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Tag: chronic health conditions

A man with sinus pain

What Is Balloon Sinuplasty?

Written by Leann Poston, MD. on . Posted in Respiratory illnesses. Leave a Comment

During a balloon sinuplasty procedure, a small, specially designed balloon is inserted into the sinuses and gently inflated to widen and open the sinus passages so they can drain. This procedure can be used to treat the 30 million people who live with chronic sinus infections.

Sinuses are enclosed chambers in the skull bones that drain via a small antrum. When these openings swell shut, fluid collects in the sinuses, creating an ideal environment for bacteria and fungi to flourish. When sinus infections become chronic, and antibiotics are not helping, your doctor may suggest a balloon sinuplasty, a minimally invasive surgery to drain the sinuses. Using this procedure, an ear, nose, and throat (ENT) doctor can expand the openings of your sinuses without removing any tissue.

Surgical balloons are used to dilate narrowed blood vessels near the heart, a procedure called angioplasty. Balloon sinuplasty (balloon ostial dilation) uses the same method.

Conditions Treated by Sinuplasty Procedure

Balloon sinuplasty can be used to treat some people with chronic sinusitis, also called chronic rhinosinusitis, as long as it is not because of polyposis. Polyps are small growths that can obstruct sinus drainage. These growths cannot be removed during a balloon sinuplasty.

If you have allergies or a viral infection, the inner lining of the sinuses may become inflamed and swollen. Swelling of the sinus openings limits drainage. The sinuses fill with mucus, causing facial pain and swelling.1 The mucus can become secondarily infected. If sinusitis is left untreated, the infection can spread to nearby tissues. In rare cases, sinusitis can cause an infection of the membranes covering the brain.

Sinusitis and rhinosinusitis refer to inflammation of the sinuses and nasal cavities. Sinusitis is classified based on duration as acute (less than 4 weeks), subacute (4–12 weeks), and chronic (longer than 12 weeks).2

If you have sinus symptoms, contact an on-call doctor to receive an online diagnosis and treatment. Online doctors on the Telegra MD platform are available 24 hours a day to provide help when you need it.

A woman with inflamed sinuses

Comparing Balloon Sinuplasty to Traditional Sinus Surgery

Since it gained Federal Drug Administration (FDA) approval in 2005, balloon sinuplasty has grown in popularity in the United States as an option for traditional sinus surgery for people with chronic sinusitis. This is likely due to its lower complication rate, quicker recovery time, and less invasive nature.3

Step-by-Step Balloon Sinuplasty Procedure

Unlike traditional sinus surgery, a balloon sinuplasty procedure can be performed in a same-day surgical ward. Your doctor may schedule this procedure after discussing its risks and benefits and ensuring you are a suitable candidate for the procedure.  

  1. Preparation: Ask about any dietary and medication restrictions before your procedure. Your doctor may prescribe a nasal decongestant and an antibiotic before the procedure.
  2. Pre-op: Before your procedure, you will probably undergo a quick pre-operative physical exam and a consultation with an anesthesiologist, unless you opt for local anesthesia only.
  3. Procedure: During the procedure, your ENT doctor will insert a guide wire through your nose and into your sinuses using an endoscope (a tube with a light that allows instruments to be passed through it). This guide wire is used to position the uninflated balloon. Once the balloon catheter is in place, the balloon is gently inflated to widen the sinus opening and compress the surrounding tissues. This will allow for better sinus drainage. The balloon, endoscope, and guide wire are then removed.
Endoscopic surgery

Candidates for Balloon Sinuplasty          

Balloon sinuplasty is indicated for people with chronic sinusitis that is refractory to medical treatment (antibiotics) and is not due to polyposis. Balloon sinuplasty dilates sinus tissues. It does not remove any tissues. The procedure is typically used to treat chronic sinusitis that involves the frontal, sphenoid, and maxillary sinuses.

People without severe or chronic sinus symptoms or who have the following conditions may not be good candidates for balloon sinuplasty:3,4

  • Polyposis
  • Significant disease in the ethmoid sinuses
  • Widespread fungal sinusitis
  • Allergic fungal sinusitis
  • Connective tissue disorders at an advanced stage
  • Potential malignancies (cancers)
  • Sinus symptoms, such as headache or sleep apnea, without chronic sinusitis
  • Cystic fibrosis

Benefits and Risks of a Balloon Sinuplasty

All surgical procedures have risks and benefits. Discuss these risks and benefits with your surgeon to make an informed decision and determine whether balloon sinuplasty is right for you.

Benefits

Benefits of choosing balloon sinuplasty to treat chronic sinusitis include the following:

  • Minimally invasive procedure
  • Reduced recovery time
  • Lower risk of complications than endoscopic sinus surgery
  • No bone or tissue is removed
  • May be performed using local anesthesia
  • Outpatient procedure
  • Should improve symptoms such as nasal congestion, headache, and facial pain
  • Most people return to normal activities within one to two days

Risks

Balloon sinuplasty has a low overall risk. Documented risks include the following:5

  • Cerebrospinal fluid leak
  • Air or gas in the skull
  • Damage to the eye orbit
  • Severe or excessive bleeding
  • Bacterial infection
  • Change in the sense of smell or taste
  • Vision changes
  • Nerve damage
  • Unsuccessful outcome

Recovery and Aftercare                                     

Depending on the type of anesthesia you receive, you will spend some time in the recovery room. You can expect fatigue, congestion, and blood-tinged drainage as you recover.

The procedure is often conducted in your doctor’s office with local anesthesia. In this case, you will be able to go home once the procedure is finished.  

Your doctor will probably prescribe sinus irrigation using saline solution to gently wash away mucus. Ask about any physical or medication restrictions you may have after the procedure.

According to the Cleveland Clinic, your doctor may make the following recommendations:

  • Avoid blowing your nose for a couple of days.
  • Rinse your nose gently with a saline solution.
  • Sleep with the head of your bed elevated to minimize congestion.
  • Avoid strenuous activities for a week after the procedure.

