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.

Treating patients with pre-diabetes: Weight loss and carbohydrate restriction

Conditions and Diseases
April 8, 2011

What physician has not stifled a groan when a patient presents with a chief complaint of “I just don’t feel right, Doc.”

About this time last year, I had that “not quite right” feeling and vague, seemingly unrelated symptoms … sweating, mid-morning headaches, and frequent feelings of hunger, which I was accustomed to satisfying with a muffin.

Like most people — patients and clinicians alike — I ignored these subtle signals.

One evening, …

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Treating patients with pre-diabetes: Weight loss and carbohydrate restriction

MKSAP: 28 year old woman with easy bruising and bleeding gums

Conditions and Diseases
April 2, 2011

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 28-year-old woman has a 3-month history of easy bruising and bleeding gums. She feels otherwise well. Medical and family histories are unremarkable, and she takes no medications.

On physical examination, temperature is normal, blood pressure is 110/70 mm Hg, pulse rate is 64/min, and respiration rate …

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MKSAP: 28 year old woman with easy bruising and bleeding gums

What is stuttering, how is it treated, and The King’s Speech

Conditions and Diseases
March 29, 2011

One of the “Crown Jewels” of the 2010 holiday movie season may be The King’s Speech.  The film centers on  Colin Firth, who plays King George VI of Britain, and Geoffrey Rush as Lionel Logue, the speech therapist who helps the king deal with his stutter.

Born Albert Frederick Arthur George, the second son of King George V, he spent most of his early years out of the spotlight, which centered …

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What is stuttering, how is it treated, and The King’s Speech

How astroturfing disease affects patients

Conditions and Diseases
March 28, 2011

One of the top hits that comes up on the Oracle of Googlius for “astroturf” is for the original company, now renamed SYNLawn, but still proudly stating, “We invented synthetic grass,” which is what astroturf is. More recently, this already synthetic term has become a verb, as in “astroturfing.”

My favorite of all credible information sources on the web, Wikipedia, has this to say about it:

Astroturfing denotes political, advertising, or public relations campaigns that are formally …

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How astroturfing disease affects patients

Food

Conditions and Diseases
March 25, 2011

by Joanne Wilkinson, MD

I have a stress test nearly every year. I do this because my mother dropped dead of a heart attack when she was thirty-six, and now I am thirty-five.

They stick EKG leads on me, and for weeks I have blotchy red circles on my skin where it’s reacted to the adhesive. I run on …

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Food

Restricting nuclear cardiac stress testing in favor of stress echocardiography

Conditions and Diseases
March 24, 2011

Dr. William Follansbee is the chairman of the American College of Cardiology/American Society of Nuclear Cardiology (ACC/ASNC) task force on non-invasive cardiac imaging and the director of nuclear cardiology at the University of Pittsburgh Medical Center Cardiovascular Institute.

He recently published an editorial in the Pittsburgh Post Gazette in which he criticized the local Blue Cross/Blue Shield carrier, Highmark, for restricting the use of nuclear cardiac stress testing in …

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Restricting nuclear cardiac stress testing in favor of stress echocardiography

How obesity is like alcoholism

Conditions and Diseases
March 21, 2011

Recently, I attended a scientific symposium on addictions.

One of the books I picked up at that conference, and read on my flight to Montreal, is A. J. Adams’ Undrunk: A Skeptic’s Guide to AA.

While this book is a very quick and highly readable introduction to AA (Alcoholics Anonymous), about which I knew very little, today’s post is not about this book.

The definition reads as follows:

Alcoholism is a primary chronic disease …

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How obesity is like alcoholism

Prostate cancer from a patient perspective

Conditions and Diseases
March 21, 2011

by Dan Zenka

As a patient, I feel for anyone who is given a diagnosis of prostate cancer.  Hearing the “Big-C” word can be upsetting enough. But the complexity of the disease—diagnosing it, trying to characterize it and selecting the appropriate treatment—can feel like insult upon injury.  We need to talk about prostate cancers. With 24 known sub-types of this cancer—from …

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Prostate cancer from a patient perspective

Evaluating dizziness in the cardiologist’s office

Conditions and Diseases
March 20, 2011

I see a lot of patients who are sent to me for evaluation of dizziness.  On the surface you wouldn’t think a cardiologist would have much to do with a symptom that relates more to the head than the heart, but there is some logic to it—poor blood flow to the brain could lead to dizziness and, since blood flow starts in …

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Evaluating dizziness in the cardiologist’s office

How to help autistic or delayed children behave and learn

Conditions and Diseases
March 14, 2011

Here are ways doctors can help autistic or delayed children behave and learn.

