Joey Wahler (Host): We're talking with a cardiology patient, plus the doctor and nurse that helped save his life. Our guests, Southeast Georgia Health System, both Dr. Mitchell Jones, a cardiologist, and Candace Anderson, she's a cardiovascular service line nurse coordinator. Plus, we're joined by Jerome Sheldon, that cardiology patient. 

This is Health Matters from Southeast Georgia Health System. Thanks so much for joining us. I'm Joey Wahler. Hi there, Dr. Jones, Candace, Jerome. Welcome to you all. Great to have you aboard.

Mitchell T. Jones, MD: Thank you.

Candace Anderson, RN, BSN: Hello.

Jerome Sheldon: Thank you.

Host: Absolutely. So first for you, Dr. Jones, I wonder what piqued your interest in healthcare and Cardiology in the first place?

Mitchell T. Jones, MD: Oh, goodness. I come from a family of doctors, actually. So, my father was a cardiologist and worked for this health system a long time ago and I have two other siblings that are physicians. And so, it was very much part of my life growing up and it's just been wonderful, wonderful career, honestly. Thank you.

Host: Doc, how long have you been with Southeast Georgia Health System and what brought you to it?

Mitchell T. Jones, MD: Well, this is my home. This is where I grew up. And I went away, was educated and trained at Emory University in Atlanta. And 20 plus years ago, came back and joined the health system. We initially were in a private practice that my father had started years ago and practiced with my sister and Dr. Strickland a long-time professional associate. And three or four years ago now, we joined the health system, which was fantastic, and we're just excited to be here.

Host: That's great. And so Candace, for you, why healthcare and nursing? What initially piqued your interest?

Candace Anderson, RN, BSN: Initially, I wanted to be a veterinarian. I've always loved animals, so becoming a nurse was something completely far out there that I didn't expect. But over time, I had some health issues growing up and I had some great nurses and doctors in my corner. They helped educate me on what I needed to do, and there was just something that clicked that said this is what I need to do. So, I've enjoyed it, I've been fulfilled by it, I'm excited about it. I learn something new every day. I do have a couple of relatives that are nurses in my family. So, I guess, I did kind of walk in their shoes as well.

Host: So, it sounds like a combination of factors there. And how long have you been with the health system and how did you wind up there?

Candace Anderson, RN, BSN: I've been here now 11 years this time, and I was here about three years. When I first became a nurse, I moved away briefly just to get some more cardiac training. We don't do open heart-type surgeries here, so I left and went to a facility where I could learn that, and I came back home. This is my home. And I wanted to bring a little bit more back here, what I've learned, so that I could be a better nurse.

Host: That's awesome. Jerome, how long have you lived in the area and what would you say your daily life was like before your heart procedure?

Jerome Sheldon: Well, I moved back to Brunswick back in 2014. Prior to that, I was here from 2003 to 2009 as a contractor at the Federal Law Enforcement Training Center. And then, after the contract, I moved back to Baltimore to Cole. And so, I head back to Brunswick and I've been here since.

Constantly moving, constantly going. And I guess because of constantly moving, I didn't pay much attention to my diet. You know, aI lways wanted to go grab something to eat and just kept on moving. As a matter of fact, prior to my episode, I actually just came back from Nigeria or West Africa, again, with the dieting and things like that, working constantly, I do work from home so that too played a part.

Host: Gotcha. And so Jerome, how did you come in contact with Dr. Jones and company? What was the episode that you mentioned?

Jerome Sheldon: When I got back from Nigeria, actually, just some discomfort in the heart, my chest actually. And I just thought maybe, you know, heart burn or something like that. I would drink a little bit of water, it goes away. But each time we come back, it came back a little bit stronger, burning. And so, my wife decided, well, let's just go to the cardiologist and see what's going on. So, we actually came up, I think, it was on the Monday, and that's when I met Dr. Jones. And of course, we went through some few diagnostics and stuff like that. And then, we're a little bit puzzled too, because didn't quite figure out what was going on. And so, the plan was to at least come back in a couple of days to go through a little scan to check or something like that to make sure what's going on in there. 

I think what helped me out too was, at that visit, I forgot the medication, but he just gave me some pills to take in case if it did come back, the heartburn. And his thought process to me was that, if it comes back or something like that, take the pills. Maybe, you know, for five minutes, it should go away. And if it doesn't, take another one and then just head on to the hospital. So when I went home that day, it was okay. But the next day, that's when that happens. And of course, when I took the pills the first time around, it was still burning. I said, "Uh-oh," I took the second one. And then, I came back to the hospital.

