Conditions

Why you should never order a herpes IgM blood test

Conditions

July 27, 2013

Routine screening blood tests for herpes are not recommended by the Centers for Disease Control. When I say routine screening I mean a scenario such as, “I want to get checked for everything, ok?”

Blood tests for herpes do have a place in specific clinical situations, but that’s for another post.

But say you did get a herpes blood test (even though it’s not recommended many people seem to get it done) …

Beware of that new car smell when shopping for a new car

Dr. Charles

Conditions

July 22, 2013

As I shopped for a new car last year, I realized that my priorities were considered odd by most car salesmen. The three most important characteristics I desired in a new car were good gas mileage, good crash safety, and relatively low concentrations of “new car smells.” The often celebrated (but particularly noxious) new car smell is actually a synthetic blend of respiratory irritants and potential carcinogens off-gassing from the …

Determining the prognosis of patients with pulmonary fibrosis

Deep Ramachandran, MD

Conditions

July 20, 2013

Sometimes it’s the simplest things that can make all the difference. Unfortunately, when it comes to informing patients with a new diagnosis of pulmonary fibrosis what to expect, things are anything but simple.

For years, pulmonologists have dreaded the moment when we inform patients of a diagnosis of pulmonary fibrosis. The discussion invariably involves informing them that this disease (which they have probably never heard of) may either kill them or …

MKSAP: 38-year-old woman with fatigue and dyspnea on exertion

mksap

Conditions

July 13, 2013

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

A 38-year-old woman is evaluated for a 6-month history of progressive fatigue and dyspnea on exertion. Over the past 2 years she has noted episodes of hand swelling, joint pain, blue color change of her fingers with cold exposure, and difficulty swallowing. She takes no medications.

On physical examination, temperature is 36.9 °C (98.4 °F), …

Should drug testing be considered screening tests?

Chris Rangel, MD

Conditions

July 12, 2013

cropped-clean_urine

Tests like cholesterol levels are considered screening tests because they are cost effective, have high sensitivities (a low rate of false negatives), and have been proven to be beneficial in the identification of conditions that may require treatment before symptoms occur. The vast majority of medical tests are not considered to be “screening” because they violate one or more of these principles, …

When does a teen girl need a pelvic exam?

Wendy Sue Swanson, MD

Conditions

July 8, 2013

Typically, teen girls do not need a pelvic exam until they are 21. Most parents are surprised to hear this, especially if they know their teen is sexually active.

About 1/2 of teen girls are sexually active during high school which puts them at risk for sexually transmitted infections (STI) and unwanted pregnancy. However, for routine prevention and care, girls rarely need an internal pelvic or speculum exam during high school. …

This is why you should wear sunscreen

Joyce Ho, MD

Conditions

July 5, 2013

I recently celebrated my birthday with a 9-hour picnic and for the first time in my life I was aware that some of my friends were starting to wear large hats and sunscreen. In fact, one of my friends was asking me about tinting her windows to block out excess sun.

Finally we are all now realizing what our mothers have been telling us since day 1 and what was popularized …

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This is why you should wear sunscreen

A surgeon deconstructs bowel surgery

Sid Schwab, MD

Conditions

June 29, 2013

Next in a continuing series.

Let’s make it easy on ourselves. I haven’t yet established why — other than liking the particular operation — we’re removing this nice person’s colon. So since our patient has agreed to remain exposed and to do so for all to see, I declare s/he has diverticulitis. (Were it cancer, the operation would be largely the same, taking a bit more out.) Most likely …

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A surgeon deconstructs bowel surgery

When a child can’t feel his poops

Roy Benaroch, MD

Conditions

June 26, 2013

Kathy wrote about her son: “What can cause a 9-year-old boy to poop in his pants occasionally and not feel it? He was completely potty trained at age three. I have found dirty underwear and poop on the bathroom floor–and it just concerns me that he is unaware of it. It has been suggested at checkups that he may be constipated. My mother suggests he may simply not be paying …

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When a child can’t feel his poops

A pediatrician’s approach to dehydration in children

Christopher Johnson, MD

Conditions

June 24, 2013

Our bodies are mostly water — about 60% water, in fact. This varies a little with age and sex, but it is a good rough estimate. Of that 60% water, about a third of it is outside the body’s cells, so-called extracellular fluid, and two thirds of it is inside the body’s cells, so-called intracellular fluid. The easiest way to remember this is the “60/40/20″ rule: total body water is …

How a heart rhythm specialist approaches PVCs

John Mandrola, MD

Conditions

June 23, 2013

Here is an edited email I received from an athletic colleague:

John,

A 50 year-old male healthy athlete has the new problem of occasional periods of premature beats. She (or he, doesn’t matter) has visited the doctor and an ECG shows PVCs, or premature ventricular contractions. Otherwise the history, exam, ECG, ECHO and electrolytes are normal.