Success Rate and Patient Experience

In a study of over 16,000 patients, 2,851 underwent balloon sinuplasty, 11,955 underwent conventional endoscopic sinus surgery, and 1,234 underwent a combination of the two procedures.4

 Balloon sinuplastyConventional endoscopic sinus surgery
Took place in an office setting87%0.8%
Complication rate5.3%7.4%
Revision rates7.9%16.9%

In another study, patients reported significant improvements in sinus symptoms when surveyed two years after the procedure.6

Health insurance know your benefits

Balloon Sinuplasty Cost        

The cost for a balloon sinuplasty varies greatly depending on where the procedure is performed, your location, and whether general anesthesia is used. Some insurance companies will cover the cost of the procedure in part or whole. Expect to pay between $3,000 to $8,000.

Consulting a Healthcare Professional

Diagnosing and treating sinusitis is fast and convenient when you seek an online physician consultation with a doctor on the Telegra MD platform. If you have chronic sinusitis, see if you qualify for balloon sinuplasty by talking with an ENT specialist online.

Telemedicine provides access for more people to receive a personalized evaluation and treatment plan and, frequently, at a much lower cost than an in-person doctor’s visit. After your consultation, your online doctor can transmit an online prescription to your local pharmacy.

While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider. You should always consult a practicing professional who can diagnose your specific case. The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice.

Disclaimer

While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider. You should always consult a practicing professional who can diagnose your specific case. The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice.

References

1. Battisti AS, Modi P, Pangia J. Sinusitis. [Updated 2023 Mar 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470383/

2. Lanza DC, Kennedy DW. Adult rhinosinusitis defined. Otolaryngol Head Neck Surg. 1997;117(3 pt 2):S1-7.

3. Lofgren DH, Shermetaro C. Balloon Sinuplasty. [Updated 2022 Sep 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK546671/

4.  Cingi C, Bayar Muluk N, Lee JT. Current indications for balloon sinuplasty. Curr Opin Otolaryngol Head Neck Surg. 2019 Feb;27(1):7-13. doi: 10.1097/MOO.0000000000000506. PMID: 30507684.

5. Chaaban MR, Rana N, Baillargeon J, Baillargeon G, Resto V, Kuo YF. Outcomes and Complications of Balloon and Conventional Functional Endoscopic Sinus Surgery. Am J Rhinol Allergy. 2018 Sep;32(5):388-396. doi: 10.1177/1945892418782248. Epub 2018 Jun 27. PMID: 29947260.

6. Weiss RL, Church CA, Kuhn FA, Levine HL, Sillers MJ, Vaughan WC. Long-term outcome analysis of balloon catheter sinusotomy: two-year follow-up. Otolaryngol Head Neck Surg. 2008 Sep;139(3 Suppl 3):S38-46. doi: 10.1016/j.otohns.2008.06.008. PMID: 18707993.

A close-up of a man holding his heart.

Cardiac Arrest vs. a Heart Attack

Written by Leann Poston, MD. on . Posted in Heart disease. Leave a Comment

A cardiac arrest and a heart attack are both life-threatening conditions that impact how well your heart works. In the United States in 2019, the number of cardiac deaths was 370,000.1 Understanding the risk factors for these two conditions can help you evaluate your risk level and take steps to prevent these serious conditions from occurring.

A cardiac arrest is when the electrical impulse through the heart is blocked or irregular and causes the heart to malfunction. A heart attack occurs when blood vessels in the heart become blocked, and heart muscle is starved of oxygen and nutrients.

What is Cardiac Arrest? 

The heart has two upper chambers, the atria, and two lower chambers, the ventricles. The left side of the heart pumps oxygenated blood to the body, and the right side pumps deoxygenated blood to the lungs.

The four chambers must contract in an orderly manner to move blood from one chamber to the next. The sinoatrial (SA) node is a small section of specialized heart cells in the right atria. These cells start an electrical impulse that travels through the atria, pauses at the atrioventricular (AV) node to allow the atria to contract, and then passes through the ventricles.

Any disruption in this orderly transmission of the electrical impulse can cause an arrhythmia or abnormal heart rhythm. The most serious arrhythmias are ventricular fibrillation and ventricular tachycardia. In these cases, the ventricles are rapidly depolarizing and contracting and are not regulated by the SA node.

With ventricular fibrillation and ventricular tachycardia, the ventricles are beating too fast to allow blood to collect in their chambers and be pushed into the body tissues and lungs. The brain and other vital organs do not get the nutrients and oxygen they need to survive.

A cardiac arrest is a medical emergency. About nine out of every ten people who have a cardiac arrest outside of a hospital will die, often within minutes of when their symptoms start.

What is a Heart Attack?

In addition to sending blood to the rest of the body, the heart pumps oxygenated blood to the heart. Cholesterol and fat lining blood vessels, called plaque, can dislodge, break open, or break off and form a clot in a blood vessel. If blood vessels become clogged and do not supply the heart muscle with adequate oxygen and nutrients, heart muscle tissue will begin to die. This blockage leading to damaged heart muscle is what causes heart attacks.

Similarities Between Cardiac Arrest and Heart Attack

Both a cardiac arrest and a heart attack can be fatal because they affect how well the heart can pump blood into the body tissues and the lungs. Heart attacks increase the risk of cardiac arrest. When heart muscle becomes damaged due to lack of blood flow, it disrupts the heart’s rhythm.

An older couple with a man holding his heart.

Risk Factors for Cardiac Arrest and Heart Attack

Sudden cardiac arrest usually occurs in people with underlying structural heart problems, such as congestive heart failure or a heart attack.

Because heart attacks are a potential cause of cardiac arrest, the risk factors for both conditions are similar.

