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.

Bret Michaels has a subarachnoid hemorrhage, and what that means

Conditions and Diseases
April 23, 2010

Bret Michaels is in critical condition from a subarachnoid hemorrhage.

bret michaelsI’ve been watching Celebrity Apprentice recently, and he comes across as a genuine person who, of course, has been raising awareness for Type 1 diabetes. As most people know, he has battled various diabetic complications on the show, and recently underwent an emergency appendectomy.

What’s his prognosis like?

Not good, I’m …

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Bret Michaels has a subarachnoid hemorrhage, and what that means

Palliative care physicians confronting their own mortality

Conditions and Diseases
April 23, 2010

Dr. Desiree Pardi was the palliative care medical director at Weill Cornell Medical Center in New York. She died of metastatic breast cancer in 2009 at the age of 41.

Her story provides palliative care clinicians an opportunity to reflect on how our own personal mortality interacts with our professional lives.

I did not personally know Dr. Pardi. I write this post knowing that many readers did indeed know her, some …

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Palliative care physicians confronting their own mortality

Dementia affects the entire family

Conditions and Diseases
April 22, 2010

by Emily P. Walker

My grandfather recently died of pancreatic cancer.

My grandpa was a WWII veteran, a nature enthusiast, an animal-lover, a chiropractor until the 1980s, and a firm believer in natural medicine. He helped my grandmother give birth to five children in her bed, and neither of them had ever taken any drugs except when both were hospitalized one winter with pneumonia.

As someone with a major respect for medical doctors …

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Dementia affects the entire family

High blood pressure treatment that patients need to know

Conditions and Diseases
April 21, 2010

When her gynecologist told her she had high blood pressure, Marie had a simple solution: switch doctors. After all, she had gone to him for a different problem, and this was the first time he had ever checked her blood pressure.

“He said, ‘Oh my God, you’re like a bomb waiting to explode.’ I said, ‘I didn’t come here for that, I came here for something else,’” she explained.

Two years later, …

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High blood pressure treatment that patients need to know

Social networks affect alcohol drinking patterns

Conditions and Diseases
April 21, 2010

by Kristina Fiore

If you’re surrounded by heavy drinkers, you’re more likely to become one, new research shows.

An analysis of data on alcohol consumption and social networks found that people are 50% more likely to drink heavily if someone they’re directly connected to does so, Nicholas Christakis, MD, PhD, of Harvard University, and colleagues reported in the Annals of Internal Medicine.

“We’ve found that the influence of your friends and people you …

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Social networks affect alcohol drinking patterns

President Obama should have had colonoscopy without sedation

Conditions and Diseases
April 19, 2010

by Michael Kirsch, MD

Does anyone out there know why President Obama underwent a virtual  ‘colonscopy’ (VC) instead of a conventional colonoscopy earlier this year?

In my gastroenterology practice, we do not offer colon cancer screening to 48-year-old individuals, unless special risk factors are present. Of course, maintaining the president’s health is in the national interest, so I understand why professional screening guidelines might not apply to him. For …

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President Obama should have had colonoscopy without sedation

Prison affects how children relate to their parents

Conditions and Diseases
April 18, 2010

It’s an unfortunate scenario I’ve seen time and time again:

* Parent goes to prison.
* Child, who already felt neglected by parent, becomes more upset when parent ends up behind bars. Child either blames the parent for misbehavior that results in parent being taken away from child and/or blames him or herself (as children often do).
* Parent tries to have contact with child via phone calls, letters, or visits.
* Child decides …

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Prison affects how children relate to their parents

Flu may be associated with seasonal deficiency of vitamin D

Conditions and Diseases
April 11, 2010

by Michael Smith

If you look at the world map, the shapes of South America and Africa look as though they should fit together. Maybe they were once together and then drifted apart.

That theory was first put forward in the late 1500s by a Dutch map maker, but it wasn’t until the 1960s that the discovery of plate tectonics finally put the idea on a — well, …

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Flu may be associated with seasonal deficiency of vitamin D

Cell phone use and driving requires attention that few have

Conditions and Diseases
April 10, 2010

by Crystal Phend

Only one person in 40 has an extraordinary ability to do safely what many take for granted in daily life — talk on a cell phone while driving.

These “supertaskers” excelled on a simulated driving exercise and a demanding, simultaneous test of memory and math skills conducted over the phone without any loss in performance on either, according to Jason M. Watson, PhD, and David L. Strayer, PhD, both …

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Cell phone use and driving requires attention that few have

Epidemiology and how confounding statistics can confuse

Conditions and Diseases
April 7, 2010

Now, as you know, I am a big fan of epidemiology. I do not believe that a randomized controlled trial is the be-all-and-end-all in evidence generation, and a well done observational study can add to our reservoir of knowledge much more efficiently. Of course, I, as many others, acknowledge certain limitations of epidemiologic design. However, many of them can be overcome with careful design and analysis.

