This ECG is nearly pathognomonic. What is it? (hint: it's not Wellens')
I was texted this ECG:What did I say?My response: " takotusubo "Even without a history, this is the likely diagnosis. Later, I obtained the history: 60-something woman who presented with agitation and had taken a benzodiazepine overdose. There was no report of chest pain. She had a respiratory alkalosis, with venous pH of 7.56 (equivalent to an arterial pH of higher than 7.60 and possibly contributing to the long QT and ECG abnormalities). Electrolytes were normal. She was also on Duloxetine, which can prolong the QT, and on Lithium (but her level was very low).This is almost certainly ta...
Source: Dr. Smith's ECG Blog - September 19, 2022 Category: Cardiology Authors: Steve Smith Source Type: blogs
Are antidepressants also pain relievers?
Did you know that antidepressant medications are often prescribed for people without depression?
It’s true. Antidepressants are frequently prescribed for chronic pain, especially pain related to nerve disease (called neuropathic pain), chronic low back or neck pain, and certain types of arthritis.
In fact, some guidelines for the treatment of chronic low back pain and osteoarthritis (the most common type of arthritis) include antidepressants. One antidepressant in particular, duloxetine (Cymbalta), is FDA-approved for these conditions.
Just how antidepressants reduce pain is not well understood. One possibility is they a...
Source: Harvard Health Blog - April 16, 2021 Category: Consumer Health News Authors: Robert H. Shmerling, MD Tags: Back Pain Bones and joints Health Osteoarthritis Pain Management Source Type: blogs
The Pain Is In Your Brain: Your Knees Know Next to Nothing
By HANS DUVEFELT
A “frozen shoulder” can be manipulated to move freely again under general anesthesia. The medications we use to put patients to sleep for such procedures work on the brain and don’t concentrate in the shoulder joints at all.
An ingrown toenail can be removed or an arthritic knee can be replaced by injecting a local anesthetic – at the base of the toe or into the spine – interrupting the connection between the body and the brain.
An arthritic knuckle can stop hurting and move more freely after a steroid injection that dramatically reduces inflammation, giving lasting relief long after any...
Source: The Health Care Blog - April 14, 2021 Category: Consumer Health News Authors: Christina Liu Tags: Medical Practice Patients Physicians Primary Care Hans Duvefelt Pain Management Source Type: blogs
The Art of Prescribing (Or Not)
By HANS DUVEFELT
I have learned a few things about prescribing medications during my 42 years as a physician. Some are old lessons, and some are more recent. I thought I’d share some random examples.
First: I don’t like to have to use medications, but when they seem necessary, I choose, present and prescribe them with great care.
CHOOSING MEDICATIONS
Medications are like people. They have personalities. With so many choices for any given diagnosis or symptom, I consider their mechanism of action, possible beneficial additional effects and their risk of unwanted side effects when selecting which one to presc...
Source: The Health Care Blog - February 1, 2021 Category: Consumer Health News Authors: Christina Liu Tags: Medical Practice Patients Physicians Primary Care Hans Duvefelt Source Type: blogs
Treating neuropathy: Which medication is best?
Imagine experiencing burning, tingling, and numbness in your legs day in and day out, getting worse over time — and your doctors can’t find a reason for it.
That’s the situation for millions of people who suffer from idiopathic sensory polyneuropathy. The term “idiopathic” means that no cause can be identified; “sensory” refers to the type of nerve, in this case those carrying nerve signals such as pain or temperature; “poly” means “many” and “neuropathy” means nerve disease. So, this is a condition of unknown cause that damages multiple nerves; the most affected nerves tend to be those th...
Source: Harvard Health Blog - December 1, 2020 Category: Consumer Health News Authors: Robert H. Shmerling, MD Tags: Drugs and Supplements Health Neurological conditions Pain Management Source Type: blogs
Getting the best treatment for your fibromyalgia
Imagine being in pain and having your doctor tell you it’s all in your head. Unfortunately, this is not an uncommon experience for many of the six million Americans living with fibromyalgia, a chronic, painful condition.
People with fibromyalgia experience widespread pain, aches, and stiffness in muscles and joints throughout the body, as well as unusual tiredness. No one knows what causes this condition, and no apparent physical cause has been identified thus far. The most likely culprit is a brain malfunction that amplifies normal nerve responses, causing people with fibromyalgia to experience pain or other symptoms wh...
Source: Harvard Health Blog - September 10, 2020 Category: Consumer Health News Authors: Kelly Bilodeau Tags: Bones and joints Fatigue Health Pain Management Source Type: blogs
What's new in midwifery - 4th March 2020
Where is last week ' s? Some disruption to service caused by the current University and College Union industrial action. Why are we striking? Read more at https://ucu.org.uk/strikeforuss andhttps://ucu.org.uk/he2019.Some recent things you may need to know. Official statisticsConceptions in England and Wales, 2018Quarterly conceptions to women aged under 18 years, England and Wales, October - December 2018Female Genital Mutilation October 2019 - December 2019 (NHS Digital)Maternity Services Monthly Statistics November 2019, experimental statisticsStatistics on Women ' ...
Source: Browsing - March 4, 2020 Category: Databases & Libraries Tags: midwifery Source Type: blogs
Top 25 Psychiatric Medications for 2018
Psychiatric medications are an important part of treatment for many people with mental disorders, such as depression, bipolar disorder, ADHD, schizophrenia, anxiety, and others. They play an important role in helping to alleviate the most serious symptoms, allowing people to better focus on their lives and on other treatment types, such as psychotherapy. Psychiatric medications are an important part of many people’s treatment plans for obtaining the most effective treatment for a mental health concern or mental illness.
It’s good to know what drugs are being prescribed most often for mental disorders in the U.S...