  • High cholesterol
  • High low-density lipoprotein (LDL)
  • Low high-density lipoprotein (HDL)
  • High blood pressure
  • Cigarette smoking
  • Physical inactivity
  • Obesity
  • Diabetes mellitus
  • Excess alcohol intake

Some risk factors for heart disease, such as family history, increasing age, and male sex, cannot be changed or modified. However, if you are able to quit smoking, lose excess pounds, reduce alcohol consumption, increase physical activity, and treat high blood pressure, obesity, and diabetes, you can reduce your risk of heart disease.

Signs and Symptoms of Cardiac Arrest vs. Heart Attack

A sudden cardiac arrest is a medical emergency. Symptoms include a sudden loss of consciousness, pulse, and breathing. These symptoms come on quickly and are immediately life-threatening.

Symptoms prior to cardiac arrest include the following:

  • Chest pain
  • Nausea
  • Vomiting
  • Irregular or racing heartbeat
  • Lightheadedness
  • Difficulty breathing
  • Shortness of breath
  • Fainting

Symptoms of a heart attack can vary. The most common and obvious symptom is chest pain, but a person having a heart attack may experience the following:

  • Sweating
  • A cold sweat
  • Nausea
  • Vomiting
  • Feelings of impending doom
  • Fatigue
  • Shortness of breath
  • Pain, stiffness, or numbness in the arms, neck, or face
  • Lightheadedness, dizziness, or fainting
  • Irregular or fast heartbeat
  • A blueish tinge to lips, fingers, and toes

In many cases, women experience different heart attack symptoms than men, leading to delayed or misdiagnosis. Women are more likely to experience a sensation of chest pressure or tightness rather than pain, pain in both arms as opposed to only the left arm, excessive fatigue, and anxiety.2

Prevention of Cardiac Arrest and Heart Attack 

Minimizing risk factors is the best way to reduce your risk of cardiac arrest and heart attacks. For example, if you smoke, consume alcohol in excess, or are concerned about your body composition, contact a doctor on call to schedule a preventative healthcare appointment. Online doctors can discuss your medical history, provide an online diagnosis, and prescribe online prescriptions, if necessary. No matter what time of the day or night, if you are concerned that you may have a medical condition that increases your risk for cardiac arrest or heart attack, you can get 24-hour doctor care access whenever you need it.

What to Do in a Cardiac Emergency

Cardiac arrests and heart attacks are medical emergencies in which survival depends on how quickly you receive optimal, heart-saving care. If you know the signs and symptoms of these two conditions, you will be prepared to act. Verify that someone is unresponsive and call for anyone nearby to help. Then call 911 as quickly as possible. One person can begin high-quality CPR while the other talks to the 911 operator and tries to get an automatic external defibrillator (AED).

Telemedicine is not appropriate care for a heart attack or cardiac arrest. However, it is the perfect venue for easy and convenient access to preventative healthcare. Telemedicine can prevent heart attacks and cardiac arrests by providing lifestyle counseling, encouraging medication adherence, refilling prescriptions, treating comorbid health conditions, and preventing disease progression.

Disclaimer

While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider. You should always consult a practicing professional who can diagnose your specific case. The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice.

References:

  1. Tsao CW, Aday AW, Almarzooq ZI, Alonso A, Beaton AZ, Bittencourt MS, Boehme AK, Buxton AE, Carson AP, Commodore-Mensah Y, Elkind MSV, Evenson KR, Eze-Nliam C, Ferguson JF, Generoso G, Ho JE, Kalani R, Khan SS, Kissela BM, Knutson KL, Levine DA, Lewis TT, Liu J, Loop MS, Ma J, Mussolino ME, Navaneethan SD, Perak AM, Poudel R, Rezk-Hanna M, Roth GA, Schroeder EB, Shah SH, Thacker EL, VanWagner LB, Virani SS, Voecks JH, Wang NY, Yaffe K, Martin SS. Heart Disease and Stroke Statistics-2022 Update: A Report From the American Heart Association. Circulation. 2022 Feb 22;145(8):e153-e639. doi: 10.1161/CIR.0000000000001052. Epub 2022 Jan 26. Erratum in: Circulation. 2022 Sep 6;146(10):e141. PMID: 35078371.
  2. Jackson MN, McCulloch BJ. ‘Heart attack’ symptoms and decision-making: the case of older rural women. Rural Remote Health. 2014;14:2560. Epub 2014 May 5. PMID: 24793837.
A person with a smartwatch

5 New and Upcoming Wearable Devices That May Improve Quality of Life

Written by Leann Poston, MD. on . Posted in Technology. Leave a Comment

Did you know that wearable devices can predict an illness or identify atrial fibrillation before you have any symptoms? These devices have come a long way since the first-generation step counters. Aside from potentially saving your life and motivating you to conquer new fitness challenges, the wearable device market was valued at $61.3 billion in 2022 and is predicted to increase at a compound growth rate of 14.6 percent between 2023 and 2030. It’s big business, so manufacturers will continue innovating and adding technology.

Whether you are an athlete or just want to track your health metrics, there are a wide variety of wearable healthcare devices to choose from. Wearable devices can track your activities, heart rate, sleep, stress level, oxygen saturation, body temperature, calorie intake, body composition, and water intake. They can also track trends, providing valuable insight into your health and wellness.

Wearable device technology helps consumers be proactive in managing their health and bringing concerning data trends to their doctor’s attention earlier. Most wearable device manufacturers also have social networks that users can join to motivate each other to improve their health and fitness. 

Fitness Trackers

Obesity, type 2 diabetes, and high blood pressure are major health concerns for U.S. adults. Over 40% of U.S. adults now meet the qualifications for obesity, a chronic medical condition associated with about 200 other comorbid conditions. We know that diet and exercise are the two most important factors that can increase weight loss and improve overall health, but maintaining a healthy diet and engaging in regular exercise is hard.

