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.
I remember September 27, 2018 like it was yesterday. When Ashley* picked me up from my apartment Thursday morning, I thought it would be like the 138 past Lyft rides I’ve taken since 2017. I was wrong.
After I waived to Ashley from the curb, I got settled into the right back seat. The doors locked, and she asked me the usual question.
“You from here?”
“Yes, I’m a local.”
“That’s great! I’m from …
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When you identify your Lyft driver as potentially having bipolar disorder
In broken English, against the backdrop of the emergency department’s chaos and clatter, Mr. Simon relayed his story: unintentional weight loss, gradually yellowing skin, weeks of constipation. He punctuated his list of devastating symptoms with laughter — exaggerated but genuine guffaws.
Over the next few days, as the medical student responsible for his care, I was also responsible for handing him piece after piece of bad news — an obstructing gallstone …
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A patient gives the gift of poop
Heart health starts in childhood to avoid cardiovascular disease, hypertension, obesity, and diabetes. Kids today have developed so many bad health habits that they are facing heart attacks in their 30s. Many experts predict they will be the first generation to have a lower life expectancy than their parents. But it doesn’t need to be this way. Parents like you have a significant influence over your kid’s habits. By modeling …
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Heart health begins in childhood: 5 tips from a pediatrician
Studies have shown that video games and other addictions, such as alcohol and nicotine, affect neural pathways in similar ways: They all lead to an increase in dopamine levels in specific pleasure centers of the brain.
While drugs increase dopamine levels far more than video games, gaming can have a similar deleterious effect of “taking over” a person’s life.
One of the key ways that gaming addiction differs from other addictions is …
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Is gaming disorder a real addiction, and how can I tell if it’s affecting my child?
Did you feel a pop?
It is a simple question that we rattle off to complete our musculoskeletal history. The answer may or may not give higher suspicion for a diagnosis of tear over sprains.
But have you — the provider — ever felt a pop?
Like any good physiatrist, I try to fill my extracurricular time with physical activity. This inevitably led to the formation of a residency street hockey team.
Ten minutes …
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The history and physical often falls by the wayside in modern medicine. That’s a shame.
“I drank beer with my friends. Almost everyone did.”
Alcohol has become constitutional to American culture: “grabbing a drink” after work, happy hour, cheers before meals, on New Year’s, or just because. Our society’s normalization of drinking creates a slippery slope toward excessive alcohol use. Unhealthy alcohol use is rampant: one in six Americans drinks excessively four times a month, according to the Centers for Disease Control (CDC). Almost thirty percent …
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How many beers is too many?
Love avocados, but hate cutting them. They are slippery little rascals and are responsible for many nasty hand injuries.
Stab wounds from using knives in the kitchen are not fun but are reported daily. Accidental self-inflicted knife injuries to digits are a common cause of tendon and nerve injury requiring hand surgery.
Many of us do not think about how much you use “your hands for your senses.”
Until you lose that ability …
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How to cut avocados: tips from an orthopedic surgeon
I met a young man in my clinic recently, who came for treatment of obesity.
He was only 26, yet suffered from obesity throughout his life — now reaching a debilitating 420 pounds. His explanation for how he developed obesity was a reflection of the issues surrounding nutrition health policy in the U.S. He said that “it would have been easier to not put the weight on to begin with,” that …
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How can we really stop obesity?
Perhaps the most important aspect of a physician’s role is our diagnostic capabilities. Truly, if we cannot identify and diagnose a patient’s pathology with reasonable accuracy, we cannot effectively treat them and may even cause greater harm.
Let’s look back. The year is 1816, and you are a physician evaluating a patient with shortness of breath. The common practice of the time was direct auscultation by placement of the practitioner’s ear …
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It’s time to update the stethoscope
During my third year of medical school, I completed a clinical rotation in surgery. I was certain that it would be horrible. I envisioned myself in the OR, getting lightheaded, passing out onto the sterile field and being yelled at by my attending physician. I worried that the medical knowledge I’d worked so hard to learn would be neglected in favor of memorizing the steps of surgical procedures. My parents, …
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Do you know why you’re having surgery?
Brittany Maynard was diagnosed with grade 2 astrocytoma, a form of brain cancer on January 1, 2014, her cancer also returned in April 2014, where her diagnosis was elevated to grade 4 astrocytoma, also known as glioblastoma, with a prognosis of just six months to live. She decided to take lethal drugs prescribed by her physician to end her life on November 1, 2014, at her home in Portland, Oregon. Under Oregon’s “Death …
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The growing role of end-of-life activists
Penicillin allergies are fake news. More than 95 percent of people with penicillin allergies are not allergic. A recent article highlighted the opportunity anesthesiologists have in helping evaluate beta-lactam allergies, in particular to cephalosporins. The author was correct, these allergies are common and usually not real. Unfortunately, premedication with antihistamines as suggested may mask allergic reactions and not clear the allergy, though the idea to think about retesting …
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Are penicillin allergies fake news?
There is something both intimate and mysterious about the waiting area for mammograms. You sit in a relatively small space; chairs close together with a gown tied to cover your nakedness, your normally restrained lady parts flopping free against the scratchy fabric. There are young and old, black and white, grey and blond and even sometimes bald. There are women with coiffed hair and manicured fingers bright with diamonds and …
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“The Wait” after a mammogram changes lives
If you think that you might have the flu, don’t head to the emergency room at the first sign of fever.
Emergency departments were created to handle emergencies – heart attacks, strokes, severe trauma, and other life-threatening emergencies. No matter how awful it feels, the flu typically doesn’t fall into this category – unless you are in a high-risk category for complications. This includes children younger than 2, adults over 65, …
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For most, the flu is a misery, not an emergency
Part 4 of a series.
By the time my father’s metastatic prostate cancer was diagnosed, he was already experiencing symptoms of poor appetite and weight loss, which grew progressively worse following his first hospital admission. As his nutritional status continued to decline, the protein level in his blood decreased, causing significant fluid buildup in his legs and abdomen. During his hospital stays, we consulted with dietitians who created individualized …
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A story of treatment failure and end-of-life decisions
“Personalized” medicine sounds appealing. Rather than just guessing at what medication to try, a genetic test can figure out, in advance, which medications will be effective and which medications are more likely to make you sicker.
Except it doesn’t work. It’s mostly marketing and hype.
The FDA has officially warned consumers and physicians that genetic tests sold to predict patient responses to medications shouldn’t be used. They’re not FDA approved, and in most cases, …
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Is personalized medicine mostly marketing and hype?
