Thursday, August 8, 2019

Medical Adherence in the Elderly

So it's been one year since becoming a Tandigm Scholar and last week I had to present my research in front of a room full of doctors.  Despite being under the weather... I did it. Whew!  I've never been a fan of public speaking so this was looming over me for a while causing stress... I get performance anxiety... 

The topic I chose was on improving medical adherence in the elderly.  Few facts in case you are interested...

25% to 50% of patients do no take their medications as recommended

Poor adherence leads to...
  • Increased morbidity and mortality
  • Accounts for approx. 125,000 deaths and 10% hospitalizations in US annually
  • $100 billion annually spent on US health services due to poor adherence


Barriers include...

  • Reviewing full medication information is challenging and time consuming
  • Accurate knowledge of actual home medication is difficult to attain
  • Complex medication instructions
  • Polypharmacy
  • Duration of medication (temporary vs permanent) and withdrawing the medication
  • Adverse effects
  • Problems with keeping medication lists up to date
  • IT systems and poor communication within healthcare systems
My project identifies those patients who may benefit from having their medications delivered in a pill pack form...

Then seeks whether adherence is improved leading to positive clinical outcomes...

Having a project to do in addition to the daily ins and outs of patient care adds a layer of purpose and intellectual challenge... with the potential to improve healthcare on a broader scope. For these reasons I was intrigued and couldn't say no when this opportunity came up... I flushed out my thoughts last year in my blog... 

So two more years to go....

Click the following link for the full story:

Tuesday, July 9, 2019

Medical Tips for Long Flights

So we just got back from Maui. Vacation was a blast catching up with extended family... 

17 cousins all together ages range from 2 to 17!

However, the travel back and recovery has been brutal. We left at night so we flew red eye. The lack of proper sleep did not help but what really did it was the two 6 hour long flights back to back with a two hour layover.

two hour lay over spent snoozing at AA business lounge...

Since summer is the time of travel and after this most recent experience, I'm prompted to blog a bit on medical tips for long flights....

1.  Dry air  

- air is thin and dry on airplanes and on long flights it is easy to get dehydrated
- increased respiration rates due to the lower oxygen also increases water loss
- symptoms of dehydration include:
  • sore throat
  • dry skin and craked lips
  • headache
  • fatigue
  • nausea
  • irritability
What can you do?
every hour you fly you are supposed to drink 8oz water
- avoid coffee or soda which has caffeine and can dehydrate you more
- avoid sugary drinks which can also cause a "crash" after a "high"
- moisturizing lotion for skin, chapstick for lips and eyedrops for dry eyes

2.  Low oxygen pressure  
- the lower oxygen pressure in aircrafts is equivalent to 6,000 to 8,000 ft altitude
- although the barimetric pressure is adjusted in the aircraft to avoid true altitude sickness you can still experience symptoms such as:
  • headache
  • sleepiness
What can you do?
- drinking plenty of water should help this as well

3.  Long periods of sitting
-  sitting in tight quarters for hours can cause decrease blood flow in body
-  symptoms these may produce include:
  • ankle swelling
  • feet swelling
  • blood clots for folks with increased risks such as
    • serious medical conditions
    • postpartum
    • on birth control
    • over 40
    • being obese

What can you do?
-  rotating ankles, extending and flexing the foot may help circulation
-  high risk folks may need compression stockings and/or medications

4.  Shifts in cabin pressure

- body's gas can expand 25 percent
- gas expands during ascent causing tympanic membrane in ears to bulge
- symptoms include
  • ears to feel full and "pop"
  • increased flatulence
What can you do?
- chewing gum, yawning and swallowing will help ears
- avoid gas producing foods may help minimize abdominal discomfort
    • dairy products
    • beans and lentils
    • asparagus, brocooli, brussel sprouts, cabbage..etc
    • fructose
    • high fiber foods
So we should have been much more diligent in implementing the above... we may not be as beat as we are now.

Well... here are some photos of the gorgeous scenery to help us recover...

Friday, June 21, 2019

Busy End of School Year

May flew by and June is almost over. It has been super hectic for me. I felt like writing a rhyming poem to summarize it all!  Here it goes...

Busy month of May
With Mother’s Day
…Memorial Day
And then comes Father’s Day

For teachers, for coaches…
Presents and gift cards to buy
Their guidance and wisdom
Our kids really do rely

String… Band… Choir…
Concerts galore!
Moving on ceremonies
And so much more!

End of year parties
And final field trips...
Signing year books
Watching slide show clips

6th grade socials
And 6th grade clap out
Cherishing the memories
Is what it’s all about

Saying goodbye to teachers
Saying goodbye to a school
Now it’s time for summer
Let’s jump in the pool!

Happy first day of summer everyone!  Whoo-hoo! My kids are finally done with school...

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