Three faculty and one family medicine resident at the College of Community Health Sciences continued the Mini Medical School program—a lectures series for The University of Alabama’s OLLI program.
The Mini Medical School program provides an opportunity for adults and community learners to explore trends in medicine and health, and the lectures by CCHS faculty offer important information about issues and advances in medicine and research.
OLLI, short for Osher Lifelong Learning Institute, is a member-led program catering to those aged 50 years and older and offers educational courses as well as field trips, socials, special events and travel.
Dr. Jane Weida, associate professor of Family Medicine and associate director of the College’s Family Medicine Residency, presented a talk on Feb. 4 titled “Family Medicine Cares: Helping Haiti Heal.”
Family Medicine Cares is a humanitarian program of the American Academy of Family Physicians, which works to provide sustainable health care to underserved populations in the United States and throughout the world.
The program first sent a group of physicians and educators to Haiti in 2010 after a 7.0 magnitude earthquake devastated the country, one of the poorest in the Western Hemisphere. More than 100,000 people perished in the first 60 seconds of the earthquake. Rescue efforts were hampered by no electricity, no cellular phone reception, hospitals were overwhelmed and the country’s only airport was destroyed. Some 250,000 homes and 30,000 commercial buildings were destroyed or severely damaged. Tent cities struggled to accommodate more than 1.5 million people left homeless; that number remained at 150,000 as late as 2014.
“It’s been six years since the earthquake but there’s still a lot of need,” Weida said.
Weida was part of a group from Family Medicine Cares that traveled to Haiti in 2014. The group was comprised of 22 people, including 17 physicians, and they brought needed medications with them. Once in Haiti, the group divided into three teams to provide patient care, medical education and service projects.
The patient care team treated more than 550 patients, which included conducting more than 130 well-child checkups, a rarity in Haiti. The medical education team conducted a full-day symposium for health care providers there on geriatric and preventive medicine. The team also conducted a faculty development workshop for medical school faculty on teaching residents and medical students, accessing medical information on the intranet and funding research. The service team painted three schools and an orphanage, three exam rooms and distributed vitamins.
Weida said future plans for Family Medicine Cares and its work in Haiti include providing continued support for residencies via faculty development and donation of medical equipment, providing continuing medical education for physicians and increasing exposure to family medicine in medical schools.
“Are we making a difference? I think we are,” Weida said.
Dr. James Robinson, the College’s Endowed Chair of Sports Medicine, presented his talk, “Preventing Athletic Injuries in the Elderly,” on Feb. 11.
Robinson said the process of aging results in a decrease of VO2 max, which is the maximum volume of oxygen a person uses. By age 65, 60 percent of one’s VO2 max is lost, and the maximum heart beat is 40 beats per minute.
This can be countered by exercise, Robinson said. He said the recommended amount of exercise for the elderly is two and a half hours per week. He said both cardio and strength training are important forms of exercise.
“You don’t have to go out and run a marathon,” Robinson said. “Walking, gardening and dancing are good exercises. Bicycle riding is easy on the joints.”
He also suggested yoga or tai chi classes, which are good for balance, which is especially a concern for the elderly. Falls are leading cause of injury-related deaths and account for 10 percent of ER visits with the elderly, he said.
To prevent injury from exercise, Robinson said to choose an activity appropriate for one’s fitness level and to work gradually at it overtime. He said to allow time for recovery after exercise, and to be mindful of nutrition.
“Water is your best fluid, and carbohydrates are your main fuel for exercise,” he said.
Dr. Anne Halli-Tierney, a geriatrician and assistant professor of Family Medicine, presented a lecture Feb. 18 titled “Dementia and delirium: Evaluation and management.” Or: “I’ve lost my mind.”
She said dementia is a loss of cognitive functioning with symptoms lasting for at least six months. Dementia can result from Alzheimer’s disease, vascular dementia caused by large and small strokes, and traumatic brain injuries. Alzheimer’s disease is the most common cause of dementia, she said, and over the course of the condition there is generally a clinical loss of memory, delusions and paranoia and a loss of ability to coordinate and swallow.
There is medication that can stabilize memory and treat dementia symptoms. Intellectual stimulation and good cardiovascular health are also important. “There are treatments for dementia, but no cure,” Halli-Tierney said. “People need to keep intellectually and physically active by reducing their cardiovascular risk and boosting their overall brain reserve.” She suggested reading, art, music, cross word puzzles, gardening and social interaction to stimulate the brain, and attention to diet and exercise to maintain good cardiovascular health.
Unlike dementia, many causes of delirium – fluctuating attention and level of consciousness – are reversible, Halli-Tierney said. Causes of delirium include infections, reactions to medication, sensory deprivation or overstimulation, metabolic disturbances and depression and anxiety.
She said delirium can often be countered by appropriate use of glasses and hearing aids, limiting noise, checking for infection and allowing for rest.
Dr. Jason Clemons, a third-year resident at The University of Alabama Family Medicine Residency, which the College operates, presented “Diabetes: Managing Your Sugars” on Feb. 25.
More than 25 million people in the United States have diabetes, Clemons said, and that by 2050, there will be 40 million Americans with type 2 diabetes.
“As physicians, we are supposed to be educating patients,” he said. “When you look at that number, it’s obvious we’re not doing something right.”
Clemons explained the science behind type 1 diabetes, which is a genetic disorder where the body doesn’t produce insulin, and type 2 diabetes, where the body either doesn’t produce enough insulin or is resisting insulin.
He said that the key to controlling diabetes is in exercise, diet and medications. Of the 25 million who have diabetes in the US, three-fourths manage it with lifestyle modifications, oral medications or both.
When it comes to eating right, Clemons gave the advice to shop the outside perimeter of the grocery store, and to eat a balanced diet. He provided handouts to participants with a food guide.
Three types of medications are used to manage diabetes: metformin, glyburide, and insulin. Metformin is the most common and the safest, he said. It is free at some grocery stores.
Exercising for 30 minutes four to five times a week is ideal, Clemons said.
“But be realistic. Start where you can. If you can only walk five minutes, start there. Then add one minute each week.”
Dr. Thomas Weida, chief medical officer of the College, will present on March 3, “To Be or Not to Be: Health Care Reform.”