‘Tis the season to be coughing …
It no longer takes an epidemiologist looking at absenteeism rates in schools to predict the start of influenza season. For several years now there have been sophisticated models using search engine terms to monitor increasing incidence of febrile cough illness in regions of the world.
Or just ask a primary care clinic what its waiting room sounds like these days. A chorus of coughs, high, low, dry, …
Justin Bieber was arrested recently in Florida for a DUI. The smirk on his face is a bit misplaced. While it’s no longer a surprise when we hear about a celebrity’s challenge with drugs and alcohol, Bieber serves up a perfect moment for education. I mean this kid (he’s 19-years-old) really could have killed himself last night. Thank goodness he’s …
I’ve spent the past four weeks learning about primary care on my family medicine rotation. A significant portion of patient care in this setting is focused on health maintenance or disease prevention. Physicians can provide their patients with evidence-based recommendations for various screening tests and vaccinations, but it is ultimately up to the patient to decide what services he or she will receive.
According to the Centers for Disease Control and …
An article published in the New York Times last weekend has been circulating widely on the Internet, and I feel that more than ever, physician voices are needed to reach the public and counter certain misconceptions put forth by the media.
The article, “Patients’ Costs Skyrocket; Specialists’ Incomes Soar,” charts the growth of specialist incomes in the past decade, using the case of a patient from Arkansas who had a …
Many times over the years, I have witnessed the following scenario in my exam room.
Here’s the set up of this one act play.
Characters:
Elderly patient
Attentive daughter
The doctor
Scene 1
I’m seated at my desktop computer. The patient is seated before me. The patient’s daughter is seated next to her mother.
A patient comes to see me in the office with medical issues that strongly suggest that a colonoscopy should be performed. As an aside, …
In 1950 Ernst Wynder, MD and colleagues began to produce convincing data that cigarette smoking caused lung cancer. Over the ensuing many years evidence has arisen linking cigarette smoking to many different cancers, chronic lung disease and heart attacks.
In 1964 the surgeon general reported that cigarette smoking was the most important risk factor for development of lung cancer and that quitting smoking reduced that risk. Since that time a concerted …
Lebron James makes over $19 million per year playing basketball for the Miami Heat. Not surprisingly, this salary is peanuts compared his endorsement earnings, which in 2012 topped $42 million. Although perhaps peanuts is the wrong word to use when discussing James outside earnings, which to my knowledge have not involved foods anywhere near as healthy as peanuts. Instead, according to …
I don’t have much in the way of eyebrows. They were victims of too much plucking back in the 1960’s and when you do that, sometimes they don’t grow back. There’s a very nice woman in Solana Beach who shapes and darkens what I have left, infrequently, when I bother to think about it which isn’t very often.
I was in there about a year ago when she told me, “I …
I’ve been skeptical of the trend of “holding back” children with late birthdays. These are kids, usually born in the summer, who are just a few months short of the next grade cut-off. Some parents wonder whether it would be wise to hold them back a few months, so they end up one of the oldest (rather than youngest) kids in their class. This might seem to confer an advantage …
The holiday season means most of us will be socializing with colleagues and neighbors, friends and family. Chances are good this circle of friendly acquaintances and loved ones will include a child with autism.
Why? An estimated 1 in 88 children are now diagnosed with the neurological disorder, with a four times prevalence for boys. Among other challenges, those with autism often have difficulties with social communication (be it verbally or …
It’s the beginning of cold and flu season. That means a lot of kiddos, big and small, are coming to the office with fever.
As docs, we know that fevers can freak moms and dads out. Kids look pretty awful when their temperature climbs, and it is understandable that parents want to bring them to the office for an evaluation.
In the exam room, I often hear worried parents …
It’s been very interesting to read the range of responses to the recent FDA recent crackdown on the personal genetic service company 23andMe. Some have decried the FDA as too paternalisticwhile others have said the FDA is rightfully protecting the health of the public.
The evidence, I believe, shows the FDA is correct: 23andMe should not be doing genetic tests that have serious medical implications. Let’s look at an …
This past spring, I went to Dar es Salaam, Tanzania to do an internal medicine elective at Muhimbili University of Health and Allied Sciences. I rotated through two sub-divisions of internal medicine while I was there: infectious disease and cardiology.
The medicine
When I initially stepped onto the infectious disease ward, I saw the janitors mopping the cement floors with soap and water. The ward was crowded and the patients lying on …
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A 74-year-old woman is evaluated for a 2-month history of fatigue, anorexia, and a 6-kg (13.2-lb) weight loss. She was treated with chemotherapy for ovarian cancer 6 months ago. She also has hypertension managed with hydrochlorothiazide.
On physical examination, temperature is 36.2 °C (97.2 °F), blood pressure is 132/75 mm Hg without postural …
Sometimes I feel as if my entire emergency medicine career is dedicated to one patient complaint. And that one complaint is chest pain. It may be that the incidence and prevalence of chest pain was the same during my medical school and residency training as it is now. But I doubt it.
I recall how I struggled to learn the salient questions. ‘Where is your chest pain? Is it heavy, dull, …
I hear it over and over again.
From a nurse, “She can’t have providine prep, she has a shellfish allergy.”
From the patient, “I can’t have the contrast because I’m allergic to iodine and shellfish.”
The list of allergies placed in the chart by a doctor, “Radiocontrast. Iodine. Shellfish.”
It’s not the fault of the patients who are typically repeating the medical misinformation they have been given. However, the medical professionals who perpetuate the …
Asthma is a common problem in children — nearly 10% now have it — and the number is increasing. Researchers are not sure of the reasons for this steady increase, but decreased air quality, lower activity levels among children, and an increase childhood obesity have all been implicated. Whatever the cause, it means that millions of American children take medicine for asthma. A significant number of these children end up in …
In March of last year I began and quickly ended a cycling career. In my first race of the weekend I placed second, and in a moment of hubris felt emboldened to reach for more.
In the second race, the very next day, I signed up for a higher category. The race was tougher, and I got stuck behind the pack, which slowed immensely around turns. In an effort to advance, …
Kerry was only 28-years-old. He showed up in the ER one night complaining of upper abdominal pain which started suddenly that day. The emergency physician did the usual workup and found two things which led to an urgent call: a large intrabdominal mass and free intraperitoneal air.
The large mass was not necessarily an emergency, but free air, that is, air outside its usual place inside the bowel, almost always represents …
However you see the Reverend Al Sharpton, one thing is certain: you see less of him now. His Twitter pic tells you he is proud of his 167-pound weight loss. Good for him, he should be.
If you care about health, the disappearance of the Sharpton-of-old is worth mention. His story teaches us a lot, and, if one dares to look a little …
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