Susan Jimenez PA-C, Coach at My Health Begins Here

12/12/2021

Chronic Kidney Disease, CKD. One woman’s story.
Anne* is a 55 year old female athlete, retired, who has chronic back and hip pain. She exercises 5-6 days a week, usually high intensity workouts, such as CrossfFit. She recently moved to a new state and had more aches and pains than usual. She had routine bloodwork done with her new P*P (Primary Care Provider) in her new state. Results showed low kidney function with creatinine = 1.2 (normal 1.0) and eGFR = 48 (normal is >60). Other bloodwork was normal: no anemia, normal liver and thyroid tests.
Anne’s P*P told her they’d recheck her kidney function in a few months and didn’t really make any recommendations or tell her what to do to improve her kidney function. Anne wanted more information so she asked me to review the results.
I explained that she had Chronic Kidney Disease Stage 3a. If her kidney function worsened by just a few points, for example, if her eGFR went down to 45 (CKD3b) she’d need to see a kidney specialist and if it progressed, she could even need dialysis in the future. While she was a long way from dialysis, I explained she shouldn’t accept that her kidney function was low at age 55! There was a sense of urgency, in my opinion, to figure out what was causing her kidney function to be so low and a call to make lifestyle changes to improve the kidney function or even resolve the CKD.
By taking a thorough history and completing a lifestyle assessment, I discovered Anne didn’t have hypertension or diabetes (the two main causes of CKD) but she was taking several NSAIDs (non-steroidal anti-inflammatory drugs) on a daily basis: naproxen (aleve), and ibuprofen (Motrin, Advil) to treat her orthopedic aches and pains. She was also eating packaged foods containing sodium, especially since moving.
Once Anne stopped taking the NSAIDs, and reduced her sodium intake, her kidney function returned to normal at her 4 month bloodwork re-check.
Not every case is this straightforward, or as easily resolved, but by working together, my clients can and do improve their health. I work with my clients to create lasting changes in behavior that improve their health.
*not her real name. All personal health information is presented in a way to protect the privacy of the individual or individuals who work with me.

06/17/2020

https://getpocket.com/explore/item/how-poverty-changes-the-brain?utm_source=pocket-newtab

The early results out of a Boston nonprofit are positive.

06/17/2020

In my work as a PA, I try to determine if a person has barriers that are keeping them from achieving optimal health, such as food or housing insecurity, financial insecurity, stress, literacy or educational barriers, transportation challenges. These are a few of the 'Social Determinants of Health'. This Atlantic article is good at highlighting these challenges. It's good to know what other people deal with that affects their health. https://www.theatlantic.com/health/archive/2014/05/poverty-makes-you-sick/371241/

Some patients are being "prescribed" bicycles and groceries as doctors attempt to treat the lifestyle consequences of poverty, in addition to its medical symptoms. Can it work?

03/12/2019

10/07/2017

I'm attending the 2017 American Conference on Physician Health: Creating an Organizational Foundation to Achieve Joy in Medicine (with amazing speakers such as Vivek Murthy (former Surgeon General) and too many others to mention!) this coming week; the following piece is definitely about 'physician' health. It's a thing. I am not sure I have many answers, but physician (and NP, PA, nurse) health is absolutely a part of the medical crisis in the USA. I'll bring back salient points after the conference! https://med.stanford.edu/cme/courses/2017/ACPH17/ACPH17.html

The only people dying in a hospital should be the sick patients for which doctors can find no answers.

09/29/2017

Joy in medicine. This is written by my former colleague and good friend, Dr Mavrinac. I have a flood of emotion when I read about her experience working w a nurse named 'Chris'. Working w 'Dr Mav' was truly fun and brought me joy at work. What if there were more teams like she describes here? Would that help more of us have the same experience of Joy in Medicine? And, improve patient care to boot!

Through over a decade and two health systems, a doctor found a friend, a coworker and a way to fight burnout.

09/28/2017

My patient’s daughter said I should probably come today, so I angled my umbrella into the downpour and didn’t lift it until I arrived at her building.

09/28/2017

Joy at work. Find it.

With burnout on everyone's mind, it's easy to forget the delight of being a physician.

08/16/2017

Happy National Physicians Day! This is for all of the amazing, dedicated, excellent physicians that I have had the honor to know and work with in my career. I'm fortunate to have been mentored by so many - too numerous to name! https://www.youtube.com/watch?v=Mh3crhKJltI

National Physician's Week :Sharing something sweet about medicine

07/27/2017

04/22/2017

Helping people create health takes more than 20 minutes. Just saying.

04/12/2017

Try this when meditating or when practicing mindfulness.

5. Intrinsic muscles: These transverse, vertical and longitudinal muscles are like paraspinals, giving the tongue immense architectural power.

03/22/2017

What activity gives you the feeling you're a part of something bigger than yourself?

03/02/2017

We will not have work-life balance until we feel safe in the place that we live and feel safe in the place that we work. - Simon Sinek, Start with why

02/18/2017

Clinicians, Practitioners... I've been thinking about this: https://opinionator.blogs.nytimes.com/2013/10/02/who-will-heal-the-doctors/?emc=eta1&_r=0

Some of the most poignant reader insights on my previous column came from doctors, and their words revealed a deep sense of betrayal.

02/13/2017

The Affordable Care Act (ACA) aka 'ObamaCare' - important points about repeal / replace. 'It's wrong to take away healthcare'... Long, but worth it... if you'd like to be informed on such things https://www.youtube.com/watch?v=uitGSYLW2f0

At Blair House in Washington, DC, on January 6, 2017, President Barack Obama speaks with Ezra Klein and Sarah Kliff of Vox about the promise and the problems...

02/12/2017

Name one change you could make to become your healthiest. Go.