Patients and caregivers writing on KevinMD about illness and the health care system from the other side of the exam table: navigating care, the doctor-patient relationship, being heard, cost, and what patients want physicians to understand. Physicians who have become patients write here too. For the record of what pain patients and physicians have said to each other about opioids since 2007, with patient authors cited at the same weight as physicians, see Opioids: what physicians and pain patients say, in their own words. For what patients pay and who is left out when physicians leave insurance, see Direct primary care: what physicians say, in their own words. For what patients, families, and physicians have said about dying, hospice, and the decisions families face, see End of life: what physicians say, in their own words. For what physicians and family caregivers have said about growing old, dementia, nursing homes, and caring for aging parents, see Aging and dementia: what physicians say, in their own words.
by Tayson DeLengocky, DO
There has been a growing public interest in complementary and alternative medicine (CAM) in recent years. Osteopathic manipulative therapy, a form of physical manipulation of the body for improvement of health and body function, has been designated as complementary and alternative medicine (CAM) by the National Institutes of Health (NIH).
According to data reported in 2007 by the National Institutes of Health’s National Center for Complementary and Alternative …
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Alternative medicine and osteopathic medical education
When it comes to football season, it’s time to think about sports injuries. We frequently have children admitted to the PICU (or to what we call the intermediate or step-down unit) for observation, typically overnight, who have struck their head. They have had concussions. What is a concussion, and what does it mean for the child?
The term itself is centuries old, but even thirty-five years ago, when I was in …
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What is a concussion, and what does it mean for the child?
At the end of a busy afternoon, Mrs. MJ was exactly the kind of case I needed.
Two of my patients had come in late but needed to be seen and another was acutely short of breath and refusing to be admitted to the hospital. The chaos had put me almost an hour behind schedule, and I still had to return to the wards to round on my cancer patients. Fortunately …
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Obesity and the crossroads between relative health and medical illness
Are reblogs encouraging suicides in the gay community?
Recently, we’ve seen numerous young gay people take their lives. Tumblr went purple and spread the word with 29,294 reblogs. The photo above has 17,300 reblogs. Obama even made an “It gets better” video with 704,000 views.
Is the blogosphere contributing and encouraging this recent suicide epidemic? Are we reblogging the stories of these “martyrs” without actually thinking about what we’re doing in …
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Blogs encouraging suicides in the gay community
Most parents and all pediatricians are aware of the 1998 study published in The Lancet by Dr. Andrew Wakefield that mentioned a causal link between measles, mumps, rubella (MMR) vaccine and the increased incidence of childhood autism. It shook the medical community and created an international movement of parents questioning the extensive combination of immunizations that are given to children. Could these immunizations be the cause of the increase in …
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How the vaccine and autism scare was a fraud to make money
“What do you think of medical marijuana?” my mother, who has never smoked a thing in her life, of the tobacco or cannabis variety, asked me one day as we drove through beautiful upstate New York woods. We had just passed a sign saying “We will destroy your crops,” with a marijuana leaf beneath. “It has its place,” I said. “No reason to be against it.” “But isn’t marijuana a …
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Legal tobacco and illegal marijuana are historical accidents costing billions
I was sitting on one of the hospital’s nursing units having a difficult telephone conversation. Anyone working nearby could have easily discerned the situation from my end of the call.
Patient’s family member wants to keep aggressive care going for a comatose, terminally ill family member against the best advice of the medical team.
Having never had to make such a decision in my own life, I am left to imagine how …
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Kind and thoughtful words from a fellow physician colleague
Your mother has been up all night.
She has Alzheimer’s Disease and now it has progressed to that inevitable stage of the dementing process where she is paranoid, agitated, and confused. She fidgets and paces and walks all day. She gets out of bed multiple times each night. She has gone out the door into the back yard and tried to escape to the street, wearing only her night clothes. Sometimes …
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Caregiving and living with those who have mental illness
I recently completed a long stretch of night shifts in the emergency department. I have done a myriad of things – spent over twenty minutes trying to convince a patient to take a pill that she needed to treat her psychosis, sutured a facial laceration for a young gentleman who kept insisting that he wanted to leave AMA (against medical advice) and just place a …
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How much we should try to help patients who do not want our help?
