Telemedicine THEN: More on Telemedicine and the VA

The year is 2003 and Brian*, a cancer patient, is having a miserable day, after an even more miserable night. The day before started out alright, but by late morning he was having difficulties breathing and he was unable to hold down any food. On top of that (even though he had remarkably high tolerance) he was beginning to feel real pain. Having had no sleep or rest he was physically exhausted and felt completely unable to cope with the stress brought on by a usual day.

Brian lived 45 miles away from his VA medical center. Because of his medications, he was unable to drive, even if he did have a car. Finances were too tight to call for a taxi and his closest friend, who stayed with him on the weekends, would not arrive until the wee hours the following morning. He just wasn’t sure he would be able to hold on.

He called his oncologist , who told him, “Listen Brian, there’s a shuttle available to your area today so just come on in to the office. You missed your last appointment so, even though it sounds like all you need is a med adjustment, today would be a good day to play ‘catch up’.” Then he added, “Besides, I think have a solution to the problem of scheduling visits.”

Enter “Telemedicine”.

Cancer patients who are either trying to deal with their ‘end of life’ issues or are at a stage where they require chemotherapy have always been an underserved demographic. They’re subject to a type of stress that most people cannot understand. Perhaps they’re unable to get transportation when they need it because they are living within a strictly fixed income. Maybe their discomfort or pain level has led them to the point where they ‘just don’t care anymore’. Constant travel back and forth to the doctor, which may only be inconvenient to some, can evolve into severe stress for patients with life threatening conditions like cancer. Either way, care during chemotherapy and end of life has suffered. Some solution has been needed.

Healthcare Innovation by Design

Healthcare Innovation by Design – one of many sources of telemedical devices

Because of collaboration that developed between the National Cancer Institute (NCI) and the Department of Veterans Affairs (VA) from the mid to late 1990’s to the early 2000’s **, the problem was tackled and initial solutions found. Cancer patients were given the option of electronic monitoring of their symptoms so that the unique health problems they encountered could be addressed quickly and effectively. One such solution was a device called the “Health Buddy”, which could be connected to a telephone, giving them immediate access to their care coordinators.

Daily calls to a central terminal would enable the patients to report concerns and issues they may be experiencing, such as pain, breathing problems, depression, nausea or any other symptoms. This would be done through responses to detailed, multiple choice, voice-prompt questions relating to a dozen symptoms, entered on the phone handset numeral buttons. These responses would then be analyzed by the patient’s oncology team provider, whether the oncologist him/herself or the oncology nurse. If responses appeared to indicate complications requiring face-to-face consultation or that intervention such as a change in medications or dosages were needed, such action(s) could be affected immediately rather than having to wait for a consultation appointment.

Getting back to Brian, his visit with his oncologist resulted in the needed change of medication to ease his pain and discomfort but, more importantly, his physician introduced him to the “Health Buddy” system. Brian was soon provided the device to use at home and his stress level, hence other health issues, improved immensely.

The subject of Telemedicine and Telehealth has progressed far beyond this technology since then. It is destined to see increased efficiency, collaboration between facilities in not only cancer care but all other branches of medicine and home health care and accelerated research on a multitude of diseases and genetic conditions.

Thanks to the VA’s decision to pursue this technology, telemedicine has already helped veterans from all walks of life gain more immediate care for their medical conditions. From telephone consultations to web based teleconferencing “doctor visits”, Telemedicine has proven its worth to the health care issues of the day.

 *Not his real name.
**Sources consulted did not provide exact dates.
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Life and Health Can Be Easy Like Sunday Mornin’!

Many thanks to Richard Crossen, Pembrokeshire, West Wales, UK…photographer extraordinaire, for his kind permission to use his photos on this site. To see his wonderful collection of nature photographs, you can visit his gallery or his blog site

I’m a ‘glass half full’ kind of person. I rarely worry about what I don’t have because I’m too busy being thankful for the things I do have. Well, except when my gas tank has only one gallon in it the day before payday.  If I had to define my thoughts on the subject, I’d say my outlook on life is “…easy like Sunday mornin’ ” (that’s a song from the ’60s for those who wouldn’t remember that era!).

A lot of times, when some great, blue funk or another tries to overtake me, my Granny comes to mind. I remember her always trying to teach us that God takes care of His own, regardless of how hard we try to screw things up. She was good at backing up her beliefs with scripture, like “…behold the fowl of the air” or “…consider the lilies of the field” as a way of showing the difference between what we need and what we want.  Yes, I learned from an early age to see the best in every situation and to find the most positive things inside of the worst possible scenarios.

This is what true balance is all about. It’s taking life as it comes and striving to make each moment count for something positive. You know the old saying, “When life hands you lemons, learn to make lemonade!”

It’s easy enough to fool yourself into feeling miserable simply by wallowing in misery, but by the same token it’s equally simple to fool yourself into being content, regardless of how your life has transitioned. Finding something good either in a situation, about a situation or what good thing can eventually happen because of a situation is the key to distracting you from whatever hardship you might be facing.

Your health is as much emotionally as physically based. You must learn to  b r e a t h e  when you feel stress creeping up on you. Find something relaxing to do whether it’s meditating, reading a good book, writing a letter to someone you love…or even just stopping your day and thinking deep thoughts!

Biofeedback, which became a ‘craze’ back in the ’60s, has been used to teach people to regulate their body rhythm and has proven that they can learn to control many “automatic” physiological functions, including slowing the heart rate and lowering blood pressure and respiration (then again, so does yoga!). Considering that even these three functions alone can cause health problems, being able to control them can help you to avoid stress related health conditions.

There are also simpler routes to controlling the “mind over matter” part of your health. You can schedule an at-home regime of relaxation, including meditation, aromatherapy and exercise using techniques designed to produce and release natural endorphins, an opium-like hormone.

Also, if you don’t already belong to one, a lot of spas and health clubs offer incentives for new members and specials for current ones, that may include anything from deep tissue massage to yoga classes or whirlpool spas to herbal wraps. These great benefits  can come by means of contests, filling out surveys, trial memberships or redeemable coupons.

Coupons for such things can be found in the newspaper or even online. The internet is a wonderful resource for finding the best deals in your area. You may even find purchasing clubs, such as Good Deals 24/7or Groupon that can help you save money on anything you need for health and beauty aids or even travel deals for a relaxing vacation.

Don’t wait until stress overtakes your life and creates illness and dis-ease (as in ‘un-easy health’) in your body. Even if life can be difficult it needn’t be hard to adapt to or accommodate its uncertainties. Learn to roll along this bumpy road with grace and acceptance. After a bit of practice, it almost becomes easy. Easy like Sunday morning.