Most of the time, I enjoy my job as a pediatric nurse practitioner working with chronic headache and pain patients. I enjoy the relationships with the families, figuring out what can help manage the headaches and life issues best to allow optimal functioning. I enjoy performing certain procedures, like Botox for chronic migraines or injection procedures for my patients, which very often improve their headache profile. I can even find …
As a physician, there are moments during the day when you must deliver a disheartening diagnosis to your patient: pancreatic cancer, ALS, leukemia, and unfortunately, the list goes on. The patient must face the harsh realities that are now placed before him/her. Those realities, at times, leave him with a very small window of hope for improvement. Sometimes, solutions cannot be found with the use of a scalpel, chemotherapy, or …
In the realm of leadership development, an array of groundbreaking initiatives is surfacing, igniting profound transformations on multiple fronts. Resilience programs, in particular, are equipping leaders with the agility to navigate our fast-paced world and fostering the internal adaptability essential for constant change. Yet, despite these promising strides, a disconcerting surge in anxiety, stress, and burnout among executives has emerged.
Startling statistics underscore this disconcerting trend. In 2022, a staggering 31% …
Every day, thousands of people lie on a couch and have their arm stabbed with a large needle. Blood from the venipuncture snakes down into a container. In some individuals, this continues until the volume is about a pint – 500 mL; for this, they get a cookie and a glass of juice. In others, the collection is larger – around 2,500 mL; for this, they get between $50 to …
Since the mid-1970s, rates for liver cancer have been on the rise. A 2017 study found that liver cancer increased by 75 percent worldwide between 1990 and 2015, with the highest rate increases occurring in sub-Saharan Africa and Southeast Asia. Worldwide, hepatitis B—a virus that damages the liver and is spread through contact with infected blood and other body fluids—is the most common cause of liver cancer; however, in …
This past week, I was speaking with a patient; let’s call her Marcy, during her regular appointment. “You’re just not like other doctors,” she said. “How is that?” I asked.
This seems like a good place to discuss the reason Marcy comes to see me. Marcy has a history of opioid use disorder. She has been on medication-assisted therapy (MAT) for many years. For those unaware, opioid use can alter people’s …
The American Diabetes Association recently released screening guidelines for liver disease in individuals with type 2 diabetes. Notably, 70 percent of people with type 2 diabetes have liver disease, and the most common form is non-alcoholic fatty liver disease. Ultimately, this can lead to cirrhosis and cancer. According to the American Cancer Society, the rates of liver cancer have tripled since 1980. Currently, one in 10 Americans has diabetes, …
Chances are, you or someone you know has fallen victim to medical gaslighting at some point, especially as we see an increase in this unfortunate practice in today’s modern health care system. Maybe you have experienced medical gaslighting without even realizing it. What exactly is medical gaslighting? It’s a term given to a practice stemming from our medical community where doctors and specialists alike make patients feel a multitude of …
The FDA approval of Zurzuvae (zuranolone), the first oral medication, has offered new hope to mothers who have exhausted all other treatment options to cope with their postpartum depression. This is a milestone in recognizing the maternal mental health crisis that plagues our country. The benefit of this drug is that it offers a new approach to treating postpartum depression and brings postpartum health into the spotlight. With Zurzuvae …
Let me describe what it’s like to operate in a potentially disastrous situation. Notwithstanding having one’s faculties and wits gathered and finely honed, being as in command of yourself as you can possibly be, it may test and demand everything you can bring to bear. I’ve been in war, where I feared daily for my life. It’s not pleasant, but in some way you can get used to it. In …
At a recent scientific conference on narcotics, a researcher mused, “Honestly, opioids make me feel gross. I don’t see how anyone could get addicted.” This is a little like a doctor in the delivery end of a needle saying, “Honestly, you’re a wimp. This doesn’t hurt.” Both examples reveal a lack of empathy and a fundamental misunderstanding of current neuroscience.
The contributions or fear, reward, fight, and flight are a complicated …
Not only is it kickoff time for college football season, but it’s also prime time for fall allergies. For the 50 million Americans who suffer from ragweed allergy, the late summer and early fall signal the onset of runny noses, sneezing, congestion, cough, itchy watery eyes, and in more severe cases, sinus infections and asthma exacerbations.
Seasonal allergies are a huge source of frustration and fatigue for many of us, causing …
In March 2023, I had a miscarriage when I was 10.5 weeks pregnant. I am blessed to have a wonderful husband and loving family, two healthy sons, and supportive friends, though I still grieve at times. I share what is helping us below, in the hope of helping others:
1. Early pregnancy assessment clinic (EPAC) and caring providers at my OB office. My obstetric office has an EPAC (also called Pregnancy …
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Biological weapons are not new. Their use by armies has taken place for centuries. Take the Plague, for example. The pandemic was reportedly first introduced to Europe during the siege of the Genoese trading port of Kaffa in Crimea by the Golden Horde army of Jani Beg in 1347. It decimated 30 percent of the European population. Paradoxically, the resultant labor shortage and lack of faith in the prevailing order …
I don’t know about you, but I learned very little about variations in sexual development during my medical education over a decade ago. Commonly presented topics were usually of a genetic nature—this person has XXY or XO chromosomes and the “abnormalities” such chromosomal variations can bring. That’s about the extent of my education regarding sex development and gender, with the impression conveyed that these were minor topics.
Fast forward to now, …
His 5-year-old daughter asked her mom, “Today is daddy’s birthday. Can we have a picnic at his grave?”
Bryan was 49 years old. He could really do anything. He could do renovations, carpentry, electrical work, play music, be a father and a husband, a son, an uncle, a brother, and a brother-in-law. He had an incredible sense of humor, was down-to-earth, and a big teddy bear to his children. No one …
Recently, I heard a news report regarding several states’ attorneys general suing the federal government to eliminate the requirement that health care providers be immunized against COVID. They argued that as fully immunized individuals still contract COVID, and that allowing unimmunized people to be rehired would relieve provider shortages, the regulation was unhelpful.
Initially, I agreed that rehiring these individuals would generate some relief for those staff members who have worked …
Setting limits, asking for help, delegating, or even saying “no” are important assertiveness skills. Health care professionals should be proficient in assertiveness because of the potential impact on patient safety, patient experience, workforce health, and cost-effectiveness.
Assertiveness examples
How might these assertive statements influence outcomes?
Tons of ink have been expended on the health effects, both positive and negative, of alcohol consumption. Beneficial effects on the heart were discussed in the 1990s based on the “French paradox.” A paper published in 1995 noted that there was less ischemic heart disease in France compared to the U.S., despite higher saturated fat intakes and a higher prevalence of smoking.
The relatively lower incidence of ischemic heart disease in …
The comedian George Burns once quipped, “By the time you’re eighty years old, you’ve learned everything. You only have to remember it.” With the average life expectancy in the United States up from 54 a century ago to 74 today, the damage that can be done by aging and mental decline is more prevalent than ever. We see evidence of it all too often in our world leaders, families, and …
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