What are we doing beyond agent orange benefits to help our veterans with Parkinson's?
I had the pleasure of interviewing my parkinsonsecrets.com co-editor about what we are doing for veterans with Parkinson’s disease. It may surprise many people to know that the VA is highly engaged beyond just benefits for Agent Orange. As Indu shares with us there is nationwide network of highly effective VA centers and a new partnership with the Parkinson’s Foundation. She sat down with me and let me pick her brain on all things VA and Parkinson’s.
How did you get interested in working at the VA?
My journey to becoming a doctor at the Department of Veterans Affairs (VA) started as a resident in Neurology at UCLA. We worked with the VA in our outpatient clinics and I fell in love with the population of patients. I come from a family full of doctors and medicine is in my blood so the choice of being a doctor was seamless. At the VA I felt I was truly able to make a difference.
Indu SubraManian and John Duda
PADRECC DiRECTORS IN THE SOUTHWEST AND NORTHEAST
I looked forward to those clinics in general neurology and specifically working with people with Parkinson’s disease (PD). We saw county patients and privately insured patients during the other rotations in residency, but the VA was my favorite. There is a tremendous sense of gratification gained from helping people who served our country. I have felt and continue to feel honored to touch the lives of these heroes and to give back to them and to their families.
How did you get involved in the PADRECCs and can
you tell us more about what they are?
In 2000, I had the opportunity to continue my work with veterans as a neurologist fellow in Movement Disorders when I started the movement disorders clinic at the West Los Angeles VA. In 2015, I took over as Director of the SouthWest PADRECC. PADRECCs are Parkinson’s centers of excellence in the VA, spaced geographically across the country. Their mission is to care for veterans with Parkinson’s disease. By joining the PADRECC, I became part of a nationwide group of Parkinson’s specialists— together we collaborate throughout the VA system and join the whole United States.
Teaching residents and fellows about the art of medicine in the VA system has been tremendously rewarding. In a world of increasing pressure to be more efficient, to focus on insurance, billing and documentation, the VA facilitates a space to spend time with Parkinson’s patients and to understand the nuances of this complex disease. In a complex medical condition where it takes 15 minutes to get the medication history I am so grateful the VA has invested in Parkinson’s disease.
What can patients expect if they come to a
PADRECC?
PADRECC’s have a multidisciplinary clinic— our integrated teams can share our ideas about how to work together for the best care of the patient. A veteran with PD can be seen by a neurologist, a geriatric psychiatrist, a geriatrics fellow, a neuro-pharmacist and a nurse coordinator all in one clinic visit. We can delve into issues caused by non-motor symptoms such as depression, anxiety and apathy— deeo dives into these symptoms can improve quality of life. Additionally, the trainees get to share in discussions about the complexity of the disease and in treating the patient— as a result, several practitioners have been inspired to work in the VA system following graduating.
What other unique resources does the VA have for
veterans with Parkinson’s?
I have been excited to treat PD in novel ways. The VA is open to integrative medicine approaches through a program called “Whole Health”. This allows access to acupuncture, yoga, Tai Chi, mindfulness, and health-coaching. Recently we have had the pleasure to offer a symposium series called “Living well with PD” that draws on the wealth of providers in our community. Representatives from PD yoga teachers, boxing for PD, dance for PD and other groups participate and teach in this setting.
We have hosted informational sessions from our pharmacists, physical therapist, swallow therapists and dietitians. These symposia have been a huge success for all involved— from the VA providers, the patients and their caregivers and the invited guests from the community. To dance to a song like “Blackbird” by the Beatles with your closest colleagues, our patients and their loved ones— is very special. The enthusiastic young therapists inspire us and create a heart-warming experience. Many of the invited guests from the community are eager return and to bring their colleagues.
Whole Health Wheel
What would you advise other health care providers
who are considering working at the VA?
Having a purpose in life is central to the wellness of the human condition. I feel lucky to have found my purpose in caring for veterans with PD— it feeds my soul. As increasing numbers of health care providers face issues with burnout and even contemplate leaving the profession, I am heartened to know that my team receives ample joy and fulfillment.
Everyday I’m in clinic, I laugh a lot; I cry sometimes too; but I know that we really do make a difference and truly impact lives . It is an honor to be part of the lives of persons with PD— I give thanks that I have the privilege to do this work alongside an amazing team— I am inspired everyday by PWP and their families.
Apps for Whole Health
Where should veterans go to get information about
how to get care at the VA?
The VA Parkinson’s Disease Research Education & Clinical Centers (PADRECCs) are Centers of excellence designed to serve Veterans affected by Parkinson’s through state-of-the-art clinical care, research, education, national outreach and advocacy. Learn more at www.parkinsons.va.gov
The Parkinson’s Foundation has recently partnered with the VA to help veterans with PD. If you are a veteran with Parkinson’s or care for one, read their new resources: Veterans and Parkinson’s Disease, Agent Orange and Veterans Benefits.
In order to provide care through the pandemic, The VA has been able to do virtual visits through VA Video connect and other modalities. Additionally there is an exciting new Program that is being deployed to help lonely veterans called the Compassionate Contact Corps where volunteers will reach out and connect with socially isolated veterans.
To read more books and articles by Michael S. Okun MD check Twitter @MichaelOkun and these websites with blogs and information on his books and http://parkinsonsecrets.com/ #Livingwith Parkinson’s #EndingPD #Parkinsonsecrets #LessonsFromTheBedside
He also serves as the Medical Director for the Parkinson’s Foundation.
To see more on Dr. Indu Subramanian she does live interviews of experts in Parkinson’s for the PMD Alliance.