'Platoon Guide' Meets 'Drill Sergeant' for Heart Care

Curtis Ashby, 49, has always been a leader rather than a follower.

That independent streak served him well in the military and made him a formidable foe on the athletic field as a teenager. However, the trait took a back seat when he suffered heart failure a year ago.
 
He came to the UC Health Advanced Heart Failure Treatment Center and found that it is OK to be someone who takes direction well, especially when there is a talented team of physicians, nurses and cardiac rehab specialists who have your back.

"It's more important than ever for me to follow directions now," says Ashby, a married Cincinnati father of four adult children. "I had a hard time with that, being a (former) manager and being strong-willed and opinionated.

"I've run everything my whole life and I've never been someone who has followed anyone. When I went in the military my second week in training I became the platoon guide. I run the show, I don't listen and I have a hard time with that."

Ashby came to UC Health with a hypertensive emergency, pulmonary embolus and uncontrolled diabetes. An echocardiogram performed in June 2014 showed he suffered a severely reduced ejection fraction of 20 to 25 percent. An ejection fraction is a measurement of the percentage of blood leaving your heart each time it contracts. Normally, it should range from 50 to 55 percent.

But staying on a restricted diet and sticking with an exercise regimen designed by the cardiac rehabilitation team at the Hoxworth Building has allowed Ashby, a former U.S. Army sergeant, to drop from 280 to 250 pounds during the past six months and return to a normal ejection fraction of 55 percent.

An athlete during his youth, Ashby became a bit more sedentary as a middle-aged adult balancing the duties of family life and a hectic work schedule. But under the prodding of Anita Whitton, a nurse practitioner in the heart failure and transplant program, Ashby started reading food labels and watching carbs and sodium in-take. He also installed an app on his phone to count calories.

"She is a drill sergeant but I love her," says Ashby, referring to Whitton. "She is direct and that's what I needed. She was like, this is your life and these are the things that must change. So you have to lose some weight. This is not something you can get rid of or get over, but you can manage it well."

Ashby learned that about 1 percent of the people with his condition would ever have a normal heart rate or ejection fraction. He was determined to make the cut.

He worked closely with Whitton under the direction of Stephanie Dunlap, DO, medical director of the UC Health Advanced Heart Failure Treatment Center. Exercise physiologists, Stephanie Moore and Chris Mueller, coordinated his physical activity, while access coordinators, Shirley White and Jeanne Flick welcomed Ashby to his weekly appointments. Ashby says UC Health's team approach really made a difference in his care.

"I was like I am not going to stay sick," says Ashby. "My goal was to recover 100 percent and get better. I took it seriously from day one because I thought I was going to die."

But Susan Duncan, a registered nurse at UC Health's cardiac rehabilitation program, says Ashby's determination has paid off.

"He has worked very hard in the last year," says Duncan. "He has changed his diet and been steadily losing weight, successfully managed a heart failure medication regimen and has shown persistence and tenacity in attending cardiac rehabilitation despite some significant challenges."

Ashby, who has an infectious smile, says his diagnosis initially made him angry.

"You can't tell because I am playful and I joke all the time, but I was mad that I was sick. That was the motivating factor," he says Ashby.  "I don't like to be told what to do. I figure if I can do it and get where I am supposed to be, I won't have to have people telling me what to do."

Ashby broke into laughter remembering his experience before adding, "I do appreciate everything they have done. I really do."