Conditions

Incurable psychiatric disorders: Should we offer palliative care or medical aid in dying?

Conditions
May 31, 2024

The application of palliative care to intractable psychiatric disorders has been debated at least since 2010, when a journal article reported that a patient with severe anorexia nervosa died in hospice after being referred there by her psychiatrist. The New York Times published a thought-provoking article earlier this year on the same topic: whether we should ever deem severe, treatment-refractory anorexia incurable and terminal.

Are there incurable psychiatric patients?

Proponents …

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Don’t wait until you’re old: Diseases hitting younger generations now

Conditions
May 31, 2024

The news is rife with articles about younger people getting cancer, heart attacks, high blood pressure, atrial fibrillation, and arthritis. We used to think of these as diseases of aging, but now we are finding high blood pressure and atherosclerosis in people as young as 20. The guidelines for colon cancer screening have been lowered to age 45 for people at normal risk. Experts can’t explain why this is happening. …

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Hemophilia treatment: new hope with gene therapy and other advancements

Conditions
May 31, 2024

Hemophilia and other bleeding disorders are rare genetic conditions that affect the body’s ability to properly form blood clots. People with these conditions often face challenges in accessing appropriate care and treatment. This is true not only in developed countries but also in low- and middle-income countries around the world.

One of the biggest access to care issues for people with hemophilia and bleeding disorders is the availability of specialized treatment …

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Why my doctor never mentioned pelvic floor dysfunction (and why it matters)

Conditions
May 30, 2024

I was 31 when I learned I had a pelvic floor: the set of muscles, ligaments, and tissues that stretch like a hammock across the pelvis. Like many women, my pelvic awakening came far too late in life. The phrase was never uttered in high school sex ed, never brought up by my gynecologist, and — despite spending most of my 20s shuttling around the health care system trying to …

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Lung cancer in Asian American women: Don’t be a statistic (never smoked)

Conditions
May 28, 2024

May is AANHPI Heritage Month so it’s a good time to share again my journey from nonsmoker to lung cancer survivor. It is such an important issue to bring awareness to this little-known and potentially deadly health disparity because, according to the 2020 census, 6.2 percent or 20.6 million people identify as AANHPI (Asian American Native Hawaiian Pacific Islander).

Wait. How can you have lung cancer? You’re not a …

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Why preventive care is the cure for our failing health care system

Conditions
May 26, 2024

“The doctor of the future will give no medicine, but will interest his patients in the care of the human frame, in diet, and in the cause and prevention of disease.”
– Thomas Edison

Mr. Edison, if he is watching over us, must be sadly disappointed.

The provocative idea of making cancer centers obsolete might sound extreme, but it underscores a critical vision for health care—shifting from reactive to preventive treatment. Envision a …

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Grandpa’s remains are helping push up daisies

Conditions
May 26, 2024

“Rejoin the natural cycle: to know that the last gesture you’ll make will be gentle and beneficial just feels like the right thing to do.”
– Recompose founder Katrina Spade

I love gardening and watching things grow, so I found the idea of human composting an intriguing concept. For those who find cremation unconventional or even unsettling, the process of disposing of the remains of a deceased loved one has taken a …

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Left in the dark: the censorship of health literature in prisons

Conditions
May 26, 2024

Kwaneta Harris had hot flashes and lapses of memory. She didn’t feel right and didn’t know why. “It felt like my body was completely betraying me,” she wrote. “I felt like I was losing my mind.” The cause wasn’t the eight years she’d spent in solitary confinement in a Texas prison. She was going through menopause. She didn’t understand it. And Texas officials wouldn’t allow …

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Crippling fatigue: a common enemy of autoimmune disease

Conditions
May 25, 2024

For many people with autoimmune disease, fatigue is the most debilitating symptom. Why autoimmune disease and fatigue go together is not entirely understood, although inflammation may be part of the reason. Other possible factors include pain, poor sleep, inactivity, and depressed mood. Fatigue is not just feeling tired. Fatigue is composed of both physical fatigue and mental fatigue. Unlike being tired, fatigue is rarely resolved with rest or sleep. Trying …

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Couples counseling: Understanding conflict and building intimacy

Conditions
May 25, 2024

Situations that trigger a call for assistance with couples counseling are generally described as a need for improved communication, chronic conflict, lack of physical or emotional intimacy, or a desire to better understand the impacts of past trauma. Therapeutic work can evolve into tackling more specific long-standing disappointments in emotional and physical intimacy. Disconnection is often exacerbated incrementally by increased responsibility with children, aging parents, and cultural differences, among other …

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Eye dryness, insomnia, and more: hidden signs you’re in perimenopause

Conditions
May 24, 2024

I am 47 years old and was today years old when I realized I have been going through perimenopause for the last four years. It is only with a retrospective lens that I can review my last four years and pick up intermittent symptoms or even just mild nuisance-level symptoms that I can say are likely from perimenopause.

