Which medications should I stop to prevent my patient' falls? What's the deal with Vitamin D and falls? And what matters most to Geriatricians? On this, the FIRST episode of VeriGeri, we speak with Dr. Lisa Miura, Geriatrician, Associate Professor of Medicine, and fall expert at Oregon Health and Science University to answer these questions and more. Hear Dr. Miura carefully walk us through a new patient fall assessment- including what physical exam maneuvers, labs, and imaging she utilizes to understand the story behind the fall. She teaches us all about identifying and reducing patients' modifiable risk factors for falls, as well as simple interventions that go a long way in fall prevention.
Show notes: Falls with Dr. Miura (verigeripodcast.com)
0:00 Intro
1:53 This episode's Guru, Dr. Lisa Miura
3:22 The Case!
3:48 Questions to ask
4:46 Conditions of the fall
5:17 Definition of a fall
7:16 Chart review approach
8:50 How to maximize time in a visit
9:09 Relationship between falls and cognitive decline, mood
10:24 The interesting medication list
11:11 The rest of the patient encounter, including social history and physical exam
12:00 Dr. Miura's approach
12:12 Addressing polypharmacy
13:42 Gabapentin
14:59 Styles in making medication changes
16:59 Cognitive workup
17:24 Sensory impairments
17:45 Urinary symptoms
18:05 Blood tests for neuropathy
18:32 Social history clarification
19:06 Things to care about in the home environment
19:34 Footwear
19:55 Exercise
21:00 Physical Exam
25:40 Labs & imaging
27:12 Vitamin D
29:06 Assessment and Plan
33:50 Outro
Hosts: Patty Lee, Sam Ing, Marissa Korte
Guru: Dr. Lisa Miura
Case writers: Patty Lee, Sam Ing with edits from Dr. Lisa Miura
