Neurologists and physicians writing on KevinMD about the brain: dementia and Alzheimer's disease and the biomarkers that now find it early, stroke and what recovery really allows, autism, Parkinson's disease, gait and balance as vital signs, and caring for a spouse or parent with a neurological illness. Three maintained records draw on this archive: Aging and dementia: what physicians say, in their own words, Heart disease: what physicians say, in their own words, and Mental health: what psychiatrists and physicians say, in their own words.
The incidence of brain trauma has been rising in recent years. According to the Centers for Disease Control and Prevention (CDC), emergency department visits related to traumatic brain injury (TBI) increased by 53 percent in the U.S. from 2006 to 2014. For 2014 alone, the CDC reported about 2.87 million TBI-related visits, hospitalizations, and deaths. Reports of concussions in high school athletes have also increased in recent …
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Concussion treatment centers: 5 red flags to watch for
A patient walks into the doctor’s office and says:
I hate feeling this way. Yes, I know it’s not cancer and it won’t kill me, but this shaking has made me a different person. I can’t sign my name. I drop and spill things all the time. I’m afraid to pick up my baby grandson. I don’t go out anymore because I’m embarrassed. And I don’t know what can be done. …
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Steadying patients’ fears about shaking hands
Earlier in June, the U.S. Food and Drug Administration (FDA) won a major legal victory by getting an injunction to prevent Florida-based US Stem Cell Clinic from offering its treatments. The company claimed to create stem cells from patients’ body fat and use these to treat a variety of serious illnesses, including Parkinson’s disease, ALS, and chronic lung disease. This company is just one of many that have sprung up …
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Beware the claims of stem cell clinics
I know what kinds of things I’m supposed to tell you. I know that your other would be advisors will usually stick to the same basic messages: “Keep reaching for your dreams” or “your hard work is all worth it in the end” or “your education will lay the world at your feet.” These platitudes are all well and good, but honestly, they’re forgettable. And pretty words don’t always translate …
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To struggling medical students: Meet the physician who conquered the “no’s”
Two recent patient experiences prompted this post. In the Wall Street Journal, Dana Hawkins-Simons described several years of being seen by specialist after specialist for her complaints of tiredness, dizziness, ringing in the ears, palpitations, shortness of breath and “brain fog.” She finally researched her symptoms and demanded that she be checked for vitamin B12 deficiency, which turned out to be the cause of her symptoms.
Recently, the …
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When should you be tested for vitamin B12?
When I served as president of the New Jersey Neurosurgical Society, I met a lot of people from around our great state. One question that I heard from many parents and coaches was, “After a concussion, when is it safe to let a student-athlete return to play?”
It is an important question because hundreds of thousands of high school students in the USA suffer concussions annually. I have given this question …
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How a neurosurgeon recommends approaching concussions
As a college freshman in 2012, my life seemed perfect. I was attending Rhodes College in Memphis, TN, with the dream of becoming a pediatric oncologist. To that end, I was serving as a volunteer, researcher, and clinical intern at the world-renowned St. Jude Children’s Research Hospital. I was thriving in my classes and building incredible relationships with my peers and professors. I had never been happier.
Everything changed when I …
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How a disability changed this medical student
Stress!
It is a fact of life for all human beings. Stress is a normal reaction — psychologic and physiologic — to the everyday demands of life. When your brain perceives a threat, the body reacts with a fight-or-flight response, releasing hormones, increasing heart rate, and blood pressure. When the situation is over, your body returns to a normal, calm state. But sometimes, in our overly-stimulated world, the stress response button …
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How to help your children manage migraines
It was the last week of my EMS elective. I was incredibly lucky to ride with one of the EMS captains who was eager to take me to any call that sounded interesting. We were called to a possible stroke. An 82-year-old woman with sudden-onset unilateral weakness and expressive aphasia. The paramedic and EMT on scene were two I had met before. We actually talked earlier that day about the …
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A medical student’s biggest fear
In medical school, you’re not taught how to give stellar patient presentations. Yes, you’re shown the traditional order of things: “Give an effective one-liner first, then tell the HPI [history of present illness] but only give pertinent info, etc.” Just exactly how to deliver the punch that impresses your attending is an art. And it’s an art that takes some time to perfect.
My very first time presenting a patient was …
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A medical student’s first patient presentation
As my patients aged along with me, I noticed both the expected increased numbers of people with some form of dementia and even more patients who were worried about this topic. Unless you have been away on a ten-year safari, you are very aware that dementia is a growing problem. Some 5.8 million Americans are living with Alzheimer’s disease, and similar numbers occur in most western countries. The incidence goes …
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Mild memory loss: Is it Alzheimer’s disease?
When a patient comes to me long after he or she suspects that something is amiss, I tell them, “I understand.” I know why they had ignored their tremors for too long. I understand why they had dismissed their balance issues as insignificant.
Depictions of Parkinson’s disease in popular culture are grim, and nobody wants to be told that they have a disorder that is associated with loss of motor skills …
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Move quickly because Parkinson’s builds slowly
Two prestigious medical journals published studies involving Alzheimer disease (AD) and amyloid beta in successive weeks; both were paired with guest expert commentaries (editorials). One editorial, about a drug study, also reviewed several other failures in anti-amyloid therapy and stated: “To be blunt, A-beta [amyloid] lowering seems like an ineffective approach….” The other editorial had an encouraging attitude toward amyloid PET imaging as part of …
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Interpreting 2 recent studies involving Alzheimer disease
“As soon as I mentioned the ‘A’ word, I knew she would not be calling me back.” This was what one of the parents I met at my preschool told me about what it was like trying to register her son with autism in a non-specialized local community program.
Once the registrar heard the “A word” – autism – they said that another child had already taken the last spot available, …
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Autism and advocacy go hand in hand
Alex and Edward Santos have just returned from a weekend away at their aunt and uncle’s place. They love it there. The couple is in their 20s and spoil the boys with late bedtimes, movies and video games, and home-made cupcakes with chocolate icing and sprinkles. It’s been a long break for Alex, who’s 15, and has been off school for a week. Now, his vacation is almost over, he …
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A mysterious case of seizures in the ER
Patients should have as much access to information as possible. The more they know — the more informed decisions about their health and life that can be made. However, faulty headlines about new therapies are infiltrating news outlets left and right. Many times this information can be misleading, and it is difficult for patients, their friends, and family members to decipher.
Lately, there has been a surge in the release of …
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Medical breakthrough headlines are over the top
He struggled to breathe, progressing from deep breaths with wet sounds reverberating in his lungs, to guppy breathing — opening the mouth like a fish, contorting the entire face. His heart rate slowly decreased, from 150 beats a minute — a pace attempting to keep up with the oxygen demands of the body — to 50 beats, to 40 beats, to that which is incompatible with life. The nurse pushed …
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A patient that reminded me of the first man I ever witnessed dying
