Conditions and Diseases

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.

Why self-care alone cannot cure systemic nursing burnout

Anonymous

April 11, 2026

Nurses are constantly told that burnout can be prevented through self-care: rest, nutrition, mindfulness, and learning to assert healthy boundaries. I followed that advice. I asserted professional boundaries. I tried to maintain reasonable limits around my time and energy. I attempted to follow the guidance nurses are routinely given about protecting our well-being. Within one year, I was fired from three jobs. This is the contradiction at the center of …

How patient portal message volume drives physician burnout

Candice Elam, DNP

Conditions and Diseases

April 10, 2026

A patient sends a portal message at 9:17 p.m. on a Tuesday. “Hey, I’ve been having some chest tightness when I climb stairs. It comes and goes. Also can you refill my metformin and check if my last A1C was OK? I don’t want to come in if I don’t have to.” This message requires clinical triage. It requires chart review. It requires a decision about whether to initiate a …

Is HPA axis dysregulation causing your chronic insomnia?

Shiv K. Goel, MD

Conditions and Diseases

April 10, 2026

Cortisol. Almost always cortisol. I say this to patients more than almost anything else. And I say it having lived it myself, years of high-output clinical work, late nights, early mornings, and the particular exhaustion of lying in bed completely depleted but unable to actually fall asleep. Tired but wired. It is a real physiological state, and it has a name: hypothalamic-pituitary-adrenal (HPA) axis dysregulation. It is not insomnia in …

Knee osteoarthritis demands layered pain management

Kayvan Haddadan, MD

Conditions and Diseases

April 10, 2026

Knee osteoarthritis (OA) remains a leading cause of chronic pain and reduced mobility, affecting millions of adults worldwide, particularly those over age 50. As cartilage deteriorates and inflammation increases, patients often face pain, stiffness, swelling, and limitations in daily activities. Although no cure exists, a structured, escalating treatment plan can significantly alleviate symptoms, preserve function, delay disease progression, and help many individuals avoid or postpone surgery. Current guidelines from the …

Why walking matters most in post-acute rehabilitation

Neha Sabharwal, DPT

Conditions and Diseases

April 9, 2026

One of the most common questions I hear in rehabilitation is not asked during therapy sessions. It is usually asked quietly by a family member after the session ends. “Will my mother walk again?” Families rarely ask about therapy intensity or functional scoring systems. They do not ask how many minutes of treatment occurred that day. They ask about walking. Walking represents independence. It represents the possibility of returning home. …

Health care lobbying is destroying the U.S. system

Richard A. Lawhern, PhD

Conditions and Diseases

April 9, 2026

In modern times, we frequently encounter messes in our public life. This seems particularly true in American health care, and it is certainly true in our politics. But few citizens seem to put the two issues together sufficiently to effectively demand change. Putting them together is what this article is about.

According to the nonprofit public interest group Open Secrets, individuals and political action committees spent a record $4.5 billion in …

Low-dose lithium treats suicidal ideation safely

Carrie Friedman, NP

Conditions and Diseases

April 9, 2026

A patient in his 20s recently came to see me in a state of severe distress. He described feeling consumed by his thoughts, constantly anxious, unable to function, and deeply exhausted. His sleep had collapsed. His sense of identity felt lost. He was experiencing persistent passive suicidal thoughts, not because he wanted to die, but because everything felt overwhelming and unrelenting.

Within three days of starting low-dose lithium at 150 milligrams …

Why cardiovascular medicine should focus on patients, not environmental advocacy

Kurt Miceli, MD, MBA

Conditions and Diseases

April 8, 2026

The treatment of cardiovascular diseases has advanced at an extraordinary pace over the past half-century resulting in an age-adjusted 60 percent reduction in heart disease death rates. This dramatic decline is directly attributable to primary and secondary preventive therapies such as statins and small interfering messenger RNAs along with disruptive technologic advances in procedural techniques. New pharmacologic options for thromboprophylaxis and novel therapies for heart failure …

Peer-led storytelling in adolescent substance use prevention

Anthony Alvarado & Stephen M. Sandelich, MD

Conditions and Diseases

April 8, 2026

Every week in the pediatric emergency department, I see the consequences of adolescent substance use that started too early and went unaddressed for too long. A teenager in crisis. A family blindsided. A window of prevention that closed long before anyone realized it was open.

We keep asking the same question: How do we reach kids before it gets to this point?

