If you’re not a mental health professional, your exposure to psychosis may come through a variety of channels. You may know someone with a psychotic disorder; you may have a psychotic disorder yourself. You may have taken an introductory class on psychology in high school or college, and you may be aware of psychotic episodes as events in which people lose touch with some element of reality — they may …
This must be my eighth cancer scare. (No, I really don’t undergo excessive testing.) Decades ago, I’d noted a possibly normal finding but dropped it after getting no response at subspecialist visits. Recently, following pertinent CME, I asked again and the physician bit. You can guess the rest.
One night while dodging traffic I accessed on my phone the ultrasound report from the designated cancer center’s (DCC) patient portal, revealing a …
My faith in healthy lifestyle choices is shaken
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.
Every physician takes the Hippocratic oath and promises to “do no harm.” In the face of the current opioid epidemic, this includes protecting our patients from dependence and addiction, including those who are suffering from debilitating acute and chronic pain. Sometimes this involves …
A young mother’s close call with opioid dependence
A number of major cities have seen shared e-scooters, or electrical scooters, take over their streets. It’s certainly popular with the riders, but it is creating waves with a lot of critics as well. In Portland, Oregon, there are four companies trialing the scooters over a several-month period. Driving around my city, I find that we are being inundated with scooters being used on the sidewalk, on the streets, in …
An orthopedic surgeon’s take on the e-scooter craze
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 48-year-old man is evaluated for a 4-week history of heartburn that awakens him at night. The symptoms occur about three times per week. He has been taking over-the-counter antacids with incomplete relief. Food triggers include coffee and spicy foods. He has not had unintentional weight loss or difficulty swallowing.
Physical examination and laboratory …
MKSAP: 48-year-old man with a 4-week history of heartburn
One of the aspects of depression that’s particularly difficult is the sleep disturbance which accompanies it and often continues after the traditional symptoms of depression have finally gotten better. When studied in the laboratory, the sleep of depressed person is short, shallow (with less deep slow-wave sleep), and frequently interrupted by awakenings. Additionally, there are abnormalities of the timing of rapid eye movement sleep and intensity of eye movements during …
How and why to treat sleep disturbance from depression
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 56-year-old woman is evaluated for a 1-year history of tremor. The tremor is more prominent on the right side. She also reports increasing problems with balance and numerous falls, especially when arising from a chair or turning. The patient does not have any significant cognitive symptoms. She has occasional urinary incontinence, intermittent …
MKSAP: 56-year-old woman with a 1-year history of tremor
I am frequently asked by patients to “run some tests to make sure nothing is wrong.” This makes a lot of sense on the surface but makes no sense as a physician. Why? Because testing without a context or a medical question is nonsensical. Let’s talk about why.
How doctors think
Studies show that doctors only let their patient speak for 11 seconds on average before we interrupt them. …
Medical testing is fraught with pitfalls
There’s no disputing that the opioid crisis has become a public health emergency in the United States. And not a day goes by when health care providers don’t encounter some aspect of this epidemic. Far too often, the mention of addiction spurns images of homelessness, back-alley deals and crime. While that can certainly be the case, addiction is an “equal-opportunity employer.” Allow me to share two true stories that illustrate …
Trends or challenges have been a part of the fabric of social media for a long time. They have ranged from the benign ice bucket challenge (which raised millions for research on amyotrophic lateral sclerosis) to the highly dangerous Tide pod challenge (which involved eating laundry detergent capsules). All of these internet phenomena involved videotaping an individual who performed a bizarre physical action for the …
The problem with extreme social media challenges
Recently, more than 70 people overdosed on K2 in the New Haven Green, a public park near Yale — in one day. In the chaos, multiple municipal staff and emergency services personnel ran frantically to help countless individuals who may or may not have wanted help. The day after, I biked by and saw two ambulances and police sirens. These issues are not solved in a day, and might not …
What the news left out about K2
Since intensive care units (ICU) were created in hospitals more than a half a century ago, there has been a steady decline in death rates for individuals who are critically ill and require life support. That’s significant and meaningful progress, and it’s thanks to the pioneering work of many doctors, nurses and researchers who have discovered better ways to liberate patients from life support so that they can …
Delirium is a serious and common outcome of treatment in hospital intensive care
Purdue Pharma recently ran a full-page advertisement in the Wall Street Journal and the Washington Post asserting that the company, which manufactures prescription opioids, wants to limit the use of prescription opioids. While this ad may have left some readers confused, one point rang true: “we believe the country needs a new approach to prescribing opioids.”
In its approach to addressing the opioid crisis, Purdue Pharma is encouraging limiting patient access …
Pain care must be patient-centered, integrated, and individualized
ADVERTISEMENT
Alvin is a 42-year-old man who was never really given a chance. His parents both had severe alcohol use disorder. At age 12, his parents encouraged him to skip school to sell marijuana in order to fund their drinking. As his parents began using various illicit drugs, Alvin started selling larger amounts of marijuana to foot their bill. Eventually, marijuana was not …
It’s time for hospitalists to be engaged with opioid use disorders
Let’s face it, “wellness” isn’t going to go away despite some of the backlash.
In my opinion, wellness is at the intersection of science, medicine, and health.
Simply, wellness means health and happiness. No matter where you are on your health journey, you can achieve your wellness goals which can help you live a healthier life. Wellness rituals that focus on prevention and self-care can do the body, mind, and …
Is wellness getting a bad rap?
Sepsis, the body’s self-destructive inflammatory response to severe infection, is the leading cause of death in U.S. hospitals, particularly among the elderly. It starts as mild sepsis, advances to severe sepsis, and all too frequently blossoms into septic shock. More than 1.5 million Americans get sepsis each year. More than 250,000 die of the illness. One in three patients who die in a hospital have sepsis. 62percent …
Sepsis awareness: Should there be different awareness goals for the young and the old?
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 49-year-old woman is evaluated during a follow-up visit. She is overweight and has hypertension and type 2 diabetes mellitus, both of which are well controlled. For several years, she has attempted to lose weight through various commercial diets; dietician-monitored, calorie-restricted diets; and physical activity. She has worked with a behavioral therapist, and …
MKSAP: 49-year-old woman with obesity, hypertension, and type 2 diabetes mellitus
Recently, a respected allergist reassured his audience: the mortality rate for food allergy is very low. The risk of dying in a car crash is much greater than the risk of dying from food allergy. The implication seemed to be that the anxiety around food allergy is misplaced. Though any loss of life is too great; statistically, food allergy deaths are rare. To the food allergy community, it just doesn’t …
Food allergy: Death is not our only fear
If somebody asks you how many bones there are in a human body, please do not blurt out, “206.” The correct answer is nuanced. To respond accurately to the query, you have to address five questions. Who? What? When? Where? Why?
Consider first that humans vary from one another in facial features, hair …
How many bones in the human body? It’s not what you think.
Two cars arrive at a stop sign at the same time. Both start into the intersection. One driver speeds through, while the other jams on the brakes, avoiding a collision. This driver feels insulted, offended, diminished. Who the hell does that other driver think he is? He nearly killed me!
This scenario, and countless others involving merge lanes, contested parking spaces, and aggressive rush hour traffic, are set-ups for road rage. …
Road rage: It’s all in your head
Get free updates delivered free to your inbox.
