Good morning! How’s the holiday week? I’m sorry, I can’t wait to tell you about this cardiology office visit – crazy!! So, last Monday I’m all excited because I’ve got Michael Hunter scheduled for 9:45 in my office. It’s a routine yearly follow-up, but Holly (my RN) told me he had a lot to share… “Hey Michael. What’s up? You look great!” Michael’s wife, Connie, was sitting  next to him. I’d only seen her twice over the years, but I could’ve sworn she looked younger as well. “Dr. Dave, it’s all non-cardiac stuff but it started pretty soon after I left your office last year. I’ve just about told everyone else, so I might as well tell you. You’re not going to believe this. “You know how you’ve been on me for years to get active and lose 5-10% of my weight?” To set the stage, Michael had, in his own words, “let himself go” over the last 8-10 years.

I shared with him numerous times that I was worried about his course. He sits in the room now, 53 years old, 5’8″ and 235 lbs (267 in July ’16). “Shortly after our last visit,” he looked over at Connie, “Was it a month?” “Three and a half weeks,” she said nodding her head. “Anyway, I started noticing things. Weird things.” he resumed. “Like what?!” I was on the edge of my seat, smiling in anticipation of a really good story (Hopefully, it was better than this one, David). “You know how I’ve taken 2-3 ibuprofen a day for years?” “Sure, your trick knee from playing ball at Swarthmore. We’d been talking about you trying to cut back (better for the ticker)” “Some day last September, I realized I hadn’t taken an Advil in months.” “Anyway, I hadn’t told you, but I’ve been sneaking cigarettes for years. Anytime something stressful came up, I’m out to the garage, and well, you know…” Connie looks at Holly and me, “Everyday” she says. “Now I haven’t smoked for 8 and a half months,” he leans over to give me a high-five. His hand is dirty, but there’s Purell in the room and I’m really happy for him. “Then on September 30th, we got back from our walk. Oh yeah, by the way, the wife and I started taking the dog for a walk for 20-30 minutes after dinner. Sometimes, we go for 45 minutes or an hour. You know, kind of like that stupid Walk with a Dog thing you do,” he chortles. “Now Michael, that’s not nice” she jumps in with her soft southern accent.
“Well we get back from our walk and the clock reads 5:25. The darn clock reads 5:25!” I look over at Connie, confused. “We always, always start dinner at 5:30. Done so for years,” she shares. “I’m staring at the clock and the DANG THINGS ARE MOVIN’ BACKWARDS!” Connie adds, “We’ve had three different repairmen out to the house. None of them can stop these clocks from moving backward.” “Then, catch this. A couple months ago I went to see, Dr. Igo, my family doc. She walked into the room holding my chart, all silent like, squinting at me cross-eyed. She didn’t say nothin'” “Scared us to death,” shared Connie. “Scared me to DEATH. She said my hemoglobin A1C (measurement to assess diabetic control), my LDL, and my blood pressure have all totally normalized. I told my nurse she gave me the wrong chart, she said. She reran my labs and they matched perfectly. She said it’s as if I’d overtaken someone else’s body.” “Like a ZOMBIE APOCALYPSE?!!” I blurted out.

Awkward pause.

“No, I don’t think so Dave.””Anyway, she said in 31 years of practicing medicine, she ain’t never seen anything close to it. Then, this is where it gets really weird” “A couple months ago some neighbor friends threw me a surprise party. The cake said Happy 43rd Michael in big, bold blue icing.”

