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 am really uncomfortable and in pain,” said Elaine tearfully as I met her in the preoperative area for the first time. She had a very sad and difficult history, dealing with complications from childbirth nearly two years ago. She had developed a communication between her rectum and vagina, which allowed feces to come out vaginally. Despite multiple surgeries from reputable medical centers in NYC, the problem recurred. And she …
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The simplest treatment is sometimes the best
You’ve probably seen it on the news – a rare, polio-like illness is causing cases of paralysis in children. Here’s the latest info, based on our best current knowledge from the CDC.
Acute flaccid myelitis (AFM) is a sudden illness that causes weakness in one or more extremities – one arm or (less likely) a leg, or any combination of arms and legs. The words in the name express the key …
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What you need to know about acute flaccid myelitis
Nearly half of Canadians aged 65 and over experience osteoarthritis in their knees. Osteoarthritis is the most common form of arthritis and occurs when the protective cartilage on the ends of bones wears down over time leading to pain, stiffness and decreased mobility. It frequently occurs in the hips and knees — and can be quite painful.
To help improve mobility and treat joint pain, it has been …
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The challenge of no to arthroscopic surgery
I was diagnosed with sickle cell disease at three months old in Haiti. The diagnosis from the doctor was followed by more tragic news; my parents were told that I was not going to live past five months. From that point on, my parents searched high and low for medication and knowledge about this unfamiliar disease. They spent an abundant amount of money in Cuba looking for any medicine that …
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Sickle cell is my neighbor
A number of media outlets recently featured a story about a Florida general surgeon who removed a normal kidney from a woman who was undergoing spine surgery. How could this have occurred?
The 51-year-old patient who had been injured in a car crash was scheduled for an anterior lumbar interbody fusion (ALIF) of the fifth lumbar to the first sacral vertebra. The general surgeon’s role was to provide …
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A surgeon mistakes a kidney for a tumor. How can this happen?
You need to chill out. Seriously. Doctor’s orders.
Research has long established a link between anxiety and health issues as grave as cancer and heart disease. In today’s world, stressors are everywhere. But thankfully, so are the antidotes to stress.
From yoga studios in your local shopping center to mediation apps on your phone, there are no shortages of ways to decompress, de-stress and simply breathe. And it seems that more people …
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Chill out. Doctor’s orders.
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 58-year-old woman is evaluated in the emergency department for a 2-day history of left lower abdominal discomfort. The pain began insidiously and has gradually progressed. She has felt warm but has not had shaking chills, urinary symptoms such as dysuria or urgency, change in bowel habits, or apparent blood in her stool. …
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MKSAP: 58-year-old woman with left lower abdominal discomfort
“Get rest and drink plenty of fluids,” might not sound like adequately aggressive medical advice. If you’ve dragged yourself out of bed to visit an urgent care or your doctor’s office, you will probably feel somewhat cheated by an admonition to head right back to bed and stay there until you feel better.
Most likely, you’ll want a prescription for an antibiotic. You might even demand it.
Don’t. Antibiotics are not the …
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When the best prescription is no prescription
An excerpt from Wrongful Deaths.
“We will name Memorial Hospital, Dr. Julie Stone, Dr. Vijay Gupta, and ICU nurse Tracy Miller in a malpractice suit involving the wrongful death of Ivy Jackson.” Venjer appeared apologetic. “But Dr. Torrins is correct. It …
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A proximate cause of wrongful death
Health care providers and even consumers who order their own genetic testing should really get to know GINA. Who or what is GINA? Is it some new virtual voice-activated personal assistant? Is she a new Italian superstar? Neither choice is correct. GINA stands for the Genetic Information Nondiscrimination Act, a U.S. federal law that was put in place to protect consumers from discrimination based on their genetic testing. GINA celebrates …
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Before ordering a genetic test, get to know GINA
I was misinformed about medical school. Growing up, I wanted to help people become healthy. After four years at the Ohio State University Medical School and three years of a family medicine residency, I still did not know enough to accomplish my goal. My training allowed me to become a disease-care expert, not a health care specialist. I was taught little to nothing about nutrition and true disease prevention. Despite …
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Doctors need to learn more about nutrition
In 2013, the American Medical Association (AMA) announced its decision to classify obesity as a disease, moving against the recommendation at the time of a group studying obesity. Yet there are still those who believe that obesity is not a disease but rather a “condition,” and this has downstream ramifications for health policy, health care provider reimbursement, and, ultimately, societal health and well-being. But this is …
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Call obesity what it is: a disease
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
An 82-year-old woman is evaluated for a 1-week history of urinary incontinence with lower abdominal discomfort. She reports no dysuria, fever, or back pain. Medical history is significant for hypertension and allergic reaction to sulfa drugs, which cause a generalized rash. Her only medication is amlodipine.
On physical examination, temperature is 36.8 °C (98.2 …
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MKSAP: 82-year-old woman with a 1-week history of urinary incontinence
A physical therapist, commenting on my blog, recently shared an excellent point of view with me:
As a therapist myself, I don’t know that I’d want to be betting on that differential diagnosis of tear, rupture, etc. when giving online advice. What is good treatment for one, can be disastrous for the other. Seeing someone in person can make all the difference, especially with the amount of self-diagnosis that the internet …
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The increasingly obfuscated medical algorithms for simple problems
For $199 and a tube of saliva, I found out that I have straight hair and green eyes. Mirrors have been telling me this my whole life for free. But as a genetics counselor, I wanted to learn more about the recreational home genetics tests that have been captivating people.
What I was left with (aside from the aforementioned physical description and unsurprising heritage data), was the sense that the dangers …
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Before you delve into your DNA, be sure to seek out a well-trained genetics team
When I finished my training, I was taught that the vast majority of dementia was Alzheimer’s disease, with occasional cases of multi-infarct dementia as well as odd syndromes such as Kreutzfeld-Jacob disease and genetic, traumatic, toxic and tumor-related syndromes. Parkinson’s disease, we were taught, caused a tremor and freezing up of a person’s movements and only very rarely was associated with any kind of memory loss.
These teachings helped us modern …
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Lewy body dementia and a farewell to a physician’s father
Imagine this scenario. Your two-year-old son has had a runny nose for a day or two and an occasional cough, but seemed no worse to you that everyone else in his preschool class. Two hours after you put him to bed you hear him coughing, only this cough is like none you have ever heard from him before. It sounds like a barking seal at the circus — a brassy, …
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Everything you ever wanted to know about croup
There is a wealth of information about your health circulating in your blood. For people with diabetes, accessing that information can be a matter of life or death.
For nearly 30 years, the prevailing technology for checking the blood sugars of someone with diabetes has been the fingerstick. People with diabetes are often asked to stick their fingers and check their blood multiple times a day to assess whether their blood …
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How technology removes the pain point from diabetes management
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 42-year-old man arrives for follow-up consultation. Three months ago he developed a proximal right leg deep venous thrombosis following a skiing-related fracture of the right tibia. Although not recommended by guidelines, a thrombophilia evaluation was performed, which revealed an elevated plasma homocysteine level, and subsequent genetic testing revealed that he is homozygous …
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MKSAP: 42-year-old man with thrombophilia
