Removing one’s own IUD is apparently “a thing.” There are even YouTube videos of women sharing their experiences. If you can get a medical degree from Google then why not get your OB/GYN residency from YouTube?
All kidding aside, I’m a gynecologist and I’m going to explain why you shouldn’t.
It’s not that people can’t technically pull out their own IUDs. It does happen accidentally, albeit rarely. An occasional …
Don’t remove your own IUD. Please.
Like nearly every gastroenterologist, we have an open access endoscopy system. This means that patients can be referred, or refer themselves, directly to our office for a procedure without an office visit in advance.
Why do we do this? We offer it as a convenience, so patients do not need to make two visits to see us when it is clear that a procedure is necessary. For example, a referring physician …
Open access endoscopy raises potential ethical issues
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
An 86-year-old woman is evaluated in her assisted-living facility for pain. Four weeks ago, she developed herpetic lesions on her right posterior thorax in a T7 distribution. She was treated with acyclovir, and the lesions healed; however, she has persistent severe burning pain. The pain is so severe that she is unable to …
MKSAP: 86-year-old woman with pain
In his last state of the union address, President Obama reinvigorated the nation’s interest in a long-sidelined disease/s: cancer. A call for a moonshot was announced, and the president in his address said, “I’m putting Joe in charge of mission control.” The last time such a national commitment towards this illness was announced was by the efforts of a cancer advocate, Mary Lasker. She advocated fiercely, and the National Cancer Act …
Defending the call for a cancer moonshot
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 52-year-old woman presents for follow-up evaluation after being diagnosed with type 2 diabetes mellitus 6 weeks ago. Her initial HbA1c level was 8.0%. Management at this time is with lifestyle modifications. She has worked closely with a diabetes educator and a nutritionist since her diagnosis. She has lost 3.2 kg (7 lb) …
MKSAP: 52-year-old woman with type 2 diabetes mellitus
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 68-year-old woman undergoes upper endoscopy for evaluation of dyspepsia. She has a history of pernicious anemia. She has no other medical problems and her only medication is oral vitamin B12.
On physical examination, vital signs are normal, as is the remainder of the physical examination.
Upper endoscopy discloses a 6-mm polyp in the body of the …
MKSAP: 68-year-old woman with dyspepsia
Move over, placenta eating — there’s a new player on the newborn scene, and its name is vaginal seeding. In case this practice hasn’t crossed your radar yet, it’s a practice involving transferring bacteria from a mother’s vagina to a newborn who was delivered by C-section. Before you stop reading because you think that sounds gross, remember that the majority of babies pass through the vagina on their way into …
What we don’t know about vaginal seeding
As an oncologist who also specializes in sexual health, I have realized just how essential it can be. I have seen many grapple with the consequences of cancer and its treatment on their own sexual view of themselves (their sexual self-schema) and how it can impact the relationship between partners. For some, the experience draws them closer; for …
Cancer’s toll on romance and sensuality
A couple of years ago, “epic fail” was the phrase my teenage son used as I unsuccessfully attempted to beat him in a game we were playing. At the time, I thought to myself it was a harsh but accurate assessment of my performance. And I was certainly motivated to practice on my own so that the next time, things would be different.
That same phrase came to mind as I …
The collective failure of the HPV vaccine is ours
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 54-year-old man is evaluated because of fatigue. He also notes constipation and cold intolerance. Medical history is significant for tonsillar squamous cell carcinoma treated with radiation 3 years ago. There is no family history of thyroid disorders.
On physical examination, the skin is dry. Mild periorbital edema is present. The thyroid is of …
MKSAP: 54-year-old man with fatigue
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 32-year-old man is evaluated for a 2-week history of a rash on his face and midchest. He describes the rash as consisting of small, reddish “lumps” that are intensely itchy; they develop and begin to resolve with development of new lesions. He otherwise feels well.
Medical history is significant for a recent diagnosis …
MKSAP: 32-year-old man with a rash on his face and midchest
In the dark lecture room, I watched the neurologist’s shadow flicker across the only source of light — a projection of the New York City subway map. He pointed at Times Square station. If the subway system were a brainstem, then Times Square would be the pons, transporting vital signals like breathing, speaking, and swallowing.
He likened the station’s abrupt destruction to a stroke producing locked-in syndrome. Writer Jean-Dominique Bauby describes …
Would you choose heaven over hospital?
Did you know that married men have a lower colorectal cancer mortality when compared to unmarried men? What about the fact that married men have higher rates of colorectal cancer screening? Interesting, right? In fact, studies showing the association between marriage and favorable behavior regarding colon cancer screening have been published as early as 2010.
More recently, a study published in the journal Preventive Medicine found that married men …
How marriage affects men’s colonoscopy rates
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This past month I had the opportunity to present at a medical conference; my research topic was burnout and depression in osteopathic family medicine residents. A variety of attending physicians and residents stopped by my poster, excited to see this topic being brought to light. With the recent rise in physician dissatisfaction and suicide, there has been increased attention to finally start addressing this issue.
I was super excited about giving …
Why it’s not OK for older doctors to dismiss physician burnout
Again and again in therapy I find myself emphasizing the distinction between feeling an emotion and acting on it. Many patients, and non-patients too, take undue responsibility for their emotions, as though feelings were volitional behaviors, the result of a choice. Often there is a stated or implied should: “I should feel this, not that.” Note how commonly people blame themselves for feeling, or not feeling, a certain emotion:
“I should be more grateful after all she’s done for me.”
“It’s wrong of …
Choose your actions, not your feelings
It was the first day of my prestigious internship at the cardiac and pulmonary rehabilitation center. I was a senior in college and eager to apply my knowledge from the field of exercise physiology to make an impact on the people beginning rehab. This was my first real opportunity to work as part of a health care team while proving that this is the right field for me to be …
The bittersweet truth about the epidemic affecting health care workers
It’s difficult to turn to any major media outlet without being confronted with the latest breaking information on Zika virus infection. The images of newborns from Brazil with excessively small heads are searing. To most of the U.S. population, the Zika virus epidemic in South and Central America is mainly a travel concern. But to the millions of people living in areas from the Caribbean to Central and South America, …
Zika virus infection in semen: A call to action and research
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 44-year-old man is evaluated for management of type 2 diabetes mellitus. He was diagnosed with diabetes 6 months ago after being admitted to the hospital with diabetic ketoacidosis. He was discharged from the hospital on a basal and preprandial insulin regimen. Medications are regular insulin before meals and neutral protamine Hagedorn (NPH) …
MKSAP: 44-year-old man with type 2 diabetes mellitus
It’s field trip season in middle school.
Which means that all over the country young adolescents are headed to memorials and museums. In New Haven, Connecticut, field trip season means the 8th graders are going to the World Trade Center in New York City. Which means that at my kitchen table, my daughters and I are discussing how safe it is to be at the World Trade Center. Two of us think it’s one of the …
Why now is the time to talk to your children about terrorist attacks
Mental health issues are something I’m passionate about and have a lot of experience with, both professionally and personally. One of the biggest lessons I’ve learned over the years is how complicated and broken our mental health system is. When one or even multiple parts aren’t functioning at their highest level, we end up with a fractured system and patients falling through the cracks.
One chasm in our mental health care …
Systemic racism and racial bias in mental health care
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