Conditions

Screening for adverse childhood experiences in pediatric primary care made my job easier

Conditions
January 3, 2022

When our pediatric clinic added the PEARLS (Pediatric ACEs and Related Life-events Screener) questionnaire to well-child visits, we were worried that we would uncover trauma that we didn’t know how to address. Our physicians feared that the volume of patients with high scores would be overwhelming. We contended that this additional work was impossible because we don’t have support services like counseling. Beyond that, we expected our patients would be …

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The high achiever and the motivated drinker

Conditions
January 3, 2022

I would like to say that this is a story much like the tortoise and the hare, only it isn’t. There is only one character in this story, the hare. The High Achiever and The Motivated Drinker are the same character and are driven by the same human instinct.

Have you ever wondered why a strong-willed, intellectually above average, high-achiever tries and fails to say “no” to one glass too many …

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A PSA from a neurologist to the medical community

Conditions
January 3, 2022

Have you ever been to a new city and realized you’d been pronouncing a street or a town name all wrong? Have you ever been from one of those cities and has it broken your heart to hear someone call Copley Square Cope-ly? Or pronounce the Schuylkill River or Worcester how it is spelled?

This is how neurologists feel when you call a stroke a cerebrovascular accident, or a CVA. It’s …

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Is it OK to leave your partner in light of a serious emotional issue?

Conditions
January 2, 2022

So, your guy or gal is struggling with a serious emotional issue. Is that a basis for bailing?

Let’s get personal here; if you’ve got one foot out the door, you’re probably asking the wrong guy. One of my key values is loyalty. But before I start lecturing, let’s take a closer look at this issue.

A well-thought-out answer is important to this emotional quandary. Did your partner come into the relationship …

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7 causes of low back pain

Conditions
January 1, 2022

The New Year is a typical time for resolutions, and one of the most common ones is to get healthier. For many of us, a common stumbling block is dealing with low back pain. As a rehabilitation medicine physician, my focus is nonoperative spine care within one of the top orthopedic practices in the country. Let’s talk about the causes of low-back pain and what we can do about it.

1. …

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The COVID vaccine is a life raft. I’m not your life raft to get out of it.

Conditions
December 31, 2021

It began with a seemingly innocuous text from a friend of the family.

“Hi, Richard. I hope you’re well. I need to speak with you. Can I call you?”

The last time we spoke was at my brother’s long-postponed “celebration of life,” which we were able to hold a year after his passing finally. Our friend attended the wake, so feeling a sense of appreciation for his support during that time, I …

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Attack COVID like the terrorist it is

Conditions
December 27, 2021

More than 1,100 in the U.S. are still dying every day from COVID-19. Every three days, we are losing more Americans than the number that died on 9/11. Just because we don’t see it sneaking up on our families does not mean the COVID terrorist is defeated. While deaths are mainly in 12 northern states, it is highly likely we will again experience a similar problem in Texas and across …

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Sustaining mental health during the holidays and starting strong in 2022

Conditions
December 26, 2021

The holiday season was notorious for causing loneliness, sadness, anxiety, and a sense of loss even before adding the COVID-19 pandemic to the mix. The pandemic has only served to magnify many of these feelings, as gatherings with loved ones are postponed or canceled. The stress of getting everything done on time and navigating family dynamics can lead to struggles that can benefit from support and self-care. In 2021, support …

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Tobacco is a painful addiction

Conditions
December 23, 2021

Smoking cigarettes is well known to cause heart disease, lung cancer, and premature death. In the face of these risks of death, quality of life issues that affect smokers are often overlooked. Although some quality of life issues such as cost, cravings, inconvenience, illness, and stigma are well known, some important effects are largely unknown to the public. For one, smoking is connected with a surprisingly large variety of pains.

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10 things this nurse is f-ing tired of saying

Conditions
December 21, 2021

Musings of a primary care triage nurse:

1. “Isolation means you aren’t around others. No, you shouldn’t be eating dinner with your family or watching TV with them.”

2. “You’ve been sick for the past week but didn’t get tested. Yes, COVID can just be symptoms like a cold or that sinus thing you get each year.”

3. “The majority of those that are hospitalized are unvaccinated. I know ‘someone’ told you that’s …

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Is life more than breathing and a heartbeat?

