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.

What a cardiologist wants you to know about loneliness

Jonathan Fisher, MD

November 12, 2019

What is the unspoken fatal epidemic of our time? And the greatest predictor of overall health, happiness, job satisfaction, and resiliency? Loneliness.

As a clinical cardiologist, I am committed to the health and well-being of my patients.

As a recovering burned-out physician who suffered in silence for years while hiding this so well from others, I am committed to finding solutions to help my partners suffering so often in silence.

As a husband, …

What’s the X-factor in life or death medical situations?

Ethan Dmitrovsky, MD

Conditions and Diseases

November 11, 2019

I was a brand-new intern in the intensive care unit, and Cassandra was the very first patient I saw there. A petite, slender woman, she was rolled in on a stretcher, accompanied by her tall, athletic husband, Jack.

Cassandra was in her 20s, like me — but mortally ill. That grabbed my attention from the start. But the biggest lesson she taught me came about because we got her prognosis all …

MKSAP: 19-year-old man with lightheadedness and nightly fevers

mksap

Conditions and Diseases

November 9, 2019

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

A 19-year-old man is hospitalized with a 6-day history of lightheadedness and nightly fevers. He also reports sore throat, headache, joint and muscle aches, and a dry cough. He recalls a blotchy rash on his trunk and arms, which has resolved. He returned home 12 days ago from a …

What does a cardiologist think of the keto diet?

Deepti Bhandare, MD

Conditions and Diseases

November 8, 2019

Being a cardiologist, the most frequent question coming my way for the last few years is “Doc what do you think about the “keto” [ketogenic] diet.”

All foods contain both micronutrients and macronutrients that are essential for the body to function optimally. The human body requires macronutrients in large amounts, which include carbohydrates, proteins, and fats. These nutrients provide energy for your body in the form of calories. Micronutrients are nutrients …

Why diverticulitis can be an elusive diagnosis

Michael Kirsch, MD

Conditions and Diseases

November 7, 2019

I have been treating diverticulitis for 30 years the same way. When I suspect that a patient has this diagnosis, I prescribe antibiotics. This has been the standard treatment for this disorder for decades. I have found that diverticulitis is a slippery entity that has two trap doors waiting for physicians to fall through.

It is an easy task to miss the diagnosis. Every physician has done this.

The diagnosis can be …

Vaping-related illness highlights the complexities of diagnosing rare conditions

Miles J. Varn, MD

Conditions and Diseases

November 6, 2019

When patients started showing up in doctors’ offices and emergency departments with coughs, shortness of breath, chest pain, nausea, vomiting, abdominal pain, diarrhea, fever, chills and weight loss, physicians’ first instincts were that the cause of these symptoms were common illnesses such as pneumonia or flu. But treatments that are usually highly effective for these diseases weren’t helping patients as expected. Many became seriously ill quite quickly and required care …

What if you are one of the 2 percent?

Samuel M. Chen, MD

Conditions and Diseases

November 5, 2019

I’m a member of the ACR (American College of Radiology). One of their recent online postings is entitled: Choosing Wisely.

Number three (of ten things physicians and patients should question) is: “Avoid admission or preoperative chest X-rays for ambulatory patients with unremarkable history and physical exam.”

In only 2 percent of cases, will it make a difference in management.

Thirteen years ago, I was working on the queue of cases …

Read more…

What if you are one of the 2 percent?

Over 2,000 prayers for the dead. This was my hardest.

Rev. Jef Gamblee

Conditions and Diseases

November 4, 2019

The day began in Mom’s room with a 10:00 a.m. conference at Upper Valley Medical Center, west of Columbus, Ohio. In attendance were my 93-year-old mother Joanne (now in her third week of hospitalization), her palliative-care nurse Richard, her Episcopal priest Mother Nancy and myself.

Mom was on high-flow oxygen therapy delivered through a nasal cannula. Despite this, her blood-oxygen levels were well below normal. Clearly, her lung function was declining. …

Are our senior presidential candidates mentally fit?

Michael Brant-Zawadzki, MD

Conditions and Diseases

November 3, 2019

Did you know, one in four people over 65 have abnormal memory impairment? This is the finding from screening with an objective test. In half of those who test abnormal, there were common conditions – such as depression and medication interactions – which can be addressed and even reverse the memory problem. But for the other half, the memory problem is a sign of mild cognitive impairment, which can be …

“I did not want a baby”: A medical student faces her hardest choice

Anonymous

Conditions and Diseases

November 2, 2019

I did not want a baby. As a 26-year-old third-year medical student who had quite recently ended a far from ideal relationship — of this, I was certain.

