Episode 16: Snoop That Headache

The sun rises over the San Joaquin Valley, California, today is June 12, 2020. 

The results of the DAPA-HF (Dapagliflozin and Prevention of Adverse-Outcomes in Heart Failure Trial) were presented in November 2019. If you haven’t heard about it, here you have it: In patients with Heart Failure with reduced Ejection Fraction, both WITH and WITHOUT Type 2 Diabetes, dapagliflozin plus standard therapy reduced the risk of worsening Heart Failure events and Cardiovascular death and improved symptoms. 

Did you hear that? It improved heart failure outcomes in patients WITH and WITHOUT diabetes. This certainly opens a new window for potential use of SGLT-2 inhibitors in patients WITHOUT diabetes.

On May 8, the CDC reported a significant decline in childhood immunizations since March. Let’s remember to prioritize well-child visits for patients who need vaccinations. As family physicians, we play an essential role in prevention, and we need to avoid the resurgence of preventable communicable diseases.  

Welcome to Rio Bravo qWeek, the podcast of the Rio Bravo Family Medicine Residency Program, recorded weekly from Bakersfield, California, the land where growing is happening everywhere.

The Rio Bravo Family Medicine Residency Program trains residents and students to prevent illnesses and bring health and hope to our community. Our mission: To Seek, Teach and Serve. 

Sponsored by Clinica Sierra Vista, Providing compassionate and affordable care to patients throughout Kern and Fresno counties since 1971. 

“The roots of education are bitter, but the fruit is sweet” –Aristotle.

Going to school and learning requires effort, patience, and perseverance, but the consequences of your determination will be well worth it. Dear residents, you will learn something new every day of your lives, even if you don’t realize it. Today we will learn even more from one of our sweetest and smartest residents. Welcome Monica Kumar, thanks for being here with us. I understand you were working nights, but now you are rested and refreshed. Who are you?

1. Question number 1: Who are you?

My name is Monica and I am a second-year family medicine resident at the Rio Bravo Family Medicine Residency Program. So, a little bit about me, I was born in Malaysia, a small country located in Southeast Asia. In 2004, my parents and I moved to Bakersfield, California, a place I now call home. I went to Bakersfield High for high school and then graduated from UC Berkeley with a major in Integrative Biology. 

After undergrad, while trying to plan out the rest of my life career wise, I worked as an air testing chemist for a year, which made me want to run as far away as I can from being stuck in a lab, so I ran all the way to the beautiful island of Saint Marten to pursue a career in Medicine. 

After finishing medical school, I was very fortunate I was able to return home to learn and serve the community that has given me so many opportunities. For fun, I love playing badminton and ping pong, flying kites, walking my dog, gardening, going on adventures, and binge watching romantic comedies and horror movies on Netflix. 

1. Question number 2: What did you learn this week?

So, after working multiple shifts in the ED while wearing the N95 for about 7-9 hours consistently and walking around with a daily headache, I thought it was only appropriate for me to talk a little bit about headaches, particularly the indications for imaging, assessment and management of headaches in the outpatient setting. 

I have had numerous patients who have come to clinic repeatedly complaining of headaches and, though we all have gotten headaches in our lifetimes, we often forget how debilitating it can be for patients who cannot find an appropriate treatment regimen to control their symptoms. 

There is a