Source: World of Psychology - December 15, 2019 Category: Psychiatry & Psychology Authors: John M. Grohol, Psy.D. Tags: General Medications Psychiatry psychiatric meds psychiatric prescriptions Source Type: blogs
Harvard Health Ad Watch: A fibromyalgia treatment ( “But you look so good!”)
It’s something I’ve heard countless times from patients with fibromyalgia. They’re telling a friend or family member about their condition and the response is, “But you don’t look sick” or “But you look so well.” Sometimes, the reaction is more of an eye roll or some other response that reflects skepticism that the problem is even “real.”
Those are issues addressed head-on in a TV ad for Lyrica (pregabalin), a treatment for fibromyalgia. “To most people, I look like most people,” a woman says. “But on the inside I feel chronic, widespread pain.” After clarifying that the pain is real, this direc...
Source: Harvard Health Blog - November 22, 2019 Category: Consumer Health News Authors: Robert H. Shmerling, MD Tags: Arthritis Bones and joints Fatigue Pain Management Source Type: blogs
Discontinuation syndrome and antidepressants
Discontinuation and change are part of life. We all start and stop various activities. Jobs change, relationships change. So, too, may medical treatments, such as antidepressants that help many people navigate depression and anxiety. Planning changes in advance tends to make things easier and smoother. You may start a medication for treatment and discover that it’s not helping your particular medical issue. Or perhaps you’re having side effects. Or maybe your condition has improved, and you no longer need the drug. If so, working with your doctor to change or stop taking an antidepressant slowly may help you avoid unc...
Source: Harvard Health Blog - April 4, 2019 Category: Consumer Health News Authors: Christopher Bullock, MD Tags: Anxiety and Depression Mental Health Source Type: blogs
Live the Wheat Belly lifestyle, get off prescription medications
Take a look at the list of medications people have been able to stop by following the Wheat Belly lifestyle.
These represent medications prescribed by doctors to, in effect, “treat” the consequences of consuming wheat and grains. They prescribe drugs to treat inflammation, swelling, skin rashes, gastrointestinal irritation, high blood sugars, airway allergy, joint pain, high blood pressure, leg edema and other abnormal effects caused by wheat and grains.
The list includes anti-inflammatory and pain medication, acid reflux drugs, injectable and oral drugs for diabetes, numerous anti-hypertensive agents, asthma i...
Source: Wheat Belly Blog - October 27, 2018 Category: Cardiology Authors: Dr. Davis Tags: News & Updates autoimmune blood sugar bowel flora cholesterol Gliadin gluten-free grain-free grains Inflammation undoctored Weight Loss wheat belly Source Type: blogs
I ’m No Psychopharmacologist
The summer of 2018 went fine. Tommy, my 13-year-old son, was enrolled in several summer camps, which he enjoyed; we had no discernible immediate family issues, and I was in a complete bipolar remission. It felt good to feel good.
But then, the school year rolled around, and I got stressed out. I was teaching two writing courses at a local college, and I noticed a big difference between the calm I’d felt over the summer and the tension that going back to work brought on. There were classes to plan and papers to grade. There were names and faces to learn and personalities to try to understand.
Pretty soon, I found myself a...
Source: World of Psychology - October 21, 2018 Category: Psychiatry & Psychology Authors: Laura Yeager Tags: Antidepressant Bipolar Medications Personal Psychotherapy Bipolar Disorder Depressive Episode Hypomania Manic Episode medication change Psychopharmacology Source Type: blogs
MKSAP: 57-year-old man with type 2 diabetes mellitus
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 57-year-old man with a 15-year history of type 2 diabetes mellitus is evaluated for bilateral burning sensation in his feet for the last 6 to 12 months. The sensation worsens at night. His HbA1c levels have remained less than 7.0% for the last 2 years but were between 8.0% and 9.0% before implementing significant lifestyle changes and transitioning to insulin therapy from metformin therapy 2 years ago.
His medical history includes coronary artery disease, first-degree atrioventricular block, nonproliferative d...
Source: Kevin, M.D. - Medical Weblog - August 11, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions Diabetes Endocrinology Neurology Source Type: blogs
True Confessions On Why I Prescribe Things Without'Evidence '
by Drew RosielleWe have a ' required reading ' list for our fellowship, which includes a bunch of what I think are landmark or otherwise really important studies. One of them is thisvery well done RCT of continuous ketamine infusions for patients with cancer pain, which showed it to be ineffective (and toxic).We also recently have seen another high-quality study published with negative results for ketamine. This was a Scottish, multi-center, randomized, placebo-controlled, intention-to-treat, and double-blinded study oforal ketamine for neuropathic pain in cancer patients. The study involved 214 patients, 75% of whom were ...
Source: Pallimed: A Hospice and Palliative Medicine Blog - July 6, 2018 Category: Palliative Care Tags: fatigue ketamine methylphenidate neuropathic pain research research issues rosielle The profession Source Type: blogs
True Confessions On Why I Prescribe Things Without'Evidence '
by Drew RosielleWe have a ' required reading ' list for our fellowship, which includes a bunch of what I think are landmark or otherwise really important studies. One of them is thisvery well done RCT of continuous ketamine infusions for patients with cancer pain, which showed it to be ineffective (and toxic).We also recently have seen another high-quality study published with negative results for ketamine. This was a Scottish, multi-center, randomized, placebo-controlled, intention-to-treat, and double-blinded study oforal ketamine for neuropathic pain in cancer patients. The study involved 214 patients, 75% of whom were ...
Source: Pallimed: A Hospice and Palliative Medicine Blog - July 6, 2018 Category: Palliative Care Tags: fatigue ketamine methylphenidate neuropathic pain research research issues rosielle The profession Source Type: blogs
