Sandra Davidson, Heart Failure Clinic

One of Sandra Davidson's joys, besides her grandkids, is riding her new fat-tire bicycle around the Galesburg neighborhood with her sister, Vicki Muraoka.

"We just pedal and talk," said the 55-year-old food service worker for Sodexho in Kalamazoo. "It's fun."

A year ago, however, pedaling and talking would have been impossible. Sandra, a Florida native who has lived in Galesburg for more than 20 years, could barely walk.

"I didn't have any energy," she said. "I couldn't breathe and I couldn't sleep at night. I was having what I thought were panic attacks and when I'd get home from work I would have to take a nap."

Sandra knew she needed to lose weight and started a diet and exercise program. But how can you lose weight if you haven't got the strength to exercise?

She thought that her lack of energy was related to the change in life for a woman her age. And for several years she took hormone replacement medications. Two years ago, at her doctor's recommendation, she weaned herself from the pills.

"Shortly after that the panic attacks started again," she said, "although I didn't have any night sweats or other symptoms (of menopause).

"One day I was at a baby shower at a house that was built partly underground. All of the sudden I couldn't breathe. I went outside to breathe and when I went back inside I had to stand."

That was in March 2009. The next day, motivated by friends who were concerned about her health, she made a doctor's appointment. Her physician ruled out change of life and said that her condition was related to her heart. He referred her to Dr. Alicia Williams, a cardiologist at the Heart Center for Excellence.

"She did some tests and of course I didn't pass," Sandra said. "She said I had an enlarged heart and that it was hereditary. She referred me to the Heart Failure Clinic at Borgess (Medical Center)."

The Borgess Heart Failure Clinic is part of its comprehensive Heart Failure Program and includes diagnoses by experts who provide optimal treatment, an inpatient unit for those who need hospitalization, a home exercise program and an on-going education series for the public.

"When she first came to us she has lost weight, about 70 pounds, but she still did not feel well," said Gail Venner, a nurse practitioner and Heart Failure Clinic director. "She did not have a heart attack and there were no blockages in her coronary arteries. Her heart muscles were weak for whatever the reason -- a viral infection or a genetic condition.

"We didn't pursue a cause because the treatment is the same for all of them. We work on improving weak heart muscles."

Venner said the first task was to find the right medications and dosages to turn down the body's natural reaction that was making Sandra's heart work harder and that was causing further damage.

Venner said that when the body senses a heart problem it triggers the release of adrenalin and other hormones as part of the fight-or-flight reaction. Normally, however, the reaction is supposed to be short term, not constant and damaging as in Sandra's case.

Once the medications were fine-tuned, Sandra began getting back her energy and in short order had purchased the bike and started biking and feeling better. Her sister, who has some weakness from polio as a child, bought a three-wheel bike to join the fun.

"It took us 50 years to bike together," Sandra said. "And when we ride together there's nothing like it."

Venner said that the best part about Sandra's case is that she is "ecstatic" about how she feels. "She comes to every class and listens to what we say and tells everybody how much the program has helped. We can help 65% or 70% of people like Sandra, especially those who have not had a heart attack."

Sandra said that despite the fact that she works in food services, the classes have been very helpful in helping her understanding the benefits of a proper diet, especially one with very low salt intake.

"I didn't know about salt and about excess fluids," she said. "The influence of salt in the diet is astronomical. Now I read every label because if you do you will be amazed how much sodium there is in so many foods.

"Changing my diet and cutting back on sodium has not been easy. It has been very, very hard. And it's so much more expensive to buy products that have little or no salt. Now I make soups and chili from scratch and don't add salt."

Sandra said that she faithfully takes her medications as prescribed and walks on a treadmill when bicycling is not possible.

"I think that Borgess is wonderful," she said. "When I went to them with heart problems I was upset and I was angry. They just swoop around you and take you in and calm you down.

"I listen to what they tell me and I can see good results. I want to breathe and feel good and I don't want someone to have to take care of me when I'm older. I want to take care of myself.

"I want a good quality of life. And I want to see her" -- gesturing to her 5-year-old grand-daughter -- "walk down the aisle."