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Allostatic Load Test
Allostatic Load refers to the physiological costs of chronic exposure to many organ systems to stress overload. It is used to explain how frequent activation of the body's stress response, an essential tool for managing acute threats, can in fact damage organ systems in the long run. To measure this accumulative wear and tear, a composite index of specific biomarker/metrics of cumulative strain on organ systems would be tested using blood samples. We have identified several of these biomarkers/metric that can measure health trajectory. In addition to the annual physicals, as an adjunct, would you take the test?
Replies to This Discussion
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Permalink Reply by International 1582 Foundation on
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Hello Dottie,
There is a battery of blood tests that measure allostatic load. Currently I am working on a protocol that I will make available to all. This booklet can be carried into your physician and presented as a battery of tests to screen for allostatic load...just as if you were getting your annual examination. More later, but in the mean time if you Google "allostasis" you will find a lot of information. Until next time, take care.
Dr Rob
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Mr rfdjumper,
I never intend to be argumentative nor confrontational. This research goes back over 25 years and is sound. I believe that the allostasis model will redirect therapy in firefighters away from manipulating low level physiological mechanisms (e.g., beta blocker, diuretics, amongst others) to "fix" such things as "essential" hypertension which means there is no identifiable cause or explanation for having hypertension. Instead, treatment would be directed towards improving higher levels of functioning to restore predictive regulation, which under this model would be the hallmark of firefighter wellness and fitness. I am not a big fitness buff, but I can tell you that your better off in a gym then on a beta blocker or diuretic in the long-run to control your blood pressure...especially if you fight fire. Your body cant do what its designed to do on these medications while fighting fire. We have tests that screen for cancer, which is also killing firefighters. This is all this test is its a screening tool that analyzes wear and tear from the job and everyday life; before a catastrophic event occurs. This analysis of biomarkers/metrics looks at every system that is critical to you, your family, and career...this is what you do and my goal is to facilitate the ability to do the job while staying healthy until the firefighter says..."okay I am done...I can retire", not because they got sick and forced to retire.
This is a basic overview of why I would take the test, but stay tuned for further updates.
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Excellent Jim
Stay tuned for updates. I am currently working on a protocol for PCP and fire department physicians.
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Permalink Reply by rfdjumper on
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Rob,
Correct me if I'm wrong but "In addition to the annual physicals, as an adjunct, would you take the test?" is a question! Nope, is an answer. Just because one answers contrary to your point of view, you don't have to get defensive.
I'm not the first to disagree with you, am I?
http://connect.jems.com/forum/topics/should-we-be-looking-at
http://connect.jems.com/forum/topics/if-there-was-a-test-health
I'm pleased to hear that you've come up with a plan to save peoples lives. That is what people pay doctors to do. I'm going to go on a limb on this one but... you've got a patent or process or something related to testing and or treatment through this allostasis model. It's cool you want to make a buck off of something your passionate about. That's why most paid fire fighter are fire fighters. I get paid to do and what I Love doing. I'll admit it. If there is something you want, don't beat around the bush. Otherwise the goods you have are a niche and I'd say only available to boutique (International 1582 Foundation, 1 employee) or University testing environments.
Oh! I get the 1582 i.e. NFPA 1582 STANDARD ON COMPREHENSIVE OCCUPATIONAL MEDICAL PROGRAM FOR FIRE DEPARTMENTS.
Welcome to FireFighter Nation!
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Not sure if your attacking me or not, but I can assure you that this is not a "niche" and available only to "boutique's." This is behavioral neuroscience and nothing to be "patented." After 25 years of research and study after study this is excellent science that indeed will save many life's.... Furthermore, just this year a company with a lot of financial backing who can afford a scientific panel of the greatest minds in medicine and biology was created. Currently this company only markets to large corporations human resources, DoD/VA, and it's only a matter of time before they capture the attention of city government.
