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WELLNESS Focus | You and Your Patients
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March/April Focus: Wellness For You and Your Patients

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Thank you for being a member of IAPA! We hope that you enjoy the premiere edition of our new Executive Briefing, the "IAPA Insider." Each month we will provide you with original, member-driven content that offers you value for your day-to-day practice, as well as essential Association updates. Formatting look strange? Click the "View this email in your browser link" above for optimum viewing. Questions? Suggestions for Topics? General feedback? Please feel free to contact our Executive Director, Elizabeth Schumacher.
President's Perspective: Teaching Moments
Jennifer Orozco, MMS, PA-C, DFAAPAIAPA President 2016-17
It’s not often that I get to attend one of my son’s school events - let’s face it, life as a PA is hectic. But this was something I was really looking forward to, “Career Day” - YAY! I would go and talk about being a PA - my son was excited, I was excited; we counted the days until the big event. But as the big day grew closer, I became more and more nervous. Adults I can handle, but how was I going to explain being a PA to a bunch of 5 year-olds? My one minute elevator speech wouldn’t work - I wasn’t going to say “like a doctor”. What was I going to do? I was at a loss for words. As I struggled to find the words, I began to realize that I didn’t have to give an in-depth explanation about being a PA or the common misconceptions surrounding our title, I could just be honest. I could tell them what it was like to practice medicine and take care of patients;oh….and I could bring some really fun props.... my stethoscope, my otoscope and tongue blades were sure to impress

The day finally arrived, and as the kids played with the instruments in my medical bag, I talked about what it was like for PAs to take care of someone when they are sick and how we help keep people healthy. I told them that they could see PAs in the hospital or at the doctor’s office, and that sometimes they even operated on people. The kids loved it! At this point I asked if anyone had any questions. Silence…then, I saw few hands go up in the back of the room. Hands not from any 5 year-old, but from the adults in the back of the room. They needed clarification on this whole “PA thing”. As I answered the adult’s questions, I recognized this as an advocacy opportunity that I had never anticipated. The local dentist, flower shop owner, school teacher, and Chicago newspaper editor ALL just learned about PAs, what we do, and why we are important.

As we continue through 2016, I encourage each of you to think about your unique PA advocacy opportunities. Is it with the members of your church? Or at your child’s ballet recital? Do you play golf with the local sheriff? You never know when an opportunity will present itself to talk about your profession. Seize it. Capture it. You never know when you might need to call on them in the future.
Jennifer Orozco is President of IAPA. She is the Director of PA Clinical Practice and Director of Clinical Education at Rush University, Chicago.
Functional Medicine |
Optimal Health Practices for You and Your Patients
Rajka Milanovic-Galbraith, MD | Focus Integrative Medicine
For me, over the past 2 ½ years, using a functional medicine approach to heal more people than the prior 16 years (using a traditional allopathic approach) has been life and career altering. Functional Medicine targets root causes of diseases and does not simply use drugs to treat symptoms, and engages patients in a therapeutic partnership. As I reflect back on my early allopathic years, I can see that even if I had the knowledge I now have, it would have been very difficult to educate patients and affect change in 15 minutes - let alone 7 minutes. However, if I stop and take a moment to think, it is possible to break up each of these measures (diet, lifestyle, and wellness) into baby steps to assist patients on their road to recovery over a series of appointments. It is also important to consider caring for your own health in today's busy medical professional environment... take the time to care for yourself too!

MIND BODY
Stress is becoming a prevailing cause of many symptoms and visits to health care practitioners.  Teaching a patient to modulate their response to stressors therefore would seem like an item of utmost importance. However with so little time, it is difficult to know where to begin. Here are some quick strategies to modulate stress.
 
  • 4-2-7 Breathing.  Inhale for a count of 4, hold your breath for a count of 2 and then exhale for 7. The breath holding triggers the vagus nerve which slows down the heart rate and usually in a very short amount of time induces a calmer state. You and/or your patient can use this any time you are feeling stressed or even when answering emails - as most people hold their breath while they work.
  •  Neutral Tool: This is a simple technique, which is one of the coherence tools that is simple to teach. Utilize this tool when feeling stressed, or 1-2 times daily for 5-10 minutes. First, focus on the area of the heart. Sometimes this can be difficult. You can start by focusing on something more tangible like the big toe. Once you have achieved focus, change the focus to the heart.  Next, breathe slowly in and out as if breathing through the heart center. There are companies that sell health sensors that work with smartphone apps (Inner Balance for example), teaching a patient how to get into coherence as an active but parasympathetic state or calm state.
 
