Conditions

The difference between complications and negligence

Conditions

November 17, 2012

A patient who was minutes away from his colonoscopy, asked me how many colonoscopies I had performed. Before I could answer, he quickly followed-up asking if any of my patients developed perforation of the colon after the procedure.

I satisfied his initial inquiry when I informed him that I have intruded into at least 20,000 colons in the past 2 decades. With regard to his second and more ‘penetrating’ question, I …

Is it possible to ignore prostate cancer?

James C. Salwitz, MD

Conditions

November 17, 2012

Is it possible to ignore a cancer? Prostate cancer infests almost 250,000 men in this country each year and will kill 28,000 men in the United States in 2012, over 200,000 around the world. Many lose their lives “too soon”, dying in their 60s or even their 50s. Nonetheless, authorities do not recommend the PSA blood test for routine screening of this disease. How can this make sense? Partly this …

MKSAP: 59-year-old man is evaluated for hypokalemia and hypertension

mksap

Conditions

November 3, 2012

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

A 59-year-old man is evaluated for recently discovered spontaneous hypokalemia and hypertension. The patient had normal blood pressure at a visit 1 year ago. He has no symptoms and takes no medications.

On physical examination, temperature is 36.9 °C (98.4 °F), blood pressure is 148/96 mm Hg, pulse rate is 58/min, respiration rate is 18/min, …

What is the best disease from which to die?

Alex Lickerman, MD

Conditions

October 14, 2012

We can’t, of course, plan the way we’re going to die (with the obvious exception of suicide). We can, however, live in such a way that reduces the likelihood of our dying from certain diseases. Which is why it’s now almost universally accepted that we should exercise regularly, not smoke, drink only in moderation (if at all), avoid too much fat in our diet (and now probably too much carbohydrate), …

Chuck Pagano has leukemia: An oncologist discusses his prognosis

John Salter, MD

Conditions

October 10, 2012

I’ve been getting a lot of questions about Indianapolis Colts’ Head Coach Chuck Pagano lately, so I thought I would dedicate a blog entry to discussing his disease and prognosis.

Coach Pagano was recently diagnosed with acute myeloid leukemia (AML), a form of blood cancer that typically carries a rather grim long-term prognosis in adults. While early reports were quite sketchy on the details of Pagano’s presenting symptoms, it seems that …

Restless legs syndrome in children: How the kids see it

Craig Canapari, MD

Conditions

September 17, 2012

When I was a kid, my parents used to avoid giving me Coca-Cola after lunch. Not because they were overly concerned about my health. (If they had been, my mom wouldn’t have given me milkshakes when I watched Kung Fu Theater every Sunday afternoon. But that is a different story). The reason was that I would have really severe problems falling asleep about a quarter of the time. I would …

Can I still have a bladder infection with a negative urine culture?

Jennifer Gunter, MD

Conditions

September 16, 2012

In a word, yes.

And this is a difficult concept for many doctors to get because we have long been taught that the gold standard is culture.

Let’s back up a little. These are the symptoms of a bladder infection: needing to empty your bladder a lot (urinary frequency), when you gotta go, you gotta go (urgency), pain just over the pubic bone, blood in the urine, burning when you empty your …

When the fear of needles paralyzes medical care

Suzanne Koven, MD

Conditions

September 11, 2012

When I was a kid, my pediatrician was a friend of my parents who practiced out of a first floor office in his home across the street from ours. He was a wonderful man and doctor, I’m sure, but I was terrified of him because I associated him with the injections he gave me periodically. Even when he and his wife came to our house for dinner I hid–just in …

Would you accept obesity advice from a fat doctor?

Joyce Ho, MD

Conditions

September 7, 2012

Something that has been on my mind recently is obesity, specifically obesity in doctors. This may be because we cover obesity in a high percentage of our stories (1 in 3 Americans is obese, after all) or because I recently discovered that I gained ten pounds since moving to New York City. Either way, after watching Dr. Snyderman speak her mind on national television about how obese leaders are unfit …

Hospice care and palliative care: What’s the difference?

James Cooper, MD

Conditions

August 29, 2012

I’ve talked to hundreds of people about the health care options and decisions they face at the end of life. It’s a challenging time and understandably many have little knowledge, while others have misconceptions, and some have bitter disagreements.

Here’s a basic primer for two common approaches: hospice and palliative care.

Hospice care

Two myths about hospice care are prevalent. First, many people believe hospice is provided in a place like a hospital. …

6 tips for choosing the right water drink

Mary Ellen Herndon, MPH, RD

Conditions

August 25, 2012

Flavored water. Water with electrolytes. Tonic water. Sparkling water. Seltzer.

Grocery shelves are packed with so-called water options. But not every drink that bills itself as water is the real deal.

Many drinks labeled as water are loaded with sugar and empty calories. Even though these drinks have ‘water’ in their name, drinking them regularly may cause weight gain and may increase your risk of obesity.

And, that’s bad news because maintaining a …

How to think like a doctor: Start with differential diagnosis

Suzanne Koven, MD

Conditions

August 17, 2012

“What would you do if you were your doctor?” Mary asked me. Mary is my physical therapist and she was trying to figure out why the rehab after my shoulder surgery was progressing so slowly. A month after my operation I was still in pain and still not moving the joint well.

Without hesitation I replied: “I’d come up with a differential diagnosis.”

Differential diagnosis is a two word summary of how …

Should I get a spray tan? A doctor discusses whether it’s safe

Bobby Ghaheri, MD

Conditions

August 12, 2012

We all know that the use of baby oils and baking in the sun for hours on end is probably not a good idea. We know that increased sun exposure correlates with increasing skin cancer rates. We know that it can cause accelerated skin damage in the form of pigmentation changes, wrinkles, and increased skin laxity. Don’t believe me? Check out this picture! Truck drivers tend to get increased sun …

How to avoid Zumba injuries: 10 physician tips

Orly Avitzur, MD

Conditions

July 29, 2012

Zumba, the Latin dance-inspired fitness craze, is a great way to burn calories, up to 500 per hour. It also gives you a good cardiovascular workout without making you feel like you’re exercising. This increasingly popular workout attracts a diverse crowd at dance studios and health clubs, including a sizable number of those 50 and up.

But for people who are out of shape, taking the first classes can be like …

The role of IVs and central lines in critical care

Mark E. Nunnally

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 …

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