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Is your heartbeat or blood sugar high? On the way, you can keep track

A new series of apps and pocket-sized medical devices that work with a smartphone or smartwatch, change travel for people with severe medical conditions.

The devices allow people with heart conditions, diabetes and epilepsy to discuss checking themselves in airport terminals, train or bus stations, in hotels or even when traveling, sending out information and alerts to doctors and caregivers. In reality, they help create a virtual support and security network.

A device helps heart patients like Nicholas LiVolsi, 40, a graphic designer who noticed several years ago that his heart continued to beat irregularly after planes.

His heart electrophysiologist, Dr. Daniel Frisch of the Thomas Jefferson University Hospital in Philadelphia, recommended an additional monitoring measure beyond the usual electrocardiogram (or ECG or ECG), which requires lying on an exam table and having electrodes attached to the chest, arms and legs to get a dozen views of the heart. The device, KardiaMobile, developed by AliveCor using artificial intelligence and approved by the Food and Drug Administration, is a personal ECG display that looks like a gum and has two sensors.

Patients place the $ 99 device near their smartphone, rest their forearms on a flat surface, and place two fingers on each hand on separate electrodes. It records a medical level ECG for 30 seconds, and tells users whether they have normal rhythm or atrial fibrillation, and saves the results as PDF on the smartphone. It also allows users to add a note to their doctor. The results can be uploaded to the doctor by subscribing to a plan.

"You can use it anywhere," LiVolsi said. "I always carry it with me when I'm away only if I need it. It's easy to use and put all my ECG readings on the cloud, so Dr. Frisch can look at them when needed."

The device said he "gives me security".

Dr. Frisch, who carries Kardia in his pocket for demonstrations, said it is "very useful for me to see what a person's heartbeat is about the symptoms, or for people who have vague symptoms, to find out what their heart is doing around them at the same times."

He said he also encouraged patients to contact him with questions or concerns after reading their own results. "The feedback is part of the agreement with wearables, and it's a new paradigm we must embrace," he said.

Apple Watch Series 4 also has F.D.A. clearance for both its irregular heartbeat alert and its ECG, which operates with an electrical heart sensor. Users take an ECG by placing a finger on the digital crown for 30 seconds. Electrodes in the crown and in the back crystal work in concert. Afterwards, a user can add symptoms and generate a PDF. But it is not possible to send the result automatically to a doctor.

Dr. Frisch said the quality of the recordings from Kardia and the latest Apple Watch was very similar and provides a single view of the heart that is "an approach" to the standard ECG. But Kardia comes out with a new device, KardiaMobile 6L, which Dr. Frisch said, would allow doctors to see the same heart rhythm from six different angles. The users rest 6L on the bare skin of either the left or their ankle and hold it in place with two fingers for 30 seconds.

Diabetics also have new devices that can help them monitor blood sugar levels.

"The most painful part of diabetes is the finger stick," said Kathleen Weaver, 59, Dallas, a dog owner and acting as a trainer for beagles and often traveling to competitions. She said she used to have to test her blood up to 10 times a day. Now she has a Dexcom G6 continuous glucose monitor, which does not require blood drawing.

The sensor remains attached to the skin of the stomach for up to 10 days, and she also uses an insulin pump. Dexcom sends glucose readings every five minutes and connects wirelessly to a reader device or via an app to the smartphone and smartwatch and sends the alarm when the blood sugar is high or low.

She said that Dexcom's biggest advantage was not to "leave the blood every time you need to check the numbers, and then check the numbers much more often."

Since her medical devices are hidden under her clothes, Mrs Weaver said she can be discreet when she wants to know her number. "I can say," Hey, Siri, what's the blood sugar? ""

Her endocrinologist can see the data stored in the cloud to determine how much insulin she should have throughout the day. Her insulin pump must be programmed manually. When traveling, Mrs Weaver said she was using an app to describe her doctor.

Dr. Bithika Thompson, director of the diabetes program at the Mayo Clinic in Arizona, said the FDA-approved wear-resistant screens – including continuous glucose monitors and flash monitors such as Abbott's Freestyle Libre, a 14-day upper arm sensor that can be read by a reader or smartphone – have "revolutionized diabetes treatment." They make it easier for patients, especially those who are insulin dependent, to measure what is happening to blood sugar – where it is at the moment and where it is going.

"It gives better blood sugar control because you only have so much more information than making the decisions," Dr. Thompson said.

Durable devices like Apple Watch include motion sensors (including an accelerometer and gyroscope) and have GPS capabilities that can provide a person's coordinates to emergency response reactors. Apps developed by medical researchers to help travelers deal with medical conditions, collect these data along with heart rate measurements.

Mary Kate O & # 39; Donnell, 29, who has been living in epilepsy for more than a decade, said she was worried that the stress of flying would cause a fit on an airplane.

"No matter how often I fly, I have this strong fear of relying on two complete strangers with my safety and just hoping for the best, which can then lead to a fit under the plane," she said.

Ms. "Donnell, who lives in Manchester, Conn., Has used EpiWatch, an Apple Watch app developed by Johns Hopkins Medicine as part of a continuous study to help patients discover and track their seizures, missed medications and others. triggers. When a seizure is imminent, the patients participate in a response response and then perform short examinations. Attacks are logged as they occur, so doctors can look at them later. And participants can set the app to automatically contact a designated caregiver when they first report a seizure or if they do not respond to an alert from the seizure detector.

The goal of the app is to help patients gain more control over their seizures and their lives, said Dr. Nathan Crone, a neurologist at Johns Hopkins Comprehensive Epilepsy Center who created the app with a colleague, Dr. Gregory Krauss. Dr. Crone said he hoped the project would "let people with epilepsy privately and discreetly share more detailed information about their condition with their doctors so that treatment decisions could be made faster."

Ms. "Donnell said that when she felt the onset of an aura, which could be an unusual sensation or movement that could be a harbinger of a fit, she checked the heart rate of Apple Watch. The higher the speed, the closer she is to having a fit.

"When I feel my wrist symbol, I know I need to find a place to lie down and someone I can tell it will understand," Mrs O & # 39; Donnell said. "If not, the app will write my emergency contact for me. It's my comfort."

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