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Arthritis Diet and Exercises

The Humanwide Project: Digital Health Devices


Ooo. Yes, I have a high blood. Stage two. Each Humanwide participant was outfitted with four digital health devices that we ended up tracking through their
electronic health record.The pedometer can be very helpful for the healthcare
team to be able to support a particular patient’s exercise related goals.The
digital scale gives immediate feedback to patients and the healthcare team on
lifestyle changes and it also attracts improvement in the body mass index. Having a home blood pressure cuff can provide a more accurate representation
of blood pressure control, giving opportunity for early detection and
intervention, whether it’s lifestyle changes or medication. When we know our own body’s response to different types of food we’re able to make healthier
choices in our diet and the healthcare team can engage with us to manage our
diabetes risk. These devices are important because clinicians now
can tailor the care according to a patient’s individual physiology in a way
that they haven’t been able to do before. This is the photograph of my dad’s
family side.This is my grandmother, she died at the age of 90, however her
husband, he died at the age of 60 with heart attack. My Auntie Baby she died at
the age of 80 with heart attack. My Uncle Nonoy he died at the age of somewhere in the 60s range as well of heart attack. My uncle Toto, he also died of
basically complications of diabetes. Uncle Boi, he died of lung cancer. And
then my dad, I don’t think my dad reached age 60. I think he died probably at the
age of late 50s. He died of basically complications of diabetes.
The youngest one, my Auntie Nanette, she also has diabetes and heart condition
problems, so that’s how they died. My brother, my sister, right, they all have
high triglycerides just like me. My brother’s higher, like six hundreds.
I’m like in the 400s. I think my sister’s, like in the 300s. My cousins
on my father side also have high triglycerides like most of my cousins do.
Humanwide is a pilot that we are conducting in a primary care clinic in
Santa Clara. We at that clinic have also implemented a team-based care model
which we think is going to help us transform what we’re doing in primary
care. The focus of Humanwide is to consider how can we leverage the best of
the art and science of medicine that we have at Stanford and across the country
in the world — technology, genomics, diagnostics — how do we leverage that so
that we are focusing on prevention and proactive care to prevent disease before
it strikes. How are you? Very good, thank you. Great. I just ask that we recheck your blood pressure before you go, okay? All right. Okay, let’s compare. See I’m normal.
So you haven’t had problems at home previously? No, what I realized is all
my readings are like high, every one at home Most of my readings at home is high.
Okay. Yeah. Wow. Just a matter of minutes. The conclusion
is that both numbers are giving us a little bit high values and so it’s just
something for us to just pay attention to regardless. I’m not sure how high it
is but it’s on the higher side. As I mentioned before, I used to eat more salt
in my diet, junk foods etc and now I eat less junk foods. But, I don’t know maybe it’s just my body right? I never had blood pressure problems
before. Yet the blood pressure has gone up. So, even at the office visit here, using our cuff, so it’s not just your blood pressure cuff. There
is a risk of cardiovascular disease with high triglycerides unfortunately. Right. But as you understand we’re not really clear on how to treat it beyond lifestyle.
We’re starting to eat healthier right. There’s Filipino foods that are not healthy but there’s also a lot of Filipino dishes that are healthy.
My family you know we have like bad genes right? Most of my family have heart
stroke. Ours on the young age already have like triglycerides, high blood
cholesterol, so that’s why it motivates me to eat healthy you know. While my
auntie’s here my mom is also recovering from surgery so we try to eat healthy
food. At least starting to. My goodness you look amazing! Really? Yes, you lost 10 pounds since April. Where are we, we’re in the middle of — end of May? I don’t even know what the date is. Maybe it’s because of working too much. Are you working. Yeah. Are you exercising more and everything? Eating healthier. I know. Exercising, probably the same as
last time. I got 132 over 92. But at least not that
high, right? It’s borderline. My feeling is if you continue to lose weight
watch your salt and get some exercise, then we’re going to see the
trend go down. If not and you’re still kind of hovering at this borderline, then I’m tempted to put you on a medication. That’s where I am, that’s what I’m thinking. Right? So let’s monitor your blood pressure if you can do it for me. Is it crazy to do that like twice a
week? That’s doable. Met with him. Still high. Pressure’s 132 over 92 but had lost 10 pounds since
April which is great. But he had changed his diet. Under a lot of stress, not sleeping. I told him to come back in a month prior to him leaving. I’ll probably put him on some hydrochlorothiazide. He’s still running hot. Because this is a new diagnosis for him, yeah. And he’s prediabetic, we’ve got the family history so I’m like we need to…it’s time. Welcome everyone to the
clinical advisory meeting. I’ll just present a case that hopefully will tee
up the second section of our discussion on digital health. So this is
a 43 year-old Filipino man with multiple cardiovascular risk factors including
high triglycerides and multiple male family members who have severe coronary artery disease. And in the Humanwide ambulatory blood pressure cuff, the one
that he just got through the pilot, detected intermittent high blood pressures
that were 145 to 160 over 90 or over 100. However in clinic he always had normal
blood pressures, it was interesting we weren’t able to find
one single elevated blood pressure in his in office measurements but later
this was verified with a more formal 24-hour ambulatory blood pressure
assessment and and then that helped us diagnose
masked hypertension which then obviously address his concern which was primarily
around his own risk for cardiovascular disease given his family history. So
that gives you a sense of maybe some of the benefits of the digital health
component. This study opens a lot of new thinking
right in terms of approach as to how you detect problems. I like the fact that
they’re doing it systematically, not just guessing. What motivates me about this
program is I see the results real time. That keeps me motivated in terms of
improving my health and my lifestyle. I want to be able to see my
granddaughters. And them also see a granddad.

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