Pumps, Pipes and our Circulatory System

Conscious or unconscious, aware or not aware, our circulatory system is flowing through a cycle 24 hours a day, 365 days a year, for our entire life. On average, approximately 5 liters of blood is pumping through our entire circulatory system at any given moment. This system is comprised of three distinct sub-systems, the coronary circulation, pulmonary circulation and systemic circulation. All three of these circulatory systems work in concert with each other to provide oxygenated and nutrient rich blood to all of our tissues with the goal of sustaining life. The system also works to help rid us of all our waste products, whether it be liquid, solid or gas. What follows is a simplified version of how our circulatory system functions to provide us with our minute by minute energy needs.

Our heart is the pump that keeps this entire system working. The process begins when our heart pumps oxygen and nutrient rich blood into our blood vessels. This is the mechanism for carrying these nutrients and oxygen to all of our tissues, from our brain to our toes. Eventually, after the body has used much of the nutrients, the blood will reach our kidneys (renal circulation) where waste is filtered from the blood.

From the kidneys, the nutrient poor blood continues its path into the small intestines. At this interchange, a large transaction takes place. As blood flows into the small intestines it is directed through the liver where it is then re-directed back out toward the heart. The liver will filter waste and will also store left over nutrients and sugars. When we eat, food travels through our stomach and into our small intestines, where our body absorbs nutrients. The left over matter, after nutrient absorption, will then be eliminated in our waste.

From the small intestines, our un-oxygenated blood, which is rich in both waste and new nutrients, will be pumped back to the heart. The heart has a tremendous mechanism which receives this used blood, and then pumps it into the pulmonary system (our lungs). The lungs will then filter the blood, exchanging oxygen for the waste, and then send the blood back to our heart, rich in oxygen and nutrients, ready to start the process over again.

This system is tremendous at keeping us alive, despite all the stress we put on it. Our circulatory system provides nutrition and oxygen to all of our tissues, and then works to filter out all of the waste and garbage. At a moment's notice, our system will respond to our physical needs, whether they be exertion or rest related. With that in mind, it is important to understand that if something does not work appropriately at any point along the system, the entire system is affected.

Our heart is the pump that keeps the blood flowing. If the heart has some irregular rhythm, or slows down or speeds up, the amount of blood being circulated will be affected. An irregular rhythm may also lead to a clot that may clog one of the circulation pipes and cause a stroke or heart attack.

Our blood vessels are the pipes that circulate our blood to all of the tissues. There are many different reasons that will cause the vessels to either relax or constrict which will affect our blood pressure. This in turn affects how hard the heart works and changes the level of circulation.

Our kidneys are similar to the faucet in the house. If, for one reason or another, the renal circulatory system is not working well, the filtering system may back up and not be eliminating the waste products as well as it should. This then affects the entire circulatory system.

Finally, our lungs are similar to an air filter system. What happens when the air filter becomes clogged? Well, the air does not get filtered and it is much more difficult to get the oxygen we need for survival.

Of course, we have medications that affect each and every system. These medications work to help our circulation flowing as best as it can. Remember, we only have one chance at keeping a strong and healthy circulatory system. Understand that each and every time we breath, eat or drink we are providing energy and nutrition to our body. Our circulatory system then needs to either use that nutrition, put it into the waste pile, or store it for later use.

At some point in our life it is possible that our circulatory system may break down, as it does during a heart attack.  At this point, assuming we get to the hospital in time, and are treated appropriately, we will be discharged from the hospital after some time on a regimen of medication.

Researchers conclude that all recommended therapies are necessary in patients after heart attack and that improved adherence to each drug reduces the risk of subsequent major cardiovascular events. The results of a
particular study highlight the importance of adherence and the need for more interventions to improve adherence among these patients."

After a heart attack patients are sent home with a handful of new medications that they have never taken before. Many heart attack survivors have never needed to take medications on a daily basis. Here they are, faced with the task arranging their schedule so they remember to take four or more new medications on a daily basis, sometimes up to three times daily.

Many tools are available to help patients remember to take their medications on a scheduled basis. Walk into your local community pharmacy and ask them to show you their pill box section, most likely you will see a rack that has over 10-15 different choices of daily or weekly pill containers. These help patients keep their medications organized in a nice manner.

This is the section I like to call Motivational Adherence. Educating a patient about their medications may help a patient to become motivated to participate in their own pharmaceutical care. When a patient understands what the medication is doing and what effects to look out for, they are then becoming an active participant in their own care, rather than just following directions.  

We only get one circulatory system, we need to do what ever it takes to keep it flowing!
Steve Leuck, Pharm.D.

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