Heartfelt with Dr Melissa Walton-Shirley
View all posts »CHAD2S2-VASc/HAS-BLED/ESC: "There's an app for that?"
Aug 17, 2012 11:02 EDT-
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I thank God every day for my iPhone. It has become nearly as important as the stethoscope in everyday office life. Each morning, I clip it onto my waistband or hook it precariously at the top of my dress or blouse, being careful not to produce some risqué Janet Jackson–like wardrobe malfunction while I'm performing a physical exam. I lovingly dress it in a bright pink otter box so I can find it at that bottomless pit of a purse I lug from home to work. I use it for reminders, alarms, work events, grocery lists, and story ideas. It is my phone directory, enabling me several times per week to call physicians around the globe for referrals, interviews, and curbside consults, but most especially I love it as my risk-assessment tool for embolic stroke.
I happily downloaded the Birmingham Calculator CHA2DS2-VASc app over a year ago, not only for convenience but because it would serve as a very effective visual aid. I carefully explain the risks and benefits of full-on anticoagulation with the help of my favorite in-office heart model, then I punch into my iPhone the patient's risk factors for stroke. Voilà! . . . Las Vegas–magician style, emerging from a figurative silk handkerchief, is my dove: The patient's risk score appears like magic on the screen. I turn it to face the patient so they can be mesmerized with their CHA2DS 2-VASC score. Warfarin, dabigatran, and rivaroxaban have all been much less difficult sells since I began utilization of that app. There is something about seeing a fact in print that makes it more believable, tangible, even touchable. It's most effective.
You can imagine my glee after I discovered the HAS-BLED app. For physician/RNP/PA geeks who've had this app forever, please don't think too harshly of me. I'm from Kentucky. I live and work in a rural area, and such fancy techno fixin's are still shiny and new. I've not used my new app yet, having just downloaded it last evening, but I'm looking forward to it. It cost me $3.99, but I gladly paid it. I like the way the icon looks on my iPhone screen. People might think I'm technologically forward if they see it, hipper, younger, and better informed. Perhaps it might just save someone's life; although I pompously think I've been able to navigate those issues just fine for 22 years, I'm always an old dog looking for new tricks.
Next Thursday, I will pack my bags and travel to Munich with several thousand cardiovascular healthcare providers. I think it will be my 10th trip to the ESC, and I'm really excited about it. I love my fellow THO journalists and bloggers. I get to meet in person for the first time Dr John Mandrola, author of the "Trials and Fibrillations" series, although I certainly have counted him as my cyber-friend for several years. I might get to see my friend Seth Bilizarian in person again, meet up with old friends, and make new ones. I certainly have the best bosses on the face of the earth, and it's always a pleasure to sit in their presence. Now if I can just navigate as efficiently as possible that maze of a convention hall in downtown Munich, I can do my best to bring more news to you from the Heartfelt series from the 2012 ESC. . . . Hey, maybe there's an app for that!
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