Conditions and Diseases

Physicians writing on KevinMD about the diseases they treat and the people who have them: cancer and its screening arguments, pain and the drugs that treat it, diabetes and the obesity argument, mental illness and who gets treated for it, and the decisions at the end of a life. Five maintained records draw on this archive: Cancer: what physicians say, in their own words, Opioids: what physicians and pain patients say, in their own words, End of life: what physicians say, in their own words, Diabetes and obesity: what physicians say, in their own words, and Mental health: what psychiatrists and physicians say, in their own words.

Infertility: Where uncertainty is the only thing that is certain

Kate Hoppock, DO

October 6, 2020

Physicians love to feel in control. We thrive in environments where we feel we can predict the outcome.

Do well in medical school and on boards—you will get into a residency.

Take the statin—it will improve your cholesterol.

Do the screening colonoscopy—it will improve your chances of catching cancer early.

I think most of us can agree we would give these recommendations. But certainty, the foundation of predictability, is not a given. We know …

The role of physician assistants during the pandemic

Leah Yoke, PA-C

Conditions and Diseases

October 5, 2020

As the world battles COVID-19, summer has turned to autumn, and a new chill is in the air. With this change, even in a pandemic, comes the flu season. As a physician assistant (PA), one concern for my patients’ health is the possibility that many will forgo routine health checks or other preventative care because they are avoiding medical settings. When it comes to flu vaccinations, I am especially concerned.

In …

President Trump received dexamethasone and had 2 episodes of low oxygen saturation levels

Molly Walker

Conditions and Diseases

October 4, 2020

President Trump was administered dexamethasone therapy for COVID-19 treatment, and had two episodes of low oxygen saturation levels that required supplemental oxygen, said doctors at Walter Reed Medical Center at a press conference on Sunday.

“In response to transient low oxygen levels, we did initiate dexamethasone therapy [and] our plan is to continue that for the time being,” …

Clinical diagnosis in the age of COVID-19

Philip A. Masters, MD

Conditions and Diseases

October 4, 2020

A guest column by the American College of Physicians, exclusive to KevinMD.

Making an accurate clinical diagnosis is one of the most important things physicians can do for their patients.

But being able to do so is not an easy process to begin with. It takes years of preparation in learning as much medicine as you …

Physicians sometimes need to deviate from established policies

Michael Kirsch, MD

Conditions and Diseases

October 4, 2020

Some time ago, I performed a colonoscopy on a patient who was having serious internal bleeding. He had already received multiple transfusions since he was admitted to the hospital. After obtaining informed consent for the procedure, I performed the colon exam. I encountered blood throughout the entire colon, but saw no definite bleeding site, raising the possibility that the source of blood might be higher up than the colon, such as …

The Trump health update that raises more questions

Molly Walker

Conditions and Diseases

October 3, 2020

A brief press conference at Walter Reed Medical Center on Saturday sought to provide answers, but may only have raised more questions about President Trump’s clinical status since his COVID-19 diagnosis.

The main point of contention between White House physician Sean Conley, DO, and reporters was if the president ever received supplemental oxygen. Conley said the president’s last oxygen …

The mysterious White House testing scheme that did not protect Trump

Rachana Pradhan, Lauren Weber, and Liz Szabo

Conditions and Diseases

October 3, 2020

President Donald Trump’s COVID-19 diagnosis is raising fresh questions about the White House’s strategy for testing and containing the virus for a president whose cavalier attitude about the coronavirus has persisted since it landed on American shores.

The president has said others are tested before getting close to him, appearing to hold it as an iron shield of safety. He has largely eschewed mask-wearing and social distancing …

COVID-19 and the college experience

Edwin Leap, MD

Conditions and Diseases

October 3, 2020

Everyone seems to be walking about in disbelief. College educators and administrators are shocked. Public health officials are incredulous. Politicians are confused, and news reporters are busily shaking their heads at the numbers. Physicians, my colleagues across the country, are beside themselves. And all of this head-scratching and hand-wringing is because students went back to their colleges and universities and behaved like, you know, students at college and universities.

And then …

Read more…

COVID-19 and the college experience

Infertility as a physician: the gift of perspective

Kate Hoppock, DO

Conditions and Diseases

October 3, 2020

As physicians, we know all too well how life can change in an instant. How tomorrow is never promised. This knowledge can sometimes feel overwhelming, but it is also a gift.

Because we know how precious life is.

I am a physician—but I am also a patient. An infertility patient, for whom each passing year can feel like a lost opportunity.

Because my eggs don’t have the perspective. They don’t see the privilege. …

Unmasking inequality: the power of community organization during COVID-19

Aishwarya Raja and Inginia Genao, MD

Conditions and Diseases

October 2, 2020

In medical school, I was charged with caring for Ms. R, a 47-year-old woman with type 2 diabetes, hypertension, and rheumatoid arthritis. She had been flagged as a high priority patient through the student-run free clinic (SRFC) and assigned to me for long-term follow-up. This signified seeing her during monthly check-ups, scheduling her appointments with specialists, and checking in with her to ensure her needs were being met.