On vacation, in New York City, walking in Soho carelessly, I laughed with my friend Noelle over the fragility of condoms. “Trust me,” I said. “They break.”

How many months in my sexually active life did I apprehensively count and recount the number of …

MKSAP: 28-year-old woman follows-up after a pre-employment physical examination

mksap

Conditions and Diseases

November 2, 2019

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

A 28-year-old woman undergoes follow-up consultation regarding a pre-employment physical examination. She reports feeling well, with no recent illness. Medical history is notable for gastroesophageal reflux disease. Her only medication is omeprazole. She is black.

On physical examination, vital signs and other examination findings are normal.

A peripheral blood smear shows …

The devastating impact of being told one has cancer

Don S. Dizon, MD

Conditions and Diseases

November 1, 2019

As an oncologist, I have seen the devastating impact of being told one has cancer. The reaction I most often see among my patients is fear that they’ve been given a death sentence, an urgent need for a plan, and hope that they will survive. I often want patients to know I too sense their …

Cancer can be an adventure into the soul

Pat Wetzel and Sherry-Ann Brown, MD, PhD

Conditions and Diseases

November 1, 2019

Storytelling is as old as humanity. In telling our stories, we share, learn, and ideally pass along wisdom. As Isak Dinesen once wrote, “To be a person is to have a story to tell.”

This story starts with PW’s cancer diagnosis in 2009. Nodal marginal zone lymphoma: not curable, hopefully manageable.

For some, cancer invites a retreat within. For others, it can be a call to action. For me, it was a …

Sexual recovery after cancer treatment

Anne Katz, RN, PhD

Conditions and Diseases

October 31, 2019

The couple that entered my office on a warm fall day seemed out of sorts. She looked nervous, and he looked irritated. Before he sat down I heard why he felt that way: “I don’t even know why we’re here.“

I explained briefly what my role is but this did not seem to clear up anything.

“I just want her to be …

Read more…

Sexual recovery after cancer treatment

Patients: Be proactive in your health care

Ton La, Jr., MD, JD

Conditions and Diseases

October 30, 2019

If you’ve ever been in the hospital for a surgery, you probably had a resident speak to you about the procedure; you were presented a laundry list of risks, the benefits mentioned, asked if everything was understood. And finally, you initial in several spots before signing your name on the dotted line. You looked at the wall clock and noted that the conversation took a mere six minutes.

Is this proper …

Should there be a disqualifying upper age limit to become president?

S. Jay Olshansky, PhD and Nir Barzilai, MD

Conditions and Diseases

October 28, 2019

The health challenge recently faced by Sen. Bernie Sanders has brought two issues to the forefront of the 2020 presidential election. Should there be a disqualifying upper age limit to become president, and should an existing health issue preclude a candidate from running for president?

As scientists in the field of aging, we cannot tell the voting public how to answer these questions. What we can do is inform you about …

Stop blaming people with cancer. Support them instead.

Gabrielle Koczab, DO

Conditions and Diseases

October 26, 2019

I am a “jack of all trades” osteopath. I practiced family medicine for over nine years and am currently on a leave of absence as I fight invasive breast cancer. Once I return to medicine, I will be moving into a more specialized role in integrative medicine and osteopathic manipulation. I have also worked in urgent care.

I have to get something off my chest (no pun intended — I’ve had …

What does cable news do to your brain? A neurosurgeon explains.

Marc Arginteanu, MD

Conditions and Diseases

October 25, 2019

The availability of up to the minute information, presented 24/7/365, could assist a democratic society in making the best choices in determining its future. That was the promise of cable news. Unfortunately, cable news has fallen short of its potential and has led to the further polarization of America. More than that, it has changed the way your brain works. Not for the better!

The various cable …

Can CRP testing guide antibiotic decisions?

Michael Hochman, MD, MPH and Pieter Cohen, MD

Conditions and Diseases

October 25, 2019

In response to concerns about the unnecessary use of antibiotics, researchers have sought to identify simple, non-specific tests to help clinicians determine which patients require antibiotics and which do not. Indeed, such tests could facilitate challenging management decisions, which currently rely predominately upon a thorough clinical assessment. To compound the challenge, patients often have pre-conceived ideas about whether or not …