Coronavirus is everyones biggest concern, but it does not mean we will not develop other health problems, such as gastro, appendicitis or injuries. We still need to see the doctor, but at the same time we do not want to expose ourselves to coronavirus, by going out. As a result, doctors have been encouraged to use Telehealth, (Telehealth is where you see a doctor via something like Skype or Facetime). Now you can see your GP by Telehealth under Medicare. As a family physician, I have been using Telehealth for many years. It will never take over from seeing a doctor face to face, but we can achieve a lot using a video consultation. As a doctor I need to gather a lot of information to work out what is wrong with you. If you can give me that information, I can perform a safer consultation via a video. If you have the right tools in your house, you can give me the information that I need and reduce the chance of missing something nasty. These tools have been around for many years and are not high tech. This week, we have created a special edition newsletter to highlight what tools can be used to help your doctor make a safe diagnosis. As mentioned before in this blog, these gadgets should be part of everyones first aid kit, to allow you to always see a doctor from the comfort of your own home, safe from the coronavirus. Online Health ServicesWhether you have the right equipment or not, there are many health services that you can access online. You can see a GP, get a blood test or even an STI check. Click on the button below for more information. For Clinic OwnersIf you are a clinic owner who is setting up a Telehealth service, please click on the link below and cut and paste the URL into an email or sms to be sent to your patients.
You can improve the quality of your Telehealth assessments by informing your patient population how to provide data that can help you make a diagnosis. Please note that your patients will need to be consented to receive communication via this process - Spam Act 2003)
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In healthcare, we are often measuring numbers related to your health: blood pressure, cholesterol, pulse rate and blood sugar. In diabetics, blood sugar is a very important reading, as diabetics lose their ability to control their levels. Developments in health technology have lead to machines that can continuously measure blood sugar levels - continuous glucose monitors (CGM). These machines reduce the number of times a diabetic needs to prick their finger to work out how high or low their blood sugar is. CGM’s are a small machine that inserts a fine needle into the skin. It measures the blood sugar levels in the fluid that bathes cells, called the interstitial fluid. The machine transmits the reading to a device that the patient can read to work out their blood sugar level. As a result they can tailor their medication (often insulin) accordingly. The concern is that the blood glucose in the fluid around the cells may have a slightly different reading to the blood glucose in the veins and thus the machine needs to be calibrated approximately twice a day (depending on the device). This is to ensure that an accurate reading is obtained such that an accurate dose of medication can be given. Getting this wrong can be fatal. The WHO states that the number of people with diabetes has risen from 108 million in 1980 to 422 million in 2014. It also states that a healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco use are ways to prevent or delay the onset of type 2 diabetes. But what is a healthy diet? The traditional model of healthcare promotes a one size fits all approach and the advice often changes. In the past a low fat diet was advocated, to more recently, a Mediterranean diet. No doubt this advice will change in the future. Taking onboard current changes in medicine, can we apply the principles of digital health to improve your diet, to reduce your risk of diabetes? Remember those 4 pillars of digital health? If you are willing to Participate, we can try and Prevent you from developing diabetes by Predicting the effect of types of food on your body with a Personalised plan? So how can we do this? At the moment your physician can do a finger prick blood test to work out your current blood sugar level - this is just a snapshot of your level and does not show any trends unless done regularly. Or they can measure your HbA1c which is your average blood sugar over the past 3 months, but can you remember what you ate every day for the past 3 months? It would be useful for you to know what effect a particular food has on your body: if you eat white bread as opposed to rye bread, or if you eat white rice as opposed to brown, it will make your blood sugar really high. But we already know this, I hear you say! True, but sometimes seeing the numbers can really focus you in changing your patterns of behaviour. Seeing your blood sugar shoot up to 12 mmol/L (that is high) after a bowl of white rice can be quite alarming. Also how one individual reacts to a particular food compared to another will also vary. It is all about understanding your body to decide what foods are best for you. This is why it is worthwhile considering the CGM in people who do not have diabetes to calibrate their bodies and work out exactly what effect a particular food has on your blood sugar levels. This can be done with the help of a dietician who can structure a plan of foods to eat across the dietary spectrum, whilst you are using the CGM. You can then know exactly the effect the foods have on your body, be they good or bad and then tailor your intake accordingly. Calibrate yourself on an annual basis and have the knowledge to make a change before problems arise. CGM’s are expensive - I am fully aware of that but their price should come down in time. The great concern in the use of CGM’s with diabetics is an inaccurate reading that may lead to an incorrect dose of insulin being given, which could be very dangerous. Mechanisms are put in place to prevent this and diabetics around the world are seeing better control as a result of using these machines. However, in a healthy individual who does not take insulin, that concern is reduced. It is still important to obtain an accurate reading but no medication is being given. We are just trying to understand the effects of particular foods on your body. Knowing these effects accurately however, will be the goldmine of information that enables you to change unhealthy habits that may lead to illness in the future. Blog post written by Dr Khurram Akhter. Khurram is an experienced primary care physician and a thought leader in the field of digital health. Disclaimer: This text does not serve as medical advice and if you have any questions, seek advice from your doctor. Today we have so many products available to use that can track our health: the Apple watch, Fit Bits etc, but are they of any use? 30 years ago, as a young child, I remember my parents returning from the local hospital having just visited one of my father’s close friends who had just had a heart attack. When I asked how old he was, the response was 36 years old. At the time, I felt that he was really old, but now I now realise that that is very young to have a heart attack. However in the 1980’s this was quite common. In 2018, how many 30 year olds are having a heart attack? Evidence shows not as many as the 1980’s. So what has changed? People have become more health conscious following better quality lifestyles: smoking less, doing more exercise. In addition to this doctors have been more proactive in monitoring certain parameters in your blood, such as cholesterol levels. If problems have been identified, lifestyle changes have been reinforced and treatment has been started to prevent heart attacks. The effect of this has been to reduce the number of individuals suffering from heart problems. Now you are more likely to hear about the 70 year old with a heart problem rather than a 30 year old. The point of me talking about this is that if you track your health you can identify a problem before it becomes a problem. Up until now your doctor may track your health on a 6-12 monthly basis. Now developments in technology mean we can track health parameters on a second by second basis. This now provides us with vast quantities of data which can be analysed and used to identify problems that may develop well into the future. As a result, changes can be made to your lifestyle to prevent or delay those problems from happening. So which parameters should we be tracking? As doctors we can make decisions on your health with information on your blood pressure, pulse rate, blood sugar levels, temperature and blood parameters such as how your kidneys are functioning or your cholesterol levels. The list is endless as to what we can monitor. The key question is what can you, as the health focussed individual or patient, monitor accurately to assist your health professional make decisions on your health. The answer depends on what your health needs are and what your health professional can suggest that is available in the market to meet your needs. This knowledge of the market is not widespread at the moment. Digital health is a disorganised mess of AI driven products, wearable devices and accessible services. What we hope to do at HealthAide.co is to bring some structure to the chaos of digital health so you and your health professional can identify which product is clinical grade (ie accurate) and most suitable for your health needs, based on scientific research and opinions that really matter. Blog post written by Dr Khurram Akhter. Khurram is an experienced primary care physician and a thought leader in the field of digital health. Disclaimer: This text does not serve as medical advice and if you have any questions, seek advice from your doctor. |
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