Wearable fitness trackers may help. According to a study published in JAMA Network Open, wearing fitness trackers, combined with other interventions like consultations with healthcare providers, can lead to increased physical activity, which can profoundly impact your health.1,2  Fitness trackers and the social networks associated with them can help provide motivation and hold you accountable as you set fitness goals for yourself.

Smart Health Watches

In the past, the fitness tracker and smartwatch categories were clearly defined. Fitness trackers focused on health and fitness, and smart watches extended your cell phone functionality. As technology has advanced, fitness trackers provide much of the same data as smartwatches, especially for monitoring your health.

Smartwatches track your fitness, sleep, stress, and sleep, just like fitness trackers, but many also offer EKG, heart rate, heart rate variability, stress, and body temperature tracking. You can also use your smartwatch to listen to music, answer texts, take phone calls, and watch workout videos and guided exercise programs. Smartwatches make it easy to fit in a 10-minute impromptu workout.

Smartwatches provide data that your doctor can use to gain more insight into your health habits and how they may affect your risk of chronic disease.

For example, atrial fibrillation is an irregular heart rhythm in the upper chambers of your heart. It is the most common heart rhythm disorder, affecting about 1% of the population. In some cases, atrial fibrillation does not cause symptoms, and the first sign of its presence is having a stroke. A smartwatch can help identify this abnormal rhythm so your doctor can evaluate your heart rhythm and suggest treatment options.

In the next few years, more sensors on smartwatches will be standard, as wearable technology is tested for its accuracy and consistency in monitoring and tracking patient health data.

Biosensors  

Biosensors are wearable devices that integrate sensors into or on the human body using tattoos, gloves, clothing, or implants. These wearable sensors collect data and display information via a phone app. The information can be transmitted to your doctor for monitoring and feedback.3

Biosensors can monitor motion states, biophysical states, or biochemical parameters. Motion sensors can monitor gait and send an alarm if the wearer falls. They can also detect seizures and tremors. Biophysical sensors track blood pressure, heart rate, and temperature. Biochemical sensors track biological fluids.3

Continuous glucose monitors (CGMs) are an example of a biochemical sensor. These devices were intended for people with diabetes to provide a less invasive way to continuously monitor their blood sugar. Now anyone can monitor their blood sugar using CGMs. Saliva, tears, breath, and sweat-based biosensors are expected to be available soon in this booming market.

Biosensors are expected to change the way healthcare is delivered. The two-way feedback these devices offer will augment the care provided during a remote doctor’s visit, providing consumers with the safest and most convenient healthcare option.

ECG Monitors   

Cardiovascular disease is the leading cause of death in the United States, with coronary heart disease accounting for almost half of these deaths. Unfortunately, most heart attacks occur without warning. Wearable electrocardiogram monitors (ECG) can help patients monitor their heart rhythms from home. This can provide reassurance that any abnormalities may be detected earlier and provide a means of transmitting data to their heart doctor for evaluation.

Smartwatches and ECG monitors, telemedicine, and public awareness and lifestyle changes to reduce risk factors are expected to reduce heart disease in the future. Telemedicine provides a safe and convenient way to prevent heart attacks by providing lifestyle counseling, tracking medication adherence, refilling prescriptions, monitoring heart rhythm trends, and reducing comorbid diseases.

Blood Pressure Monitors

High blood pressure is often called the “silent killer” because it has no symptoms. People of all ages and body shapes and sizes can have high blood pressure. High blood pressure that is not treated is a risk factor for cardiovascular diseases, such as heart attacks and strokes.

Smartwatches and home blood pressure monitors can track blood pressure and provide alerts if your blood pressure is too high. Blood pressure fluctuates throughout the day, and it is classically much different in the doctor’s office than at home.

While blood pressure cuffs for home use have been around for a while, they are very difficult for most people to use correctly. It is hard to get the cuff in the right place and position your body correctly to get an accurate measurement. They are also bulky and uncomfortable.

Wearable blood pressure monitors make it easy to take blood pressure measurements anytime, even outside your home. They are simpler to use and easier to put the monitor level with your heart, a technique that usually gives the most accurate reading. Unfortunately, wearable blood pressure devices are new and do not yet have large-scale scientific studies to support their accuracy.

Use your wearable blood pressure monitor to track trends and calibrate it periodically with your blood pressure readings from doctor’s visits or medical-grade blood pressure monitoring devices in stores and pharmacies.

What Are the Benefits of Wearable Healthcare Devices?  

Wearable devices are expected to revolutionize healthcare. Remote patient monitoring is more economical and convenient than monitoring in a hospital setting. In 2019, 88% of healthcare providers surveyed had invested in or evaluated investing in remote patient monitoring technologies. Most healthcare providers surveyed encouraged their patients to monitor their health proactively. While remote patient monitoring is not an option in all cases and still faces some deployment challenges, it is likely to become more commonplace over the next decade.

More Insight for Doctors  

Wearable healthcare devices provide telehealth doctors with data that helps with medical decision-making. Patients bring their data and information about their symptoms and medical history. Doctors provide their knowledge, experience, and insight. Together, they engage in a shared decision-making process that empowers patients to take charge of their medical care. The telehealth environment makes it easier for patients to access specialists and for doctors to share information. Interprofessional collaboration improves mental and physical health outcomes.

Easier Diagnosing

Remote doctors have some disadvantages. They don’t have access to the patient in the same physical space as they are. They can’t take blood pressure, pulse, temperature, and body weight measurements and cannot physically examine the patient. In cases where a physical exam would impact medical decision-making, an in-person appointment is the only option. For example, if your doctor suspects appendicitis, you will need an abdominal exam and further testing.

Wearable devices overcome the other obstacle when consulting with a web doctor. They provide the measurements an online doctor needs to rule out or support an online diagnosis. If, after making a diagnosis, your online doctor believes you need a prescription medication to treat your condition, it is easy to get a prescription online.

