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What you put IN the patient may be as important as what you put ON them

I have been focusing more on nutrition with my patients. It is amazing how prevalent nutritional deficits are among patients with non-healing wounds. In late March I saw a woman with severe ulcers on both knees due to vasculitis from an uncharacterized collagen vascular disease. She weighed only 83 lbs (BMI 13.8), so it was obvious she was in trouble nutritionally.

This is one of her knees on her first visit.


This is the knee 4 weeks after starting Arginaid®.


And this is the way she looked 6 months later, almost healed.


Join me for a breakfast symposium about the role of nutrition in wound healing on Saturday September 9, at the upcoming APWCA meeting. I will be discussing how practitioners can avoid losing 4% of their Medicare Part B payments by performing a Clinical Practice Improvement Activity (IA) focused on nutritional screening of patients with wounds, and prescribing appropriate supplements.
http://www.apwca.org/2017-Overview
The USWR now has 2 nutritional screening measures which can be reported under MIPS, one that is provider reported, and one that is patient reported. Read more about the measures here: https://uswoundregistry.com/qualitymeasures
Arginaid® can be hard to find, but patients can order it to be sent directly to their home at DirectPatient: https://directpatient.com/nutrition