Host: And so, Dr. Jones, what wound up being Jerome's condition?

Mitchell T. Jones, MD: Well, Jerome has coronary artery disease and had an atherosclerotic buildup in an artery, which ultimately when he came in, resulted in an acute loss of blood flow to an area of his heart and a heart attack. My initial visit with Jerome, he came in complaining of burning in the chest and his wife accompanied him. And she volunteered as well that maybe this was heartburn, but clearly they were concerned and puzzled as to what this was. And it was distinctive because, as I first talked with him, he described a burning in his chest and I thought perhaps this is heartburn. And then, the longer I talked to him, the more concerned I became. So, my point, this is just a good learning case and what I want to point out is that typically heart pain occurs as a pressure or a tightness in the central area of the chest. But it can be different in different people. And sometimes people do describe it as burning.

And the second really point that I want to make here is that Jerome followed his instincts. I would use the word oppressive. I ask some people sometimes, was the pain, was the discomfort oppressive? And what I mean when I say that is you don't like it, you want it to go away. And there was that sort of feeling I got from Jerome that this was something that really got his attention. And so, he followed his instincts and came in. And that's a second very important point I want to make.

And then, the last point, Jerome underwent stress testing and had evidence that he may well have a blocked artery and was scheduled for a coronary angiogram or a cardiac catheterization. That's a test where we insert a tube catheter in the radial artery. So, the access is gained at the wrist. And with x-ray guidance, the catheter is advanced to the area of the heart, and x-ray dye is injected into the coronary arteries.

The last point I just want to make is that Jerome experienced these symptoms and came to the hospital, and was emergently treated for a heart attack, underwent an emergent cardiac catheterization, had a stent placed in a major artery on the front wall of the heart. But he really did a good job following his instincts coming in and was treated. And the thing that is so important about that is despite having what could potentially have been a very large and damaging heart attack to the heart muscle, his heart muscle is preserved. So, we often say in these type of emergencies that time is muscle. We want to preserve heart muscle by treating patients quickly and effectively. So, I'm just happy that we're here with Jerome today.

Host: Absolutely. And so, just how quickly, doctor, did you have to do the procedure?

Mitchell T. Jones, MD: Yes. I mean, we have a whole system set up to respond to emergent care in terms of direct coronary intervention, we call this. So from the time a person either calls 911 and is evaluated by EMS or whether they present to the emergency department, a whole system is triggered where the goal is certainly under one hour and is oftentimes 30 minutes. So, we have our staff coming in emergently, the quicker the better.

Host: Indeed. Now, Candice, what's post-cardiac surgery rehab like for a patient like Jerome?

Candace Anderson, RN, BSN: So, post-cardiac rehab, it consists of monitored care by healthcare professionals, exercise physiologists, as well as registered nurses. There is a gym set up, especially for these types of patients where they are given a prescription to exercise that cardiac muscle. We want to build it back up to make it a little bit stronger from where they've had an injury that occurred whenever they went without oxygen because of a blockage. So, we want to help them also build up cardiovascular pathways, collateral vessels, whenever you do cardiac activity. It helps build collateral vessels to help feed the heart. And that way, if our native arteries are blocked, we still have help from these collateral vessels to continue to feed the heart in other areas.

So, that's something that I help initiate after they've discharged and seen in their followup with their primary care physician as well as their cardiologist. When they've been cleared by both of their physicians, then they're able to come in for an orientation. And in that orientation, they also meet with a dietitian. The dietitian helps them with their diet choices, making better choices, helping them be consistent with meals. It's a program to treat them, as a whole, and we also include their family in it as well. So if a family member wants to come in and wants to learn what they can do to help their family member be successful, we offer them that as well. Going over medications with them so they can learn the different side effects, so they'll be prepared on what they need to do, when they need to call their physician, and when they need to seek more help.

Host: So obviously, what you're saying there, Candice, is that once the procedure is behind the patient, there's still work to be done, particularly on the patient's part, along with, of course, the help and guidance of you and yours. And so, Jerome, how would you describe your experience with that stent procedure, and then with this Cardiopulmonary Rehab working with Candice and her colleagues.

Jerome Sheldon: That I can't really put it into words because, I mean, I remember when Candace first came into the room, just getting out of my sedation, you know, with the medication and with that smile that she had there, and I'm saying, "Okay, what's she about to say to me?" She kind of asked me some few questions, how was I feeling, and things like that. But I think most importantly, for me, because in that moment, you know, you just had a life experience. So, the shock is still there. And of course, I'm going through all the different emotional experiences and things like that.