Wearable devices provide online doctors with data they can use to make a diagnosis. Is it time for you to move your doctor’s appointment online?

Better Patient Adherence 

Feedback from wearable devices can be motivating. Having data on hand and tracking it helps healthcare providers monitor whether patients are adhering to their treatment recommendations. This transparency will lead to better long-term health outcomes.  

References

  1. Hodkinson A, Kontopantelis E, Adeniji C, et al. Interventions Using Wearable Physical Activity Trackers Among Adults With Cardiometabolic Conditions: A Systematic Review and Meta-analysis. JAMA Netw Open. 2021;4(7):e2116382. doi:10.1001/jamanetworkopen.2021.16382
  2. Cheatham SW, Stull KR, Fantigrassi M, Motel I. The efficacy of wearable activity tracking technology as part of a weight loss program: a systematic review. J Sports Med Phys Fitness. 2018 Apr;58(4):534-548. doi: 10.23736/S0022-4707.17.07437-0. Epub 2017 May 9. PMID: 28488834.
  3. Sharma A, Badea M, Tiwari S, Marty JL. Wearable Biosensors: An Alternative and Practical Approach in Healthcare and Disease Monitoring. Molecules. 2021 Feb 1;26(3):748. doi: 10.3390/molecules26030748. PMID: 33535493; PMCID: PMC7867046.
A woman sitting in a wheelchair at a computer.

How To Succeed Professionally With a Chronic Health Condition

Written by Leann Poston, MD. on . Posted in Business. Leave a Comment

A full-time job can be demanding, even more so if you have a chronic health condition. Nearly half of all American adults have a chronic health condition, which is defined as a physical or mental condition that lasts more than a year, causes some restrictions in their ability to function, or requires ongoing monitoring or treatment.1

Medical visits, hospitalizations, and illness flare-ups all add up in terms of lost income and time off work. According to the Centers for Disease Control, about 75% of all healthcare spending in the U.S. goes toward treating chronic diseases. This translates to an estimated $5,300 per person per year.

When you have a full-time job and a chronic medical condition, you have to balance the needs of your job with the needs of your health. Working too much can worsen your chronic disease, but taking too much time off can affect your employability. This is especially true for people who have less-visible chronic health conditions. However, there are several steps you can take to foster professional success while protecting your health.

Make Time for Self-care

Self-care takes time, but the adage is true: You cannot care for other people if you don’t take care of yourself. Self-care is an essential part of managing your chronic disease. Time spent caring for yourself will result in less time off work and being better prepared to achieve high job performance levels.

Self-care components include:2

  • Nutrition: buying, preparing, and consuming a nutritious, whole-food diet. Avoid processed foods and consume healthy sources of protein and fat.
  • Stress management: making time for hobbies, exercise, and activities you enjoy to reduce stress.
  • Social habits: spending time with family and loved ones reduces stress and improves your quality of life.
  • Sleep: practice good sleep hygiene and get 7 to 9 hours of restful sleep each night.
  • Exercise: depending on your health condition, aim for 150 minutes of moderate or 75 minutes of vigorous exercise each week.
  • Set goals: set personal and work-related goals and track your progress toward achieving them.
  • Build a team: health professionals, psychologists, social workers, rehabilitation specialists, physical therapists, friends, neighbors, and relatives are all potential team members to help support your efforts to manage your chronic disease.
  • Healthcare: keep your appointments, get lab work done, and take all prescribed medications. Take care of your mental and emotional health as well.

Taking time for self-care and balancing home life, work needs, and your health can be even more challenging if you have your own business. Read 6 science-backed self-care tips for entrepreneurs to learn how to better manage work, family, and health demands.

Work Remotely When You Can 

Before the COVID-19 pandemic, remote work was uncommon and hard to get. Necessity is the mother of invention. Employers in all sectors showed that remote work is possible in more ways than anyone could have imagined. Working remotely frees you from demands that may drain your energy.

Commuting can be a challenge for anyone, especially people with mobility issues. Remote work opens more career possibilities for people with disabilities, allowing them to work in a comfortable environment that reduces stress and anxiety.

Working remotely can increase productivity without increasing work hours. Whether it is workplace dramas or unnecessary distractions, working remotely gives you more control over your work environment.

Remote work can offer a more flexible schedule, which makes it easier for people to work when they have the most energy and to make medical appointments. Setting a schedule based on an individual’s productivity levels instead of when an office is open can also mean greater productivity for the business. Of course, this is not always possible, especially in service-oriented industries.

Whether your chronic health condition affects your immune system, is affected by stress levels, makes it difficult to be mobile, or causes increased fatigue, remote work may make it easier to work.

Monitor Your Health With Wearable Devices 

In many ways, healthcare for managing chronic diseases is coming out of the medical setting and entering homes. Wearable devices may improve the quality of life for people with chronic diseases as they collect health metrics anytime and from anywhere. Devices are now available to measure oxygen saturation, temperature, exercise, blood sugar, blood pressure, and much more. This makes it much easier to notice trends and catch changes in our health earlier. It also gives you feedback on how self-care is impacting your overall health.

Remote patient monitoring is a more formal monitoring system. Apnea, heart rate and variability, oxygen saturation, positional trackers, and blood pressure monitors can send a constant data stream to your healthcare provider. Artificial intelligence can evaluate large amounts of data and organize it. Patient monitoring that previously would have required an extended hospital or rehabilitation center stay can now be done from home.

Take Advantage of Telehealth Services

Using a telehealth service, you can schedule appointments or even see a medical provider on the same day, all from the comfort of your home or office. This saves time and money. Besides the worry of taking time off work and setting appointments based on a provider’s schedule, people with chronic diseases also risk catching an illness while at their medical appointment that could lead to extended time off work. A remote doctor’s visit may be the safest and most convenient option for everyone, but especially for people with chronic health conditions.