I love blue icing. Connie jumped in, “They were all at his 50th in 2010. They all know his age.” “When I tried to correct them, they just laughed at me. Then Billy, the shy sandy-haired kid down the street grabs my arm, pulls it down and whispers, “Keep this up and next year you’ll be 42.” Dr. Dave, I tell you what. Sure as the sun will rise in the mornin’, he meant it.” “Keep what up?” I asked. “Huh? Oh, the boy. Like I said, I got no idea what’s going on. We’ve gone over it a million times. The only thing we done differently, the ONLY thing (his right index finger raised to emphasize importance) is take Muffin Cakes on a walk after dinner.” Connie smiles. I’m looking at this guy and the dude looks young! “So, Doc. Whaddya think about them apples? Pretty friggin’ weird, huh?” “What do I think? What do I think? You started out by saying it’s non-cardiac. You bet it’s cardiac! Little muffie cakes is sav…” “Doc!” he interrupts, “it’s Muff-IN Cakes. Muff-IN Cakes.” “Muff-in Cakes saved your life. That’s why we do Walk with a Doc – it’s the cure.” “But, doc – clocks spinning backwards?” Our office clock now read 8:22. We entered at 8:45 “Did you think doctors are kidding when they say it’s the Fountain of Youth?” I share. Michael shakes his head, smiles and says, “Well, doc, Holly – Connie and I say thanks. I feel like a million bucks” We all look over at Holly who’s sitting on our beige leather swivel stool in the corner of the exam room. Normally she’d be transcribing, but here she sits, legs crossed at the ankles, looking to the sky, and eating a chocolate chip cookie. “HOLLY?!!” In one continuous motion she stands, puts down the cookie, reaches into her white lab coat and pulls out a Milk-Bone, flipping it perfectly to Connie. “Don’t thank us; thank Muffin Cakes,” she shares as she slips out of the room. Holly’s cool like that.

“When In Doubt, Walk”

The Walk with a Doc program is “CEERIAS” business in Chicago’s neighborhoods. With three active sites and one more in the process of being on-boarded, Robert DeStefano rising MS2 from Rush Medical College is excited as to what this program brings to Chicago’s diverse communities. Working with two CEERIAS neurologists, Drs. Neelum Aggarwal and Shyam Prabhakaran, and CEERIAS Community Advisor, Dr. Knitasha Washington, Robert successfully obtained a Dean’s Summer Fellowship award to develop a network of WWAD sites throughout Chicago’s neighborhoods to raise awareness of stroke signs/symptoms, how to respond if one witnesses a stroke (call 911) and how to prevent stroke by reducing stroke risk factors. (www.ceerias.com).

The positive correlation between diabetes and cardiovascular risk has been well established; 68% of diabetics aged 65 and older will experience a fatal heart-related incident. Heart disease remains the nation’s primary cause of death, while the percentage of Americans with diabetes has nearly doubled since 1994. Especially pertinent is the risk of ischemic stroke among both diabetics and prediabetics. Stroke remains the second global cause of death, with women having a higher lifetime risk and poorer functional outcomes compared to men. Treating these intertwining diseases can be pharmacologically complex and financially burdensome, thus empowering the first-line approach: lifestyle modification.

With increasing attention toward lifestyle intervention for systemic wellbeing, a multitude of studies have assessed walking programs. Often a barrier for walkers are concerns of safety, such as neighborhood crime or sidewalk conditions. Structured walking programs are a popular alternative, providing a safe and generally controlled environment. Several studies evaluating this effectiveness reported reduced body mass index (BMI), decreased waist-to-hip ratio, and decreased rate of perceived exertion after an 8-week commitment.

Promoting cardioprotective effects such as lowering “bad” cholesterol (LDL), lowering blood pressure, and improving the body’s glucose regulation, walking has a tremendous impact on diabetes and heart health. Similarly, physical activity among adults with chronic pain such as arthritis suggests an improvement in physical function, a decrease in pain severity, and improvement in quality of life. Walking is great for aging as well, serving as a low impact aerobic activity which slows cognitive decline.

Beyond the physical benefits is the social connectedness provided by organized walking groups. This sense of community boosts satisfaction and commitment, heightening the physical benefits. Check out where we are CEERIAS- ly walking in Chicago and come out and join us!

Welcome to the Family

St. Anns Family Medicine in Westerville, OH (Dr. Andrew Sitzmann)