CONTACTS
SUBJECTS
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0403 -
0403 - ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 27 0000. ref SDS 26 0000.
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040507 - ..
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0407 -
0408 - Progress
0409 -
040901 - Sent letter to Karen in VA Cardiology saying...
040902 -
040903 - 1. Subject: VA Pamphlet - One Step at a Time for Better Health
040904 - Date: 2017-05-22 00:26
040913 - ..
040914 - 2. On Friday, 170519, I was on campus in module 2 for wound care,
040915 - explained in the letter below [...shown in the
040916 - record on 170515 1942. ref SDS 24 BY9S...]. As usual Lana did
040917 - a great job, and was kind enough to help with plantarflexion
040918 - taping of both feet prescribed in orthopedics. It only takes a
040919 - few minutes, but is too difficult for me to do alone.
040921 - ..
040922 - 3. While waiting for Lana to call me for treatment, noticed a
040923 - pamphlet [...reported on 170519 1000. ref SDS 27 4G5J...],
040924 - among many tacked to one of the bulletin boards....
040925 -
040926 - "I Walk Because...
040927 - One step at a time Improving your health"
040929 - ..
040930 - 4. This caught my attention, because some are suggesting I back off.
040932 - ..
040933 - 5. Looking through the pamphlet there were 101 reasons to
040934 - continue. The pamphlet lists reason #17 to raise "good
040935 - cholesterol," which evidently means HDL. When I met with
040936 - Doctor Simpson on 170412, he commented that the Welch case
040937 - shows clear correlation between increasing hiking and
040938 - increasing HDL. ref SDS 9 I35I We're still talking about how
040939 - elevated HDL and EPCs translate to better quality of life
040940 - through RCT that maximizes blood flow, thus slowing vascular
040941 - cell senesence (aging), and strengthening cognition.
040942 - ref SDS 9 E963
040943 -
040944 - [On 170530 0924 Rob called and said he and Joyce have been
040945 - hiking the past 3 days. ref SDS 28 4R6M
040947 - ..
040948 - 6. Have you seen this pamphlet?
040950 - ..
040951 - 7. Sharlene in Physical Therapy has been working with me, and
040952 - mentioned the other day, her schedule changed. She is now
040953 - assigned on Thursdays, to give an exercise class to VA patients
040954 - for warming up to play golf. That's right: golf. She said the
040955 - VA supplies clubs, balls, green fees, and I imagine golf carts.
040956 - ...[reported on 170512 0800. ref SDS 21 6V5L...].
040958 - ..
040959 - 8. As with sponsoring golf, there might be a concomitant
040960 - opportunity to improve health, reduce stress, have fun, and
040961 - save lots of money by proactively encouraging hiking, all as
040962 - set out in the VA pamphlet. Miles could be another metric
040963 - tracked along with vitals and labs, so patients are encouraged
040964 - seeing HDL rise and LDL and blood pressure fall.
040966 - ..
040967 - 9. There are lots of hiking trails for beginners, intermediate,
040968 - and people in better condition, just walking around the
040969 - perimeter of the Medical Center. It doesn't cost a penny. For
040970 - added encouragement, the VA could sponsor hiking trips to
040971 - various locals. Of course people can do their miles just by
040972 - walking out the front door - it is mind-numbingly easy.
040974 - ..
040975 - 10. Encouragement to participate might be increased through
040976 - enrolling patients in classes, when they become Cardiology
040977 - patients. Start with classes once a month covering 1 or 2 of
040978 - the 101 reasons for hiking. Cardiology meetings can engage
040979 - patients in dialog on easiest way to strengthen heart, raise
040980 - HDL, improve circulation, lose weight, reduce risk of cancer,
040981 - etc, etc.... YES it's walking!
040983 - ..
040984 - 11. Pretty sure Doctor Abrams in Neurology would be on board with
040985 - this initiative. When he saw me in the hospital on 160619, 2
040986 - days after being diagnosed with stroke on 160617, I asked him
040987 - about hiking around the campus. He said "Yesssssss - keep
040988 - hiking! It is the best medicine for you."
040990 - ..
040991 - 12. Anyway, I know your plate is full. Just seems like a way to
040992 - reduce the burden on your desk, and that of other case
040993 - managers. An easy 1st step would be to simply hand this
040994 - pamphlet to all new patients, and have discussions with the
040995 - doctor on correlations between labs, and goals for mileage
040996 - until the next visit -- or something along these lines. I know
040997 - the VA has experts on everything, so likely the walking idea
040998 - has already been tried in various forms. Possibly more
040999 - structure and feedback loops might increase participation to
041000 - yield better metrics with healthier patients and lower costs.
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