Design notes: list of providersWe want this to look much more inviting—these chairs are way too cold.Had thoughts about putting the actual providers in the chairs. Could be an actual live picture with a sample patient in the red chair or could be a group of providers sitting around the table.
Based on a survey of our patients, we found a consistent theme of what frustrates them about conventional medicine practices and why they felt First Health was different. Since identifying these 4 key areas, we have made a consistent effort to offer our absolute best to:Listen attentively to Patients concernsMake the patient the driving force as the center of careMinimize wait timesExplain all the options for treatment, and give the patient choices (medications, alternative medicine, nutritional medicine/supplementation, psychological medicine)
1. The Low down onHigh Blood Pressure Enrique Saguil, MD We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.
2. The First Health Approach We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.
3. Your Team Ric Saguil, MD Jason Gruss, MD Tom Jordan, RDKatrina Christie, LCPCMike Blumberg, LCPC Jennifer Green, ND Joe Musolino, DC Amy Iaquinta, DC Nick Nowicki, DC Emery Paredes, PT Courtney Day, EP Aimee Weber, EP Yu Zhu, MD China You
4. Ric Saguil, MDWe didn’t invent the practice of medicine…. we’re just changing the way it’s provided.
5. “Hypertensive?….I feel fine doc!”
6. …more like this.
7. Let stress be your mantra• Don’t have enough time to sit down• Don’t have enough money• Don’t have any cooking skills• Don’t have the will power right now• Don’t have a secure job• Don’t have medical insurance to cover• Don’t have any “medical problems”
8. American Heart Association Blood Pressure Systolic Diastolic Category mm Hg (upper #) mm Hg (lower #) Normal less than 120 and less than 80 Prehypertension 120 – 139 or 80 – 89 High Blood Pressure 140 – 159 or 90 – 99(Hypertension) Stage 1 High Blood Pressure 160 or higher or 100 or higher(Hypertension) Stage 2 Hypertensive Crisis (Emergency care Higher than 180 or Higher than 110 needed)
9. Fact• Obesity leads to hypertension.• Hypertension lead to heart disease• Heart disease leads to coronary artery clogging• Clogging leads to sudden death
10. Physiology – The PumpMuscle contracts and squeezes blood out
11. How it all beganSodium potassium pump -Pump pushes sodium out -Potential is created -At threshold, channels open -Negative is “depolarized” -Action potential created -Electricity gradient started -Action potential spreads
12. Impulse waves travels one direction Think of a snake swallowing food
13. Arteries push/Veins flow
14. First medical intervention – -blockers calcium = alpha receptor = beta receptor = both Calcium = channel ACE = angiotension c e inhibitr (Dr Ric Quicky = relax smooth muscle)
17. Physiology – The Fluid• Total volume 6L• Relative to the pump = preload/after load (preload is what we just discussed) Diuretics/water pills (Dr Ric Quicky – DASH diet)
18. RX• Loop diuretics – furosemide/lasix• Thiazides – hydrocholorothiazide• Potassium Sparing – spirololactone/ triampt• All work on the kidney
19. alternatives• Green Tea• Dandelion leaf• Push fluids (high volume initially gives a diuretic effect)• Fluid restrict• Lymphedema massage• Blood letting with leaches
20. Physiology – The Brain• Sympathetic tone “fight or flight”• Excellent for survival• Not good for procreation• Dangerous for long term function/balance Catapress Aldomet (Dr Ric Quicky – Calm)
21. RX• Catapress• Aldomet
22. alternatives• Valerian• 5HTP (peak x –eosinophilia myalgia syndrome)• Magnesium• Breath exercise• Meditation and cultivating stillness• Exercise (cardio)• Nature• Aromatherapy
23. HTN Summary• High blood pressure caused by: -blood vessels clamping down -tissue pushing on blood vessels -too much volume -over active neural tone
24. TX RX• Drugs/ Dash+/-
25. Alternative Treatments• Herbals• Supplements• Lose wt• Move to warm climate• Relaxation response• Fluid restrict• Massage• Breath/Meditation/RR• Exercise• Aromatherapy
26. Untreated• Crisis escalation or chronic end organ damage
27. The “End Organs”
28. Damages – eye(slow)
29. Damages – brain(sudden)
30. Damages – kidney(chronic)
31. Damages – blood vessels (chronic but sudden)
32. Damages – heart(slow)
33. Damages – heart(fast)
34. Role of the MD• Review numbers• Determine Causes/Diagnosis (rule out secondary HTN)• Identify and Assess Risk Factors• Instruct patient on how to self-monitor BP• Review and Assess abpm record in 3 months• Keep safe with meds until 6-12 months• Oversee team care plan (Refer to special forces…)• Special Mention: TCM and Ayurveda We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.
35. Live Long and Prosper!!! Next Lecture: Whole Foods Market SchaumburgManaging Holiday Fatigue….an Integrative Medicine Approach December 8th 530-630pm We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.