A Reconstructer Of Disassembled Parts
To say that William hardly thought about hospice would be an inaccuracy. He contemplated it, from time to time, during his thirty year tenure as a trauma surgeon. Usually for fleeting moments before dodging the conversation or deferring to one of his more junior colleagues. Surgeons didn't give up so easily, he reasoned. He fancied himself a fixer, a reconstructer of disassembled parts.Mostly, that is what was expected of him. His patients didn't come because of cancer or chronic illness. They came after tragedy. Unwillingly. Bodies sprawled on metal tables with insides amiss. And h...
Source: In My Humble Opinion - December 30, 2016 Category: Primary Care Authors: Jordan Grumet Source Type: blogs
Only the ECG Diagnoses Acute Coronary Occlusion. Do not be Fooled by a Negative High Sensitivity Troponin.
This case was sent by Peter Hammarlund, 2nd year Internal Medicine/Cardiology resident (and self-proclaimed ECG nerd) at Helsingborg Hospital, Sweden. Peter frequently sends me great cases like this, but I never post them because the Swedish standard, explained below, is very difficult to interpret.This time I could not resist.Especially interesting is the troponin data and the manipulated images seen below.Casep.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 16.0px Calibri; color: #222222; -webkit-text-stroke: #000000; background-color: #ffffff} span.s1 {font-kerning: none}Hi Steve,I was involved in this highly...
Source: Dr. Smith's ECG Blog - December 28, 2016 Category: Cardiology Authors: Steve Smith Source Type: blogs
How scientists are hunting for a safer opioid painkiller | Science News
An opioid epidemic is upon us. Prescription painkillers such as fentanyl and morphine can ease terrible pain, but they can also cause addiction and death. The Centers for Disease Control and Prevention estimates that nearly 2 million Americans are abusing or addicted to prescription opiates. Politicians are attempting to stem the tide at state and national levels, with bills to change and monitor how physicians prescribe painkillers and to increase access to addiction treatment programs.Those efforts may make access to painkillers more difficult for some. But pain comes to everyone eventu...
Source: Psychology of Pain - December 27, 2016 Category: Anesthesiology Source Type: blogs
Exporting Pain: Here ’s Why Some Doctors are Labeled ‘Opioiphobic’
Exporting Pain: Here’s Why Some Doctors are Labeled ‘Opioiphobic’
While patients and medical professionals in the United States have wised up to the potential harm of prescription opioids like OxyContin, its manufacturers aren’t willing to sell any less, instead choosing to pursue an aggressive marketing campaign internationally rather than give up on potential profits. This move is a threat to the health and well-being of millions of people worldwide.
There’s no need for other countries to make the same mistakes we’re still overcoming. America is in the thick of an opioid addiction and overdose crisis that sta...
Source: Cliffside Malibu - December 20, 2016 Category: Addiction Authors: Richard Taite Tags: Richard Taite Source Type: blogs
Research and Reviews in the Fastlane 164
Welcome to the 164th edition of Research and Reviews in the Fastlane. R&R in the Fastlane is a free resource that harnesses the power of social media to allow some of the best and brightest emergency medicine and critical care clinicians from all over the world tell us what they think is worth reading from the published literature.
This edition contains 6 recommended reads. The R&R Editorial Team includes Jeremy Fried, Nudrat Rashid, Soren Rudolph, Justin Morgenstern and, of course, Chris Nickson. Find more R&R in the Fastlane reviews in the R&R Archive, read more about the R&R project or check o...
Source: Life in the Fast Lane - December 14, 2016 Category: Emergency Medicine Authors: Justin Morgenstern Tags: Emergency Medicine Intensive Care R&R in the FASTLANE Resuscitation EBM literature recommendations research and reviews Source Type: blogs
What to Ask Your Doctor Before Taking Opioids
Every patient should ask questions when getting a new prescription. This is especially important when your doctor, dentist or other health care professional prescribes you an opioid, such as hydrocodone, oxycodone, codeine and morphine. The U.S. Food & Drug Administration (FDA) provides information to assist health care consumers to dialog with their physicians before taking opioids. Information is also available in Spanish. Learn what to ask at https://nnlm.gov/bhic/09p3 (Source: BHIC)
Source: BHIC - December 13, 2016 Category: Databases & Libraries Authors: Carolyn Martin Tags: General Health Information Literacy Multilingual Public Health Source Type: blogs
Elephant Sedative Carfentanyl is the Latest and Deadliest Heroin Additive
One of the biggest risks associated with illegal drug use is that there’s no way to know for sure exactly what’s in the substance you’re consuming. Many drug cartels dilute their products with nearly indistinguishable substances, for example mixing powdered milk into a batch of heroin, in order to increase the overall quantity of the drug, sell more, and make more money.
One uncommon heroin additive that’s been making headlines recently is carfentanyl. An analogue of the more commonly known opioid analgesic fentanyl, carfentanyl was first produced in 1974 and intended for sedating large animals like elephants and ...
Source: Cliffside Malibu - December 12, 2016 Category: Addiction Authors: Richard Taite Tags: Richard Taite addiction Addiction Recovery addiction treatment addiction treatment center drug treatment center prescription drug abuse prescription drug addiction substance abuse Source Type: blogs
I'm Sorry
Dear Mrs J,I would like to express my deepest condolences in the passing of your mother. A magnificent woman, I had the pleasure of being her doctor for almost a decade. And it was a pleasure. During our short visits she regaled me with stories of childhood and often gently sprinkled in advice gleaned from years of experience. Even as she began to decline, we would sit together in the nursing home and she would reach out to hold my hand. She was a gift, your mother. A gift that I in no way deserved.I'm sorry she got cancer. As a physician, there is no word worse than the wordmetastases.&n...
