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.

How to prevent ski injuries: tips from an orthopedic surgeon

Nancy Yen Shipley, MD

March 7, 2019

Ski season is here, and it’s time to think about how we can avoid injuries on the slopes. As an orthopaedic surgeon, I most often see knee injuries, but also plenty of wrist, elbow and shoulder injuries as well.

Hopefully, you’ve done some pre-season conditioning — but if not, go ahead and start now! Obviously, avoid a heavy workout the day before your first ski day, but if you have time …

The most loving thing: end of life and saying goodbye

Jonathan Staloff, MD

Conditions and Diseases

March 6, 2019

“Grandma fell and we’re in the emergency room. She’s very distressed and does not look good. I’m going to put the doctor on the phone.”

I could hear my mother’s voice strain on the other end of the phone line as I braced myself for my conversation with the emergency department physician.

The emergency physician told me that though the work-up was still developing, my grandmother was in respiratory distress, and that …

How do fitness trackers fit in the future of health care?

Subbarao Myla, MD

Conditions and Diseases

March 6, 2019

I view medicine as a team effort. Doctors, nurses, technicians, and patients work together to promote and improve health. Recently some new members have joined the team: My patients’ Fitbits, phones, and watches.

For years, the pessimists out there have predicted that wearable technology would lead to mass hysteria. Patients would misdiagnose themselves as having heart attacks and strokes and fill the ER with blaring watch alarms but no actual symptoms.

I’m …

After Luke Perry: a greater awareness of stroke symptoms

Michael Brant-Zawadzki, MD

Conditions and Diseases

March 6, 2019

When your grandmother suffers a devastating stroke, it is a family tragedy, but it does not necessarily make the headlines. When Luke Perry has a massive stroke at age 52, it does. Stroke remains a surprisingly common occurrence, striking someone in the United States every 40 seconds, and killing someone every 3 minutes and 45 seconds. Not only one of the top 4 causes of death in the U.S., but …

It’s time to wave goodbye to the handshake

Brandon Jacobi

Conditions and Diseases

March 5, 2019

As I sit in the conference room awaiting one of my first interviews for residency, the angst among all the applicants was palpable. We all make awkward eye contact and conversation with each other as our interviewers pull us out of the room one by one to speak with us. Amongst the awkwardness and anxiety, my attention was directed at the applicant next to me when I heard the dreaded …

Never take your eyes off of a bleeding patient

Ton La, Jr., MD, JD

Conditions and Diseases

March 4, 2019

“Please help me. I was brushing my teeth this morning and started bleeding a ton from my mouth.”

Joe (identifying information changed) pointed to a bucket next to his bed. I was horrified to see close to two pints of blood in it.

With gloves on, I pulled out my penlight and a new tongue depressor.

“Open your mouth wide for me Joe. I need to see where you are bleeding from.”

I clicked …

MKSAP: 81-year-old woman with headaches, redness of the face, and itching

mksap

Conditions and Diseases

March 2, 2019

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

An 81-year-old woman is evaluated for a 1-year history of headaches, redness of the face, and itching. She indicates being otherwise capable of performing her daily activities on her farm. She reports no shortness of breath, chest pain, or difficulty sleeping. Medical history is significant for hypertension; she has …

A plastic surgeon explains the dangers of the Brazilian butt lift

Patrick Hsu, MD

Conditions and Diseases

February 28, 2019

The Brazilian butt lift (BBL) is a procedure that enhances the buttocks through fat transfer. Excess fat is harvested from other areas of the body including the abdomen, hips, lower back and thighs through liposuction. BBL is a popular procedure for those seeking to enhance their bodies. However, with the recent reports of patient deaths from undergoing BBL, many have now labeled it as the most dangerous cosmetic procedure.

Dangers of …

Here’s why pediatricians ask about trauma and violence

Nerissa Bauer, MD, MPH

Conditions and Diseases

February 28, 2019

As a behavioral pediatrician, I see children with behavior problems. Kids with aggression, kids who have been kicked out of multiple daycares or schools and kids who are not doing well at home or school.

One of the things I always look for are clues as to why. Behaviors, while stressful, are not a diagnosis. They are symptoms of something else. For example: Just because a kiddo is not completing homework …

Measles outbreaks: Getting to the root of the problem

Melvin Sanicas, MD

Conditions and Diseases

February 26, 2019

Measles outbreaks across the United States have been identified with Texas being the 11th state so far to report an outbreak. The Philippines with over 2 million unvaccinated children has declared an outbreak of measles after nearly 2,000 cases and 26 deaths since January alone. In Madagascar, more than 50,000 people have been infected by the disease since October — more than the total number of …

A rare case solved by listening to your patient. And your mother.

