Narrative Matters: On Our Reading List
Editor’s note: “Narrative Matters: On Our Reading List” is a monthly roundup where we share some of the most compelling health care narratives driving the news and conversation in recent weeks.
An Emergency In Slow Motion
In “Wait Times,” the prize-winning lead essay in Creative Nonfiction’s summer issue, writer Joe Fassler tells the harrowing tale of his wife’s lengthy ordeal in a New York emergency room. For hours, his wife Rachel suffered in excruciating pain, while clinicians dismissed her symptoms as those related to kidney stones, and did not perform the needed exam that would have diagnosed her true c...
Source: Health Affairs Blog - September 25, 2015 Category: Health Management Authors: Jessica Bylander Tags: Elsewhere@ Health Affairs Equity and Disparities Featured Health Professionals Hospitals Narrative Matters Organization and Delivery Population Health Quality Emergency Medicine End-of-Life fibromyalgia On Our Reading List Physic Source Type: blogs
Letter to my patient
These 'letters' were passed to me by colleagues. I guess I work with alot of...frustrated docs. (these were not written by me)Dear Patient:You came in at 11pm last night with a chief complaint of sore throat while munching on a sandwich at triage. Next time you choose a sandwich to bring with you to the ED, try something that will go down easier. Peanut butter and Jelly – while I’m sure was very tasty, made my ENT exam, well… a bit difficult. But alas, we did get through it and I got to see your very normal throat. While I was tempted to leave the diagnosis of “no real complaint” on your chart, after envisioning ...
Source: EM Physician - Backstage Pass - September 8, 2015 Category: Emergency Medicine Authors: Taylor Source Type: blogs
Letter to my patient
These 'letters' were passed to me by colleagues. I guess I work with alot of...frustrated docs. (these were not written by me)Dear Patient:You came in at 11pm last night with a chief complaint of sore throat while munching on a sandwich at triage. Next time you choose a sandwich to bring with you to the ED, try something that will go down easier. Peanut butter and Jelly – while I’m sure was very tasty, made my ENT exam, well… a bit difficult. But alas, we did get through it and I got to see your very normal throat. While I was tempted to leave the diagnosis of “no real complaint” on your chart, after envisioning ...
Source: EM Physician - Backstage Pass - September 8, 2015 Category: Emergency Medicine Authors: Taylor Source Type: blogs
Is the crusade against pill mills turning into a witch hunt?
I care for a 65-year-old woman suffering from sarcoidosis affecting her lungs, her skin, her bones, her nerves, her blood chemistries, her kidneys, her colon and her mind. She has gone from an active spouse, mother, grandmother, tearing up the dance floors with her husband, to a home recluse calling friends to drive her to medical and care appointments while ambulating with assistance of another strong individual supported by a 4 wheel walker with a seat. She describes her foot pain as feet burning on fire.
An evaluation with the Cleveland Clinic and ultimate biopsies of her skin and nerves led to a diagnosis of severe sma...
Source: Kevin, M.D. - Medical Weblog - August 16, 2015 Category: Journals (General) Authors: Steven Reznick, MD Tags: Meds Pain management Source Type: blogs
Post #42 A book review - Being Mortal: Medicine and What Matters in the End by Atul Gawande
In his breathtaking book, Being Mortal: Medicine and What Matters in the End, Atul Gawande (one of my favorite authors) elegantly describes three different modalities of patient counseling that doctors employ. The first is the oldest and most traditional approach, a paternalistic relationship. The doctor not only has the knowledge to guide the patient, but also possesses the experience and wisdom to make decisions on their behalf. The second type of relationship is termed "informative." Here the doctor informs you about the facts and figures related to your medical problem, along the lines of a talk...
Source: A Pediatrician's Blog - August 10, 2015 Category: Pediatrics Source Type: blogs
Kidney Stones - Mayo Clinic video
William Haley, M.D., Nephrologist at Mayo Clinic in Florida, discusses the many frequently asked questions regarding kidney stones:
Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook. (Source: Clinical Cases and Images - Blog)
Source: Clinical Cases and Images - Blog - July 1, 2015 Category: Universities & Medical Training Tags: Mayo Clinic Nephrology Urology Video Source Type: blogs
LITFL Review 185
Welcome to the 185th LITFL Review. Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM.
The Most Fair Dinkum Ripper Beauts of the Week
Incredible reenactment videos of the Elaine Bromiley case, “a routine operation that went horribly awry.” From EMCrit, where Nicholas Chrimes’s videos show how things go wrong and how they can go right. [AS]
The Best of #...
Source: Life in the Fast Lane - June 7, 2015 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs
Top stories in health and medicine, May 25, 2015
From MedPage Today:
Time to Retire Lithotripsy for Kidney Stones? More than 30 years ago, extracorporeal shock wave lithotripsy (ESWL) had a highly anticipated, much-ballyhooed introduction as a nonsurgical therapy for kidney stones. Obviating the need to cut the skin or insert a device into the body, ESWL would use acoustic shock waves to pulverize stones into dust that would be washed out of the kidneys.
Senate Committee Mulls Medicare Hospital Observation Stays. Hospital observation stays for Medicare patients can be problematic, but finding solutions is also tricky.
Sildenafil May Help Heal Scleroderma Ulcers. Silden...