Source: In My Humble Opinion - December 9, 2016 Category: Primary Care Authors: Jordan Grumet Source Type: blogs
Alzheimer's Care Killing our Parents with “Kindness”
We were proud of the fact that we had managed to honor our promise to never put her in a nursing home; and that, she was still able to continue living with dignity in her own home.By Shira SebbanAlzheimer's Reading Room“Who authorized this patient to be administered morphine?” The hospital geriatrician’s voice was stern as he addressed the staff clustered around my mother’s bed. “She’s for active care, not for palliative care – she’s going home!”Dying from Dementia, Suffering Often UnnecessaryWith the doctor finally on side, I felt like I had won a battle –the battle to stop the morphine, which the hosp...
Source: Alzheimer's Reading Room, The - December 7, 2016 Category: Neurology Tags: care of dementia patients care of dementia patients at home dementia care elderly dementia care help alzheimer's help with dementia care Hospice Care memory care palliative care Source Type: blogs
How to eliminate this uncomfortable, embarrassing problem.
Our ancestors who lived without grains, sugars, and soft drinks enjoy predictable bowel behavior. They ate some turtle, fish, clams, mushrooms, coconut, or mongongo nuts for breakfast, and out it all came that afternoon or evening—large, steamy, filled with undigested remains and prolific quantities of bacteria, no straining, laxatives, or stack of magazines required.
If instead you are living a modern life and have pancakes with maple syrup for breakfast and you’ll be lucky to pass that out by tomorrow or the next day. Perhaps, you will be constipated, not passing out your pancakes and syrup for days, passing it inco...
Source: Wheat Belly Blog - December 6, 2016 Category: Cardiology Authors: Dr. Davis Tags: Constipation Dr. Davis Grain Brain Grains Weight loss Wheat Belly Wheat Belly Lifestyle Wheat Belly Total Health Wheat Watch Wheat-Free Lifestyle Wheatlessness gluten Inflammation Source Type: blogs
Make Sleep Meds Work For You
I’ve been busier than I like, and haven’t had as much time for posting. But I spend a lot of time answering emails from my patients, and some of my responses may be useful for others. Below I’ll share my answer to a patient who has been unable to get quality sleep. Next week I’ll find another answer to share with readers.
This patient asked whether her insurance would cover Lunesta. She wrote at 2 AM that she is up most of the night tossing and turning. She now takes 10 mg of Ambien, and wrote that it ‘stopped working’. She doesn’t think 20 mg of Ambien would be covered b...
Source: Suboxone Talk Zone - November 27, 2016 Category: Addiction Authors: Jeffrey Junig MD PhD Tags: pharmacology Research ambien best sleep medication insomnia treatments lunesta sleep medication no working sleeping pills Source Type: blogs
So Much to Gain by Giving Up Grain!
Elimination of grains can do more than just free you from the health-impairing effects of the seeds of grasses.
This will unleash physical, mental & life performance. – Tweet this!
We are not grain-free supremacists; we are people who have removed the yoke of impairment placed on us by the easy, accessible, and addictive products produced from grains.
Grain-free performance means that you can be freed from common impediments to performance such as joint pain, swelling, bloating and gas, water retention, and mind fog, leaving you able to run longer, jump higher, think more clearly, and focus longer and more ef...
Source: Wheat Belly Blog - November 15, 2016 Category: Cardiology Authors: Dr. Davis Tags: Dr. Davis Grain Brain Grain Free Lifestyle Grains Weight loss Wheat Belly Wheat Belly Lifestyle Wheat-Free Lifestyle Wheat Belly Total Health Source Type: blogs
Codeine is a terrible choice for treating children ’s pain and cough. Here’s why.
Codeine is a terrible choice for treating children’s pain and cough, and we ought to just stop using it. It’s like an old yogurt container, way at the back of your fridge — sure, it was once tasty, and then for a while, you held on to it for sentimental reasons. “Remember that yogurt?” you’d say to your spouse. But it’s well past time to throw that stinky stuff away.
For a long time, codeine was thought to be safer than other opiate-based pain medications. It’s a naturally occurring form of morphine with good oral bioavailability (that means you can swallow it in pill or liquid form.) But codeine, the m...
Source: Kevin, M.D. - Medical Weblog - November 9, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/roy-benaroch" rel="tag" > Roy Benaroch, MD < /a > Tags: Meds Medications Pediatrics Source Type: blogs
Medical errors: Honesty is the best policy
“It’s a definite that you’re all going to screw up, but it’s not a definite that any of you will learn from that,” declared one of our medical school instructors, years ago. “Cultivate the attitude that allows you to own your mistakes, and then, not repeat them.”
How common are medical errors?
Medical errors are, frankly, rampant. A recent study used data analysis and extrapolation to estimate that “communication breakdowns, diagnostic errors, poor judgment, and inadequate skill” as well as systems failures in clinical care result in between 200,000 to 400,00 lives lost per year. What this means is that i...
Source: Harvard Health Blog - October 3, 2016 Category: Consumer Health News Authors: Monique Tello, MD, MPH Tags: Health care Managing your health care Safety Source Type: blogs