Conditions
December 20, 2021

A few months back, I read about a two-year-old child with a terminal cardiac condition who has spent her life in a hospital bed attached to multiple devices that maintained her survival. At the staff’s request, the institution’s ethics committee reviewed the child’s history and prognosis and decided that the equipment could be disconnected. Her mother repeatedly blocked this option, insisting that the child, although frequently sedated, had a “bubbly …

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The trouble with resiliency: It’s time to get to the root causes of health care worker burnout

Conditions
December 19, 2021

Over the last several years, there has been an increasing recognition that burnout is rising exponentially among health care workers – and there has been a positive shift in the public understanding of burnout and other mental health issues in general. Unfortunately, the policy response from governments, health care institutions, and policy-makers has been woefully inadequate.

Instead of addressing the root causes of burnout and mental distress among our health care …

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Diabetes impacts the whole body, but the foot can’t be forgotten

Conditions
December 18, 2021

Diabetes is a complex yet common disease that impacts over 34 million Americans. Blood glucose is just the tip of the iceberg; related complications include neuropathy, eye disease, ketoacidosis, kidney disease, cardiovascular disease and more. In fact, it could be said that diabetes is a “whole body” disease, in the sense that it spirals out to cause devastating problems that impact many regions of the body, including …

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A milligram of understanding for anti-vaxxers

Conditions
December 17, 2021

When the COVID pandemic first reared its ugly head in 2020, I was mentally prepared (as much as any of us could be) for the patient care wave that was coming our way. What I was not prepared for was the mass of anti-science and anti-intellectual pushback that we have seen over the past one and a half, almost two years, in regard to the virus itself and the vaccine.

To …

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Think eating disorders don’t happen to Black people? Think again.

Conditions
December 17, 2021

I remember receiving the email, “Eating Disorder Panel Q & A.” My physician colleague had become very experienced at caring for eating disorder patients. She understood the importance of this work and how misinformed much of the health care community was on the topic.

She took it upon herself to set up a medical didactic session for the health care providers in our practice to provide us with additional education. The …

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Is Omicron a sheep in wolf’s clothing?

Conditions
December 15, 2021

Make no mistake, the newest variant in the COVID-19 family is far more contagious than any of the others. Will it cause a drastic surge in the pandemic? Or could it have a mitigating influence?

First identified in South Africa on November 11, Omicron quickly became the dominant variant in that country. In October, Delta variants were found in 80 percent of all samples sequenced, while in November, 75 percent were …

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Viral upper respiratory infections in the age of COVID

Conditions
December 14, 2021

Your toddler has had a cough and runny, stuffy nose on and off for months. They also attend daycare and have a sibling in preschool. You are worried about the symptoms. You are also exhausted because your child’s coughing and congestion is not letting either of you sleep at night. Does this sound familiar?

You ask yourself, “Is this normal?” and “What is wrong with my child?”

Well, to calm your fears, …

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3 ways to reawaken nurse purpose in the era of burnout

Conditions
December 12, 2021

In September, the American Nurses Association asked the Department of Health and Human Services to declare the national nursing shortage as a national crisis. At the same time, the American Association of Critical Care Nurses found 66 percent of ICU nurses were considering leaving the profession. Talk to any hospital, and you’ll hear of high turnover and struggles to fill shifts. So far, the …

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Tired of the dying: Finding parallels in COVID-19 and HIV

Conditions
December 11, 2021

Recently, while visiting with a colleague in our doctor’s lounge, I blurted out, “I’m tired of the dying.” He looked at me quizzically, “But you’re the hospice doctor.” True, death comes with my work, but the recent volume of and the loss of younger patients have been especially difficult. It reminds me of an earlier time we faced a new virus.

As we endure this pandemic well into its second year, …

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Wear your mask to protect your family

Conditions
December 10, 2021

Below is a story a patient shared with me about how he went from being against mask-wearing to wearing one every day.

***

Last year, my mom died from stage 4 lung cancer. Before she passed, she received her transplant at this hospital, but it was too late for her.

Now, I am fighting cancer. Lymphoma. Stage 2 verging on Stage 3.

Before my diagnosis last summer, I never wore a mask. I walked …

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