Have heart disease and arthritis? No reason to stop moving!

November 18, 2010 by  

What a bummer! You need to exercise to keep your heart fit but arthritis keeps you from moving. This is especially tough because arthritis seems to be quite common among those with heart disease. A whopping 14.1 million American adults suffer from some form of heart disease. Another couple of millions have arthritis. Many suffer from both.

 Physical activity is on top of the list of recommendations for people with heart disease because exercise brings lots of health benefits including “improved physical function and lowered blood pressure and blood cholesterol levels.”

And though it may not seem so, those with arthritis also benefit from regular exercise because it reduces arthritis pain and improve functioning of the joints.

But then check out the following statistics:

It seems that heart disease and arthritis co-occurring together make the perfect combination to make a patient sedentary. Data from the Behavioral Risk Factor Surveillance System show that lack of physical exercise is common among those with both heart disease and arthritis which unfortunately makes these diseases even worse. Much more, many of these people are not aware of the adverse effects of being sedentary and may even think that exercise would exacerbate rather that help with their conditions.

So what are these people supposed to do?

According to Dr.  Janet Collins, director of CDC′s National Center for Chronic Disease Prevention and Health Promotion:

“These fears are readily addressed by good information, consultation with their doctor, evidence-based programs, and strong social support.”

Some of the recommendations they have come up with are:

It is possible to consider alternative physical movement programs such as yoga, tai chi, pilates, etc. These programs are not as physical strenuous as regular exercise but can still be beneficial if done properly and can be tailored to individual needs.

Telestroke: delivering stroke care virtually

June 18, 2009 by  

multimedia_icon_setWe can see where health care is going. More and more procedures are automated and remote medical consultation and treatment is catching on. The goal is to make health care delivery faster, more efficient and cheaper. Recently, the American Heart Association published a policy statement that gave “recommendations for the implementation of telemedicine within stroke systems of care.”

Aside from the abovementioned reasons for implementation of telemedicine in general, here are a few specific reasons why virtual delivery of stroke care system may be necessary

  • There is a shortage of neurologists in many rural parts of the United States, making these areas underserved in terms of stroke care.
  • Even in urbanized areas, fewer neurologists are willing to provide 24/7 emergency room coverage for acute stroke care.

This calls for more creative and radical changes in stroke care that will work for patients and doctors alike and telemedicine seems to be the answer. Currently, telemedicine encompasses

In the specific case of stroke telemedicine (telestroke), the following

  • Patients and doctors are can interact through secure web camera video technology that allows remote yet rapid assessment of the patient but still protects patient confidentiality.
  • Medical history is provided remotely, mostly using electronic health records.
  • Neuroimages are displayed on the physician’s local computer and quickly interpreted
  • Diagnosis may be done using the so-called crowdsourcing diagnostics (see below for details)
  • If necessary, treatment including thrombolysis is ordered and monitored.

In fact, in many cases, telestroke diagnosis may prove to be more accurate than “face-to-face” diagnosis. Neurologists can use crowdsourcing diagnostics, a tool wherein doctors enter the symptoms and test results, and a computer software give the most probable diagnosis. This is almost like having access to the knowledge and experience of hundreds of health professionals, making diagnosis faster and cheaper.

Although telestroke is catching on, there are still barriers to overcome before telemedicine in general can become widespread and widely accepted. The authors of the policy statement have identified six major barriers.

(1) Defining medical specialties suitable for telemedicine

(2) Medical licensure and liability laws

(3) Securing the health information being shared

(4) Creating simple processes for requesting and performing the consultation

(5) Developing financial models for reimbursement of telestroke services

(6) Gaining acceptance of remote consultation from patients, physicians, and payers.

These barriers may be daunting, especially the legistation on medical licensure and liability, but the authors feel that they can be overcome with the right approach.

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NOTE: The contents in this blog are for informational purposes only, and should not be construed as medical advice, diagnosis, treatment or a substitute for professional care. Always seek the advice of your physician or other qualified health professional before making changes to any existing treatment or program. Some of the information presented in this blog may already be out of date.