It’s been a privilege for Dr. Amy O’Donnell to treat veterans and their spouses at Veterans Affairs Medical Center for the last 18 years.
“It’s rewarding, because you’re treating America’s heroes,” she said. “It’s interesting because they have very different military experiences. My physician partner is a history buff – especially military history – and he always asks people about their experiences.”
O’Donnell, chief of endocrinology at the VA, works with fellow endocrinologist Dr. A. John Ryan, nurse practitioner Roberta Hughes and other staff in a clinic that treats the most challenging endocrinology cases involving veterans in a region that stretches from Lake Ontario into northwestern Pennsylvania, the shores of Lake Erie to Elmira.
She clicked off the key advantages of VA care during an interview this week at the Bailey Avenue hospital:
• The VA takes a “patient-centered care” approach, with a variety of specialists under one roof, as well as testing services and a pharmacy.
• It has had an electronic medical record system since the mid-1990s. “It’s connected throughout the country,” O’Donnell said, “so if a veteran goes to Florida in the winter, VA staff can open their medical record from here.”
• O’Donnell is part of a TeleHealth system that allows doctors to confer with patients live via computer from seven VA satellite sites across Western New York and the Southern Tier.
• Providers use two software programs – Health Buddy and My Healthy Vet – that remind patients to check blood sugar levels and other vital signs at home and provide them by phone or computer to VA staff.
“All of this keeps people connected and involved in their own health care,” said Evangeline Conley, a Buffalo-based VA spokeswoman.
Much of O’Donnell’s patient load involves hard-to-control diabetes cases. As if there weren’t already enough risk factors for diabetes, Vietnam War veterans have an extra one: Agent Orange.
“You can presume that anyone who set foot in Vietnam was exposed to Agent Orange. Anyone who was exposed has a 2½ fold risk of getting diabetes,” said O’Donnell, an Amherst native, Boston University and University at Buffalo medical school alum who also is a clinical associate professor with the UB School of Medicine and Biomedical Sciences,
She and her husband, John O’Donnell, an orthopedic surgeon, have four children.
Q. What are the most common conditions you tend to see in the endocrinology clinic?
Diabetes, thyroid problems and low testosterone.
Q. What is the endocrine system and what does it help us do?
It involves hormones and the glands that make hormones. Hormones are substances within the body that act on cells at different sites. They help regulate some of the key body systems that we have. People can have risks for problems from glands that are making too much or too little of any given hormone. For example, the thyroid regulates your whole metabolism. When it’s underactive, everything slows down. Your heart slows down, your body slows down, your thinking slows down. You gain weight. Your temperature regulation slows down and you feel cold all the time. When the thyroid is overactive and producing too much, just the opposite happens. Everything speeds up. Heart speeds up. Brain speeds up. You’re nervous, anxious, jittery. You feel hot, sweaty. You still might feel tired, but for different reasons. Your bowels speed up.
Similarly, the pancreas makes insulin and if it doesn’t make enough you can’t store and use you glucose properly.
Q. What advice would you give to patients who become prediabetic and diabetic?
The main treatment would be diet and exercise for Type 2 diabetes. Even with advanced diabetes, it’s still the most important component, but with prediabetes, diet and exercise can delay, and maybe even prevent, the onset of diabetes. It’s not just what you eat but to be mindful of what you’re drinking. Some people start getting extra symptoms of diabetes and start getting thirsty, and start drinking soda pop or sweetened tea. Things with sugar just makes it worse. ... In general diabetes is the leading cause of blindness, kidney failure requiring dialysis, nonhealing foot ulcers requiring amputations. It’s also a major risk factor for stroke and heart attack. What I tell people is, “You may think, ‘If I don’t control my diabetes, so what, I’ll die sooner.’ ” But it’s not that. It’s a lot of suffering before you die sooner.
Q. Can you talk about a good recipe for success with diabetes?
They’ve found a way to stay motivated, especially with diet and exercise. They take their medication as prescribed and keep a good log of their blood sugars, which they bring to their appointments. Even with that, there are some people who do everything right and just have such severe problems with diabetes that it’s still difficult to control.
On the Web: Dr. Amy O’Donnell talks about low testosterone at refresh.buffalonews.com.