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.

A neurologist explains why delaying school start time is important

Jay Puangco, MD

October 24, 2019

Do teenagers know how to sleep? If you’re the parent of a teen, you might be laughing to yourself. That’s all they know how to do. In truth, teens (and their parents) might not know enough about how to sleep, when to sleep, and why.

California recently became the first state to require most middle and high schools to start no earlier than 8:30 a.m. As a neurologist specializing in sleep …

Nicotine addiction happens quickly in vapers

Elly Yu

Conditions and Diseases

October 24, 2019

When Will tried his first vape during his sophomore year, he didn’t know what to expect. It was just something he had vaguely heard about at his high school.

“I just sort of remember using it a bunch of times, like in a row,” he said. “And there’s this huge buzz-sensation-like head rush. And I just … didn’t really stop.”

Will kept vaping nicotine addictively for the next year and a half. …

The unintended consequences of keeping hospital patients in bed

Melissa Bailey

Conditions and Diseases

October 22, 2019

Dorothy Twigg was living on her own, cooking and walking without help until a dizzy spell landed her in the emergency room. She spent three days confined to a hospital bed, allowed to get up only to use a bedside commode. Twigg, who was in her 80s, was livid about being stuck in a bed with side rails and a motion sensor alarm, according to her cousin and caretaker, Melissa …

A father-physician tests if a little peanut a day keeps allergy away

Edwin Kim, MD

Conditions and Diseases

October 20, 2019

No one I knew had food allergy, let alone peanut allergy, when I was a child. I grew up at a time when peanuts were given freely on airplanes, and there was no such thing as a peanut-free table at school. Fast forward to today and the world has changed, with food allergies taking on almost epidemic-like proportions.

I am an allergist and became interested in food allergies …

How “Joker” gets mental illness wrong

Dr. Sudhir Mane

Conditions and Diseases

October 20, 2019

Spoiler alert: Plot points of the movie “Joker” are revealed.

“Joker” opened to a mix of rave reviews and criticism on October 2, 2019, amid fears of mass-shootings at theaters in the U.S.

This left law enforcement agencies scrambling to beef up security at movie theaters to prevent any untoward incidents. Quite ironically, October 2, is also the 150th birthday of Mahatma Gandhi — the crusader and champion of non-violence.

Warner Brothers even …

Read more…

How “Joker” gets mental illness wrong

Why the flu shot cannot give you the flu (and why you should get one now)

Libby Richards, RN, PhD

Conditions and Diseases

October 19, 2019

Flu vaccination prevents millions of flu-related illnesses and deaths annually, but vaccination rates are low for many reasons.

During the 2018-2019 flu season, the Centers for Disease Control and Prevention reported that about 45% of U.S. adults received the flu vaccine. While this is an increase of 8% from 2017-2018, it falls way below the national goal of 70% of American adults …

MKSAP: 65-year-old man interested in colorectal cancer screening

mksap

Conditions and Diseases

October 19, 2019

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

A 65-year-old man is evaluated during a visit to establish care. He is interested in colorectal cancer screening; however, he adamantly refuses to undergo colon preparation, and he does not want to modify his diet for screening. He has never undergone colorectal cancer screening. Medical and family histories are …

Physicians explain Sia’s chronic pain

Michele R. Berman, MD and Mark S. Boguski, MD, PhD

Conditions and Diseases

October 18, 2019

Australian singer/songwriter Sia (born Sia Kate Isobelle Furler), 43, is known for wearing elaborate wigs and headpieces that hide her face. However, the “Chandelier” singer is not hiding the fact that she was recently diagnosed with the connective tissue disorder Ehlers-Danlos syndrome.

In a t weet, Sia wrote:

“Hey, I’m suffering with chronic pain, a …

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Physicians explain Sia’s chronic pain

Hospital immobility is an encapsulation of our system’s fundamental flaws

John Corsino, DPT

Conditions and Diseases

October 17, 2019

Is your patient having trouble breathing? I can ask respiratory to give him a nebulizer. I’m looking at his chest X-ray now — why don’t we bump up that Lasix, too? I wish the ER would have grabbed an ultrasound of that swollen leg. Does he need more oxygen?

If something is missing from this picture, it isn’t the clinical people who are at fault.

Clinicians solve problems with the tools they’re …

Denial and rationalization will not save you from a heart attack

Debbie Moore-Black, RN

Conditions and Diseases

October 16, 2019

Smoking was cool. And he started smoking at the age of 15. Two packs a day — every day.

When he was 32 years old, we had our first-born son. And he decided to quit cold turkey.

