Surviving a potentially fatal injury and the fragility of life

Patient
October 18, 2010

You are now out of the Gray Zone, and you are now a member of an exclusive club.

But membership to this club comes at a steep price.  Membership is not offered, it is not dependent on your income, title nor your social status.  Membership is granted simply by surviving or living with a grave or potentially fatal illness or injury and realizing just how fragile life is and how quickly …

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Surviving a potentially fatal injury and the fragility of life

Is the critical value reporting system truly life saving?

Conditions and Diseases
October 18, 2010

We at the Los Angeles County/USC Medical Center are generally credited with having created the “Panic Value” or “Critical Value” laboratory reporting system in 1969.

A Panic or Critical Value is a laboratory finding at such variance with normal as to be life-threatening if something is not done quickly, and for which there is a corrective action that can be taken.

We determined that it was the laboratory’s responsibility to recognize such …

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Is the critical value reporting system truly life saving?

Controversy about NSAIDs and heart health

Medications
October 18, 2010

by Marianna Rakovitsky, RPh

Recently there has been a lot of controversy  about the use of NSAIDs and heart health.

NSAIDs are medications for pain and inflammation. Many of them are sold over the counter and they are used by millions of people for various aches and pains as well as for more serious chronic conditions such as arthritis. Aspirin is technically an NSAID, but its effects …

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Controversy about NSAIDs and heart health

A sweet and tender moment between a mother and daughter

Patient
October 17, 2010

I had been running late on another busy summer day. The type of day where you gain one step and lose two. Meetings and paperwork had filled up another summer morning. Baseball games, swimming practices, and soccer scrimmages had filled up another summer afternoon. And for this particular summer evening, I was scheduled to work an odd emergency room shift from eight p.m. to four a.m.

While driving to work, I …

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A sweet and tender moment between a mother and daughter

Common throat problems that sleep apnea sufferers face

Conditions and Diseases
October 17, 2010

If you wake up every morning needing to hack up lots of thick mucus or have throat pain, hoarseness, or a chronic cough, you’re not alone. You may think it’s the beginning of a cold, but a cold doesn’t continue for weeks to months without progressing into full-blown viral symptoms.

Instead, these symptoms are the beginnings of the most common throat problem sleep apnea sufferers face. And as I explain below, …

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Common throat problems that sleep apnea sufferers face

How working in the White House breaks down your body

Patient
October 17, 2010

by Keith Humphreys, PhD

When my friend Paul Costello left the Carter Administration, he wrote a funny New York Times article suggesting a special course for departing staffers:

There ought to be an “outward bound” course for White House employees facing exile. Must we face this cruel and unusual punishment cold turkey?

Maybe people were tougher back then – I personally would have collapsed five minutes into the first day of the …

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How working in the White House breaks down your body

Advice for a second year medical student

Medical Education
October 16, 2010

A rising second year medical student read some of my posts and wrote me a kind note asking if I would write something for students. I taught students and ran surgical clerkships at community teaching hospitals for my entire career until about 19 months ago.

I also was prompted to address this subject after reading a recent New York Times story about a new admissions policy at Mt. Sinai …

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Advice for a second year medical student

How a tyranny of health is bad for both patients and physicians

Physician
October 16, 2010

Something happened to the public perception of health and medicine in the 1970s. People began to adopt — and financial interests and the media began to profit from – “healthy lifestyles.”

This was not without consequences.

• Americans became increasingly preoccupied with diet, exercise, and health habits.

• There was a big uptick in the use of alternative “medicine” and stress reduction practices – acupuncture, chiropractic, herbalism, naturopathy, nutritional therapies, yoga, massage, biofeedback.

• …

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How a tyranny of health is bad for both patients and physicians

MKSAP: A 70-year-old man with a history of a systolic murmur presents with exertional dyspnea

Conditions and Diseases
October 16, 2010

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

mksap 15A 70-year-old man with a history of a systolic murmur presents for further assessment of exertional dyspnea. He has had dyspnea his entire life, but has noted a recent deterioration in his exercise capacity. He has no other medical conditions and is on …

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MKSAP: A 70-year-old man with a history of a systolic murmur presents with exertional dyspnea

Searching for solace while balancing the care of patient

Patient
October 16, 2010

by Brian McMichael, MD

The NEJM recently published an interesting case in the ongoing series: “ A Request for Retrieval of Oocytes from a 36-year old Woman with Anoxic Brain Injury.” Usually these cases are diagnostic dilemmas. This one focused on an ethical dilemma at end-of-life.

The Case

A 36-year-old woman, in overall good health taking oral contraceptive pills (OCPs), was on a prolonged international flight, and …

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Searching for solace while balancing the care of patient

Are social networks competitive or compatible with the medical blogosphere?

