Neurology

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.

Repaving your path: How clinicians can prevent burnout by embracing core values

Scott Abramson, MD

Physician

June 8, 2024

Don’t blame others for the burned-out road you are on: It is your own “Ass-Phalt.”

OK.

I know that sounds harsh. We, physicians and other clinicians suffer under the demands of irrelevant EMR guidelines, insensitive hospital administrators, and tyrannical medical–big pharma dictates. However, all these are “external” forces. They are not our “phault.” But what about the “internal” forces, forces that may be, in some way, our “phault” (or at least under …

The first time I walked again after a spinal cord injury

Dr. Olivia Ong

Conditions and Diseases

May 19, 2024

Once upon a time, I’d imagined myself the Lone Ranger physician, self-sufficient and incapable of weakness, and when I had my spinal cord injury in 2008, I really felt alone, in the negative spiral of a victim mindset, my own worst enemy and in a dark space where my idea of myself felt entirely lost.

Then, one day, in December 2009, I heard about a center for spinal cord injury recovery …

Big pharma ignores low-cost migraine solution

John C. Hagan III, MD

Medications

May 16, 2024

If you are a fan of pharma, you might want to skip this article. Some pharma enthusiasts will call it a rant. By pharma, I mean avaricious pharmaceutical (a pleonasm) companies collectively. On the other hand, those of you who treat acute migraines will learn of a highly effective, innovative, inexpensive, and relatively safe way to help many of your migraineurs. Those of you who believe that pharma is interested …

Alzheimer’s agony: a son’s vow to never endure

Lewis Cohen, MD

Conditions and Diseases

April 28, 2024

An excerpt from Winter’s End: Dementia and Dying Well.

Are there really fates worse than death? Like most people, Dan Winter was uncertain. That is until he visited his father at a memory care unit in Lawrence, Kansas.

Dan’s father had been diagnosed with Alzheimer’s disease at the age of 70. Winton “Wint” Allen Winter Sr. survived for 13 years, spending his final days in …

I had a (incorrect) memory screening. Have you even had one?

Carol Steinberg

Conditions and Diseases

April 22, 2024

Although it’s hard for me to comprehend and even harder to admit, I’m “of age” to be on Medicare. Recently, I visited my primary care physician (PCP) for a Medicare Annual Wellness Visit, a one-hour appointment that requires the inclusion of a cognitive screening—whether or not the patient or clinician suspects a decline in memory, judgment, or other brain functions.

The myriad brief screening tools, consisting of various questions and tasks, …

Breaking through the cobwebs of dementia

Althea Halchuck, EJD

Conditions and Diseases

April 3, 2024

“Some memories are unforgettable, remaining ever vivid and heartwarming!”
– Joseph B. Wirthlin

I love my role as a hospice volunteer mostly because I enjoy meeting the patients and hearing their life stories. I heard a tale from the Vietnam vet who won the Congressional Medal of Honor, which he humbly said was for “just driving a jeep.” (He later admitted that he saved a general by “just driving a jeep” through …

How my sister’s rights were taken away, like thousands of others with developmental disabilities

Franke James

Conditions and Diseases

March 29, 2024

Teresa has Down syndrome and was 49 when the capacity assessment took place in Ontario.

I saw her as happy, healthy, and active. She enjoyed living nearby with my 91-year-old father, who often said, “We’re a team. We help each other.”

But that’s not how the social worker saw her.

Teresa didn’t understand what the assessment was for, and according to the records, she did not agree to be …

Can you predict Alzheimer’s? New research on early detection.

Marc Arginteanu, MD

Conditions and Diseases

March 27, 2024

You can’t treat something until you know it’s there. Currently, there’s no cure for Alzheimer’s disease (AD) but earlier diagnosis may lead to better understanding of how the disease inexorably progresses, which in turn may lead to prevention of AD and ultimately eradication of this horrific scourge. The latest breakthroughs in earlier diagnosis and even perhaps pre-diagnosis have involved lumbar punctures, brain MRIs, eye exams, and blood tests.

A 2024 study, …

Inside the mind of Alzheimer’s: a caregiver’s haunting nightmare

Max Sherman

Conditions and Diseases

March 6, 2024

An excerpt from Releasing the Butterfly: A Love Affair in Four Acts.

Imagine there must be thousands, if not millions, of family members and caregivers who wonder what it must be like to be the one who has Alzheimer’s. Genie and I have always shared our thoughts and experiences with each other. Often, I would imagine telling her about something that had happened to me and could hear her voice …

Surviving a 28-hour hospital shift: a resident’s struggle and passion

Stephanie Wottrich, MD

Physician

February 28, 2024

I recently worked a 28-hour shift in the hospital. I am on a rotation where I work these long shifts every four days, and my last 3 or 4 of these shifts have been the kind that really tries a person’s soul. I got called all night to see new patients and take care of existing ones, and mind you, this is after a 6:45 a.m. to 5 p.m. day …

How narrative medicine empowers neurodivergent patients

Arthur Lazarus, MD, MBA

Conditions and Diseases

February 26, 2024

It’s been said that the challenges neurodiverse people face are the ones that neurotypical people view as easy, and vice versa. It speaks to the hard-wired diversity of cognitive styles and perspectives among different individuals.