The answer, it turns out, might already be sitting in …

How diagnostic overshadowing delays hyperprolactinemia care

Carrie Friedman, NP

Conditions and Diseases

April 7, 2026

She was 16 the first time she noticed it. Milk. From her breasts. No pregnancy. No childbirth. No explanation. She told a provider. Labs were drawn. Her prolactin was elevated. She was told it was “not a big deal.” Over the years, multiple providers suggested she must be stimulating her nipples and advised her to stop. She insisted she was not. She felt embarrassed, dismissed, and increasingly reluctant to bring …

The hidden realities of the HIV/AIDS epidemic and U.S. health care policy

Richard A. Lawhern, PhD

Conditions and Diseases

April 7, 2026

The modern acquired immunodeficiency syndrome (AIDS) epidemic was first recognized in the United States in early June 1981, when clusters of rare opportunistic infections were reported in young gay men in Los Angeles and other cities. Before the cause was understood, it was commonly called “GRID” (gay-related immune deficiency). In popular and some medical discussions, it was also referred to as the “gay plague,” “gay cancer,” and similar gay-specific labels. …

Living with numbness after mastectomy: the unseen impact on survivorship

Emily Hansen

Conditions and Diseases

April 5, 2026

For years, I have heard breast cancer survivors share a common refrain: “I expected to lose my breasts. I did not expect to lose the ability to feel.”

Yet in exam rooms across the country, persistent numbness after mastectomy remains underdiscussed and poorly understood in routine care. It is often framed as an inevitable side effect rather than a life-altering outcome that impacts quality of life after cancer.

We have made tremendous …

The physician-in-triage model and rapid evaluation in emergency medicine

Marilyn McCullum, RN

Conditions and Diseases

April 5, 2026

Most emergency departments feel perpetually behind. The waiting room fills, ambulances stack, and staff move quickly yet still feel behind. The reflex explanation everyone gives is capacity. We need more beds, more rooms, more space. That explanation is intuitive. It is also often incomplete.

In many departments, nothing meaningful happens after triage until a patient is placed in a permanent treatment room. No bed means no provider evaluation. No provider evaluation …

Why bariatric patients struggle with protein and how to fix it

Kevin Huffman, DO

Conditions and Diseases

April 4, 2026

I have treated over 10,000 bariatric patients across my career, and if there is one issue that comes up more than almost anything else, it is protein. Specifically, patients not getting enough of it. The research confirms what I see every day in practice. Only a minority of bariatric patients reach the recommended minimum of 60 grams per day, resulting in the loss of fat-free mass rather than the …

A patient’s poem on invisible illness and trauma-informed care

Michele Luckenbaugh

Conditions and Diseases

April 3, 2026

You tell me it is all in my head.

As though my head were a small room where false alarms
ring for sport,
like I have no better way to spend my time and life.

You hold films up to the light,
of bones and blood,
nothing cracked or out of place,
or a catastrophe waiting in the wings
that has earned a name in your stack of books.

My blood you have drawn
has traveled through your machines
and has …

How a minor dry cough amplifies caregiver burden in home health care

Gerald Kuo

Conditions and Diseases

April 3, 2026

A dry cough can be one of the most misleading symptoms in medicine. At home, it can dominate the emotional climate of an entire household. It interrupts sleep, breaks conversations, unsettles meals, and keeps caregivers in a state of low-grade vigilance. It appears in cold air, at the beginning of a speech, during the first few sentences of a phone call, or in the quiet moment when everyone is finally …

How to treat sacroiliac joint pain effectively today

Kayvan Haddadan, MD

Conditions and Diseases

April 3, 2026

If you have nagging pain deep in your lower back or one buttock that never seems to settle, you are not alone. Many people chase answers through discs, nerves, or muscles, yet the real source turns out to be the sacroiliac (SI) joint. This connection between the base of your spine and your pelvis is built for stability with just a hint of motion. When it becomes irritated or unstable, …

Why clinicians fail at writing expert reports

Tracy Liberatore, Esq, PA

Conditions and Diseases

April 3, 2026

I want to tell you something attorneys already know but will never say to your face. When your expert report lands in their inbox and they read it, I mean really read it, they know within the first two paragraphs whether they are calling you again. Not after the case. Right then. And if the answer is no, they do not tell you. They do not give feedback. They do …

Leucovorin for autism: Why physicians must protect hope from hype

Ronald L. Lindsay, MD

Conditions and Diseases

April 3, 2026

In September 2025, The Atlantic reported on a frenzy surrounding leucovorin, a folate derivative long used in oncology and rheumatology. Families desperate for answers were suddenly told it might be a miracle therapy for autism. Waitlists stretched years, clinics were overwhelmed, and hope surged. The problem was not just scientific, it was political. When President Trump and HHS Secretary Robert F. Kennedy Jr. endorsed leucovorin, they amplified demand …

The hidden link between chronic stress and oral health

Deanna J. Gilmore, RDH

Conditions and Diseases

April 2, 2026

In health care, we are trained to measure what we can quantify. We check blood pressure, glucose, cholesterol, and weight. We monitor lab trends and adjust medications. We look for numbers that confirm risk. What we do not routinely measure is whether a patient is living in a constant state of stress, even though the signs are often right in front of us.

In dentistry, those signs are hard to miss.

Over …