Dr. Vickie Becker received her DUO Digital Stethoscope days before the coronavirus outbreak was ruled a pandemic and millions of people across the country were ordered to shelter-in-place. As an internist, she only sees complicated patients, many of whom are regarded as high risk should they contract COVID-19.
"Nobody comes in well. Everybody comes in with some kind of a chronic problem, " Becker explained. "I depend on my stethoscope. I'm really happy with the Eko. It's helped me make the diagnosis of atrial fibrillation or atrial flutter a couple of times when I was uncertain what was going on. "
One of those cases was a man with chronic lower extremity deep vein thrombosis.
"He's on and off anticoagulation all the time and he's a young guy too, so it's surprising. I listened to his heart and lungs and thought 'this doesn't sound right.' He had no other risk factors that I could tell. "
Listening through the Eko DUO, Dr. Becker picked up the abnormal heart rhythm of atrial fibrillation, a condition that comes with the risk of blood clots and stroke. Using Eko's phone app, she was able to look at the tracing. Becker even printed out an image of the rhythm to enlarge it.
"I was certain. I started anticoagulating him again and sent him for lower extremity dopplers and an echocardiogram. I was right. It was AFib. It was kind of amazing. "
Now she's been going back to other patients already diagnosed with atrial fibrillation and using the Eko to check on rates and make sure the rhythm hasn't degenerated. She also puts the data the DUO collects right into electronic medical records.
Auscultating During the COVID-19 Crisis
COVID-19 has raised the stakes of every auscultation Dr. Becker performs. As a clinician in rural Illinois, an area that has not had widespread access to testing, doctors need to be very suspicious before recommending the patient be swabbed.
"The Eko is invaluable to me in figuring out which direction to go to. If I listen to someone's chest and they sound terrible, I'll do an influenza test on them, I will check a chest X-ray, do a routine blood test. Then if I'm really suspicious, I'll do a COVID test as well. "
So far, none of the patients Dr. Becker has personally recommended for testing have ended up in the hospital's COVID Unit. However, she is confronted with one of the main symptoms of the virus several times a day.
"I've heard plenty of concerning lung sounds. People that I didn't even expect to have rales, rhonchi or wheezing, who thought they had a little sinus infection. Chest X-rays have come back with unexpected infiltrates. People with congestive heart failure have ended up with pulmonary vascular redistribution. Coronavirus is a really big deal. It's made a huge difference in my practice. "
One of the big changes is the reliance on telehealth to follow up with patients being treated for things like COPD, uncontrolled diabetes, and hypertension. Most routine check-ups have been postponed indefinitely as well.
Eko Aids in Curiosity, Confidence
Once the pandemic eases, Dr. Becker says she plans to continue to rely on the Eko. It is a formidable ally in her lifelong goal to find out why things work the way they do. That distinct curiosity, along with some remarkable mentors, is what ultimately led her to medicine.
In 1978, Becker entered Loyola University Chicago Stritch School of Medicine. She was one of just a handful of women among hundreds of male peers. She ended up marrying one of those male peers, whose father was instrumental in her decision to pursue internal medicine. This was during her internship and residency at University of Illinois, Chicago.
"My husband's father and his colleagues were actually pioneers of internal medicine in the Chicago area. I met all these people while I was in training and was so impressed and inspired. I wanted to do what they did. I wanted to know the reasons for things. This went back to my father. "
Becker's father died when she was eight years old. Part of the lasting impression of that trauma is tied up in how limited doctors were at the time.
"They had no way of making a diagnosis of pancreatic cancer. And they couldn't do anything about it once they did make the diagnosis. I decided I wanted to be the detective who makes the diagnosis. "
Today, Dr. Becker's rural location makes it all the more important that she is confident in each diagnosis. Many of her patients don't come in until they are already sick.
"Oftentimes sending them to a specialist is just not an option because it's too far to go, or they don't have money for gas or a ride, so we have to do it all on our own. The Eko makes me feel more secure that I'm making the correct diagnosis and I can treat on the basis of that. "