January 17th, 2014 - In This Issue:
Walk with a Doc Newsletter
Shadow Day
January 17th, 2014

Good morning! Thank you for being here, it means a lot to us.
We've been asked a couple times over the years what led to the start of wwad. We could tell you, but we'd rather show you.
Any chance you could see our first patient with us this morning? I'm serious.
We'd prefer to see all of them with you, but we know that you have a busy day.
I bet even this one patient can explain why practices and hospitals around the country are starting to Walk with a Doc. 
You will see him? Cool!   
This is great. Here's your white coat and my partner's stethoscope just in case you want to listen to a murmur.
Wow. You are a good-looking doctor my friend. Hubba-hubba.

Ok, Mr. Robert Thompson is ready for us in room 1. He's 54 has Type II diabetes and it looks like he was in the ER last weekend with chest pain.
Knock, knock.
"Mr. Thompson, good morning! David Sabgir and this is my nurse Megan. We also have a friend interested in medicine with us today. Do you mind if they sit in?"
"No, that's fine. I can use all the help I can get" His frustration is not hidden.
"Everyone calls him Bobby, doc", his wife Ellen shares with a smile from the side.
"Bobby, thanks for coming in. What's going on?"
"Okay, so this past weekend we were moving my mother into our place in Powell. She's got early Alzheimer's (there's a 58% reduction in development of Alzheimer's with modest exercise) and just got out of rehab."
"She broke her hip over Christmas" Ellen shares with Megan. (41% reduction in hip fractures in post menopausal women in women who exercise v. those who do not).
Bob continues, "We had gotten her dresser up the first few steps then my knees (47% reduction in pain and disability due to knee arthritis with exercise) jaw, and chest started to hurt (up to 50% reduction in heart attacks and strokes with ~ 150 minutes walking/week).
Like someone was squeezing it.
Ellen made me chew 4 baby aspirin (smart, Ellen). I wanted to drive to the hospital but she called the squad (very smart, Ellen). Anyway, everything in the ER checked out and they wanted me to see you this week. It hasn't come back since Sunday. The doctor in the ER said something about a stress test."
"Good history. Let's go through some of the risk factors for cardiovascular disease"
"Do you smoke Bobby?", Ellen begins to glare at Bobby who is now lowering his head as he smiles nervously.
(Exercise is proven to play a strong role is tobacco cessation. The chemicals released in exercise hit the same receptors that nicotine stimulates - it cuts cravings significantly).
"We need to talk about that later.How's your blood pressure been?"
"At home, I'm usually 140's-150's over 80's" (Exercise lowers BP).
I bet you're going to ask me about my cholesterol too, right doc? It's somewhere around 205, is that good?"
(Exercise increases the good cholesterol, HDL, and lowers the bad, LDL) 
"How long have you had diabetes?"
"Well, they diagnosed me 4 or 5 years ago, but I've probably had it a lot longer." 
(Coupled with other interventions exercise reduces progression or onset of diabetes by 58%)  
"Anything else we should know Ellen?"
"Yes. He snores. Oh Lord, does he snore! You'd think the whole house was coming down! (Exercise prevents or dramatically improves sleep apnea).  "Also, I don't know if its his mom moving in or what, but he's not been the same person recently. He's worrying about everything and, I love him but it's hard to be around him. He's turned into Debbie Downer (Exercise reduces anxiety by 48% and depression by 47%).  He's also tired all the time (Exercise is the #1 treatment for fatigue). So Doc, can you just give us a pill that will fix ALL of this! (...actually, yes, we can kind of do that).
 
 "Do you go for walks Bobby? Swim, bike, elliptical?"
"I've been tryin' but with the weather like it is..."
"Bobby Michael! Ellen jumps in. "Tell me the last time you went for a walk!"
Same nervous smile as his chin lowers to his chest. Long pause before he pops up is right index finger.
"We did Race for the Cure! (in the right amount, simple exercise reduces breast cancer onset, or its recurrence, by up to 42% and 53% respectively). When was that El?"
"1996!"
This actually got us all to laugh, even Megan typing away in the corner. I think it was her delivery.
"I'll be right back Bobby," I share as I lead you into the hall.

I really appreciate you seeing Bobby with me. I know you have to go so I wanted to get you out of the room before we start him on his new meds ($$$) and schedule his stress test ($$$$).  But, hopefully that gives you a little insight as to why we do Walk with a Doc. Statistics show 97% of the United States is not getting their recommended amount of exercise. I may have one patient today that's getting 150 minutes/week.
80% are like Bobby and don't exercise at all.
You can see, Bobby is a great guy. He also has a lot of people that are depending on him.
We hope you agree as you look at the numbers; we have a cure and we need to bring it into play. Walking in the park will send Bobby's quality of life through the roof.
It's been debated whether or not getting Bobby walking is a doctor's responsibility?
Honestly, we couldn't care less who's responsibility it is.
What we care about is the opportunity. This gift of an opportunity to get Bobby out moving.
We hope you agree that it doesn't take much thought to see how you are transforming the way medicine will be practiced moving forward.
We just need to continue to be assertive and persistent in getting our doctors out into our country's parks. We have the cure, we just need to act.



Have a great weekend!
Stay Foolish. Stay Hungry.

David
614-714-0407


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