An excerpt from Saying Goodbye: How Families Can Find Renewal Through Loss. Published by arrangement with Berkley, a member of Penguin Group (USA), Inc. Copyright(c)2011.
by Barbara Okun, PhD and Joseph Nowinski, PhD
One of the first tasks facing families upon receiving a diagnosis is to learn more about the illness or disorder that faces them. There are many ways to do this: by visiting Internet web sites; by …
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Saying Goodbye: How families can find renewal through loss, an excerpt
How many times have I been asked by the trauma surgeons to see a trauma patient for respiratory failure? The reason for intubation and ventilatory support – being combative and non-cooperative.
Intubating, sedating and sometimes even paralyzing a combative patient is an established practice. Combative patients are dangerous to themselves and to the medical staff. Clinical and radiological evaluation of these patients is difficult as well. Asking “What is hurting, Sir” …
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Intubating the combative patient
When I was an intern in internal medicine, I admitted a patient to my service with pancreatic cancer.
Pancreatic cancer is a bad one; back then, only ten percent of patients with it would be alive within five years after being diagnosed. My patient was a farmer in the full bloom of late middle-age health when he began rapidly losing weight. An abdominal CT scan ordered by his primary care physician …
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Doctors play a role in helping people through transitions with rituals
I’m thankful that I don’t have to research symptoms on the internet, diagnose myself, and come up with my own treatment. All I have to do is go to my doctor and describe my symptoms. My doctor can listen to my symptoms, match them up to what he knows, ask questions to pinpoint what might be going on, order appropriate tests, and recommend a treatment plan.
Odds are, when people get …
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See the same doctor when the diagnosis isn’t obvious
by Brian Jackson, MD and Brian Shirts, MD, PhD
We’ve heard a lot of talk lately about personalized medicine (i.e., using advanced diagnostics to guide customized therapy).
A great deal of research is going into creating new molecular and genetic tests. But whether the health care system is prepared to actually generate value from these advanced diagnostics remains an open question. Our group’s research, presented in …
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HPV test: Doctors are still not following testing guidelines
Advocacy is an important and vital skill for any young adult, but young adults with cerebral palsy and other disabilities have a bit of a unique need for developing the skills. I would argue that the skills needed for self advocacy need to have the opportunity to develop in small ways when a child becomes a toddler.
For me, the roots of my advocacy were planted in the years prior to …
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How patients can advocate for themselves
In my opinion, people are often too embarrassed to see their doctor about sexually transmitted infections (STIs)—in my opinion.
“In my opinion” is one of the most dangerous phrases in science. But when in comes to attitudes toward STIs, the data are scarce. STI’s are very much a “behavior”-based disease, so knowing what attitudes prevail can help us design effective prevention strategies. Attitudes toward HIV have been …
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Disconnect between knowledge of STIs and behaviors to reduce risk
Doctor D has dodged some questions in his career, but he has also been on the receiving end of some non-answers and can attest to their usefulness on the patient’s side of things.
How can a doctor dodging a question help the patient?
Let me tell you a story:
Doctor D’s son Little D was born with a very rare genetic condition which required he see an expert at a big university. As …
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Can a doctor dodging a question help the patient?
Winning the lottery — yes, I’ve heard the horror stories of how people’s lives have taken a turn for the worse after it’s happened. But, like many others, I still wonder what it would be like. I’d be willing to take my chances with the win!
But this post is not about money. Not at all. Actually it’s about gratitude.
It’s about the many ‘lotteries’ in life that have nothing to do …
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Lotteries in life may have to do with suffering, disability and death
We have an intuitive sense of what is meant by those urging medicine to “go digital.” It seems to refer to modernizing, becoming more flexible, and basically following the path of modern computing and information technology.
Is it useful to think more rigorously than this hazy conception, without necessarily reading a special report from The Economist?
Digital information is special because it can be transmitted to and instantiated within any number of …
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Explore information technology and safely digitize medicine