See a doctor online and experience the benefits of telemedicine. Once you do, you will probably want to receive as much of your healthcare online as possible. It is so much easier to integrate telehealth into your healthcare routine than it was in the past. Your online doctor can diagnose most medical conditions safely and securely via a phone or video call. If you need a prescription, they can transmit it electronically to your pharmacy. It can then be delivered to your home or picked up at your local pharmacy.

If you are interested in telehealth but have questions or are unsure how to start the process, Telegra MD has resources and answers to your questions.

Discuss Your Condition with Your Employer

Disclosing your chronic medical condition to your employer can be stressful. You don’t need to tell anyone about your health unless you want to, but if you need accommodations or your health condition affects your job performance, you may need to disclose at least some information to your supervisor and ultimately to human resources if you need more frequent breaks or a different work schedule. Be straightforward and disclose details about your chronic health condition only to people who need to know them.

Prepare for this conversation by knowing your rights and what accommodations you need. Focus the conversation on the accommodations you need to be as productive as possible at work. Be as specific as you can and only share as much information as you need to help your employer understand how your chronic health condition affects your ability to work in the job environment.

Delegate Tasks When Possible 

If possible, delegate tasks inside the home and workplace to prevent burnout and make it easier for you to focus your energy on more important tasks.

It can be hard to ask for help. Start with your manager or supervisor. Discuss your current limitations and ask for help in identifying tasks that can be delegated to others. Prioritize your tasks. Pass the less critical ones to others so you can focus your energies on the more important tasks. Cross-train in your department to make it easier for people to cover for each other. This will also normalize the idea that people need to help each other.

It is important to strike a balance between protecting your health and meeting your job responsibilities. Delegating tasks can reduce stress and help you manage your workload, leaving more time for self-care.

Establish Clear Boundaries

Set clear boundaries about what you can and cannot do. Establish the importance of keeping your medical appointments early on. Give as much notice as you can about upcoming appointments, but make it clear that your top priority is to keep them. 

Be clear and consistent when discussing your workload expectations, working hours, and roles. Be consistent in enforcing these boundaries. Set realistic expectations about what you can and cannot do and stick to them.

Be Aware of Your Rights

Finally, it is important to see if your chronic health condition qualifies as a disability. The Americans with Disabilities Act (ADA) does not provide a list of disabilities. It defines a disability as a physical or mental impairment that substantially limits one or more major life areas, has a history or record of such an impairment, or is perceived as having such an impairment.

ADA is a federal civil rights law that prohibits discrimination against anyone based on disability. The ADA applies to any employer with 15 or more employees. Learn more about these workplace requirements at Equal Employment Opportunity Commission’s guidance for employers.

Telehealth services, remote monitoring, and remote work may make it much easier to overcome some obstacles people with chronic health conditions face as they balance the demands of their job with protecting their health.

References:

  1. Raghupathi W, Raghupathi V. An Empirical Study of Chronic Diseases in the United States: A Visual Analytics Approach. Int J Environ Res Public Health. 2018 Mar 1;15(3):431. doi: 10.3390/ijerph15030431. PMID: 29494555; PMCID: PMC5876976.
  2. Tulu SN, Cook P, Oman KS, Meek P, Kebede Gudina E. Chronic disease self-care: A concept analysis. Nurs Forum. 2021 Jul;56(3):734-741. doi: 10.1111/nuf.12577. Epub 2021 May 3. PMID: 33938572.

6 Science-Backed Self-Care Tips for Entrepreneurs

Written by Marie Hasty, BSN on . Posted in Business. Leave a Comment

So you’ve made the leap from the 9-to-5 and started your own business. Congratulations! You’re forging your own path as an entrepreneur, and the world is better for it. But sometimes running your own business means your business is running you. Entrepreneurs often realize they’ve traded an eight-hour workday for a 24-hour workday. How can small business owners and start-up entrepreneurs take care of themselves when there’s always more to do? In this week’s blog post, we’re exploring 6 science-backed self-care tips for entrepreneurs.

Learn to identify and reduce stress

In the U.S., we put a high value on professional and financial success. The average work week for Americans is 41.5 hours, one of the highest among developed nations. We put a lot of pressure on ourselves to be as productive as possible, maximizing our hours and even chastising ourselves for relaxing. 

But does stress help us to be better entrepreneurs, or at least be more successful financially? It may be tempting to believe that a more stressed workforce will complete more tasks. But a 2010 study found that increased stress actually reduced productivity. Inversely, feeling more satisfied with work led workers to be more productive. A more recent study of miners found that workplace stress led to impairment at work, more absences, and losses in productivity over time. 

What’s worse, stress can lead to harmful health complications. One study found a close relationship between work stress and metabolic syndrome. This means that workers who are under stress for longer periods of time could be more at risk for diabetes, heart disease, and stroke. 

But what are proven ways to reduce stress? New studies have found that yoga and mindfulness are great ways to manage stress, and both can be learned from a free youtube video. Regular exercise has also been linked to better resilience in adults. Making one of these habits a part of your daily routine can improve your mental and emotional health. 

Be your own [good] boss

Who you work for matters, even if you’re actually working for yourself. A 2017 review found that the most consistent stressor for employees is managers. You may not have been happy with the last boss you had in your last job, but be sure you’re not replacing them with an even harsher manager (yourself). 

Many of us can tend to be our own worst critics. But part of being a good self-manager is being kind to yourself as an employee. Here are a few ways to be a good self-boss:

  • Schedule (and stick with) quarterly check-in times with yourself. These are times to identify what is going well in your business and what could be improved. This also gives you an opportunity to look back on your successes and the progress you’ve made. 
  • Keep specific hours. Write in the times when you plan on working, and stick to them on your time off. Don’t answer client calls or check your email during your scheduled off-hours.  
  • Accept that some days will be more productive than others, and show compassion for yourself. If you find yourself practicing harmful self-talk, try correcting your negative thoughts with positive affirmations. You wouldn’t put up with berating comments from anyone else. Why put up with them from yourself?