But the damage was done.

Somehow, someway, it would catch up with him in devastating ways.

By the time my husband was 66 years old, he developed shortness of breath and chest pain. With exertion and without …

We need vaccine advocacy now more than ever

Gretchen LaSalle, MD

Conditions and Diseases

October 16, 2019

It was flu season.

I was meeting the usual frustrations of trying to convince my patients to get the flu shot. The flu vaccine has such potential to save lives, yet its reputation is marred by misinformation, leading people to decline this simple, inexpensive, and effective way to limit disease and death. Day in and day out, I felt like I was beating my head against a wall.

This particular day, I …

The irrational exuberance of early cancer detection

H. Gilbert Welch, MD

Conditions and Diseases

October 14, 2019

Here’s some good news for a change about cancer: Cancer mortality — the rate of death from cancer — has fallen substantially over the last four decades.

There is also, however, some not-so-good news: Cancer incidence — the rate of cancer diagnoses — has been rising. This doesn’t reflect increasing dangers in our environment, but a danger in …

Save health care by saving kids

H. Robert Cannon

Conditions and Diseases

October 14, 2019

My wife is a teacher. Her passion is helping the Bart Simpsons of the education system. This past year the school district in the rural area where we live tasked her with the job of opening the community’s first alternative education school.

Imagine taking 60 of some of the hardest kids in the area and creating a school just for them, so they have an opportunity to feel success, thrive, and …

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Save health care by saving kids

Will Alzheimer’s disease researchers miss seeing the forest from the trees?

Ron Louie, MD

Conditions and Diseases

October 14, 2019

The National Institute of Aging (NIA) just announced $73 million over five years to fund two new research centers. “The Alzheimer Centers for the Discovery of New Medicines are designed to diversify and reinvigorate the Alzheimer’s disease drug development pipeline,” says the NIA online. The AlzForum.org has more details, quoting researchers saying they will change the direction away from amyloid-beta and tau (the presumed …

A cardiologist’s take on red meat consumption

Anthony Pearson, MD

Conditions and Diseases

October 13, 2019

The Skeptical Cardiologist was recently greeted by headlines announcing that an international panel of 14 unbiased researchers had concluded that it was OK for humans to continue eating red meat and processed meat at current levels.

The startling news was a reversal of what the Dietary Guidelines for Americans, the American Heart Association, and the American Cancer Society …

Why multidisciplinary and coordinated cancer care matters

Don S. Dizon, MD

Conditions and Diseases

October 12, 2019

While it would be ideal if all of our decisions in medicine were based on clear and definitive data, that isn’t the case, for most of what we face with our patients. Data is open to interpretation, studies can always be criticized, and the results are not always clear. Still, as clinicians we must help our …

MKSAP: 30-year-old man with ongoing symptoms of dysphagia

mksap

Conditions and Diseases

October 12, 2019

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

A 30-year-old man is evaluated for ongoing symptoms of dysphagia. He was previously diagnosed with eosinophilic esophagitis on upper endoscopy and has completed an 8-week course of swallowed aerosolized fluticasone, which did not alleviate his symptoms. He takes no other medications.

On physical examination, vital signs are normal; BMI is …

We don’t just have cancer. We have a whole life to live.

Elizabeth Lerner Papautsky, PhD

Conditions and Diseases

October 9, 2019

When asking about a potentially overwhelming side-effect of an impending new medication, my nurse told me, “Don’t worry until you get there.”

OK, I get it. I just didn’t die from breast cancer. I’ve had worse. But come on. Let’s do better. Let’s have a conversation.

There are many things nobody tells you about cancer. Nobody tells you that cancer is a full-time job. We are not just navigating our cancer care …

Football and concussions: Define the risks first

Munro Cullum, PhD

Conditions and Diseases

October 7, 2019

Awareness about concussions has never been greater among high school athletes and coaches, thanks to the spotlight shone on some former NFL players who’ve experienced problems later in life. But a downside to this heightened awareness is the fear it has sown among parents that their children who play sports like football, soccer, or hockey may end up the same way.

As a parent, I understand that fear. My …

What to know about C. auris, the deadly fungus affecting our sickest patients

Gerald Blackburn, DO

Conditions and Diseases

October 7, 2019

Candida auris (C. auris) is a multidrug-resistant fungus responsible for a rising number of infections and deaths around the world, the origin of which is currently subject to investigation. Spread primarily in the health care setting, it is a growing threat to high-risk patients in hospitals, nursing homes, and other health care facilities.

The CDC estimates that between 30 percent and 60 percent of people who become ill with C. auris infections have died. …