What is perimenopause? Perimenopause is the transition stage before reaching menopause, which is …

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Pain management for Black patients and painful realities

Conditions
May 23, 2024

This piece is inspired by my recent patient encounter. Within the past week, I received a call from the ER to admit a 29-year-old African-American female whom, for the sake of this essay, I will call Keisha. Keisha presented with severe lower abdominal pain and was found to be in hypertensive crisis. Her systolic blood pressure consistently was in the upper 200s. It turned out that the young lady suffered …

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Healthy hierarchy for patient safety, experience, and staff wellbeing

Conditions
May 20, 2024

The hierarchy must be healthy to achieve critical outcomes in patient safety, patient experience, workforce health and wellbeing, and cost-effectiveness.

In a healthy hierarchy, staff must have the right skills, education, and experience to direct and carry out clinical and care-related tasks. Clear lines of communication, roles and responsibilities, policies and protocols, and scope of practice are all important. We can think of such things in terms of the structure. We …

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The first time I walked again after a spinal cord injury

Conditions
May 19, 2024

Once upon a time, I’d imagined myself the Lone Ranger physician, self-sufficient and incapable of weakness, and when I had my spinal cord injury in 2008, I really felt alone, in the negative spiral of a victim mindset, my own worst enemy and in a dark space where my idea of myself felt entirely lost.

Then, one day, in December 2009, I heard about a center for spinal cord injury recovery …

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Secret support for this family caregiver  

Conditions
May 19, 2024

Last month, while spring cleaning my home-based office, I faced off with a bookshelf full of past writing journals.

Get rid of them (I coaxed myself). Whatever you wrote here is history now.

My inner packrat resisted. Couldn’t I just box them up and move them to the basement to join all those other journals that, together, chronicle my three-plus decades of living in the United States?

One gray-covered notebook with pink post-it …

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Breaking the stigma with science

Conditions
May 18, 2024

Oxford Dictionary defines stigma as “a mark of disgrace associated with a particular circumstance, quality, or person.” In other words, it’s a state of being in shame. One of the most influential thought leaders in shame is Brene Brown. She describes shame as “the intensely painful feeling or experience of believing that we are flawed and therefore unworthy of love and belonging. We feel like something we have experienced, done, …

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Autoimmune disease? You’re more likely to get heart disease. Here’s why.

Conditions
May 13, 2024

The prevalence of coronary artery disease (CAD) and stroke is increased in patients with chronic inflammatory diseases such as rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE). These are also known as IMID: immune-mediated inflammatory diseases. Rheumatic IMIDs, including rheumatoid and osteoarthritis, are associated with multiple cardiovascular issues with an enhanced cardiovascular risk, including premature coronary artery disease. Lupus can also increase coronary artery disease because of the elevated chronic …

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Overcoming disparity in access to uterine artery embolization

Conditions
May 12, 2024

Uterine fibroids are a common condition that affects up to 7 in 10 women. While some fibroid patients live with the condition without serious issues, many suffer from disruptive symptoms, such as heavy menstrual bleeding, pelvic pain, and infertility, which make it difficult for them to go about their daily lives.

Treatment options are broad and include medical management, hysterectomy, myomectomy, uterine artery embolization (UAE), endometrial ablation, and magnetic resonance-guided focused …

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Eating our way to the next pandemic

Conditions
May 12, 2024

The Texas Department of State Health Services reported the first case of H5N1 avian influenza in a human who contracted the virus not from a bird but from an infected dairy cow. The next pandemic could be around the corner, and the food we choose to purchase (or not to purchase) is playing a role in its development.

As we saw with the COVID-19 pandemic, viruses can undergo mutations rapidly, …

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Long COVID and your brain: the effect of virus and vaccines

Conditions
May 12, 2024

A bunch of symptoms, which may persist many months or even years after an acute COVID infection has cleared, have been described in the medical literature with increasing frequency since the onset of the pandemic. This constellation of findings has been dubbed “long COVID.” Long COVID’s effects on the brain, in particular, have certainly been in the news, and it’s also been popping up in the medical literature. So, what’s …

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