So, the program actually kind of helps to calm me down and especially when you become discharged, you know, you're away from the hospital. For some reason, if I'm at the hospital, I feel much better, so to speak. But the minute I get home, you know, every little twinkle here and there, I think Dr. Jones know I kept calling him. You know, he kept telling me, "You're okay, you're fine. But I think the program kind of built my confidence back up just kind of reassure you that, okay, you can work through this." And so, I got on a regimen where I think we're three times a week. I was going in there and working with the staff. They're all checking, constantly checking my blood pressure with the different programs and things like that and gradually started to build that confidence in myself, so to speak. And of course, that'll feel much better as times went by.

So, the program was really helpful for me. I'm really glad that I was able to enroll into the program. I didn't know anything about the program, but I was glad that she came up there. And of course, when she told me about it, I got my wife involved. We sat down with Candace, had a nice conversation with the program, even with the diet, the dietitian too, came in and helped me with some of my dieting, you know, food to eat and things like that. So, I'm now more cautious, you know, if I grab a food off the shelf, I'm looking at it now, the back of it, to see the ingredients and things of that nature. So, with the program, it helps you to be aware of those things too.

Host: And so, Jerome, how long has it been now since your procedure and what would you say is the biggest difference? You alluded to it a little bit there, but overall, what's the biggest difference in your lifestyle now?

Jerome Sheldon: I think now I've just been more aware, for me, what I'm eating, exercising. I work from home, so a lot of time I'm sitting. And so now, I come out, do some walking, things like that. But it has been a big change for me, even just health wise. I was able to lose some weight. Before the episode, I was like about around 203, something like that, 204. But I came down to about 180, 181, that's where I'm pretty much fluctuating. And it feels much better. It feels good. You know, the energy is there. When I get up, I'm not feeling a little sluggish or anything like that. I think in the beginning, the medication, trying to get adjusted to it, but after a while, once my body, I'm assuming, got adjusted to it, it was okay. I feel much better.

Host: Dr. Jones, how rewarding is doing this kind of life-saving and life-changing work?

Mitchell T. Jones, MD: I'd just like to say what we do, we take this very seriously. And for Jerome to entrust our healthcare team with his health and in this situation with his life, it's amazing. And really, there's just no better use of my time really. So, I'm proud to help.

Host: Absolutely. And Candice, how about you? What goes through your mind when you hear Jerome talk there about seeing your face and how much that meant to him in terms of his confidence improving going forward?

Candace Anderson, RN, BSN: It's really humbling to hear that. I appreciate it. I'm just grateful I can be in this position to help others get better, spend more time with their families and really take hold of life the way they would like to.

Host: And in summary here, Jerome, kind of wrapping up on the point that the doctor made earlier about how you were smart enough to listen to your body and not wait until it was too late. So, what advice along those lines would you have for others that may be concerned about their heart health and they're not quite sure about whether to act on it considering your experience and the way things have turned out so well?

Jerome Sheldon: I think in my case, you know, the fact that, I mean, I don't smoke, I don't drink, when this thing started to happen, you know, it caught my concern because it's not a usual thing for me. I couldn't put my finger on it. And I know a lot of times, too, for males, you want to kind of stick it out, so to speak. But it's always nice to get a legal advice. I think now I realize, like, so much that goes on in your body that you just don't know. Because I remember some of the questions Dr. Jones would ask me when I was there, "Do you smoke? Does anyone in your family have this?" And I'm like, "No, no, no." But that really lets me know that, at times, it's not hereditary. It's the body, things can happen. And so, if you feel uncomfortable with certain things, it's because you know your body, you know your comfort level. You know, you don't have to be in severe pain to go to the hospital, so to speak.

You know, if it's just something off, my advice is try to get there and get that insurance on what's going on. And in my case, it worked out. And fortunately, for me too, I think the first visit with Dr. Jones is what really helped me because maybe if I would have went through the night trying to say, "Well, I'll just go ahead and wait it out and go." But I remember he saying to me, if you take the first pill, right? And if it's still persistent, take the second one and then head to the hospital. So, that advice actually helped me. That was because I went in to see him the first time around.

Host: And the results speak for themselves. Well, folks, we trust you're now more familiar with heart health. Dr. Jones, Candice, keep up your great work. Jerome, continued good health. And thanks to all of you for being with us and sharing a story with a very happy ending indeed. We appreciate it.

Mitchell T. Jones, MD: Thanks so much.

Host: And for more information, please visit sghs.org/cardiology. Now if you found this podcast helpful, please do share it on your social media. I'm Joey Wahler. Thanks again for being part of Health Matters from Southeast Georgia Health System.