One of our many missions is to teach students interested in primary care the joy of developing a professional relationship with a patient and the power of detective work as we discuss with each patient the different possibilities of what is causing their health challenge.
To ensure their understanding we have requested students write an essay to describe their learning of each experience. From time to time, we will present some of these student essays.
- Husna R. Baksh, MD
I learned a lot from Dr. Baksh’s emphasis on cardiovascular health, a subject of profound importance at the center of human health. During patient visits, she explained how problems like inflammation, resulting from conditions like allergies, impact normal cardiovascular health. She also explained that cardiovascular disease is the number one cause of death and disability in the United States, so management of any condition intertwined with cardiovascular disease is of crucial importance.
One patient had a history of allergies that usually worsened during outdoor activities like gardening. In addition, this patient’s lipid panel showed elevated cholesterol. Dr. Baksh explained that allergies and high cholesterol negatively impact cardiovascular health. Allergies thicken the “walls” of the upper airways by causing inflammation, and this “thickening” decreases oxygen Uptake during inspiration. Similarly, cholesterol plaques narrow blood vessel diameter, decreasing blood flow and, thus, decreasing oxygen delivery to the tissues. To prevent these issues, the patient’s goal for the coming years is to decrease the severity of their allergies through natural means such as sublingual immunotherapy or medication such as antihistamines or antiinflammatory nasal spray. An obvious goal would be to decrease cholesterol levels through diet and exercise. If that was not helpful then medications would be recommended as an additional tool.
Another patient had a history of asthma and presented with cold symptoms beginning seven days ago and intensifying three days ago. This patient tested positive for allergies, and the patient’s diastolic blood pressure was elevated. In short, the reasons for the patient’s visit tied into cardiovascular health in similar ways to those of the other patient. The patient’s cardiovascular and respiratory health were assessed via skin allergy testing and the Cardio Pulmonary Exercise Test (AKA bike test). The patient’s cholesterol level was assessed via lipid panel. Treatment consisted of Mucinex, Claritin, and Nasonex to reduce mucous and inflammation of the airways. The patient would also manage hypertension with exercise. At the center of these treatments was the motive to improve oxygen uptake (in airways) and delivery (through the blood vessel) for cardiovascular health.
To summarize, listening to Dr. Baksh explain to these patients the intertwined relationship of inflammation and cardiovascular disease was highly informative. Management of conditions like allergies that give rise to inflammation facilitates healthy breathing, improved emotional health, better concentration and allows each of us more energy to deal with the challenges and activities of each day