Source: Kevin, M.D. - Medical Weblog - May 25, 2015 Category: Journals (General) Authors: MedPage Today Tags: News Nephrology Pulmonology Source Type: blogs
Cancer is Not a Death Sentence
Life is Good!
If you or a loved one has just gotten a cancer diagnosis, I want to reach out to you with this article to let you know you don’t have to be afraid. Of course you will be in the beginning. We are conditioned to fear cancer. But, I want you to know that you have enormous hope for a high quality, healthy, even long, life in your future if you want that and are willing to listen to the message from your body and take action to heal it.
Let’s Face the Fear Factor First
I realize that having “death” in the title is a little scary, but it’s true: Cancer is not your death sentence. Being born is. At birth...
Source: Life Learning Today - May 21, 2015 Category: Consumer Health News Authors: AgentSully Tags: Green Living Happy Healthy Living How To Solving Problems Spiritual alternative cancer cures alternative cancer healing Believe faith fear fear of cancer heal yourself healing cancer healing power love yourself Source Type: blogs
Ultrasound Treatment for Amyloid in Alzheimer's Disease
Researchers are investigating the use of ultrasound to reduce levels of harmful amyloid in the brain. At this point it is showing benefits in mice, but there is a way to go yet before there can be any certainty that this strategy can also work in humans:
From imaging babies to blasting apart kidney stones, ultrasound has proved to be a versatile tool for physicians. Now, several research teams aim to unleash the technology on some of the most feared brain diseases. The blood-brain barrier, a tightly packed layer of cells that lines the brain's blood vessels, protects it from infections, toxins, and other threats but makes...
Source: Fight Aging! - March 12, 2015 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
Calcium – Forget the Supplements. Get it in Your Diet.
In this study, women were given 1000mg a day of calcium plus 400 IU of vitamin D (regardless of vitamin or dietary intake) or a placebo. Not surprisingly, there was a significant reduction in fractures in women over 70 who took their calcium as prescribed, but at the price of a 17% increase in kidney stones. For every 10,000 women taking calcium, there were two less hip fractures but 5 extra cases of kidney stones.
Constipation. Calcium can also cause constipation, so why take more than you need? (If constipation is a problem for you, try taking calcium with magnesium).
Interference with absorption of both iron and zinc...
Source: The Blog That Ate Manhattan - December 8, 2014 Category: Primary Care Authors: Margaret Polaneczky, MD Tags: Women's Health calcium Calcium supplements Dose food sources calcium RDA. Vitamin D Recommendation Source Type: blogs
MKSAP: 38-year-old man with a mass in his right neck
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 38-year-old man is evaluated for a mass in his right neck that he first noticed 2 weeks ago while shaving. The patient also reports experiencing a pressure sensation when swallowing solid foods for the past year and daily diarrhea for the past 2 months. His personal medical history is unremarkable. His younger brother has nephrolithiasis, and his father died of a hypertensive crisis and cardiac arrest at age 62 years while undergoing anesthesia induction to repair a hip fracture.
On physical examination, vital...
Source: Kevin, M.D. - Medical Weblog - December 6, 2014 Category: Journals (General) Authors: mksap Tags: Conditions Endocrinology Source Type: blogs
Imminently Croakable
Coming out of a patient's room, my eyes immediately fell on a hallway bed on which a sobbing linebacker-sized 26-year old man rocked back and forth in a fetal position. He looked sort of like “a kidney stone,” but the tech handed me an EKG chirping "chest pain." The EMR indicated he had a past medical history of asthma, hypertension, and congestive heart failure, but he didn't take any medications. He smoked but denied drug use.
The EKG was not normal. There was no worrisome ST segment elevation, but left ventricular hypertrophy with diffuse T wave repolarization abnormalities suggested longstanding poor...
Source: Lions and Tigers and Bears - November 12, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Imminently Croakable
Coming out of a patient's room, my eyes immediately fell on a hallway bed on which a sobbing linebacker-sized 26-year old man rocked back and forth in a fetal position. He looked sort of like “a kidney stone,” but the tech handed me an EKG chirping "chest pain." The EMR indicated he had a past medical history of asthma, hypertension, and congestive heart failure, but he didn't take any medications. He smoked but denied drug use.
The EKG was not normal. There was no worrisome ST segment elevation, but left ventricular hypertrophy with diffuse T wave repolarization abnormalities suggested longstanding poorly...
Source: Lions and Tigers and Bears - November 12, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Top stories in health and medicine, October 27, 2014
From MedPage Today:
Nurse Beats Ebola. Fourteen days after she felt her first symptoms, Nina Pham, RN, has conquered Ebola.
‘Bad’ Fats Down but Not Out of Diets. Trans and saturated fat consumption have dropped, but not far enough to meet recommended levels for heart health, and omega-3s have plateaued too low.
Can Comics Help Treat Mental Illness? Comic books may be a helpful tool for treating mentally ill adolescents and adults.
Kidney Stones Up Fracture Risk. Patients who have kidney stones may be at increased risk of fracture.
Your patients are rating you online: How to respond. Manage your online reputa...
Source: Kevin, M.D. - Medical Weblog - October 27, 2014 Category: Journals (General) Authors: MedPage Today Tags: News Infectious disease Nephrology Psychiatry Source Type: blogs