Randall S. Fong, MD

Conditions and Diseases

February 25, 2019

History is important. “The farther back you look, the farther forward you will see,” Winston Churchill once said.

Particular to our profession as doctors, William Osler’s famous adage: “Listen to your patient, he is telling you the diagnosis,” rings true even to this day. But there is another, often forgotten edict, created long before these two figures came into being, handed down from generation to generation. And that is: “Listen to …

Turning a patient: a nurse’s act of duty and compassion

Justin Millan, RN

Conditions and Diseases

February 25, 2019

I met a fellow nurse at a wedding recently who, upon hearing that I worked at a long-term acute care hospital (LTAC), shrugged his shoulders and said, “Oh, sure. A lot of turns.”

I shrugged, too. He had belittled my work, but in a way, he was right. We do execute “a lot of turns” at my hospital. We complete at least one turn every 2 hours per patient. With an …

How mundane health findings can be prettied up with PR magic

Mary Chris Jaklevic

Conditions and Diseases

February 23, 2019

As all researchers know, science is a grinding parade of failure and dead ends. But as we’ve often written, news release writers sometimes seem hell-bent on making the public believe otherwise.

Like expert makeup artists, they can add sparkle to lackluster findings, mask blemishes in study designs, and smooth over unimpressive data.

One thing I won’t miss much about my job at HealthNewsReview.org is reading the daily churn of PR releases.

Every weekday morning …

MKSAP: 75-year-old man with progressive dysphagia

mksap

Conditions and Diseases

February 23, 2019

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

A 75-year-old man is evaluated for progressive dysphagia of 8 months’ duration for both solid food and water, and the necessity to induce vomiting several times each month to relieve his symptoms. He also has experienced chest pain and heartburn symptoms. He has lost approximately 6 kg (13 lb) …

The questions clinicians never think to ask

Maria Yang, MD

Conditions and Diseases

February 20, 2019

The chief complaint was belly pain. He described the pain as both dull and crampy. It came and went, but bothered him the most on the same night of each week.

The notes from the primary care doctor show a thoughtful search for the underlying cause. There were comments about activity logs, blood tests, and imaging studies. Months later, it remained a mystery: He still had belly pain. The investigations did …

Will the public be able to resist the pitch from 23andMe?

Michael Kirsch, MD

Conditions and Diseases

February 19, 2019

Just because something is legal, doesn’t make it right. Just because we enjoy a right of free speech, doesn’t mean we should be verbally insulting people. Just because the Food and Drug Administration (FDA) approves a treatment or a test, doesn’t mean we should pursue it.

The FDA has given approval to 23andMe, a private company, to provide genetic testing directly to individuals. The results provide genetic risks of contracting several …

Be careful of assigning the diagnosis of ADHD to young children just entering school

Christopher Johnson, MD

Conditions and Diseases

February 19, 2019

Attention deficit hyperactivity disorder (ADHD) is a common diagnosis in children today, and is increasingly a diagnosis assigned to adults, too. ADHD is a real thing, despite some having some skeptics and a few outright denialists; differences in brain scans between persons who have it and who don’t show there is a definite physiological basis for the disorder.

But in practice, we don’t do brain scans. We base the diagnosis on …

Breastfeeding and newborn hospitalization rates: What should be done about it?

Roy Benaroch, MD

Conditions and Diseases

February 18, 2019

An August 2018 paper in Academic Pediatrics found an unsettling conclusion: Breastfed newborns have about double the risk of needing to be hospitalized in their first month of life, compared to babies who were formula-fed. The numbers are solid, and they jibe with the real-life experience of many pediatricians, including me. So what should we do about it?

The study itself looked at about 150,000 healthy, normal newborns born in …

Should we start screening for colon cancer at age 45?

Peter Ubel, MD

Conditions and Diseases

February 17, 2019

Here’s what most medical experts agree on: People 50 and older should be screened for colon cancer.

Here’s what is more controversial: Whether that screening should start, routinely, at age 45.

Recently, the American Cancer Society (ACS) recommended that colon cancer screenings start at age 45. Their recommendation was based in large part on an uptick in the number of people 45 to 50 years old who are being diagnosed with colon cancer …

A physician defends Ayurveda: Is it the original personalized medicine?

Madhuri Sharma, MD

Conditions and Diseases

February 16, 2019

As more patients and clinicians are searching for holistic approaches to health care, Ayurveda, or the traditional medical system of India, has been gaining popularity in the Western world. Unfortunately, many allopathic physicians still view this system as “quackery” because of its focus on the “intangibles” of health. However, Ayurveda has contributed immensely to the foundations of modern medicine, which many may not know. Sushruta was an Indian scholar and …

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