for yourself. And yeah, and, and if this is an approach that interests you, and maybe your provider's not into a holistic approach? Well, then maybe find another provider, right?

Samantha Feltner, NP: Absolutely. You know, that's another thing, you know, if you do not feel comfortable with your provider and they don't agree with what you want to do, it is okay to say, I think I want to find someone else.

Host: Yeah, no hard feelings, but I want to, yeah, I want to sort of take this holistic path towards heart and mind and body and soul health. And I'm just going to, you know, move elsewhere. So no problem. Samantha this is good stuff today. A lot to think about. I'm in my fifties and came up through medicine and healthcare in a very traditional way. And so I've never really considered any other options. This holistic approach, you've given me a lot to think about. I'm sure listeners as well. Thank you so much.

Samantha Feltner, NP: Thank you. It's been a pleasure.

Host: And visit franciscanhealth.org/heartcare to learn more about Franciscan's award winning cardiac care team. And if you found this podcast helpful, please share it on your social channels and be sure to check out the full podcast library for additional topics of interest. This is the Franciscan Health Doc Pod. I'm Scott Webb. Stay well, and we'll talk again next time.