Do you think disease awareness campaigns will help chronic illness patients win the most important contests of their lives?
In previous posts, I described the challenge in figuring out what was wrong with me and developing a treatment plan. In future posts I will discuss the inevitable setbacks that come with a chronic illness, and how I am growing to accept the fact that heart failure will be with me for the duration of my life. So one thing that occurred to me as I wrote this post is that we are in an election year and the campaigns have been relentless. While I haven’t been running for election, I have been waging a battle to win one of the most important contests of my life. I need to be relentless and so do my partners.
I have learned that I need to maintain as much positive energy as I can. So on the plus side of my health ledger, I have taken a very energetic and proactive role in my treatment. I stay on top of my diet and exercise routine, I take my medication on a strict schedule, and I report any positive or negative issues to my cardiac team. I study the development of new options to treat heart failure, and I know that progress continues be made in the development of new drugs and medical devices.
I was excited in July 2015 to see that the Food and Drug Administration approved a new heart failure drug known as “Entresto” manufactured by Novartis. The drug had been shown to reduce the rate of cardiovascular death and hospitalization related to heart failure. Shortly after Entresto was approved, Novartis released what in the medical world is referred to as a disease awareness ad campaign. Here is a summary of the ad, entitled “Keep it pumping”. It begins with a man sitting in his chair reading a newspaper with the television on while water slowly floods his living room. In the background you can hear the water flowing into the room. The man’s dog is whining and seeking higher ground.
The man continues to read the sports section of the paper, apparently oblivious to the fact that there is a crisis that poses an imminent threat to him. The voice over warns: "With heart failure, danger is always on the rise. Symptoms worsen because your heart isn't pumping well. About 50% of people die within 5 years of getting diagnosed. But there's something you can do. Talk to your doctor about heart failure treatment options. Because the more you know the more likely you are to keep it pumping.” (Note to family and friends reading this: Based on what my doctors tell me, I do not fall within the population defined by this sobering statistic . Please don’t worry!)
So what did I initially think of the ad? I had a very visceral reaction. I was discouraged to see a heart failure patient who is oblivious about his condition and his options. I mean, seriously - the dog is more perceptive about what is happening than his owner. To be fair to Novartis, the statistic about the potential life span quoted in the ad appears on other websites. Also, the advice to partner with your doctors was excellent. So it was not the accuracy and overall advice regarding treatment options that concerned me. It was the implication that patients may be indifferent to their condition and treatment that bothered me.
I know that I have worked hard to develop a productive collaboration with my cardiac care team. After working through the fear and anxiety of heart failure, I had begun to take back my life and do everything in my power to turn it around, to the encouragement and reassurance of my cardiac team and my therapist. I will admit that after the first few times I viewed the ad, it seemed to hang over me like a death sentence. I felt like I might as well start writing my obituary because heart failure was gunning for me. But then I just refused to let it bother me because I have taken charge of my health and I am doing whatever I can to help my heart.
I have found some articles on-line criticizing Novartis for the release of this ad. But while some have criticized the ad, I also saw quotes indicating that the ad was well done and empowered patients to learn more about heart failure. A Novartis spokesman said that the goal was to create awareness so that people with heart failure could take action to live longer, healthier lives. They wanted to not only educate people but to facilitate the dialogue between doctors and patients.
Because I was still a little bothered by the ad, I discussed the ad with some friends. One friend said to me that perhaps there are patients who are not as well informed or as proactive as I am. This caught my attention and it occurred to me that before I was told that I had heart failure, I had no clue what heart failure was. Also, maybe I was not the patient that Novartis was trying to reach through the ad campaign. Because I am so absorbed in my treatment, I sometimes forget about all the other people out there who have heart failure. While I see many patients in the waiting rooms with me, I suspect there are more patients who need to be there.
This is who the ad campaign is trying to reach. If there are patients who do not realize the risks that are associated with heart failure, hopefully the ad will not intimidate them but will motivate them to find a cardiac team. Hopefully they will be encouraged to ask their cardiac teams the right questions and to figure out a plan to keep their hearts pumping for as long as possible.
I recently saw some print ads for Entresto. These ads are upbeat. One ad portrays a grandfather helping his grandson construct a model airplane with the caption: “TOMORROW I hope to help Leo use his hands for something besides video games.” Then it says: “If you have heart failure, tomorrow is not a given. Help Make Tomorrow Possible.” It reflects the seriousness of heart failure balanced against hope for those who are willing to partner with the medical profession to improve their odds.
The bottom line is that it is good when we can generate a healthy partnership between the pharmaceutical companies, the medical device companies, heart doctors and the patient population. Novartis and other companies are a critical piece of our lifeline to better health. I would like Novartis, and the entire medical community for that matter, to know that many of the patients they are reaching out to are heavily invested in their treatment. We need to combine their resources with our determination in order to help us win the campaign of our lives.
So am I taking Entresto? Well right now, my doctor says I am too healthy to take Entresto. But I have this drug and other options in my campaign tool box in case my health deteriorates. While the Keep it Pumping ad can be daunting, the sobering information in the ad keeps me focused on heart health discipline. It keeps me motivated to look for silver linings that will help me retain my optimistic outlook, which is also important for good heart health. My medical partners in the campaign against heart failure are equally energetic, and they are well-qualified and resourceful. As far as I'm concerned, we're in this campaign to win it!
Melanie discovered that she had heart failure in 2013. She spent the next 7 years learning how to live with the condition, and how to achieve balance and personal growth. Then in October 2020, she received a heart transplant. This blog is about her journey of the heart.