I certainly do not mean to trivialize the behavior issues that erupt as typical children develop, but the problems of atypical kids are more difficult and less likely to be fully addressed by general pediatricians and society at large.

1.  Understand the ABCs of behavior. Antecedent = What happened immediately before the behavior?  Behavior = A description of the …

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How to help autistic or delayed children behave and learn

Making sense of colorectal cancer headlines

Conditions and Diseases
March 11, 2011

by Robert Bresalier, MD

Did you hear the one about the cancer-sniffing dogs?

Sounds crazy, right? This is just one of many recent headlines that may leave you scratching your head.

Not every study you read in the news is the final word. But recent research can provide interesting new insight on colorectal cancer — the second leading cause of cancer death in the United States.

Here’s some insight to help you make sense …

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Making sense of colorectal cancer headlines

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Gout is a common cause for episodic joint pain and swelling

Conditions and Diseases
March 10, 2011

For Christmas Eve dinner, our family congregated at Café Opera, in the Intercontinental Hotel for a scrumptious seafood buffet. Going to a buffet is a little bit evil, as you know that you’re about to commit the sin of gluttony.

I usually tell my patients who suffer with gout to avoid buffets. That 3rd mountain of prawns may precipitate an acute episode of gout. Christmas party season is a dangerous time.

Overindulgence …

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Gout is a common cause for episodic joint pain and swelling

Your laser facial rejuvenation questions answered

Conditions and Diseases
March 9, 2011

Laser facial rejuvenation is one of the most popular but most confusing  treatments today.

What’s the difference between a lunchtime laser and a fractionated laser?  An ablative or a nonablative laser?  If many plastic surgeons are confused by the plethora of lasers available, how can the average consumer or patient know what laser is best for removing their wrinkles and tightening their skin?

Lasers work by focusing energy on a certain color of the …

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Your laser facial rejuvenation questions answered

Treatment-resistant depression is a myth

Conditions and Diseases
March 9, 2011

Treatment-resistant depression is one of those clinical terms that has always been a bit unsettling to me.

Maybe I’m a pessimist, but when I hear this phrase, it reminds me that despite all the time, energy, and expense we have invested in understanding this all-too-common disease, we still have a long way to go. Perhaps more troubling, the phrase also suggests an air of resignation or abandonment: “We’ve tried everything, but …

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Treatment-resistant depression is a myth

Lifestyle changes to control the symptoms of prostate enlargement

Conditions and Diseases
March 7, 2011

Prostate enlargement, or benign prostate hyperplasia (BPH), is a common, non-cancerous condition affecting nearly 14 million men over the age of 50.

The symptoms of prostate gland enlargement include a decrease in the force and caliber of the urinary stream, frequency of urination, urgency, a feeling of not emptying the bladder despite urination and nocturia, or the need to get up at night to urinate. Although lifestyle changes will not cure …

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Lifestyle changes to control the symptoms of prostate enlargement

MKSAP: 64-year-old man with a new right-sided headache

Conditions and Diseases
March 4, 2011

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 64-year-old man is evaluated for a new right-sided headache that began 1 day ago. He awoke yesterday with a dull ache over his right forehead that has gradually increased in intensity. He also notes some right eye discomfort, sensitivity to light, and that his eye …

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MKSAP: 64-year-old man with a new right-sided headache

Lack of sexual interest is the most common sexual complaint in women

Conditions and Diseases
February 28, 2011

Lack of sexual interest is the most common sexual complaint in women.

The latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), which defines psychiatric disorders, defines Hypoactive Sexual Desire Disorder (HSDD) as ‘‘persistently or recurrently deficient (or absent) sexual fantasies and desire for sexual activity’’ that causes ‘‘marked distress or interpersonal difficulty.’’ Epidemiologic surveys have suggested that from 25 to 50 percent of women report prolonged periods …

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Lack of sexual interest is the most common sexual complaint in women

The torture and emptiness of psychological hoarding

Conditions and Diseases
February 25, 2011

Humans are imbued with a competitive spirit. And as a result, we like to count our victories.

There are an infinite number of possibilities in human experience. And when the possibility of death looms over us, the sudden fear that we might not have done everything we might have creates immense distress. This “range” or “number” idea rarely has the effect it is supposed to have. Every kind of sex, every …

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The torture and emptiness of psychological hoarding

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