I have to confess, though, …

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Epidemiology and how confounding statistics can confuse

Children whose parents refuse vaccination may spread measles

Conditions and Diseases
April 2, 2010

by Todd Neale

Children whose parents refuse vaccinations for them provide fertile ground for the spread of vaccine-preventable diseases, an investigation of a 2008 measles outbreak in San Diego demonstrated.

Although the rate of two-dose immunization against measles was 95% in the area, a single case of measles from a 7-year-old child returning from overseas sparked an outbreak that exposed 839 people and sickened 11 other children, according to David Sugerman, …

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Children whose parents refuse vaccination may spread measles

Radiology tests, and how to find their price

Conditions and Diseases
March 30, 2010

I am often asked how we get the prices for the radiology imaging tests, such as MRI’s and mammograms, or ultrasounds. Most people assume that my day job as a doc gives me some sort of special access to this info. But that’s just not the case. Anyone can find out testing prices.

However, over the last year, those of us working at LesliesList.org have gotten more experienced and better at …

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Radiology tests, and how to find their price

Cancer deaths are improving, but a cure remains distant

Conditions and Diseases
March 26, 2010

Originally published in MedPage Today

by Joyce Frieden, MedPage Today News Editor

Almost 40 years and 100 billion federal dollars have been invested in the “War On Cancer” since President Richard M. Nixon declared it, but the campaign is far from over, two researchers concluded this week in the Journal of the American Medical Association.

“These funds have been more than matched by …

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Cancer deaths are improving, but a cure remains distant

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VBAC rates are low, but are obstetricians to blame?

Conditions and Diseases
March 25, 2010

My daughter, who turns two years old in June, is becoming something of a medical rarity. This isn’t because she is showing signs of a late-developing handicap or extraordinary ability for her age – it’s because she came into the world as a vaginal birth after Cesarean section (VBAC), delivered by a certified nurse midwife.

Although more than three-quarters of women who choose a trial of labor over a repeat Cesarean …

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VBAC rates are low, but are obstetricians to blame?

VBAC should not be a woman’s right

Conditions and Diseases
March 25, 2010

VBAC activists are clinging to their resentment and aggressively ignoring reality.

Amy Romano at Science & Sensibility asks the bizarre question: Do women need to know the uterine rupture rate to make informed choices about VBAC? It’s bizarre because she implies that this is a medical question and that the answer is unknown. However, this is a legal question and the answer has been clearly established by the courts. Not …

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VBAC should not be a woman’s right

Cancer side effects are being ignored by the media

Conditions and Diseases
March 25, 2010

Originally published in MedPage Today

by John Gever, MedPage Today Senior Editor

When the mainstream media report on cancer treatments, they seldom note that aggressive therapies may fail or cause severe side effects, researchers said.

Analyzing more than 400 articles about cancer in major newspapers and magazines, investigators at the University of Pennsylvania found that adverse outcomes or palliative care were hardly …

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Cancer side effects are being ignored by the media

Allopathic medicine has alternative medicine roots

Conditions and Diseases
March 24, 2010

Whether we like it or not, the lines between allopathic and alternative medicine continue to blur. Just last week I recommended glucosamine-chondroitin to a patient who suffers from osteoarthritis and wrote a prescription for Lovaza, a prescription-strength preparation of fish oil. And today I was asked about red yeast rice from a patient interested in controlling her cholesterol through “natural means.”

Like nutrition, complementary and alternative medicine, or CAM, is somewhat …

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Allopathic medicine has alternative medicine roots

Atrial fibrillation as experienced by an electrophysiologist

Conditions and Diseases
March 20, 2010

Middle age introduces itself in many ways; one is atrial fibrillation. Youth, vigor and a medically-problem free life was seemingly right there in the recent past. A rhythm doctor often hears this suddenness of onset described as “Doc, yesterday, I was fine.” As is always the case for a first episode of an arrhythmia, yesterday, you were fine, but today is indeed a new day.

It happened during a bike ride. …

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Atrial fibrillation as experienced by an electrophysiologist

Coronary angiography is being overused

Conditions and Diseases
March 19, 2010

Originally published in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

For patients without known heart disease, the diagnostic yield of coronary angiography appears to be low, researchers found.

Only about 38% of those referred to the cath lab for the elective procedure had obstructive coronary artery disease, Manesh R. Patel, MD, of Duke University, and colleagues reported online in the New England …

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Coronary angiography is being overused

Homebirth does not protect against serious maternal infections

Conditions and Diseases
March 16, 2010

Homebirth advocates like to tout the many “advantages” of giving birth at home. High on the list is limiting exposure to hospital acquired infections, and since only your “own germs” are in your home, you are protected.

Yes, you are protected from hospital acquired infections, but the most dangerous infectious agents are actually those that live inside the mother, not the ones in the hospital. Consider that for newborns both Group …

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Homebirth does not protect against serious maternal infections

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