Conditions

What to do when chronic illness is a source of embarrassment

Conditions
November 26, 2019

Embarrassment is a feeling of awkward self-consciousness or shame. It manifests as a sense of discomfort or even foolishness around others. Feeling embarrassed is emotionally painful because it means you feel uncomfortable with yourself.

The problem with embarrassment is that it adds a layer of mental suffering to the difficulties you’re already facing with your health. Here are four reasons why those of us who are chronically ill feel embarrassed at …

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MKSAP: 67-year-old man with a carotid bruit

Conditions
November 23, 2019

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 67-year-old man is evaluated for a carotid bruit detected on routine medical examination. He reports no history of previous focal neurologic symptoms or visual loss. He has type 2 diabetes mellitus and hyperlipidemia treated with metformin, moderate-intensity pravastatin, and aspirin.

On physical examination, blood pressure is 128/64 mm Hg, …

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A call to increase the availability of the Butrans patch

Conditions
November 20, 2019

Janelle had overdosed 32 times.

Fentanyl coursed through her veins as she was given naloxone (Narcan) for the 32nd time in the ER, from the police, from a bystander. She could never get off of fentanyl. It had made her feel warm and numbed her from the trauma and horrors she had grown accustomed to. When she would wake up in the hospital, sore and discombobulated, she would beg for help. She …

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What does a cardiologist think of the keto diet?

Conditions
November 8, 2019

Being a cardiologist, the most frequent question coming my way for the last few years is “Doc what do you think about the “keto” [ketogenic] diet.”

All foods contain both micronutrients and macronutrients that are essential for the body to function optimally. The human body requires macronutrients in large amounts, which include carbohydrates, proteins, and fats. These nutrients provide energy for your body in the form of calories. Micronutrients are nutrients …

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Why diverticulitis can be an elusive diagnosis

Conditions
November 7, 2019

I have been treating diverticulitis for 30 years the same way. When I suspect that a patient has this diagnosis, I prescribe antibiotics. This has been the standard treatment for this disorder for decades. I have found that diverticulitis is a slippery entity that has two trap doors waiting for physicians to fall through.

It is an easy task to miss the diagnosis. Every physician has done this.

The diagnosis can be …

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MKSAP: 28-year-old woman follows-up after a pre-employment physical examination

Conditions
November 2, 2019

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 28-year-old woman undergoes follow-up consultation regarding a pre-employment physical examination. She reports feeling well, with no recent illness. Medical history is notable for gastroesophageal reflux disease. Her only medication is omeprazole. She is black.

On physical examination, vital signs and other examination findings are normal.

A peripheral blood smear shows …

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Patients: Be proactive in your health care

Conditions
October 30, 2019

If you’ve ever been in the hospital for a surgery, you probably had a resident speak to you about the procedure; you were presented a laundry list of risks, the benefits mentioned, asked if everything was understood. And finally, you initial in several spots before signing your name on the dotted line. You looked at the wall clock and noted that the conversation took a mere six minutes.

Is this proper …

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Should there be a disqualifying upper age limit to become president?

Conditions
October 28, 2019

The health challenge recently faced by Sen. Bernie Sanders has brought two issues to the forefront of the 2020 presidential election. Should there be a disqualifying upper age limit to become president, and should an existing health issue preclude a candidate from running for president?

As scientists in the field of aging, we cannot tell the voting public how to answer these questions. What we can do is inform you about …

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What does cable news do to your brain? A neurosurgeon explains.

Conditions
October 25, 2019

The availability of up to the minute information, presented 24/7/365, could assist a democratic society in making the best choices in determining its future. That was the promise of cable news. Unfortunately, cable news has fallen short of its potential and has led to the further polarization of America. More than that, it has changed the way your brain works. Not for the better!

The various cable …

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Can CRP testing guide antibiotic decisions?

Conditions
October 25, 2019

In response to concerns about the unnecessary use of antibiotics, researchers have sought to identify simple, non-specific tests to help clinicians determine which patients require antibiotics and which do not. Indeed, such tests could facilitate challenging management decisions, which currently rely predominately upon a thorough clinical assessment. To compound the challenge, patients often have pre-conceived ideas about whether or not …

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A father-physician tests if a little peanut a day keeps allergy away

Conditions
October 20, 2019

No one I knew had food allergy, let alone peanut allergy, when I was a child. I grew up at a time when peanuts were given freely on airplanes, and there was no such thing as a peanut-free table at school. Fast forward to today and the world has changed, with food allergies taking on almost epidemic-like proportions.

I am an allergist and became interested in food allergies …

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How “Joker” gets mental illness wrong

Conditions
October 20, 2019

Spoiler alert: Plot points of the movie “Joker” are revealed.

“Joker” opened to a mix of rave reviews and criticism on October 2, 2019, amid fears of mass-shootings at theaters in the U.S.

This left law enforcement agencies scrambling to beef up security at movie theaters to prevent any untoward incidents. Quite ironically, October  2, is also the 150th birthday of Mahatma Gandhi — the crusader and champion of non-violence.

Warner Brothers even …

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Why the flu shot cannot give you the flu (and why you should get one now)

Conditions
October 19, 2019

Flu vaccination prevents millions of flu-related illnesses and deaths annually, but vaccination rates are low for many reasons.

During the 2018-2019 flu season, the Centers for Disease Control and Prevention reported that about 45% of U.S. adults received the flu vaccine. While this is an increase of 8% from 2017-2018, it falls way below the national goal of 70% of American adults …

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Avoiding late-stage dementia with advance directives for stopping eating and drinking

Conditions
October 6, 2019

On October 1, 2019, Nevada began allowing individuals to avoid living in late-stage dementia. The new statute recognizes the legitimacy of an advance directive that instructs health care providers to stop hand feeding food and fluid by mouth. Individuals have already been completing such directives in New York and Washington. The Nevada law is the first that explicitly authorizes such instructions.

Growing …

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MKSAP: 54-year-old woman with flushing of the face

Conditions
October 5, 2019

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 54-year-old woman is evaluated for flushing of the face of 1 year’s duration. These episodes occur two or three times per week and last about 30 minutes. She went through menopause at age 50 and is on estrogen and progesterone hormone therapy. She also experiences episodes of anxiety, …

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Is it physician burnout or perimenopause?

Conditions
September 20, 2019

I am an experienced OB/GYN, well-versed in obstetrics, infertility, gynecology, surgery and — yes — menopause, or so I thought. So why was I so blindsided by my own menopause transition?

I thought I was going through burnout, with anxiety, anger, mood swings, irritability, and depression. I was at a point in my career as an OB/GYN of 20-plus years that patients flocked to me because of my reputation and expected …

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CME Spotlights