Although I had …

Meniscus tear surgery and treatment: What you need to know to decrease your pain

Jeffrey Peng, MD

Conditions and Diseases

September 28, 2020

Meniscus injuries of the knee are common. There are lots of treatment options, including meniscus tear surgery or injections. But which one is the best to address your meniscus tear pain? The data surprises almost everyone.

History of meniscus tear treatments

Orthopedic surgeons used to perform a total meniscectomy for patients with meniscus tears. This procedure involved taking out the entire meniscus. If you have a tear that causes you pain, why …

Doctoring in the age of COVID and the possibility of dying in the near future

Nupur Gupta, MD

Conditions and Diseases

September 27, 2020

On January 19, the first case of the coronavirus in the United States was announced. Initially, COVID cases were detected in Washington. As time elapsed, other states did best to prepare for if and when COVID came to our area. As spring break arrived, my husband, an intensivist, debated the best course of action regarding our vacation. We decided we could not take a vacation with heavy hearts while our …

COVID-19 in Italy: the good, the bad, and the ugly

Susan Levenstein, MD

Conditions and Diseases

September 27, 2020

The good

Italians star at disorganization, disobedience, and discord. They sneak past no-entry signs, light up under no-smoking signs, barrel along at 80 in 35 mph zones, fasten their seat belts under their butts. Plus, they had the worst COVID-19 epidemic in Europe.

So how come they’re doing so well …

Racial disparities and maternal mental health during COVID

Brennin Brown, MD and Susan Hatters Friedman, MD

Conditions and Diseases

September 27, 2020

As the coronavirus pandemic has unfolded, the uncertainty of this crisis has stoked heightened awareness and precaution in each aspect of our lives. We have incorporated personal protective equipment into our human interactions, and we are compulsively practicing sanitation rituals. Our social connections have been tethered at a distance for months on end. As a society, we are experiencing collective grief. Grieving hundreds of thousands of lives lost and the …

Dopamine fasting, debunked by a psychiatrist

Steven Reidbord, MD

Conditions and Diseases

September 27, 2020

Taking a break from technology is a fine idea, but we don’t need a pseudoscientific new name for it: dopamine fasting. Launched with viral Silicon Valley memes, online reports, and articles in the New York Times and elsewhere, dopamine fasting is now a thing. Basically, the idea is to temporarily deprive oneself of the usual stimulations of life — largely …

From a dermatologist: How to beat “maskne,” dry hands, and other safety-related skin problems

Hoag Memorial Hospital Presbyterian

Conditions and Diseases

September 26, 2020

You are doing all the right things: washing your hands frequently, wearing a mask when out in public, getting the requisite sunlight needed to reduce stress and maintain your health. And the reward you’re getting for all your diligence?

Dry skin, damaged nails, acne, and sunburns.

As we continue to live with the threat of COVID-19, more people find themselves wrestling with skin issues they never anticipated. Fortunately, there are easy and …

Why that wound won’t heal

Clayton Foster, MD

Conditions and Diseases

September 26, 2020

Despite the advances in modern health care, chronic wounds remain highly problematic. For the critically ill and those with mobility issues, missing just one routine repositioning could send them down a protracted path of intensive wound care therapies. Even our ambulatory patients develop non-healing ulcers from neuropathy and microvascular disease. For purposes of this discussion, the question of how the wound formed isn’t nearly as important as why it persists …

Read more…

Why that wound won’t heal

Getting young adults on board with public health measures to reduce the spread of COVID-19

Silvana Barone, MD

Conditions and Diseases

September 23, 2020

The recent increase in the number of COVID-19 cases in North America, particularly among young people ages 20-29, is a cause for concern. The reason for this increase seems to be related to poor compliance with public health recommendations. The past few weeks have been filled with reports of university students, for example, having intimate gatherings at bars and dancing the night away at parties with nary a mask on …

Do COVID restrictions in the office negatively affect patients?

Anne Katz, RN, PhD

Conditions and Diseases

September 21, 2020

Many health care facilities are enacting policies during this time of COVID-19 that restrict the number of people attending appointments in person. Family care providers are asked to wait outside or drop off the patient for their appointment and come back to pick them up later.

There are, of course, exceptions made for those receiving a new diagnosis or when the …

Patients vs. customers during COVID

Rada Jones, MD

Conditions and Diseases

September 20, 2020

Somewhere in Wuhan, China, a bat was eaten — and the world as we knew it was over. (Note to self: Never have your bat below medium, and avoid bat tartare like the plague.)

Kids stayed home. So did their parents. They started talking to each other, instead of watching their phones while rushing from soccer games to ballet rehearsals via McDonald’s.

Sports got suspended, and millions of rabid sports fans remembered …

Read more…

Patients vs. customers during COVID