Technology as health tools

I thought that being an RA patient was a full-time job.  If so, then taking care of an aging parent qualifies not just for overtime, but for double-time! It is exhausting, which hasn’t been so good for my RA.  Fortunately, I’ve learned a few things that have actually helped me improve my own health.  My brothers are assisting with mom, and between us all we’ve done a few things that have helped my mom to be in better health now than she has been in at least a decade.  Two of those things we’ve done might be helpful for RA patients, too.  Technology is great.

The first thing we did involved gadgets.  We got Mom a Fitbit Charge2 (and an iPhone). There’s some interesting research showing that use of a pedometer can ease RA fatigue, so we might all want to make ourselves get up and get moving. If all you want is a pedometer, spend $5 at WalMart.  The fitbit does so much more than count your steps, though.  This is a pretty neat little gadget. It’s a wristwatch. It’s an exercise tracker. There’s a setting that will make the thing vibrate every hour if you haven’t taken at least 250 steps (but not at night), so you get a gentle reminder to get up and get moving (which I need).  I knew that with my RA diagnosis I’d learned to conserve steps, but didn’t realize quite how sedentary I’d gotten until I started looking at my step-counts. You can set a goal for how many steps you want to take each day, and when you reach your goal, the fitbit congratulates you 🙂  Adding in an app to sync the fitbit with your phone makes it easy to set exercise goals, sleep goals, and even track how much water you drink each day.

The next thing we did was take a look at mom’s glucose readings.  (skip this paragraph if you don’t care about diabetes) There have been problems with mom’s medicare-approved glucose meter, the most significant being that mom’s anemia is severe enough that the meter often gives errors instead of reporting results.  Nearly as important, imo, is that the black numbers on a grey background are nearly impossible for her to read. Why Medicare pays for something that’s basically useless, I don’t know.  We found a solution! We bought a meter that is able to give results in spite of the anemia, and which has a white background and extra-large numbers so that mom can read the display. This solves both problems. (OneTouch Verio, if you’re in need of a good glucose meter.)  What we’re really liking is that this meter syncs with the OneTouch Reveal app on mom’s phone, so there is an easily-viewed record of all mom’s glucose readings.  We showed her doctor at the last appointment, and the doctor loved it. My brothers and I also put the app on our phones and logged into mom’s account, then set reminders to check mom’s glucose readings about 10 minutes after her meal times.  It’s nice to see those numbers and know that mom’s okay. Before switching to this meter, we’d asked her to text us every time she tested, which she found a little more cumbersome than she wanted to deal with. Now she just tests like normal, and we can see her numbers. The way the report is set up, it’s easy to look at it and see patterns.  “Gee, mom, you’re always high at lunch time; maybe you should consider changing what you eat for breakfast.” We’re finding the right balance between, “You’re an adult; do what you want,” and “Given your family’s life expectancy, you probably have another 20-25 years; controlling your glucose will have a significant impact on what those years are like, so you might want to get this under control.” If her numbers are high, then my brother texts, “What did you eat?!” and that helps her be mindful of her diet. If she doesn’t post something, or if her reading is low, I contact her to make sure she’s vertical and not in need of assistance.  Never again will she nearly die because nobody knew she was sick.

The final thing we did that seems to be helping mom tremendously, and is helping my brothers and me lose weight, too, is set up a free MyFitnessPal account. We all set up accounts and friended one another so we can help mom keep track of what she’s eating and how that affects her glucose levels. I know that the fitbit app allows tracking of what you eat, but we’ve found MFP to be easier to use.  It also displays the info we want (and it syncs with the fitbit so the data is both places).  We did the math to help mom figure out how much protein and how many carbs she should be eating (and did the same for ourselves). We named the meals with that information because she was having a tendency to forget, so, for example, her meal names are:

  • 7:30 am: Breakfast (32g carb, 15g protein)
  • Noon: Lunch (32g carb, 15g protein)
  • 4:30 pm: Dinner (32g carb, 15g protein)
  • 7:30 pm: Bedtime snack (32g carb, 15g protein)

Combining these three things (three apps on our phones) has made it really easy for mom to see the correlation between what she eats, how much she moves, and what happens to her glucose. She thought she was controlling what she ate, but seeing exact protein:carb numbers has been extremely helpful. She got her A1c down to 7.0 ! It helps me, too, because I can do a virtual check on my mom at any time.  Honestly, it was exhausting when I had to drive to her house every.single.day.  Getting mom to really get things under control with the help of these tools (apps) has made my fatigue level decrease 🙂  If you have diabetes, or are caring for someone with diabetes, maybe these things can help you, too.

As for RA, I find these apps quite useful in a couple different ways.  First, using MyFitnessPal makes it easier to keep macronutrients in the right proportions, which means that I have to eliminate foods that provoke inflammation, so my disease is better controlled. As a bonus, eating the right proportion of macronutrients means that I don’t get hungry between meals so am not tempted to snack.  Second, the “friends” aspect of MyFitnessPal means that others in my family can see what I eat, which inspires me to make choices that I won’t be ashamed to have them see :).  Finally, getting a fitbit has me moving way more than I used to. Although it seems counter-intuitive, the extra activity actually decreases fatigue.

I’m looking forward to browsing the iMedicalApps site to see what other helpful tools might be out there!

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Dancing With The Doctors

A great family physician blogger who I sometimes read is Jill of All Trades, MD.  If you’re not already following her, check out the post:  Dancing With the Doctors: Learn 5 Steps to Tango Effortlessly at Your Doctor’s Office.  It’s a fun, well-written post.

One step she mentions is an aspect of obtaining medical care that drives me crazy:

Tell the nurse who takes your vital signs and places you in the exam room exactly what you are there for.

When I make the appointment, I have to tell the scheduler why I need an appointment.  I can’t just ask for an appointment; they want the story.  Then when the nurse shows me back to the exam room, I have to repeat that story for the nurse.  Later the doctor comes in and wants me to repeat it again.

And I think, what was the nurse writing if she didn’t write down why I’m here?  or why are you asking me something that’s already written in my chart? 

My solution – and I honestly don’t know if my doctor likes it or hates it, but it works for me – is that I now type up my answer to the question “why are you here?” before I go see my doctor.  I try to keep it short, but include details like how long it’s gone on, what I’ve tried as home treatments, if anything makes it better or worse… 

When the nurse shows me into the exam room, I hand her my short write-up (half-sheet, max).  She documents whatever she wants in the chart, but usually just slides my little paper under the clip so the doctor can read it.  When my son hurt his arm, I included a photo so that the height from which he fell was clear.  I feel that I’m able to give clearer information in less time this way, because I’m less likely to forget details that might be omitted in a verbal narrative.  I don’t get half-way home and say, “I forgot to tell him…”

Do you have little things you do to make your appointments go more smoothly?