Neurotypical people, who generally fit within the societal norms of cognitive functioning, might find certain tasks or social situations easier due to their alignment with mainstream expectations. On the other hand, neurodivergent individuals, who have variations …

Autism spectrum disorder and medicine: strengths, challenges, and stories

Arthur Lazarus, MD, MBA

Conditions and Diseases

February 18, 2024

Dr. Shaun Murphy (played by Freddie Highmore) stars in ABC’s The Good Doctor, a television drama that centers around an autistic surgeon whose job at the hospital was frequently threatened and would be lost if it were not for the practical and emotional support from the hospital president.

I don’t know how many “Doctor Murphys” practice medicine in real life – autism spectrum disorder (ASD) prevails in about 1% to 2% …

A intern’s journey in delivering tough diagnoses

Francisco M. Torres, MD

Physician

February 6, 2024

I was an intern who had recently graduated from medical school with little hands-on experience when the patient signaled me to his bedside. Initially, I did a double-take, wondering if the man would be asking for me. I glanced anxiously at the morning rounds as they hurried to the next patient. I’d just watched my attending physician present this patient’s case, speaking about him as though he weren’t there. The …

Treating inflammation provides hope in the fight against Parkinson’s

Ken Blaker

Conditions and Diseases

February 5, 2024

The acceleration of new Parkinson’s disease cases outpaces other age-related conditions, and as a result, the patient population is growing quickly. In 2022 there were about 90,000 new diagnoses in the U.S., versus the previous prevailing estimate of 60,000. While some of the increase can doubtless be attributed to improved diagnostics and improved access to health care, those factors affect the statistics of other diseases and cannot explain why …

A dementia patient’s poignant return to childhood

Dr. Damane Zehra

Conditions and Diseases

February 2, 2024

I recently watched an Indian movie called The Three of Us, which revolves around a woman named Shelujah. She is in her late 30s, very charming, traditional, and intelligent. She works as a marriage counselor, leading a happy married life with one son studying abroad. Shelujah diligently maintains a diary, documenting even her minor daily chores. Often, she becomes engrossed in her thoughts, even failing to respond when called by …

Ketones may be the key to unlocking a healthier brain

Marc Arginteanu, MD

Conditions and Diseases

January 29, 2024

You’ve undoubtedly heard the buzzwords: ketogenic diet, intermittent fasting. I don’t have much of an opinion about what that all does for your waistline, but I venture to say that ketones may benefit your brain.

Some doctors have recommended, with rock-solid evidence, diets that increase brain ketone levels as part of the regimen to treat drug-resistant epilepsy in children. Others claim that high ketone levels are like a magic bullet and …

Lifelong learning: a game-changer in diagnosing dizziness

John Corsino, DPT

Conditions and Diseases

December 21, 2023

The eyes can’t see what the mind doesn’t yet know – an axiom to remind us not just of the value of lifelong learning, but that the answers are often in the exam room with us.

Though bright and committed clinical people we may be, we’re dragged by the tendrils of a lumbering behemoth. American health care is designed to produce revenue and built to punish highly visible mistakes over more …

The harsh reality of dementia

Michele Luckenbaugh

Conditions and Diseases

December 19, 2023

Dementia is a general term for diseases affecting memory, thinking, or decision-making, impacting daily activities.

Someone in the world develops dementia, on average, every 3 seconds. That’s 10 million new cases of dementia each year worldwide. In 2020, over 55 million individuals worldwide were living with this disease. This figure is expected to double every 20 years, reaching 78 million in 2030 and 139 million in 2050. As you can see, …

Read more…

The harsh reality of dementia

Protect your brain with a good night’s sleep

Marc Arginteanu, MD

Conditions and Diseases

December 15, 2023

No one knows exactly why we need to sleep, but we certainly do. Although the brain can’t thrive on sleep alone, good sleep is an essential ingredient necessary to keep your brain functioning at its best. New research is shedding light on how a good night’s sleep may protect your brain from neurodegenerative diseases.

In 2022, Canadian scientists evaluated the medical literature regarding sleep apnea and its link to the risk …

Embracing the Huntington’s disease community

Erin Paterson

Conditions and Diseases

November 30, 2023

I had chosen a seat towards the back of the conference room because I noticed the legendary Jimmy Pollard sitting there. I didn’t want to miss the chance to sit next to this Huntington’s disease (HD) advocate and all-around amazing person.

I was at the Help4HD conference in Detroit, Michigan. It was my first time attending an event like this on my own. In the years past, I wouldn’t have had …

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