What’s up with PVCs? Why? Could they be 1) consequence of (chronic) exercise or 2) related in …

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How a heart rhythm specialist approaches PVCs

The problem with a negative BRCA test

Jan Gurley, MD

Conditions

June 19, 2013

There is nothing so horrifying as when your doctor is too nice to you. During my first mammogram at Kaiser Permanente, I knew I had cancer before they even told me because of the hushed voices, the pats on my shoulder, and the way, suddenly, no one cared how much time was being spent on my visit. When that happens to you before the diagnosis is official, there is nothing …

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The problem with a negative BRCA test

Grilling with aluminum foil: What are the health risks?

Dr. Charles

Conditions

June 10, 2013

grilling aluminum foil

As the weather heats up and the allure of grilling returns, it is important to consider some of the potential health risks. One of the great joys of my life is “manning” the grill – beer in hand, wafting smoke rising through the air, a delicious anticipation building. It seems worth the risk of consuming carcinogens present in the smoke …

How to know if your baby has autism

Naline Lai, MD and Julie Kardos, MD

Conditions

June 8, 2013

Autism is a communication disorder where children have difficulty relating to other people. Pediatricians watch for speech delay as a sign of autism. Even before your child is expected to start talking, around a year old, you can watch for communication milestones. Problems attaining these milestones may indicate autism or other disorders such as hearing loss, vision loss, isolated language delay, or other developmental delays.

By six weeks of age, your …

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How to know if your baby has autism

Letting your infant cry it out: Will it hurt your baby?

Roy Benaroch, MD

Conditions

June 5, 2013

shutterstock_128923511

Jess, like many parents, has been hearing conflicting information about what crying can do to your baby.

She wrote: “So, my husband and I accidentally let our kiddo (5.5 months) cry it out. So of course, I’m spending all sorts of time on Google finding out that I’ve caused long-term damage to my son and he’ll be more likely to get ADHD and …

Migraine is very much a childhood disorder

Roy Benaroch, MD

Conditions

May 29, 2013

“My wife gets migraines—really bad ones—and now my daughter seems to be getting them too. She’s only 7! Is she just copying what her mom does? Can a child really start getting migraines?”

Oh, yes they can. Migraine is very much a childhood disorder. About 5% of adults have migraines, and half of them started having their migraines as kids.

As in adults, migraines in children can be severe and debilitating. However, …

How to have a hospital stay without pain

Anita Gupta, DO, PharmD

Conditions

May 19, 2013

Too often patients feel like they’re in the passenger seat when entering the hospital. Even in the best of circumstances — such as planned admissions — patients often don’t feel in control of their own care.

One of the most unnecessary issues facing patients when they enter the hospital is untreated (or undertreated) pain. Often the focus of the medical team is to treat a condition, and controlling a patient’s pain …

Understanding psychotic and bipolar disorders

Tali Shenfield, PhD

Conditions

May 19, 2013

Psychotic and manic depressive disorders can not only disrupt the life of the person suffering with one of these illnesses, but the lives of family and friends as well.

You should seek professional advice if you suspect that you, a friend or a relative or even a spouse may be experiencing a psychotic or bipolar disorder. It’s important not to attempt a diagnosis yourself. There are many external factors that can …

Did Mike Huckabee foreshadow his journey back to obesity?

Barbara Berkeley, MD

Conditions

May 15, 2013

Ah, the addictive power of modern food. Never underestimate it.

On a recent trip to New York I happened to be flipping through the channels on my in-flight TV when I ran across Mike Huckabee doing an interview on Fox News. I was surprised to see that he had gained his weight back. The former governor of Arkansas and presidential candidate had staked quite a bit on the success of his …