Every so often I see a patient who views cancer as a constant threat to be handled. The cancer becomes so significant that she feels she can never let her guard down. I always worry about this — partly because that singular focus on fighting cancer can sometimes detract one from other aspects of life, and those facets that give …
When you can’t let your guard down: Cancer as a constant threat
The ink hadn’t yet dried on the report of the 2015 Dietary Guidelines Advisory Committee before the assaults began. I guess in this day and age, that’s not much of a big, fat surprise.
Despite all the over-heated rhetoric I’ve seen about not trusting this report because the “government” can’t be trusted, this report is not from the government. While we may, indeed, need to worry about what the political authorities will …
No, it’s not the broccoli: What to make of the new dietary guidelines
A 75-year-old woman with progressive constipation. An 82-year-old man with unexplained anemia. A 39-year-old mother of two with intermittent blood in her stool. These are three of my patients. And sadly, they are three of nearly 150,000 Americans diagnosed with colorectal cancer every year.
March is National Colorectal Cancer Awareness Month for good reason. In the United States, colorectal cancer is the third most commonly diagnosed cancer. It is also the …
March for colorectal cancer awareness
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 21-year-old male student is evaluated for a murmur heard during an athletic preparticipation physical examination. He is asymptomatic. His medical and family history is unremarkable and he takes no medications.
On physical examination, the patient is afebrile, blood pressure is 118/76 mm Hg, pulse rate is 68/min, and respiration rate is 14/min. …
MKSAP: 21-year-old male student is evaluated for a murmur
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 60-year-old man is evaluated as a new patient. He was diagnosed with type 2 diabetes mellitus during a health insurance evaluation 6 months ago. At that time, metformin was initiated. Medical history is otherwise unremarkable.
On physical examination, blood pressure is 145/94 mm Hg; other vital signs are normal. BMI is 29. …
MKSAP: 60-year-old man with type 2 diabetes mellitus
My last patient, Joyce, a 45-year-old single mother of four with high blood pressure and diabetes, is late. She was in the emergency department last week with dizziness and blurred vision, a blood sugar of 345 and a blood pressure of 190/110.
Her last office visit was a month ago, when weighing in at 222, she joked that she wished she could pull those numbers at the casino’s slot machines. She …
Food insecurity is an undiagnosed medical problem
The medical condition provocatively called exploding head syndrome, or EHS, brings back the disturbingly graphic images of the 1981 sci-fi horror flick Scanners where the main character blew up people’s heads with the power of telekinesis. Fortunately, as ominous as exploding head syndrome sounds, no skulls have actually exploded, and the condition is reassuringly non-life threatening. For the people who experience the symptoms of EHS, however, the ordeal can be …
Exploding head syndrome: Is it really terrifying?
I read with interest the recent article written by Dr. Rourke Stay, “What ESPN doesn’t tell you about MRI in professional athletes,” and couldn’t agree more. The bigger issue, however, is what ESPN may leave out of broadcasts about sports injuries. Prominent figures on the air often espouse their knowledge with enough charisma to convince even the most doubting fan that their opinion is more than just an armchair …
Consult experts in sports medicine when discussing players’ injuries
Over 100 million Americans suffer from chronic pain such as spinal disorders (lower back pain, disc disease, pinched nerves and neck pain), complex regional pain syndrome, fibromyalgia and headaches. The cost of chronic pain in human suffering, lost worker productivity and in health care dollars is counted in the billions.
Yet despite newer, expensive and invasive treatments like spinal fusions and disc surgery, spinal cord stimulators, steroid and painkiller injections, nerve “burning” and of …
How the health care system is making pain patients worse
My father’s sister Mary died from measles when she was six years old. Her death haunted my grandparents for the rest of their lives.
She was one of the thousands who died each year from measles before there was a vaccine to prevent this life-threatening disease.
