An excerpt from Sleep Reimagined: The Fast Track to a Revitalized Life.
Stimulus control is highly useful in treating insomnia and can be considered a partner to sleep restriction because it helps maximize sleep efficiency by limiting disturbances. Stimulus control is based on the concept of conditioning and association. Its goal …
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Today’s episode features Brian Gelbman, a pulmonary and critical care physician. The COPD management space is facing a growing crisis, with a shortage of pulmonologists and respiratory therapists, and limited access to pulmonary rehabilitation facilities. This has …
It wasn’t until I reflected upon how many times the highway rumble strip had potentially saved my life that I sought the help of a physician trained in sleep medicine. Prior to that, no doctor had ever asked me about my intractable insomnia.
Sleep is increasingly being recognized as an underappreciated vital sign. An estimated 50 to 70 million Americans may have a sleep disorder, and according to the Centers …
My daughter was born with cystic fibrosis (CF). CF has been a catastrophic disease, historically fatal in childhood. CF is not pretty; it affects nearly every organ system, slowly and systematically damaging them. People with CF have thick, sticky mucous, which clogs their airways, pancreatic ducts, sinuses, and intestines. This mucous causes numerous health issues.
CF has been around for a long time. In the Middle Ages, a poem warns parents, …
The first dying patient I saw as a medical student was a man newly diagnosed with lung cancer, a chronic smoker with now oxygen-dependent COPD. In rounds, our medical team stopped outside his room, and the learned men and women pontificated about what to do next with the man. Chemo? Radiation? Both? I pretended to listen and rubbed my chin with feigned discernment, trying to understand the conversation like any …
There’s a burgeoning crisis taking hold in the COPD management space; there are simply not enough pulmonologists, respiratory therapists, or pulmonary rehabilitation facilities to treat the growing number of COPD patients. This has left our field with an urgent window of opportunity to implement digital innovation into traditional treatment paradigms. Ironically enough, it was a respiratory disease that led to a global pandemic more than two years ago, which …
Every pediatrician is familiar with this endemic seasonal virus, expecting to see several cases in their office during the winter months and maybe even admit the occasional one for inpatient care. Even amongst the latter, most do well and recover without incident, though the stay can be prolonged.
However, the respiratory syncytial virus — when it causes pneumonia and bronchiolitis (inflammation of the small airways — can result in serious illness …
In November, Mariah Carey defrosts for another holiday season with her iconic tune, “All I Want For Christmas Is You,” and social media floods platforms with content about Black Friday and the holidays.
November is also Lung Cancer Awareness Month. Lung cancer is the No. 1 cancer killer of both men and women in the U.S. and worldwide. Lung cancer kills more people each year than breast, prostate, and colon …
One morning, I was sitting in resident lecture. This time was supposedly protected, but we realized fairly quickly that the work still had to be done, and “I had lecture” never really worked out well as an explanation.
By this time in the week, I had already worked 80 hours, and the luxury of sitting down for an hour in a row was the main upside to the lecture. I kept …
“Even low dose mercury toxicity can be harmful to human health in a variety of ways: enhanced free radical stress, reduced glutathione levels, increase in apolipoprotein E g4 genotype expression, promotion of neurofibrillary tangles and altered immune sensitivity. It has been implicated in contributing to autism, Alzheimer’s disease, Parkinsonism, and even lupus …
Pneumonia is the deadliest of all hospital-acquired infections in the United States, costs 3 billion dollars per year and is the leading cause of new antibiotic initiation in hospitals. Hospital-acquired pneumonia is classified as either ventilator-associated pneumonia (VAP) or non-ventilator hospital-acquired pneumonia (NVHAP). For the past 15 years, VAP has dominated our attention, resulting in the wide implementation of evidence-based prevention strategies that have …
Why should doctors become involved in social media? I asked myself this same question a few years ago. My answer was, “I don’t know.” I saw no redeeming reason to get involved with social media as a physician. At the time, I just saw it as a social platform for posting cute family photos, funny pet videos, jokes, inspirational quotes, and links to entertaining stories. Sure, a lot of that …
“You were doing it wrong.”
The patient in my pulmonary clinic for follow-up after her discharge from a hospitalization in January of this year for COVID-19 pneumonia was explaining why she would not reconsider getting vaccinated despite her recent illness.
I told her I had been seeing people die from this disease for the last two years; I wanted to prevent others from suffering from severe illness and death—like her.
“People were dying …
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The fertility rate in the United States, and globally, has been on a steady decline. This is the sixth consecutive year that there has been a reduction in the fertility rate, which has decreased by an average of 2 percent. Numerous factors contribute to the global decline in fertility, such as economic instability, increased educational attainment among women, delaying marriage, and the decrease in …
Cities and urban environments tend to have large gaps in health care accessibility and correspondent health care disparities. Despite the existence of localized public health infrastructure, such infrastructure tends to be fragmented and cannot fully encompass the level of nuance within its patient population as a result. As such, health care inequities are cyclically perpetuated in part through discontinuous health systems. Smarter, patient-centric approaches are needed to move the needle …
I’m writing this case report to raise awareness about a condition plaguing the health care system. The condition is Prior Authorization Fatigue Syndrome (PAFS). This condition is the direct result of the circuitous process of prior authorization (PA).
I am the physician owner of a medium-sized allergy practice in Southern Colorado. In our clinic, we spend many hours navigating the PA system to obtain approval for a range of health conditions. …
Wood art
When Air Hurts
When the Lung Repulses Air
When Air Becomes the Harshest Invader
When Air Is Heavier Than Mountains
This work was inspired by my father and many other patients who were struggling to breathe. The soft, unnoticeable air suddenly becomes a palpable matter wildly invading the walls of the respiratory system, making noises and creating resistance.
A “refreshing” breath leaves the person more tired, …
About a year ago, I was referred to a sleep clinic and was diagnosed with “very mild obstructive sleep apnoea” (OSA). A continuous positive airway pressure (CPAP) device was recommended with a litany of disorders that would occur (heart disease, CVA, HTN, decreased mortality, motor vehicle accidents, etc.) if I did not use the apparatus consistently and properly.
I assiduously used it for two test periods. Though the physician reported improvement, …
Asthma is one of the most common chronic diseases in the U.S., with a prevalence of 15.2 percent. The condition is manageable when treatment is appropriately prescribed, adjusted, and accessed by the patient. However, uncontrolled asthma can impair various facets of life and may even be fatal. This dichotomy is noteworthy, especially when considering how strongly asthma outcomes correlate with other elements of an individual’s social …
“Boxed warnings” or “black boxes” are the strictest FDA label warnings. They appear on cigarettes, fluoroquinolones (for tendon rupture), Lamictal (for SJS and TEN), Accutane (birth defects), and other products with well-known risks.
The industry obviously dislikes black boxes since they reduce sales (though their lobbyists charge the boxes “confuse” and “unnecessarily alarm” patients).
So it was no surprise that when the Read more…
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