Step in the Right Direction
Resolutions, whether for a New Year or a new lifestyle … no matter how motivated or well intentioned … are all too often short lived.
Tina Covington Gresham, MD, knows this to be true.
She tries to make sure that her patients at the Gresham Cardiology Group in Murfreesboro take their resolve to improve their lifestyles one step further —literally.
She has set up her cardiology practice with the tools and personnel to help her patients follow her medical advice that focuses on interventional cardiology through testing, exercise, and nutrition counseling as well as education about risk factors for heart disease.
Gresham grew up in New York in East Meadow, Long Island. By the time she was seven years old, she knew she wanted to be a nurse. Her father encouraged her to think that she could also be a doctor.
After graduating with a nursing degree from Howard University, she worked as a Registered Nurse for four years, serving as a clinical specialist in oncology and critical care nursing, before she decided to pursue a medical degree. Gresham recalled, "What I loved about nursing was the patient care aspect, and I realized that advancement in nursing would mean less direct patient care responsibilities and more administrative duties."
For the first two years of medical school, she combined a full-time position as a nurse on weekends with her class work and graduated from Howard in four years with her medical degree.
Gresham's professors at Howard encouraged her to specialize in internal medicine, but she realized that her real inclination was "cardiology, always."
"My family had a history of hypertension which led to my focus – preventive cardiology," she explained.
"In the ER, it was clear to me that we saw the same patients revolving back through about three months after undergoing an angioplasty. Having returned to the same environment in which their condition developed after their procedures, it was just a matter of time until they showed up again in the same condition," she observed.
After graduation, Gresham moved to North Carolina to complete her internship, residency and fellowship in cardiology at Duke University. She came to Tennessee when she accepted a position at the Page-Campbell Cardiology Clinic in Nashville. Gresham and her husband, whom she had met and married in Washington D.C. while at Howard, "had always planned to go back to D.C., but the position here was the opportunity of a lifetime."
While at Page-Campbell, she was instrumental in developing the Diagnostic and Invasive Cardiology program at Middle Tennessee Medical Center. Gresham decided to start her own practice in Murfreesboro after working with the large cardiology group for the decade spanning 1993-2003.
Gresham & Associates Cardiology Group, her current practice, includes a staff of more than 20 healthcare professionals committed to practice services which include diagnostic, invasive, preventive and rehabilitative clinical care and wellness learning.
Gresham developed a program called "Heart of Tennessee," collaborating with MTSU, the city of Murfreesboro, the YMCA, and industries in the area. The program encourages companies to send employees for wellness testing, including lipid studies, nutrition and exercise counseling, and the identification of clinical stress challenges.
Through the YMCA, she also does DNA testing for the IL1 gene, which has been correlated to heart disease. Patients who are identified with IL1 gene are encouraged to adopt lifestyle changes to reduce risk and to consider a natural supplement that has been shown to be effective in reducing inflammation. "Follow-up tests show remarkable improvement with this regimen," she said.
She counsels patients pointing out their risk factors, looking at their lifestyle choices, initiating pharmaceutical regimens where indicated, and making them aware of the availability of natural supplements such as multi-vitamins, Omega 3, and anti-oxidants that can be helpful in reducing risk factors.
"Often we help them adapt healthier lifestyles by such simple steps as portion control and pro-active planning for meal preparation so that they have more choices than fast food takeout in the middle of a busy week. We devise a personalized meal plan taking into account what they like and what they can afford." Staff dieticians make weekly modifications to eating plans to adjust to patients' schedules and preferences.
If gym membership is not an option, Gresham's staff encourages patients to incorporate exercise into their daily lives. "Little things really matter — taking the stairs, parking further away — to get them feeling better and wanting to do more," she noted.
"My challenge in this practice has been getting people in place who have the same passion that I have to change lifestyles … people who are willing to push patients to achieve the results. Now that I have the right people who share my commitment to preventative cardiology, we are well on our way."
Gresham worries that national goals for cardiac health such as those identified by the National Cholesterol Education program are not well known. She hopes to spread the word to her patients and others through the presentations on health-related issues she gives to churches and other local community groups.
In addition to family time with her husband, Earl, who owns a men's clothing business, and 15-year-old son, Earl, Jr., and aerobics, weight lifting and walking, Gresham enjoys working with minority college and high school students interested in medicine and science.
In a specialty that has a preponderance of men, Gresham said she has never felt challenged by the strenuous physical demands required by diagnostic tests. She observed that maybe "there is a balance of sexes in the profession — women are supposed to be better listeners!"