VeriGeri

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