Unspoken, heart disease can be one of the greatest clocks set on someone’s life.
For Sterling resident Vickie Walber, it felt like a matter of time. Heart disease runs in her family, recently claiming a brother. She decided it wasn’t going to get her.
Heart care has been historically hard to access on the Kenai Peninsula, though. Until last year, there was no full-time practicing cardiologist in the central peninsula. Homer’s South Peninsula Hospital has a number of commuting physicians through the Alaska Heart and Vascular Institute in Anchorage. There is no catheterization lab on the Kenai Peninsula where patients can get heart imaging tests and procedures like pacemaker implantation, though Central Peninsula Hospital is currently planning a project to build one in the next few years. Kenai Peninsula residents have had to travel to Providence Health and Services Alaska in Anchorage to get those services in the past.
However, a new service at Family Medical Clinic in Soldotna allowed Walber to get a full picture of her heart health in one go. Called Heartwise, the program does a battery of systems tests and provides the patient with a comprehensive evaluation of her cardiac disease risk in an understandable way.
“I would recommend it to anybody,” Walber said. “Stroke, heart attack … you have a chance, an opportunity to find out in advance and fix it.”
Cardiac diseases were the second leading cause of death in Alaska in 2015, according to a Jan. 25 news release from the Alaska Department of Health and Social Services. Age-adjusted rates of stroke have decreased in the last decade, possibly due to decreased use of tobacco products, according to the release.
The Heartwise program is designed to provide people with a full picture of their heart health, said Renee Howard, the Heartwise manager at Family Medical Clinic. In addition to the standard tests people can have done at their primary care physician’s office — stress tests and electrocardiograms, for example — the Heartwise program will conduct a full blood panel and screen for stroke, diabetes, cancer, varicose veins, circulation issues and other heart diseases, she said.
“One of the biggest things … is the detection of atherosclerotic plaque,” she said. “The (Centers for Disease Control and Prevention) has just rates stroke as the fifth largest cause of death (in the U.S.). 90 percent of those things can be prevented if detected early.”
The service is also cheaper because the program has condensed and negotiated the procedures with insurance companies, Howard said. Individually, the array of tests the Heartwise program includes would cost about $10,000. Taken together, the whole program costs about $5,000, and most commercial insurances cover it. Medicare and Medicaid do not currently cover it, but Heartwise is looking into negotiating some coverage for it, she said.
Although the company that developed the program is based in Austin, Texas, and has established itself in clinics across the Lower 48, the program in Soldotna is the first in Alaska, Howard said. Eventually, the company hopes to expand operations to other locations as well, she said.
One of the struggles of heart disease is that it’s largely asymptomatic until something drastic, like a heart attack or stroke, happens, said Tina Minster, the clinical operations manager at Family Medical Clinic. The Heartwise screenings can also help detect other kinds of disease, such as thyroid cancer, and are a tool for preventative care, she said.
“You go in for your well women’s exam once a year, because you have to,” she said. “You go in for your mammogram once a year because you’re supposed to. Then, any other doctors’ visits are going to because you’re sick … you don’t really go in thinking, ‘I need to have my whole body checked out, to find out what’s going on with my heart, find out what’s going on with my thyroid,’ anything like that. There hasn’t really been a preventative program available that offers something like that, and then (we got) Heartwise.”
That’s how it worked out for Randy Smith. Last April, he had the Heartwise evaluation done after hearing about it during a routine checkup. Not only did he learn a lot about his heart, but he also learned that he had aggressive prostate cancer. The cancer was already advanced enough that it couldn’t be completely eliminated, but he was able to get treatment to control it, he said.
“For a lot of people, (the Heartwise program is) a peace of mind,” he said. “Other people are going to find out, ‘Oh, I guess I didn’t know that — I’m going to have to go get that fixed.’ (For me) it was a very aggressive form of prostate cancer, and it was probably going to eat me up pretty fast. Now it’s under control.”
The Heartwise test turned up a lot of other details about his heart health as well, he said. Patients are provided with a full packet detailing the test results and come in for their doctors to interpret them. The service is open to patients from other medical practices as well on a referral basis — in that case, the results are forwarded to the patient’s primary care provider, Minster said.
Minster and Howard also plan to do more outreach with the program. After Walber had her Heartwise exam done four months ago, she invited them to come to her church and do some of the basic screenings, such as a carotid artery check, that would be indicative of heart health. Walber said it was successful and a lot of the other members went to go do it.
The program has been busy since Family Medical Clinic started running it. Besides Howard’s office, where she does ultrasounds and other screenings, there is a dedicated exam room in the practice for the Heartwise screenings. They intend to take it further, too, bringing the basic tests to the upcoming Kenai Peninsula Health Fair on Feb. 18 and visiting churches and offices as invited, Howard said.
They’re also offering a discount through the clinic to incentivize people to get the check done. For the remainder of 2017, if someone wants to have the test done but their insurance only covers part of the cost or there is a deductible left over, the clinic will work with the patient to cover the cost for them.
“We want that for people from the whole Kenai Peninsula,” she said.
For Phyllis Allen, the tests brought peace of mind and allowed her to keep an eye on her future. With ten grandchildren and two great grandchildren on the way, she said she wanted to stay healthy to be there for them. Heart disease also runs in her family and the program is thorough, providing and opportunity to find out if anything is wrong, she said.
“(It) relieves the stress of hey, this is happening, that’s happening,” she said. “I’d recommend it to anybody. I think it’s a great thing that they’re doing heart awareness. Heart attacks take out a lot of people. Knowing the signs, knowing what to watch for, is important.”
Reach Elizabeth Earl at firstname.lastname@example.org.