Turn to your family in times of stress, but set firm boundaries between work and relationships

Our natural and chosen families are often the first people we turn to when life gets hard. Strong social nets have long been a means of support for humans. But did you know that strong family connections can actually make you a more successful entrepreneur?

A recent study found that entrepreneurs with strong family ties were better able to weather adversity and stress. Those who were able to turn to families for business advice and support were more resilient than people who “go it alone”.

Yet, the data found that certain family interactions were less helpful for entrepreneurs. According to the same study, family members shouldn’t interfere with business decisions when they’re not asked to. In these instances, drawing firm boundaries can help create a better separation between personal and work life. 

If you find yourself needing better boundaries for your family, refer to the business-hours method mentioned above. Practice setting limits with family or friends who try to call while you’re working, and make it clear that your business is your own. 

Create (and stick to) goal-oriented habits 

The SMART format for goal-setting is a great way to get started, and you can use this approach to aim for improvements in both your work and personal life. But setting goals won’t magically make them happen three months from now. With each goal you set, it’s important to create a list of daily, weekly, or monthly actions you’ll take to help you achieve that goal. 

Setting goals is an executive brain function, but actually performing the tasks to get to those goals is a matter of motivation. According to the latest neuroscience research on goal-setting, it’s important to reward yourself even at the smallest increments of progress to maintain your motivation. This reinforces the association with positive action and positive results, even if your results are delayed. So next time you make ten cold calls, treat yourself to 20 minutes with a book or TV show to tell your brain you did something good. 

Another way to reinforce good habits is to actually make them who you are. When people link goals to their identities, they are far more likely to commit to the actions to make those goals a reality. For example, the statement “I am a person who exercises every day” is more compelling than “I exercise every day”. By integrating habits into your own self-identity, you make it more likely that you’ll continue with those habits even when your motivation is low. 

What’s more, daily habits and routines can help you feel more grounded in times of stress. During the COVID-19 pandemic, experts recommended creating new routines when old ones were lost due to isolation. If you are feeling unusually stressed, creating a new routine can help add comfort to your life. 

Build your business around your needs

Many entrepreneurs have the unique ability to structure their days around family, projects, and personal needs. You can find list after list of famous entrepreneurs and their rigorous daily routines. But the daily routine that works best for them may not be the one for you.

Our culture values early risers, and entrepreneurs love to talk about their morning routines. But for those who aren’t fans of getting up at the crack of dawn, there’s still evidence to support a strong evening ritual instead. One recent study found that people who identified as morning or evening people showed the same amount of focus and alertness, just during their preferred times of the day. So don’t feel less productive if you wake up at ten and work into the evening. 

Another study found that cognitive functioning falls in the afternoon. We’ve all found ourselves fighting to stay awake around 3 pm. A task that would have been easier in the morning becomes much harder, like running through water compared to running on land. 

The same study notes that our first three hours of work are often our most productive. Make sure you’re performing the most important tasks first and avoiding interruptions.

Creating your own daily routine can help you avoid the stress of working against your body’s natural rhythms. It also helps you capitalize on your own strengths, rather than orienting your day around someone else’s. 

Take care of yourself by getting some sleep

Start-up business owners may be tempted to work longer hours, sacrificing sleep for work. But the research shows that this behavior can actually hurt your business in the long run. A 2019 study found that entrepreneurs who were sleep deprived made worse decisions and had less accurate judgments about their business ventures. 

Most of us think that the magic number for sleep is between six and eight hours. But the reality is that there is no magic number for the amount of sleep people should get per night. The latest sleep research shows that sleep needs vary from person to person, and even across the lifespan. 

‘Optimal sleep’ is the amount of sleep you need to perform at your best. This includes performance, cognitive function, mental health, physical health, and quality of life. To know whether or not you’re getting enough sleep, evaluate these aspects of your day. Do you find yourself feeling foggy in the afternoon? Are you more irritable or depressed than you used to be? 

Practicing good sleep hygiene and keeping tabs on your sleep habits can help you feel your best when working and relaxing. Sleep gives your brain the chance to catch up with your body, reducing stress and keeping you healthy. It’s just one of the ways you can take care of yourself as an entrepreneur and a human. 

In this article, we’ve listed 6 science-backed self-care tips for entrepreneurs. By using these strategies, you can improve your life and your business. We know it’s tough out there as a small business owner, but we believe in you and your ability to succeed. As small business owners ourselves, we think start-ups are the way of the future and we want to help you on your journey. 

Check back on our website for more information and tips for small businesses and entrepreneurs. If you are looking for advice about stress or your health, talk to one of our doctors at Telegra MD.

rural America

Can Telehealth Help Rural Communities?

Written by Marie Hasty, BSN on . Posted in TeleHealth. Leave a Comment

Americans in rural areas have long suffered from less access to care and worse outcomes. In this week’s blog, we ask the question: Can telehealth help rural communities? To answer this, we’ll get into why rural America suffers from less access to care, how the healthcare system has tried to make up for these disparities, and telehealth amidst the COVID-19 pandemic.

For the last five decades, the 60 million Americans living in remote parts of our country have suffered from worse health outcomes than their urban counterparts. They’re more likely to die early from the five leading causes of death; stroke, chronic respiratory infection, heart disease, cancer, and unintentional injury. In fact, Americans living in rural areas have lower life expectancies overall; about 77 years compared to 79 in metropolitan areas. 

According to the 2017 U.S. Census, 1 in 5 Americans lives in a remote or rural part of the country. But this 20% has less access to primary and preventative care, with 40 physicians per 10,000 residents compared to 53 in cities. 

More than three-quarters of rural areas are considered health professional shortage areas by the Health Resources and Services Administration. Between 2010 and 2020, 70 rural hospitals closed, and more than 700 were at risk of closing. 

