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.
Whenever I diagnose a person with asthma or allergies, I usually ask a few questions about his or her living environment. Is there shag carpeting in the bedroom? Is the air conditioning filter changed every month? Is there evidence of roaches and other vermin? I ask these questions because mold, dust mites, animal saliva and insect droppings can worsen the symptoms of asthma and other illnesses.
But some of my patients …
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Rental housing can worsen your health
Who hasn’t heard the story of a friend or acquaintance who retires only to become seriously ill or die soon after?
Are we working ourselves to death? For anyone who has ever wondered “is this worth it?” a move is afoot to question the concept of the American work ethic. We are currently the most overworked society on the globe. The United States has surpassed Japan as the nation with the …
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Voluntary simplicity can ease the stress of American life
by Emily P. Walker
I was covering an FDA tobacco meeting a while back when I heard a Howard Koh, MD, assistant secretary of health at the Department of Health and Human Services (HHS) start his speech with the World Health Organization’s definition of health.
“Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or …
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Definition of health includes social well-being
Radiation. Powerful enough to turn Dr. Bruce Banner (Bill Bixby) into The Incredible Hulk (Lou Ferrigno), or meek Peter Parker (Tobey Maguire) into The Amazing Spider-Man (still Tobey Maguire, but more buff and spandexed). It also obliterated two cities in Japan, and continues to contribute to cancers near Chernobyl. It’s sciency, strong, and scary. No wonder it creates so much apprehension.
We’re all living every day surrounded by radiation sources, and …
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Radiation and whether cell phone towers are dangerous
by Diana E. Lee
When I start to think about all the things I want to do, I end up feeling like my life is on hold, waiting for some miracle to come along and make me better. There was a time when I believed I would get better. Now I’m not so sure.
I was just getting started in my career in 2003 when my migraines exploded from periodic to chronic. …
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Chronic migraines changed this patient’s life
Ahhh spring.
The lovely blooms unfurling. The trees budding.
It’s enough to make a girl get tears in her eyes.
And sneezes in her nose.
And itching on her face.
Yes, it’s allergy season again — but what can you do to make yourself more comfortable without emptying your wallet?
1. Avoidance. Close the windows. Make someone else cut the grass. Stay inside. (Yes, I hate this one too- let’s move on.)
2. Neti pot or other nasal saline rinsing. LOVE …
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Allergy drug recommendations for patients on a budget
The bioethics community has been working on defining the concept of medically futile care for more than a quarter of a century, yet the debate continues. The way in which the current notion of medical futility becomes folded into the proposed healthcare reform bills is at a critical point.
Sophisticated medical technology that is at once life-saving, life-prolonging as well as death-prolonging has created populations which, in the past, would have …
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Ethics of futile care
A common clinical problem in aging is when should driving a motor vehicle be discontinued. When does driving become a significant safety hazard as cognition and motor skills decline?
The American Academy of Neurology recently published a Practice Parameter update: Evaluation and management of driving risk in dementia. This important review provides clinicians and family members with assistance in making an accurate and timely decision.
The authors of the guideline review research …
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Patients with dementia and when they should stop driving
by Todd Neale
Clinicians should actively persuade families not to participate in the ritual cutting of female genitalia, the American Academy of Pediatrics urged.
However, the organization suggested that legislatures and doctors might ultimately consider legalizing ritual “nicks” to satisfy cultural or religious demands without more serious and problematic cutting.
The centuries-old practice, which is illegal in the U.S. and several other developed countries, carries with it a host of physical and psychological …
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Female genital cutting complications
by Crystal Phend
When children with complex chronic diseases have do-not-attempt-resuscitation orders in place, schools should honor them, the American Academy of Pediatrics urged.
More children with diseases that may involve sudden and potentially fatal attacks are attending school due to legal and societal trends over the past decade, according to a statement in the May issue of Pediatrics.
While these requests are honored in hospitals and nursing homes, schools may find it …
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Children with DNR orders and the liability risk for schools
Last week, I again had the privilege of teaching pediatricians in training. These students were very bright, challenging and asked excellent questions. They all agreed about the limit of the pediatric model of “giving advice.” One resident, who had young children of her own, spoke of new mothers using blogs for emotional support. Many of these mothers speak less than kindly about their pediatricians, who they perceive as “not getting …
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Pediatricians need to wonder when dealing with behavior problems
by Cole Petrochko
As a person who has handled salt in cooking, is prone to headaches from sodium, and has written an article on legislating salt content in prepared and packaged foods, let me tell you about salt, because I know a thing or two.
Well, it would be hard to not know much about salt after the recent string of attention paid to the “white shaken one” — eat too …
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Fight against salt needs consumer help
There is a lot of focus on what elders with dementia can’t do. But what about more discussion of what they can do?
When you see a patient with dementia, how do you help family members maintain meaningful interactions with their loved ones? I am sad to admit that I don’t do this nearly as well as I should. After all, this is not the type of thing we are taught …
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Activities for family members with dementia
My friend, the Buckeye Surgeon, has resisted reforms in medical residency training programs, that have eased some of the inhumane exhaustion on young interns and residents.
I have a different view on the subject. This issue generates spirited debate in the blogosphere and in teaching hospitals across the country.
Not all medical education reforms, however, provoke controversy. I learned recently from an Ohio medical student that they are now being taught …
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Transparent medical pricing lowers health costs
by John Gever
“Jersey Shore” wannabes beware: some people crave the indoor tanning experience so much that it qualifies as an addiction, researchers said.
Among 229 college students completing a survey, 39.3% met DSM-IV criteria for addiction, reported Catherine E. Mosher, PhD, of Memorial Sloan-Kettering Cancer Center in New York City, and Sharon Danoff-Burg, PhD, of the State University of New York at Albany, in the April issue of Archives of Dermatology.
Participants …
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Indoor tanning can be an addictive behavior
Although some psychiatric conditions are acute and transient, most are chronic. They may wax and wane, but most of them do not go away. Likewise, psychiatric medications can significantly improve people’s functioning and quality of life, but they manage, not cure, mental illness.
It’s therefore not surprising that a common conversation that patients and psychiatrists have revolves around the question, “Do I have to be on this medication ‘forever’?”
I’ve previously written …
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Explaining chronic medical treatment to patients
by Todd Neale
Although inhalant abuse has become less prevalent since the early 1990s in all age groups, it remains a source of injury and death, particularly among teenagers, researchers have found.
From 1993 to 2008, intentional exposure to 3,410 different inhalants was reported to U.S. poison control centers, Toby Litovitz, MD, of the National Capital Poison Center in Washington, and colleagues reported in the May issue of Pediatrics.
The highest rate of …
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Inhalant abuse remains prevalent in teens
