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    Wednesday, May 08, 2024

    Go for the easy wins

    We spend so much time in medicine thinking about the latest and greatest that we often ignore the low-lying fruit.

    Not that the latest and greatest isn’t cool. Two weeks ago, the Yale Structural Heart Team presented a case conference in Mystic: diseased heart valves that would have been fatal two years ago but can now be fixed or replaced through a catheter placed in the leg. To me, this is thrilling and even a bit sexy (yes, I am a bit of a nerd).

    Cardiology is undergoing a technological revolution. Around 2008, Dr. Brian Cambi told me of his vision that L + M Hospital would have a world-class cardiac cath lab and be a key player in a larger Yale Cardiovascular Program. Truth be told, I thought Brian was nuts. But Brian kept true to his vision, not only bringing the resources of Yale Cardiology but also ensuring that the magic of our New London community didn’t get lost. A few years ago, a patient and neighbor of mine, then dying of heart failure, went to Yale and got a battery-pack-powered mechanical pump to assist his heart and soon afterward took my wife and me skeet shooting. (Carla shot a lot better than I ...) And he’s still shooting!

    It is up to us in New London, of course, to make sure that we don’t miss the easy wins, the low-lying fruit. And that, as they say, takes a village. Because many more lives can be improved, saved, lengthened with just a very little effort. When I was a trainee in cardiology, I had stayed up all night saving this man’s life, doing procedures and giving medicine that cost more than the GDP of a small country. But when I looked over the meds the next day, I realized that I never started aspirin, a drug that decreases the risk of death from heart attack more than any other expensive drug or procedure we were doing, and that costs less than a penny a pill. Doh!

    Blood pressure control is another easy win. If BP is a major cause of stroke and heart attack, a simple BP cuff can save and improve the lives of an entire community. But what if, instead of leaving it to the medical profession to do it, we enlisted people to become health coaches — disciples in the community — in churches, in Boy and Girl Scouts, in civic groups. Deacon Keith Fowler and Dr. James Mitchell of Shiloh Baptist Church came up with such: a plan to teach health coaches to go out and literally save lives. We are developing a syllabus to teach how to recognize hypertension, how to get a doctor, how to motivate others to exercise and eat right. It’s a program we hope develop in our community at large, possibly funding scholarships for young people who excel as health coaches and want a healthcare career.

    And since it’s about community, what better community resource than our parks? ParkRx.org is a national program where you can go online and design an exercise/health regimen, using parks in your region. The website www.GrotonRec.com/ParkRx is a local interactive web site of our own parks.

    New London County is undergoing a wonderful transformation in heart healthfulness. Time to gather the low lying fruit!

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