Her story has always stayed with me — from my days as a child to my years in medical school. And once again I’m reminded of …
Eliminating personal belief exemptions will save lives
There’s been a lot written about the measles outbreak and antivaccine parents. Fact is, the current situation is a direct and predictable result of many social/political trends that have emerged in America over the last generation. I am sharing five easy steps to take if you want to create an epidemic just like this.
1. Raise a generation ignorant about science. The majority of Americans are Read more…
How to create a measles outbreak in 5 easy steps
On Valentine’s Day weekend last year I found myself at Paddles, the local dungeon in New York City’s Chelsea neighborhood, for the first time. I was perched at the alcohol-free bar when a man politely introduced himself as a human carpet. He asked that I tread on him and lay on the floor to demonstrate. A professional dominatrix-in-training stepped onto his …
Doctors should pay more attention to their kinky patients. Here’s why.
March is colon cancer awareness month. We have made tremendous strides in the fight against cancer especially colon cancer.
Between 1991 and 2011, U.S. cancer death rate decreased by 22 percent (1.5 million lives saved), and colon cancer death rate decreased by almost 50 percent. This decrease coincides with widespread adoption of colorectal cancer screening particularly colonoscopy.
Despite this progress, colon cancer is still the 2nd leading cause of cancer death in …
3 ways to prevent colorectal cancer
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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 23-year-old woman is evaluated for a 1-year history of morning stiffness and achiness of the hands as well as Raynaud phenomenon. Two months ago, she experienced a sun-induced rash on the chest and back and patches of discoloration on the hands.
On physical examination, temperature is 36.4 °C (97.5 °F), blood pressure …
MKSAP: 23-year-old woman with stiffness and achiness of the hands
Cancer patients depend on denial. Without its protection, we would be overwhelmed by terror. Denial filters and slows bad news, so we can digest reality in the merciful morsels; thus, we cope. Without denial, we would shut down, withdraw, and lose hope; healing would not be possible. However, if we do not move beyond denial, accept the diagnosis and loss, make a plan, we die.
Allen, a 43-year-old man, came to …
What cancer denial has to do with global warming
My mother-in-law texted me about The Dress, random friends are blowing up my inbox, and the nurses in the emergency department were huddled around the computer at 2 a.m. debating the color of the dress. Everyone in the world seems to be wondering what color the dress really is and why.
The best way to find the answer to such questions is to find …
The medical truth behind #TheDress. And yes, it makes sense.
Some people who argue against vaccinations claim that vaccine policies infringe on their “rights” — their rights, as parents, to make medical decisions for their children. It’s a scary, misleading, and chilling message. We need to be careful about where one person’s rights end and the next person’s rights begin. We need to remember that children (their children, and your children too) have rights of their own.
For example, Dr. Bob …
On vaccines: Don’t forget the rights of children
Recently, Ohio became the 20th state to pass a law mandating that hospitals and clinics performing mammography screening to notify a patient in writing if results suggest something known as “dense breast tissue.” Standard mammography creates a 2-D image of breast tissue. In general, this is sufficient for screening purposes. However, especially in younger patients, the presence of dense breast parenchyma can lead to higher false negative readings and …
Politicians and dense breasts: Here are 2 questions to ask
The high cost of health care in the United States in part relates to how clinicians are paid. Performing expensive and often risky procedures simply pays better than engaging patients in a shared decision-making conversation. Shared decision-making (SDM) is a process where clinicians and patients educate each other about treatment options, risks and benefits, and preferences, and then they decide on the best approach together. Patient decision aids can assist …
Help patients make better decisions about lung cancer screening
As medical librarians, we’re certainly the first to say that PubMed is a superb database, elegantly crafted at the National Library of Medicine to do fast and efficient searches for almost all medical and health subjects. Much of the power of PubMed is that it makes it possible to search broad subjects easily. When the user searches “cancer,” for example, PubMed quickly finds thousands of citations on all types of …
PubMed misses the big picture when it comes to nutrition
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