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.
About seven months ago, I began training kung fu with my family. Our classes are intense and require the students to really pull out our personal best. Periodically our instructor will remind us by shouting out, “Train like a black belt!” when she catches us being sloppy or less than enthusiastic. Her exclamation inspires me to squat a little lower in my horse stance, amps up my intensity, and focuses …
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Integrity, discipline, respect: Using kung fu to control your eating
Many of our most popular stories are about diets and weight management.
Did you know that some psychologists and psychiatrists would like to classify obesity as a brain disease? The reason for this is that there is mounting evidence that food, or certain types of food, can trigger the same addictive effects in the brain as drugs like heroin and cocaine. There is also substantial evidence that some people lose control over …
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Should obesity be classified as a brain disease?
Menopause often brings more than physical changes. It also may bring uncertainty about cancer risks and cancer prevention.
Below, I’ve compiled some of the questions I frequently hear from patients about menopause and cancer. I hope these answers will help other women start informed conversations with their doctors about menopause-related concerns.
How does menopause affect a woman’s cancer risk?
Menopause does not cause cancer. But your risk of developing cancer increases …
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Menopause and cancer: What women should know
Along with millions of Americans, I’ve tried to comprehend the tragic shootings in Tucson, reaching deep within myself to find compassion for a young man who has forever changed the world for himself and so many others through his actions.
For those of us who assess, diagnose and treat college students struggling with mental illness while trying to succeed in their academic pursuits, the events leading up to his impulsive killings …
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Mental illness in the college student
As an infectious diseases physician with a special interest in head and neck infections, I had extensive experience in otolaryngological illnesses. However, when I was exposed to new, different, and challenging experiences as a neck cancer patient, I had to deal with these as a patient — not as a physician. I endured the consequences of radiation, repeated surgeries, and prolonged hospitalizations. I confronted medical errors in my care, discrimination …
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A laryngectomy shakes this physician to the core
by Roberta Bivins
As a historian who writes about the controversial topic of ‘alternative medicine’, I get a lot of questions about whether this or that therapy ‘works’. Sometimes, these questions are a test of my objectivity as a researcher. My questioners want to know whether I am ‘believer’, or a fan of alternative medicine, or have any stake in promoting or disdaining a given medical …
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A historical perspective of alternative medicine
Either as a patient or as a physician there’s a very high chance that you’ve ever got your hands on a simple blood test.
These range from very basic ones to complex ones with multiple pages and are substantial to any cinlical evaluation. Blood tests are probably one of the most performed tests in a clinical environment with direct patient contact. Also, if you’ve ever seen a typical blood test from …
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Your blood test and the need for better designed results
When it comes to football season, it’s time to think about sports injuries. We frequently have children admitted to the PICU (or to what we call the intermediate or step-down unit) for observation, typically overnight, who have struck their head. They have had concussions. What is a concussion, and what does it mean for the child?
The term itself is centuries old, but even thirty-five years ago, when I was in …
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What is a concussion, and what does it mean for the child?
At the end of a busy afternoon, Mrs. MJ was exactly the kind of case I needed.
Two of my patients had come in late but needed to be seen and another was acutely short of breath and refusing to be admitted to the hospital. The chaos had put me almost an hour behind schedule, and I still had to return to the wards to round on my cancer patients. Fortunately …
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Obesity and the crossroads between relative health and medical illness
by Joyce Graff
Medical dramas can play powerful roles in increasing awareness of rare diseases, but it’s critical that the diseases are portrayed accurately. Mischaracterizations by the popular media of medical conditions, particularly rare ones, can be very demeaning to people afflicted with those conditions, and can affect how people look at them in the workplace or at school.
The TV show, Grey’s Anatomy recently broadcast the first …
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Mischaracterizations by the popular media of medical conditions
How many times have I been asked by the trauma surgeons to see a trauma patient for respiratory failure? The reason for intubation and ventilatory support – being combative and non-cooperative.
Intubating, sedating and sometimes even paralyzing a combative patient is an established practice. Combative patients are dangerous to themselves and to the medical staff. Clinical and radiological evaluation of these patients is difficult as well. Asking “What is hurting, Sir” …
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Intubating the combative patient
I’m thankful that I don’t have to research symptoms on the internet, diagnose myself, and come up with my own treatment. All I have to do is go to my doctor and describe my symptoms. My doctor can listen to my symptoms, match them up to what he knows, ask questions to pinpoint what might be going on, order appropriate tests, and recommend a treatment plan.
Odds are, when people get …
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See the same doctor when the diagnosis isn’t obvious
by Brian Jackson, MD and Brian Shirts, MD, PhD
We’ve heard a lot of talk lately about personalized medicine (i.e., using advanced diagnostics to guide customized therapy).
A great deal of research is going into creating new molecular and genetic tests. But whether the health care system is prepared to actually generate value from these advanced diagnostics remains an open question. Our group’s research, presented in …
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HPV test: Doctors are still not following testing guidelines
Generally, Alzheimer’s disease is diagnosed only after patients have progressed to major levels of cognitive impairment that results in substantial problems in daily functioning. But the brain changes that result in cognitive impairment start years, if not decades, before patients become symptomatic. So, wouldn’t it make sense to try to diagnose Alzheimer’s Disease in patients who have the brain changes, before they have clinical symptoms?
The answer would be yes if …
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Alzheimer’s disease diagnosis criteria: A critical review
In my opinion, people are often too embarrassed to see their doctor about sexually transmitted infections (STIs)—in my opinion.
“In my opinion” is one of the most dangerous phrases in science. But when in comes to attitudes toward STIs, the data are scarce. STI’s are very much a “behavior”-based disease, so knowing what attitudes prevail can help us design effective prevention strategies. Attitudes toward HIV have been …
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Disconnect between knowledge of STIs and behaviors to reduce risk
During my training at Hennepin County Medical Center (HCMC) in Minneapolis, MN, my mentor would use the following teaching pearl during rounds: “When you hear hoofbeats, think of horses not zebras!” He would also frequently use: “If it looks like a duck, swims like a duck, and quacks like a duck, then it probably is a duck.” What did my mentor, the Sage of HCMC, mean by this?
From Wikipedia: “Zebra …
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Common things are common, except when the diagnosis is rare
“She just got permanent eye liner and eyebrow augmentation—looks fab,” emailed one of my closest friends last month, about her coworker. “I am seriously considering permanent liner/eyelash augmentation. Do you have any interest in doing this with me?”
I understood the appeal … I’d never have to reapply makeup after showering at the gym, save time on my morning routine and enhance features like thinning lashes and brows. Although we had …
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Permanent makeup risks and dangers
For everything, there is a season…
– Ecclesiastes
“Are you giving up on me?” My patient looks at me severely. “There must be other treatment options! Aren’t there some experimental drugs out there? I have beaten this cancer twice before. Are you saying that I can’t beat it again?”
No one can ever know with absolute certainty whether my patient’s newly recurrent cancer might miraculously disappear with one more treatment. His recurrence, however, has …
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Discussing cancer treatment with the terminal patient
As a kid I had allergies and asthma.
Because of this, for several years, my mother wrote a note excusing me from the 600 meter run in elementary school. My father took me to weekly allergy shots. At times I had eczema on my forearms and eyes, and according to my allergist, whose notes I later read, I had moderate allergic shiners (also known as dark circles under my eyes). My …
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Lessons learned from asthma therapy
A 74-year-old man is evaluated for a 5-year history of gradually progressive dyspnea and dry cough without wheezing or hemoptysis. For the past 2 years he has had pain and occasional swelling in both knees. He has not had fever or lost weight. He smoked one pack …