EXERCISE
We tell our patients to exercise all the time - but usually it is said so quickly that the average patient may not be certain what to do with this information. Evidence points to how exercise is important but yet Americans are becoming increasingly sedentary and sitting is becoming the new smoking. 
  • Standing/Movement Breaks: Set a timer on your watch, phone, or computer to remind you to take a break at the 45-minute mark of every hour. Either work standing for 15 minutes, go for a walk around the office, or do any form of movement that not only gives the mind a break, but also increases activity.
  • High Intensity Interval Training: The 90’s did such a disservice to so many of us who were exercising for long periods of time, but without intense bursts of activity.  High Intensity Interval Training or HIIT is more effective in increasing metabolic rate, along with building speed, than long hours of endurance training.
  • 7-minute Workout:  You don't need to workout for hours a day to stay fit and gain benefit. Many news and journal articles have highlighted that as little as 7 minutes per day is beneficial. This 7-minute workout is available as a smart phone app and requires no equipment except a chair, a wall and a step.  

NUTRITION
Most of the moderate symptoms I see respond profoundly to minor nutritional adjustments.  I have seen great responses in anxiety, depression and ADHD with diet and nutrients alone. Yet many patients are not educated on how to make these dietary changes. Understanding glycemic index, knowing which foods are high in the nutrients our body needs, and knowing that some foods can serve as triggers for our immune system are all important teaching items. A few tips to consider for general health:
 
  • Low Glycemic Load and Index Trackers. Trackers are easy ways to help patients highlight what they should eat daily (low load foods), weekly (moderate load) and rarely (high load foods). Use the tracker yourself. In the office, it is easy to give one example of a high load vegetable like potatoes, which should be eaten as a treat once in a while, and a low glycemic load vegetable such as broccoli, which should be eaten often. 
  • Eat the Rainbow.  So many patients are fatigued and usually an exam and lab does not uncover the source for their fatigue.  But if you evaluated their diet, you would find that most are not eating a diverse enough, let alone a “whole foods” diet. Encourage the patient to eat 2 servings per week of every color food: red, orange, yellow, green, brown, and purple. Optimum would be to include daily servings of these colors. The bright colors are what give these foods their benefit. Remind them to "Eat the Rainbow."  
  • Four Food Elimination Diet: So many patient symptoms have responded to eliminating foods, which may serve as triggers to the immune system, as well as triggers to the brain causing inattention, hyperactivity, depression, anxiety and joint pain. The gut is the second brain after all. Whole books have been written on this topic such as Dr. David Perlmutter’s, Grain Brain. Top foods causing symptoms are: gluten, dairy, eggs and legumes. Introduce the idea to the patient at the first visit. Advise them at follow-up to try this diet just for 21 days. If all four foods seem to difficult have them pick one or two. Then, see them at 21 days and teach them how to reintroduce one new food every three days in its pure form, such as a whole egg, not just eggs in a recipe, and observe symptoms.  If the food causes symptoms than that is their trigger. Imagine a world without where food is thy medicine. The possibilities are endless!


Dr. Rajka is an MD, board certified in family medicine as well as integrative and holistic medicine. She is trained by the Institute of Functional Medicine and the proud owner of the newly launched clinic: Focus Integrative Medicine in Naperville, IL. You can follow her on twitter or on Facebook.
Make Time To Safely Exercise...
Both You and Your Patients!
Thom Rosen, PA-C | CORE Orthopedics and Sports Medicine | IAPA Board Member
With spring fast approaching, many of us may be planning to start a new exercise regimen.  Whether you have your eye on a 5K race this spring, or just want to get in shape for summer, following these tips will keep you safe and injury-free. Remember to take care of yourself physically - just as much as you remind your patients... safe exercise is important for everyone.
 
  • Start slow.  It can be easy to be a little over-enthusiastic at the onset of a new exercise plan, but doing too much, too soon, can lead to injury. Consistency is key, and increasing the duration and intensity of your sessions slowly over time will help prevent injuries. 
  • Hydrate.  There are dozens of fluid replacement products that you can use before, during, and after exercise to keep you well-hydrated and replace lost electrolytes, but plain water can work just as well. Staying well hydrated will allow your muscles to work efficiently while flushing away exercise byproducts such as lactic acid. 
  • Cross-train.  Varying your activities on “off-days” will allow rest for those sport-specific sore muscles, keep you active, and work your muscles and joints from different angles. One or two strength training or yoga days per week worked into your triathlon training schedule, for example, can be beneficial to your performance and help avoid over-use injuries.

