Psychology Around the Net: September 3, 2016
Here in the U.S., we’re currently in the throes of Labor Day Weekend (and I’m at a local music and arts festival, celebrating!).
Labor Day is the first Monday of September, and although it gives us a nice little three-day weekend, it’s about much more than that: Labor Day honors our country’s labor movement and “constitutes a yearly national tribute to the contributions workers have made to the strength, prosperity, and well-being of our country.”
So, Happy Labor Day! I hope you’re doing something to celebrate all your hard work and, once you get a chance, check out this weekR...
Source: World of Psychology - September 3, 2016 Category: Psychiatry & Psychology Authors: Alicia Sparks Tags: Brain and Behavior Celebrities Depression Disorders Happiness Medications Memory and Perception Personality Psychology Psychology Around the Net Research Sleep Stress Technology Android Anti-Anxiety Medication Antidepressan Source Type: blogs
At the end of life, searching for the right word
During the first few days that my mother spent in hospice, I silently sat by her bed watching her chest rise and fall, listening to her moan, counting her doses of Ativan, Tylenol, and Morphine, and tallying the days she’d been without food and water.
On day five of my vigil, I asked her nurse, “How long can Mom live like this? She hasn’t opened her eyes or eaten or had anything to drink for five days.”
The nurse replied, “The journey varies. But it may take a while because your mom is fighting.”
She’s fighting?
Continue reading ...
Your patients are rating you online: How to respond. Manage your online repu...
Source: Kevin, M.D. - Medical Weblog - August 8, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/k-anne-smith" rel="tag" > K. Anne Smith < /a > Tags: Patient Palliative care Source Type: blogs
I will not let medicine dehumanize me
Dear Dad,
I often think about the night you passed away. I was caring for you while you were dying from metastatic colon cancer. Every hour I woke up to give you Dilaudid so you wouldn’t feel pain and Ativan so you wouldn’t be scared. You had only just been diagnosed eight months before. Despite aggressive chemo, radiation, abdominal surgeries, and all the hope and prayer in the world, the cancer still spread. Little did we know, when I started my internship in family medicine, you would be gone before the year was over.
I hadn’t been there for you during most of your battle with cancer. When ...
Source: Kevin, M.D. - Medical Weblog - August 4, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/kristina-dakis" rel="tag" > Kristina Dakis, MD < /a > Tags: Physician Cancer GI Source Type: blogs
Benzodiazepine addiction is real. This physician shares his story.
Say the words, “drug addiction,” and most of us think of heroin, alcohol, cocaine, or opiates. However, lurking in the shadows is a less talked about epidemic: addiction to benzodiazepines, commonly known as “benzos.” I should know because after taking a nighttime dose of lorazepam (Ativan) for about ten years; I finally weaned myself off this and all other prescription sleep medications.
About twelve years ago, my father died and then my dog. But that was nothing in comparison to the fight to save my marriage from alcohol addiction: not mine, but my wife’s. It occurred around the same time. S...
Source: Kevin, M.D. - Medical Weblog - July 24, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/david-mokotoff" rel="tag" > David Mokotoff, MD < /a > Tags: Meds Medications Source Type: blogs
Beta-Blockers for Cocaine and other Stimulant Toxicity
Dogma: “a belief or set of beliefs that is accepted by the members of a group without being questioned or doubted; a point of view or tenet put forth as authoritative without adequate grounds.”
Years ago I treated a university student who presented to the emergency department (ED) after drinking several cans of a popular caffeinated energy drink to “pull an all-nighter” during final exam week. He was tremulous, agitated, and pale, with sinus tachycardia ranging from 140 to 160 bpm and normal blood pressure (BP). The house officer (registrar) working with me that night proposed treating him with a benzodiazepine, bu...
Source: Life in the Fast Lane - July 4, 2016 Category: Emergency Medicine Authors: John Richards Tags: Toxicology and Toxinology alpha stimulation amphetamines Beta Blockers cocaine dogma John Richards Stimulant Toxicity Stimulants Source Type: blogs
The Opioid Crisis: Nociception, Pain and Suffering
By MARTIN SAMUELS, MD
In order to understand the concept of pain and its relationship to the current opioid crisis, it is prudent to review the neurology of pain an why it exists. Several concepts are important to integrate.
Nociception: Nociception is the capacity to sense a potentially tissue damaging (noxious) stimulus. To illustrate this one should place a forefinger in a glass of ice water and determine how long passes until an unpleasant sensation arises. If one performs this experiment in a large group, one can recognize that, although the stimulus is the same (a glass of ice water), the sensation arises at...
