Conditions

The role of IVs and central lines in critical care

Conditions

July 22, 2012

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

As a critical care anesthesiologist, I care for patients when they are most vulnerable. Critical care patients require intravenous (I.V.) fluids and medications, frequently through central venous access. These are catheters inserted into larger veins with a special procedure. I believe managing I.V. lines requires procedural skills, …

10 topics to discuss with your teen this summer

Natasha Burgert, MD

Conditions

June 27, 2012

In a pediatrician’s office, summertime is teen check-up time.

And, I love it.

Annual checkups are a time for me to catch up on the school year, brag about amazing extra-curricular accomplishments, and swoon over summer vacation plans. It is also a time for anticipatory guidance, private conversations, and facing the often sobering reality of teen life.

Throughout this past year, I have had the privilege of being involved in the lives of many …

Lesser known symptoms of seasonal allergies

Sakina Shikari Bajowala, MD

Conditions

June 26, 2012

My boys and I suffer from tree pollen allergies. More than birds chirping or flowers blooming, I have come to associate boogery sleeves and sneezing with the onset of spring. But these are the typical symptoms, which are easily recognizable as allergy-induced.

What I’d like to address in this post are some lesser known symptoms of seasonal allergies, which may also be rearing their ugly heads this spring. Red eyes and …

What can be done for children with migraine headaches?

Mark W. Green, MD

Conditions

June 9, 2012

Recently, as I finished up a visit with one of my patients who has migraine, she asked me the following: “My 10 year old daughter gets headaches. Is it possible that she has migraines too? I had headaches as a child and was always told it was nothing to worry about, but now I have headaches several times a month. Is there anything I can do to prevent this from …

Is the daily blood draw in the hospital truly necessary?

Ioana Baiu, MD

Conditions

June 5, 2012

One of the most memorable discussions regarding the cost of care was at 4:45AM during surgical morning rounds.

As usual, the interns would present the overnight events of their patients to the chief resident and a plan for the day would be agreed upon. These morning rounds were particularly intense: in addition to the 30 patients that an intern had to manage solo over night, the brutal hours that the surgical …

Where you have your mammogram, and who reads it, matter

Stacey Vitiello, MD

Conditions

May 15, 2012

I’ve received several inquiries from women living in various regions of the country, asking how they should choose where to go for their mammogram, and if it really matters. I cannot emphasize this enough: It matters! Here are a few tips to help your search:

The most basic requirement is whether a facility is accredited under the MQSA (Mammography Quality Standards Act). The accrediting body for most states is the ACR …

Are smokers to blame for the damage they do to their bodies?

James C. Salwitz, MD

Conditions

May 12, 2012

He had yellow nails, leather neck, stained teeth and a deep cough. He wheezed slightly, breathed too quickly and occasionally sprinkled the white handkerchief red. No surprise his ticket to my office was a lung mass to match. We talked about tests, treatment and prognosis. About the future, probably short. Devastated, he was not surprised. He was reaping the reward of 30 smoking years. He sadly admitted, “I knew better, …

Tips for successful home blood pressure monitoring

Erin Marcus, MD

Conditions

April 18, 2012

Sometimes, the simplest tools in medicine are the ones that give us the most useful information.

Take the humble blood pressure machine, for example. It’s been around for years, and it’s cheap, compared with a lot of other medical devices. It’s simple to use, and it doesn’t require a medical or a nursing degree to operate. But the numbers it reports are valuable in helping predict a person’s risk of a …

MKSAP: 32-year-old man is disoriented, combative, and agitated

mksap

Conditions

March 25, 2012

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 32-year-old man is brought to the emergency department after becoming disoriented, combative, and agitated earlier that day. He is accompanied by a friend, who states that the patient has a history of alcohol and drug abuse, including inhalants.

On physical examination, the patient is uncooperative and …

Will Peyton Manning ever fully recover from his spinal nerve injury?

Edward Pullen, MD

Conditions

March 15, 2012

Does muscle weakness improve after disc surgery?

For an NFL fan arguably the best thing that could happen to your team is to sign Peyton Manning and have him perform at or near his pre-injury level. The corollary is that one of the worst things to happen to your team would be to take a huge salary cap hit to get a Peyton Manning with such weak throwing arm that even …

How to prep for a successful colonoscopy

Gottumukkala S. Raju, MD

Conditions

March 9, 2012

If you really want to know what’s going on inside your colon, don’t show-up for a colonoscopy without a clean colon.

