A solution to the typical afternoon sinking spell is short bursts of exercise. In this blog, I will discuss the concept of short bursts of exercise and how just 1 to 2 minutes of cardio exercise that won’t make you break out in a sweat will make you more productive and less lethargic.
The evidence continues to grow that even short periods of activity can make a difference. A recent …
Short bursts of exercise can ease the afternoon slump
We all have times when we wonder, “Did I choose the right profession? Should I recommend a medical career for my children? Is it time to retire?” These questions creep into the minds of mid-career physicians. We often ask ourselves how we should address the mid-career blahs. What can we do to improve our professional satisfaction? How can we combat the dullness and tedium of our workday lives? And how …
5 ways to beat mid-career physician burnout
One morning after finishing surgery, my nurse pulled me aside. “You need to get into Exam Room One,” she said. “He’s in bad shape.”
Curled up on the floor was an active-duty Navy SEAL. His girlfriend knelt beside him, rubbing his back as he rocked back and forth in pain. A military backpack leaned against the wall. When he looked up at me, tears streamed down his face.
“Doc,” he said between …
What kidney stone pain taught me about human suffering
I still remember the mist that morning. Not because it was unusual, but because some mornings refuse to be forgotten.
I was approaching the end of my second year of surgical residency. The nervousness of my first few months had slowly given way to confidence. I could evaluate patients independently, formulate plans, and perform a growing number of procedures. I believed I was learning how to become a surgeon.
What I did …
You could have been professional, but you chose kindness
For decades, the digital rectal exam (DRE), the traditional “finger test,” has been a routine component of prostate screening. It is quick, inexpensive, and engrained in medical culture. But the question is no longer whether we can do it. It is whether we should. With PSA testing, advanced imaging, and refined risk stratification, routine DRE in asymptomatic men is increasingly indefensible.
Low sensitivity and limited value
Recent studies show that DRE has …
Why the digital rectal exam fails prostate cancer screening
She came to me with a manila folder stuffed with urine culture reports. 14 of them, spanning three years. Every one showed a different organism, or the same organism with a longer and longer list of resistances. Her most recent culture, the one that finally prompted her primary care physician to refer her to urology, showed an Escherichia coli (E. coli) resistant to 15 antibiotics. 15. She had been treated …
A new approach to treating recurrent urinary tract infections
A physician who had a side gig as a pig farmer wanted to breed his three female pigs with the boars on a neighboring farm. He loaded them into the back of his pickup truck and took them to visit several boars at the nearby farm. While the pigs were getting acquainted, the farmer of the female pigs asked the second farmer, “How will I know if my pigs are …
7 practical tips to improve the patient experience in your clinic
Our nation and the health care industry have been in shock following the assassination of the CEO of one of the largest insurance companies in the U.S. in December 2024. The reaction to Brian Thompson’s death and suspected shooter Luigi Mangione appeared to have captured America’s attention. The assassination has focused public outrage toward the health care insurance industry and a lack of empathy for the victim and his …
Physician patient advocacy: Fighting insurance denials effectively
A man notices it in a moment he did not plan to analyze.
An erection that used to be straight now bends. There is a new ache. Sex feels different, less reliable, more tense. He tells himself it is temporary. He avoids looking too closely. He stops initiating intimacy. And most of the time, he does not say a word.
That quiet delay is one of the most overlooked parts of Peyronie’s …
Peyronie’s disease symptoms: Why men delay seeking help
Few things scare parents faster than seeing blood where it doesn’t belong.
Maybe your child took a hard fall off a bike. Maybe there was a rough sports collision. Maybe it was a car accident, and everyone is still shaking. Then a nurse asks for a urine sample, or your child goes to the bathroom and you notice pink or red in the toilet.
Your mind immediately goes to the worst place.
As …
Blood in urine after a child’s injury: When to worry
“I’m surprised I haven’t had a kidney stone.”
It’s a running joke among my co-residents, when it’s 3 o’clock in the morning, with over 20 patients in the waiting room, and nobody can remember the last time they had water. Most days, my fluid intake is limited to the sips needed to swallow my antidepressants (to quote my parents, “you can’t just take them whenever you feel sad,” and “it’s not …
Why doctors ignore their own advice on hydration and health
A man in his late 40s sits down in my office and says, “Doctor, I think my testosterone is low.”
Sometimes he is already holding lab results. Sometimes he is coming from a gym forum, a friend’s recommendation, or a late-night Google search. But almost always, the story sounds familiar: lower sex drive, fewer morning erections, weaker erections, fatigue, brain fog, mood changes, and that stubborn belly fat that seems to …
Low testosterone in men: a doctor’s guide to TRT safety
It has been six months since my robotic-assisted radical prostatectomy, and I find myself suspended in a strange middle space, grateful to be cancer-free, yet still struggling with a question I cannot fully answer: Is it safe for me to restart testosterone replacement therapy?
Before my diagnosis, testosterone replacement was not just a prescription; it was a restoration. I have lived with hypogonadism for years, and TRT helped me regain the …
Is testosterone replacement safe after prostate cancer surgery?
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Urologist William Lynes discusses his article “A urologist’s perspective on presidential health transparency.” William examines the medical plausibility of a former president being diagnosed with widespread metastatic prostate cancer just months after …
Urological analysis of delayed cancer diagnoses in political figures [PODCAST]
Scrotal pain in young men is a frequent reason for emergency department visits and urology consultations. While many underlying causes are benign and self-limiting, others, most notably testicular torsion, represent true urologic emergencies in which delayed intervention can result in irreversible testicular damage.
The clinical challenge lies in distinguishing conditions that allow for short-term observation from those requiring immediate evaluation. This distinction is particularly important in adolescents and young adults, …
Scrotal pain in young men: When to seek urgent care
As a 93-year-old physician, I am well acquainted with the ravages of aging and the continuous adaptations we all must make to accommodate its increasing demands. One area that is particularly troublesome is nocturia with repeated, late-night calls to the toilet. This is not only an issue of disturbed sleep, but also of safety. Nocturia involves leaving my bed, turning on a light, and making my way to the bathroom, …
A simple nocturia management technique for seniors
Bladder cancer is one of the most common cancers worldwide, yet it often receives far less attention than other smoking-related cancers. According to the GLOBOCAN global cancer fact sheet, bladder cancer is among the top 10 most frequently diagnosed cancers globally, with more than half a million new cases diagnosed each year worldwide. It occurs significantly more often in men than in women, and the risk rises steadily with …
Why smoking is the top cause of bladder cancer
Kidney stone disease remains one of the most common and painful conditions in urology, affecting millions worldwide each year. Global data show a continued rise in incidence (more than 100 million new cases in 2021) making prevention and long-term management a priority for both clinicians and patients. Despite significant advances in minimally invasive treatment, many patients still ask a familiar question: “Is there a natural remedy that can help …
Phytotherapy for kidney stones: a clinical review
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Urologist William Lynes discusses his article, “The decline of the doctor-patient relationship.” William explains why he believes this relationship, the critical center of medical care, is broken after 40 years of insidious …
Why the doctor-patient relationship is nearly dead [PODCAST]
Studies show that many patients have strong convictions regarding their rights and values. Some avoid or delay life-saving medical procedures due to modesty concerns, which can stem from religious, cultural, or personal reasons, or anxieties from previous bad experiences in medical settings. Some patients even travel to another state or country to seek medical care. Others who have been diagnosed with PTSD from abuse in medical settings avoid medical care …
Patient modesty in health care matters
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