Thom Rosen serves as Treasurer of IAPA. Thom has been a practicing PA for 12 years, working mainly in orthopedics. Thom is Co-Founder of the STAR Global Connection, a non-profit that provides support to communities in need through medical education, medical care, disaster response, and community care.
IAPA News and Updates

Springfield Scene- Legislative Update

Mindy Sanders, PA-C | IAPA President- Elect [Chair, Legislative Committee]

These are exciting times for IAPA! Springfield has been bustling with activity. We continue to monitor the political climate in the state of Illinois. Lots of uncertainty remains in Springfield right now due to the budget. Dan Shomon, our IAPA lobbyist, has been instrumental in helping us develop relationships with legislators, as well as key groups (Medicaid, Pharma, IDFPR, etc.) Dan deserves a standing ovation for helping all PAs in Illinois with the looming licensure delay. If you are still having issues with licensure renewal, please contact us right away. We are here to help our members! IAPA is also proud to report that Mindy Sanders, President-Elect and Legislative Committee Chair, has been appointed to the IL Prescription Monitoring Program Advisory Board. "It is a great honor for a PA to be nominated to this Board. PAs play an important role in IL healthcare and Mindy has been instrumental in advocating for PAs in our State. Thanks to Mindy for her outstanding work on behalf of all of us" Jennifer Orozco, IAPA President.

The IAPA has been collaborating/communicating with Illinois State Medical Society (ISMS) providing input on educational documents (provided to their physician members regarding PAs) as well as bills under review. In fact, IAPA representatives are scheduled to meet with ISMS to review the current bill regarding PA Rules and Regs (click to view). We have recently formed a Legislative Action Network developed of six Springfield area PAs in different specialties so that we have more local help. IAPA is organizing a Lobby Day for April 5th. Please let us know if you would be interested in participating. As you may know, our PA Practice Act will be coming up for renewal soon - this is a crucial piece of legislation that is important not only for ourselves but for our patients, colleagues, and employers. Without the Practice Act being renewed, you and I will no longer be allowed to practice in the state of Illinois. Your membership in IAPA helps support these efforts. We ask you encourage your colleagues to join so we can increase our efforts to support Illinois PAs!

 

The Student Section

Kris Bridgman, PAS-1

On January 30, Rush University PA student Andrew Mastro and Sharon Gates (Senior director of Multicultural Affairs & Community Service), along with the help of the Chicago Bulls, NBA GetFit, JrNBA, and Rush Students, coordinated an event at the Advocate center (the Official Training Center of the Chicago Bulls). This event was aimed at educating kids from schools located on the south side of Chicago on exercise and nutrition. "Whether it was cooking healthy meals in the kitchen, or running drills on the Bulls' practice court, all involved gleaned a truly memorable experience. Especially the kids, who had the time of their lives while breaking a sweat...The buzz that was filtering through the building that evening was deafening and more importantly - inspiring. We all had the chance to talk with the kids while we were eating dinner and you'd be hard pressed to find a face without a huge smile.

However, the real success story was one that was detailed to me by the head trainer involved, Coach Larry. He delivered a message which underscored the importance of bringing people from all walks of life together. He said that some of these kids may have never interacted with people that were 'different' from them, both visually and socially. This event was a critical step in bridging that gap, by having them run side by side with the Rush students and trainers. In doing so, we succeeded in, "emphasizing unity, embracing diversity, and urging forth positivity." - Andrew Mastro.  Opportunities such as this play an integral role in the education of Rush University students by revealing the impact that health education can have on its community members. Special thanks to Andrew Mastro and all those who made this event such a success!

 

2016 IAPA Student Challenge Bowl | PA Student Professional Development


This year's program will be held on April 16th, 2016 from 1-6 pm at the Northwestern University- Chicago Campus, Baldwin Auditorium, in the Robert H Lurie Medical Research Center, 303 E. Superior Street, Chicago. Please email Kristine Burgess for more information.

Schedule:  
  • 1-4 pm: Programming includes professional development for IAPA PA students (CV/resume Writing, Contract Negotiations & Licensure Information, PANCE Prep Recommendation and  "A Day in the Life of a PA").
  • 4-6 pm:  IAPA Student Challenge Bowl

Spring 2016 CME Event | April 30


IAPA and Springfield Clinic will co-host a Spring CME Event on April 30, 2016 from 7:30 am - 5:30 pm. Eight (8) credits will be offered through this program. Topics include:
  • Diabetes Mellitus Update
  • Dermatology for Non-Dermatologists
  • Urgent Stroke Care
  • Concussion Management
  • Resistant Hypertension
  • Rheumatology Options
  • Autism Spectrum Disorders
  • Dizziness Workshop
  • NCCPA Update
Costs: $120-IAPA Member | $150 Non-Member. CLICK HERE to register for the event. Email IAPA for more information.
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