Many say that preparing for the colonoscopy is the worst part of the entire exam. But, it just so happens that it’s also the most important part.

If the prep is done right, it’s easier for your doctor to see not only big polyps but also flat polyps, which can be …

A Grammy artist with Tourette Syndrome

Michele R. Berman, MD

Conditions

February 17, 2012

Would you consider a career as a singer if you had involuntary tics from Tourette Syndrome?

Well, it apparently didn’t stop 20-year-old Contemporary Christian musician Jamie Grace.

In fact, Grace attributes singing with helping her cope with her disease.

And now she is being rewarded with a Grammy nomination for best contemporary Christian music song, Hold Me. The song features TobyMac, who is a Grammy winning Christian recording and hip/hop artist. He …

Read more…

A Grammy artist with Tourette Syndrome

Why we need truth in labeling of medical conditions

Toni Bernhard, JD

Conditions

February 16, 2012

Labels matter. We quickly form judgments based on them. If we hear someone called lazy, the label “lazy person” attaches in our mind even though we may not have even met the person. The same is true for labels given to various medical conditions. If the label for an illness uses language such as “fatigue,” we abstract from our experience and think we know what it’s like to suffer from …

The psychological basis of Morgellons disease

Dominic A. Carone, PhD

Conditions

February 15, 2012

If you are like most people, you have probably never heard of Morgellons disease or Morgellons. The first reason you have likely never heard if it is because it is so bizarre and uncommon. Most of what is known about it is based on rare case reports or anecdotal stories. The second reason is because it is not recognized in the medical community as a legitimate medical disease. It is …

Why we should eliminate the diagnosis of ADHD

Steve Balt, MD

Conditions

February 8, 2012

I’m reluctant to write a post about ADHD. It just seems like treacherous ground. Judging by comments I’ve read online and in magazines, and my own personal experience, expressing an opinion about this diagnosis—or just about anything in child psychiatry—will be met with criticism from one side or another. But after reading L. Alan Sroufe’s article (“Ritalin Gone Wild”) in the New York Times, I feel compelled to write.

If …

How the CA-125 became a $50,000 blood test

Keith Marton, MD

Conditions

February 3, 2012

What could be so simple as a blood test?

A quick prick with a needle, a wait of a day or two for results and a discussion with the doctor about those results. In the words of our vaunted politicians, it would be an “up or down vote” on whether there was anything to deal with.

That was the thinking of my wife’s physician when she ordered a test called the “CA-125.” …

How Patrick Swayze died: Why we should care

Barron H. Lerner, MD

Conditions

January 26, 2012

When I finished my book on famous patients, the most common question I received was “Are the stories of sick celebrities really relevant to other patients?” My answer was that yes, with some caveats, these experiences are well-worth knowing.

The same can be said for the story of Patrick Swayze’s terminal pancreatic cancer, which has now been told by his widow, actress Lisa Niemi Swayze, in a new book, “Worth Fighting …

Incorporating 12-step program concepts into cancer survivorship

Richard Just, MD

Conditions

January 23, 2012

The fact that the term “cancer survivorship” is now part of our vocabulary is a testimony to advances made in management of these diseases. Most cancer survivors, however, are not unscathed by the experience. As I tell my patients, they won’t be entirely as they were before treatment. How these issues are dealt with varies from person to person. But, awareness that chronic problems may persist long after treatments end …

Overweight people have a weight thermostat that is turned up too high

Albert Fuchs, MD

Conditions

January 22, 2012

I’ve written many times that losing weight is the second hardest thing I ask my patients to do. (Breaking an addiction like smoking or alcoholism is the hardest.) The frustrating thing is how little we know about how to lose weight successfully. But we are learning more all the time about why losing weight is so difficult.

Much about dieting and weight loss is poorly understood, but let’s first lay out …

Obesity is a sign of good health in some cultures

Arya M. Sharma, MD

Conditions

January 20, 2012

On the first day of the 1st Caribbean Obesity Forum, I presented various talks on obesity – its economic implications, its assessment and the need for firmly anchoring obesity treatment in primary care.

Interestingly, several family doctors in the audience raised the interesting issue that here on Barbados (as probably on other islands) many patients are actually quite happy with their weights.

One family physician noted in his presentation the case of …