Integrative Cardiac Health Project building healthier lives
July 10, 2012
WASHINGTON (Army News Service, July 10, 2012) -- A wellness program launched at the former Walter Reed Army Medical Center in 1999 is still helping people today. Take Navy Capt. Brent George.
Last summer, George decided to attend a Boy Scout outing with his sons. He went to see his primary care physician for a required physical, and the news was not good.
"He and I discussed my condition and state of fitness at that time," he recalled. "I was 15 to 20 pounds overweight, not working out on a regular basis, and my health numbers (blood pressure, cholesterol, etc.) were trending upward.
"We also discussed my family's history of obesity, diabetes, high blood pressure, high cholesterol and colon cancer," George continued, adding that by December, he wasn't feeling well physically, and didn't like how his uniforms and clothes fit.
"I did not want to decline any further, plus, it was troubling to know that I was borderline on many of my health numbers," he added. "I didn't relish the thought of having to take medication every day if I couldn't get my numbers under control.
His physician showed him a flyer about the Integrative Cardiac Health Project, or ICHP, at what was then Walter Reed Army Medical Center, or WRAMC, which has since moved to Maryland and merged with the former Bethesda Naval Hospital to become the National Military Medical Center, or WRNMMC.
"We discussed what the ICHP was about, and he recommended I give them a call," George explained. "(My physician) asked me if I wanted to halt any further slide into even worse health, or start making positive lifestyle and health changes. I did want to make changes, so I called ICHP."
George said his sons, 16, 14 and 12, were part of his motivation to live healthier.
"I very much wanted to get back into a state of health and fitness through natural means under my control, and I had the incentive of knowing that if I did, then I could once again keep up with my sons who are very active in outdoor sports, Boy Scouts, and life in general."
In January this year, he began ICHP.
"We have a vision of a healthier population, preventing disease before it affects the quality of life, changing outcomes that will make a positive difference to our patients individually as well as collectively," explained retired Army Col. Marina Vernalis, executive medical director of the ICHP.
A board certified cardiologist and chief of cardiology at WRAMC from 1996 to 2005, Vernalis called ICHP a "one-of-a-kind Department of Defense Cardiovascular Health Center of Excellence." It's located in Building 17 at Walter Reed Bethesda, in what Vernalis described as "a state-of-the-art facility containing patient education rooms, a large kitchen for healthy food demonstrations, a spacious room for stress management to promote optimal wellness and healing, (and an elevator ride up) from a brand new fitness center with an Olympic pool and an inside walking/running track."
She said this gives ICHP participants such as George the opportunity to take full advantage of their personalized programs to improve cardiac health.
"The primary mission of ICHP is to teach, implement and study lifestyle changes, attitudes and best medical practices that will result in cardiovascular health, incorporating a "whole-person" approach to enable patients to be in charge of their health regimen, Vernalis explained.
"Plans are created and individualized by an expert team cardiologists, sleep specialists, nurse practitioners, dietitians, clinical psychologists, exercise physiologists and stress management instructors who incorporate evidence-based research to help participants achieve their personal goals for optimal health," she added.
"I like the fact that I have a personal team of health professionals and coaches who are there for me," George said. "The integrated program looks at the whole person and not just specific facets in isolation."
Mariam Kashani, director of clinical operations at ICHP, has been with the project for more than 10 years. Also the senior nurse practitioner, Kashani has been responsible for increasing participant engagement in the program.
"Most people lead busy, fast-paced lives that lack a sense of balance," Kashani said. "At ICHP, our mission is to help our patients achieve life balance with a personalized and practical plan of action to improve nutrition, exercise, stress and sleep management. Our experience tells us that even small adjustments in daily routines can lead to healthier, happier and more productive lives."
Amanda Lalicato, also a nurse practitioner with ICHP, is one of the first health providers participants see when they begin the program. She assists participants with their initial comprehensive cardiovascular assessment, which includes their medical history, physical, body mass index, or BMI, measurement and electrocardiogram, or EKG. She also receives information from participants about their lifestyle habits in nutrition, exercise and sleep, as well as how they handle stress.
Following their initial appointment with the nurse practitioner, participants have lab work done, which is reviewed along with their medical history by the ICHP team, who use the information to tailor a program for the ICHP participant.
Lalicato explained participants then usually come in once a month for four to six months to collaborate with their team members in ICHP. If they have been successful in following their regime, participants usually don't come back in ICHP for a year, but receive periodic motivational calls from their team members to sustain their gains.
"At first, I found it had to be a very deliberate decision to work out each day and really consider what I wanted to eat," said George. "You have to make very conscious choices about what your plan is each day regarding working out, nutrition and even to sleep."
He said now it's pretty much routine for him as he nears some of his goals.
"To date, I have lost 15 pounds; I work out every day and look forward to it," George continued. "My health numbers and indicators have all dropped to much better levels, and I truly feel better about myself. I consider everything I eat and make the mental decision on what and how much. You don't have to cut out the items you love; you just need to consider their impact and do everything in moderation."
"I think a lot of people know what they need to change, but they just need the knowledge and motivation to make those changes," Lalicato said.
"Because the program is so individualized, we're able to work with participants from where they are when they begin the program to institute practical, small changes to improve their health," added Ginny Kolb Jones, another nurse practitioner at the ICHP.
In over half of their patients, the ICHP program has helped reverse pre-diabetes, according to the Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., also known as HJF. The HJF is a global organization dedicated to advancing military medical research and supports more than 1,000 research projects ranging from small bench-top projects to complex, multi-site programs, according to HJF officials.
Other participants in ICHP have reported similar improvements in weight, exercise, stress management, sleep and energy levels, as George. In addition, the participants have improved blood sugar levels, blood pressure and lipids, the HJF reported.
Retired Navy Cmdr. Richard Geel and his wife, Linda, were referred to the ICHP by their primary care doctor after deciding they wanted "to lose weight and keep it off." They've been in ICHP for about four months.
"The combination of nutrition, exercise, relaxation and encouragement by the ICHP team make things practical and personal," he said. "The teaching by the staff helps us understand our bodies and our habits better. We have made the changes in our lifestyles and want to maintain our health," he said. "We're looking better, feeling better, and still losing weight.
"We look forward to our time with the ICHP staff," he added. "We are so grateful for the program and feel that it is extending our quality of life for ourselves and our family."
Participation in ICHP is available to active-duty and military beneficiaries 18 years and older, added retired Army Col. Rosemarie Edinger, chief nursing executive at ICHP. Participants may be referred by a provider without a consult, or they can self refer by calling (301) 400-1111, or visiting www.ichpcenter.org.