Fighting Hubris in Medicine

By ANISH KOKA The weekend started with a tweet about an elderly man with atrial fibrillation.  Atrial fibrillation is an arrhythmia of the heart that predisposes those who suffer with it to strokes.  The strokes are a  result of clots being thrown from the heart into the brain.  The typical treatment for this condition in those deemed high enough risk is to thin the blood to help prevent these clots from forming, and thus reducing the risk of stroke. 101 year old with a history of a stroke stops his Pradaxa. Only other history hypertension. https://t.co/Ai5z519rcX — Anish Koka (@anish_koka) June 3, 2018 The problem with thinning the blood is that the risk of bleeding increases, and it does so especially as one advances in age.  It doesn’t help matters that the risk of having a stroke also increases with age. In a 101 year old deciding on the best course of action is thus a challenging one.  It is easiest when patients are adamant about a certain path.  Far be it from me to tell a centenarian what to do.   In this case, the man who had been alive for two world wars chose to come off the anticoagulant he had been dutifully prescribed. I queried the audience Curious how many would advise him this is a good / bad idea?@AndrewFoy82 @drjohnm @f2harrell @stephensenn @ADAlthousePhD @RogueRad @narrowQRS @rdschaller — Anish Koka (@anish_koka) June 3, 2018 Most leaned towards stopping Pradaxa, and some responded that there wasn’t a wrong answer. I as...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Uncategorized Source Type: blogs