What does this mean? it means that they can employ this battery of tests as a pre-employment or annual medical screening. This company also developed "smart" technology using a neural platform that assimilated 25 years of data, and markets as the only company who can predict, with a greater than 85% accuracy, a patients projected health trajectory with in 3-5 years. Yes there are laws to protect individual privacy, but not on a pre-employment physical or annual exams we have to take.
There are people who just want to do the right thing...not make a buck on it. I worked 30 years on the streets, the last nine with a public safety agency (police & fire) and make plenty of money in retirement...I don't have to do this!
The WFI and NFPA 1582 Standards in and by themselves are truly "life-saving" and "career saving" guidelines that very few departments can afford to implement in their entirety. Sad as it may be, elected officials are the final budget decision makers. Its also going to be those elected officials who are going to bring heat down on your administration if workers comp is too high. Its also going to be elected officials who contract with this private company who offers a battery of tests that can save the city millions of dollars in workers comp and overtime.
I created the International 1582 Foundation because I believe knowledge is power. If your department decided that your cardiovascular risk factors on your annual physical were too high and suggested you to consult with your department physician and/or PMD regarding treatment, you would have no other choice, you would have to comply. In the meantime NFPA 1582 Standards declare you as having a "category B medical condition" and your taken off line, you dont have a single argument because those are the "standards" that every judge will rely on when hearing your case, should you bring an ADA lawsuit against the city/department. Thats the facts...I went through it!
Lets be real here...does your PCP have any idea what the physical and mental demands of your job is, or the 13 essential job tasks are? So just like Mr. Rogers who works behind a desk 9-5 who takes two 15 minute breaks and a 30 minute lunch M-F; your prescribed X medicine for your cholesterol and hypertension and told to go to the gym and watch what you eat, and lastly, lay off the salt. Yes those medicine's are necessary but do effect your ability to fight fire and do your job... and is probably the reason <32% of this occupational group is compliant and take as directed.
I am the person who will educate firefighters on what exactly those biomarkers mean, how is this medicine going to effect your ability to do "the job," and why its important to "rehabilitate" and eventually ween off the meds when your healthy enough to do so safely. How many NHL players have you heard of playing hockey at that level on diuretic and or beta blockers/ACE-Inhibitors? Why should you be any different...there on the ice for 2 minutes...your in a fire breathing through an SCBA with 70lbs of wet PPE and equipment dragging a charged line for 20 minutes. And we wonder why firefighters are dropping dead on the fire line at an average age of mid to late fortys?
Knowledge is power, if you have a family history of prostate cancer that has stricken male family members in their 30's, the intelligent and safe bet would be to have a physical annually that included a PSA. Firefighters are dying of heart disease and cancer (combined 97%), but whats alarming to me is the AGE of onset. I have a disease that statistically has a 6-7th decade of life onset. Firefighters, cops and medics are also being diagnosed with diseases statistically at an alarming early age.
I have been a paramedic since 1982 and I ve saved a lot of lives, but nothing is more important to me now then being an advocate for public safety personnel health and wellness matters...and if thats a niche than so be it. We have to start somewhere my friend. And, yes I have leading scientific advisors from UCLA, Stanford, Harvard, and Rockefeller University's, to name a few. I also know that several leading medical schools now are including Allostasis and Allostatic Load in their medical curricula.
This model is able to answer questions much better than the homeostasis model, because we have discovered in physiology parameters such as blood pressure are not constant. When they deviate from a predetermined set point (120/80 mm hg) its not significant as an "error", but rather our bodies are designed physiologically to reduce error. Even though your blood glucose is 200 mg/dl prior to fighting a fire doesn't mean your hyperglycemic. Allostasis dictates that your body has predicted a need for higher energy loads to help you physically fight that fire. Our body accomplishes this by using prior knowledge to predict the demand, and then adjusted all physiological parameters to meet it. Thus allostasis considers an unusual parameter value (blood glucose 200mg/dl prior to making an interior attack on the fire), not as a failure to defend your blood sugar at a normal 80mg/dl, but as a physiological response to the prediction of a higher physical load and a need for higher energy production.
Please feel free to contact me. I hope I helped you better understand the concept of allostasis.
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