All of these factors have led us to a crisis in rural health. But what challenges make rural Americans more vulnerable to health disparities?

Why do rural health disparities exist?

According to the CDC, rural Americans have worse health outcomes for several reasons:

  • Longer travel distances to hospitals and clinics. Rural Americans live an average of over 10 miles from the nearest hospital. In emergencies, EMS response times in remote areas are double that of cities. 
  • People living in remote communities have less health insurance than metropolitan areas. 
  • Rural residents experience more risk factors for illness and report having less leisure time. Rates of smoking, obesity, and high blood pressure are all higher in rural areas.
  • Remote communities tend to have an older median age. In some states, more than half of those 65 years and older live in rural areas. Older adults are far more likely to need ongoing medical care, with approximately 82% having at least one chronic illness. 
  • Poor access to high-quality, affordable foods. “Food deserts” are areas where the nearest grocery store is more than 10 miles away. People living in food deserts have worse health outcomes and higher rates of chronic disease. 
  • Lower median household incomes and higher rates of poverty. Both are linked to worse health outcomes, according to the Bureau of Labor Statistics.

To add to these disadvantages, the global pandemic highlighted the weaknesses in our rural health systems. Even though they were safe from the disease’s first wave, remote areas were hit hard later in the pandemic, and the death rate continued to rise through the winter. In the first few weeks of December 2021, death rates in rural communities were nearly double those of cities. 

In the second year of the pandemic, rural Americans were left wondering how they would get the care they needed and deserved. Not only are they less likely to be vaccinated, but they’re also more likely to experience complications while being further from hospitals when they need care most. What’s worse, more rural hospitals have closed in recent years due to a lack of funding. 

How has the healthcare system tried to help rural Americans?

The Annals of Family Medicine journal suggests promoting medical residents from remote areas while training them in those communities. Another strategy is to broaden the scope of existing providers, essentially making a doctor a one-stop shop for mental health, obstetrics services, geriatric care, and more. Most rural doctors work in primary care, which puts more pressure on them to help their patients with a wide range of health problems. 

The CDC recommends networking with community organizations, such as churches and schools, to educate residents and promote better health habits. Strategies to improve transportation to non-emergent medical appointments have been helpful for remote residents. 

But the fact is that few rural Americans have seen the impact of these efforts. They still face limited access to providers, and could be in for more hardships as COVID-19 and other viruses ramp up in unvaccinated counties. People with non-emergent health issues will face longer wait times for services, if they can be seen at all. Folks with chronic conditions will experience gaps in care while their providers stretch to see their sicker patients. 

Could telehealth fill the gaps for rural communities?

The concept of telehealth isn’t new. Almost since we’ve had the technology to communicate without being face-to-face, people have dreamed of remote healthcare. Early people used smoke signals to communicate disease. In 1879, the Lancet published an article about using the telephone to cut down on visits to the doctor’s office. 

But telemedicine went under-utilized for a long time, held back by legislative and liability concerns. It wasn’t until the COVID-19 pandemic that providers and patients turned to telehealth en masse.  

Early 2020 saw a dramatic spike in telehealth usage; up 150% in March compared to the previous year. Legislators increased access in response to need, which helped encourage providers to offer remote services. The federal government removed location restrictions while expanding the services that remote care physicians could give. They also started reimbursing telehealth visits as they had done for in-person care. 

Use continued to change as case levels rose and fell. Telehealth providers filled the gaps when it wasn’t safe or necessary to come into the clinic, and many physicians had to switch to an entirely online model for care. Now, we’re turning back to our screens for non-emergent care. 

Telehealth and the COVID-19 Delta wave in rural America

According to a 2020 article published by Family Medicine and Community Health, “It is critically important that changes are made to fully immerse telemedicine services into the healthcare landscape in order to be prepared for future pandemics as well as to reap the benefits of this service in the future.” As we consider how to manage future waves of COVID-19 and other infections, demand for telehealth services is expected to grow. 

While people suffering from the virus may need in-person care, those with non-emergent illnesses face the choice between long wait times and going entirely without care. Beck’s Hospital Review expected two surges by the end of 2021: one of COVID cases and another of those who couldn’t access care for long-term illnesses. Many of these are older folks; one poll estimates that one in three older adults put off in-person care due to fear of the COVID-19 virus in 2020. 

Our hope is that telehealth will bridge this gap. Remote care has the potential to treat non-emergent problems and prevent further illness. But even after this next wave passes, we hope that the expansion of telehealth will continue. 

In July 2021, Nature Medicine noted; “Telehealth has emerged as an unexpected silver lining of the COVID-19 pandemic, improving access to care and facilitating a transition toward digital medicine. Cementing these gains now could help make healthcare more equitable once the pandemic has ended.” 

Can telehealth help rural communities achieve better care access?

To answer the question, can telehealth help rural communities? Our answer is yes! The best thing we can do is continue the momentum of telehealth that started with the pandemic. Remote care has the potential to level the playing field for rural Americans, and create better outcomes and support for all. 

At Telegra MD, we are proud to be making access easier for people in both rural and urban areas of the United States. While the traditional healthcare system is constantly innovating with new treatments and technologies, many people never experience these benefits because of limited access. We hope that our network of skilled providers can help change that. 

As we enter this next phase of the pandemic, we hope that we can give you, your family, and your business peace of mind. Whether you’re living deep in the country or in the hustle and bustle of the city, we’ll meet you on your turf to be sure your health needs are being met. 

We offer non-emergency physician consultations nationwide and 24/7 for everyone, regardless of where you live. That’s because we believe that your zip code shouldn’t determine your health. Neither should your insurance. That’s why we’ll never ask for coverage to speak with one of our providers. 

Don’t wait to get your health questions answered. Schedule an appointment with one of our remote doctors.