Social Media in Medicine
October 15, 2010

I’m back from my whirlwind trip to Las Vegas, and I want to think those who followed our panel at BlogWorld 2010.

I was joined by Bryan Vartabedian of 33 Charts, and Kerri Morrone Sparling of six until me in a panel moderated by Kim McAllister of Emergiblog.

A few thoughts from my end.

Photos …

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Are social networks competitive or compatible with the medical blogosphere?

Is healthcare is a right? A balanced opinion

Health Policy
October 15, 2010

Chris Mathews had Ron Paul on his show, Hardball, earlier this year to discuss Social Security and the new health care bill.

Mr. Mathews pointed out that people get old and no longer have an adequate income source to take care of their basic needs, and pointed to this as a reason to force working Americans to save for our retirement through a government program as a sort of …

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Is healthcare is a right? A balanced opinion

How drug reps increase drug sales by influencing physicians

Medications
October 15, 2010

An excerpt from Unhinged: The trouble with psychiatry- a doctor’s revelations about a profession in crisis. Copyright © 2010 Daniel Carlat. Excerpted with permission by Free Press, a Division of Simon & Schuster, Inc.

It may be hard for people to imagine that drug reps can get us to prescribe a particular drug by simply giving us a meal or being nice to us. The process is subtle, but …

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How drug reps increase drug sales by influencing physicians

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Breast cancer and understanding your breast type

Conditions and Diseases
October 15, 2010

What does your breast type say about your cancer risk? Quite a bit, actually.

Whether you have large, small or lumpy breasts, self-awareness is very important. Getting to know how your breasts look and feel can help you recognize possible red flags.

Large vs. small breasts

When it comes to cancer risk, size really doesn’t matter. But, size can affect your mammogram and clinical breast exam.

For example, women with large breasts may need …

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Breast cancer and understanding your breast type

Protecting kids in the world of social media, a Cybersafe excerpt

Patient
October 14, 2010

An excerpt from CyberSafe: Protecting and Empowering Digital Kids in the World of Texting, Gaming and Social Media.

by Gwenn Schurgin O’Keeffe, MD, FAAP

Screen Time and Childhood

Have you ever tried to go “screen-less”? I often tell the story of taking my girls to New York City on an April vacation, looking forward to Turnoff Week. This is a semiannual event that encourages families to flip off the screens …

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Protecting kids in the world of social media, a Cybersafe excerpt

Challenges facing patients adopting personal health records

Health Technology
October 14, 2010

by Kristina Fiore

They’re still there. Rows upon rows of number- and color-tagged manila charts, packed in so closely together that Fiore sometimes sticks to Fiori, or hides behind it.

None of my physicians has yet converted to electronic health records. I dream of the day when my PCP can pull up my chart on her iPad, accessing all of the important information (allergies, family history) before …

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Challenges facing patients adopting personal health records

Tips for questioning costs in today’s health care system

Health Policy
October 14, 2010

by Joanna Fief

About two years ago in the wee hours of the morning, I found myself in a local emergency room with severe stomach pain, incessant vomiting and dehydration.  It wasn’t pretty, and I was desperate for something – anything – to ease my pain and stop my vomiting.

Gratefully, within minutes of receiving an IV with medications for pain and nausea, my symptoms subsided.  After a couple of blood tests …

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Tips for questioning costs in today’s health care system

Finasteride, fruit, and the matter of prostate health

Medications
October 14, 2010

by Arnon Krongrad, MD

The noose was loose on its neck. At first I worried, but then I relaxed. This was a bottle of pomegranate juice, the antioxidant superpower. As the billboard implied, it could cheat death. Perhaps if I consumed pomegranate juice, I could cheat death.

Last week, the Federal Trade Commission charged POM Wonderful, LLC, makers of pomegranate products, with deceptive advertising. …

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Finasteride, fruit, and the matter of prostate health

What makes an e-Doctor?

Physician
October 13, 2010

The rise of the e-Patient movement has the potential to change the practice of medicine, in my opinion, for the better.  e-Patients demand to be taken seriously, to be “equipped, enabled,  empowered, engaged, equals, and emancipated.”

My recent post on KevinMD.com suggested the need for e-Doctors as well, in response to the growth of the e-Patient movement.

So how do you become an e-Doctor?  I believe you, and I, need to be equally …

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What makes an e-Doctor?

Selecting health insurance requires free choice for individuals

Health Policy
October 13, 2010

by William Bayer

Buying health insurance across state lines and health savings accounts are good – but they do not resolve the core issue.

The core issue is that the employer is making the main choice for the employees, leaving them essentially with a choice between small, medium or large. That may satisfy the most important needs, but it does not encourage competition because the …

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Selecting health insurance requires free choice for individuals

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