Source: The Health Care Blog - June 10, 2016 Category: Consumer Health News Authors: John Irvine Tags: THCB Source Type: blogs
The Rigid Patient
A 24-year-old man with a history of schizophrenia presented with altered mental status. His mother said he had become more catatonic and rigid over the previous two days. She reported that he was prescribed Abilify 5 mg by mouth daily for three years, but a long-acting depot of Abilify 400 mg had been administered two days before by court order. His vital signs include a heart rate of 120 bpm, blood pressure 140/90 mm Hg, temperature 38.5°C, respiratory rate is 14 bpm, and SPO2 is 98% on room air. The patient is alert and diaphoretic. Pupils are 3 mm. Cogwheeling, rigidity, and two beats of ankle clonus are also o...
Source: The Tox Cave - June 2, 2016 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Altered Mental Status with Agitation and Tachycardia
This was originally posted on May 8, 2014. It was one of the FOAM posts used to evaluate the ALiEM AIR Rating for FOAMed resources, just published online at Annals of EM. It got pretty good ratings from the eight educators who evaluated all the posts, so I thought I would repost it. Here is the list of posts that were evaluated.A young male with unknown past medical history presents with AMS and tachycardia. EMS was called by a roommate after the patient was noticed to be nonverbal and lethargic. He reportedly took meth and had a recent drinking binge, but has not had alcohol for the last 2 days. His HR w...
Source: Dr. Smith's ECG Blog - March 30, 2016 Category: Cardiology Authors: Steve Smith Source Type: blogs
Longing for the QT
A 58-year-old man presented to the ED with a reported overdose of an unknown medication. The patient was agitated, combative, and altered. Initial vital signs included a heart rate of 115 beats/min, blood pressure of 154/93 mm Hg, respirations of 22/min, and temperature of 99.5°F. The patient was difficult to evaluate because he was agitated, and he was given 5 mg of haloperidol IV and 2 mg of lorazepam IV. The patient continued to be agitated, and was given another 10 mg of haloperidol IV, followed by a repeat dose of 10 mg IV 15 minutes later. The patient then became unresponsive, and his cardiac monitor demonstrated th...
Source: The Tox Cave - March 1, 2016 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
To See or Not to See
A
A 17-year-old boy presented to the emergency department after having a seizure. Initial vital signs included a temperature of 38°C, heart rate of 134 beats/min, respiratory rate of 22 breaths/min, blood pressure of 142/93 mm Hg, and pulse oximetry of 97% on room air. His physical exam is significant for tachycardia and pupils are 5 mm bilaterally and reactive to light with horizontal nystagmus. He is awake, confused, and combative.
Paramedics report that his mother found him in his bedroom was acting strangely before he fell to the floor and began convulsing. ED staff administered 2 mg intravenous lorazepam, ...
Source: The Tox Cave - January 4, 2016 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Terminal dehydration: A gentle way to die?
On a September night not long after his 83rd birthday, my father suffered a massive stroke. It left him conscious yet unable to talk and communicate, unable to swallow, and almost completely paralyzed.
After numerous scans and other tests, his doctors determined that there was no chance for recovery. My father would never walk, talk, or swallow food again. With nothing more to do for him in the hospital, we — my mother, my sister, and I — needed to decide what to do next. The social worker on the case encouraged us to put Dad in a nursing home. A gastric feeding tube could be put in, and he could be f...
Source: Kevin, M.D. - Medical Weblog - October 7, 2015 Category: Journals (General) Authors: Christopher Stookey, MD Tags: Physician Palliative care Source Type: blogs
What medications have you been able to stop on the Wheat Belly lifestyle?
I posed this question on the Wheat Belly Facebook page recently and received an overwhelming response. Here, I share a partial list of the responses: medications people have been able to stop by following the Wheat Belly lifestyle.
Just take a look at this incredible list: these represent medications prescribed by doctors to, in effect, “treat” the consequences of consuming wheat and grains. They prescribe drugs to treat the inflammation, swelling, skin rashes, gastrointestinal irritation, high blood sugars, airway allergy, and other abnormal effects all caused by wheat and grains.
The list includes anti-inf...
Source: Wheat Belly Blog - October 6, 2015 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Lifestyle asthma cholesterol diabetes drugs gluten grains hypertension prescription medication reflux Source Type: blogs
