A patient ’ s resilience and the challenge of dialysis
After she developed a serious complication, she wanted to know the facts plainly stated. I told her the treatment would change her quality of life; it would be hard but doable. To this, she replied, “Now, don’t bullsh*t me, I don’t like bullsh*tters.” These words were uttered by my resilient, 75-year-old patient undergoing peritoneal dialysis.
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A patient’s resilience and the challenge of dialysis originally appeared in KevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - October 14, 2023 Category: General Medicine Authors: Tariq Shaheed, DO Tags: Conditions Nephrology Source Type: blogs
Heart failure in chronic kidney disease – Cardiology Basics
Heart failure in chronic kidney disease – Cardiology Basics
Prevalence of both heart failure and chronic kidney disease (CKD) are increasing as the population is aging globally. Hence heart failure in chronic kidney disease is seen more often. Presence of CKD in heart failure increases morbidity and mortality. Though there is increasing use of effective medications and special devices like cardiac resynchronization therapy in heart failure patients in general, those with CKD have not been benefited well.
CKD is defined as abnormalities of kidney structure or function, present for >3 months, with implications for h...
Source: Cardiophile MD - October 21, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Remote Monitoring for Peritoneal Dialysis: Interview with Aly ElBadry, CEO of CloudCath
CloudCath, a medtech company based in San Francisco, has created the CloudCath system, a remote monitoring technology that provides clinicians with data on the spent dialysate fluid of at-home peritoneal dialysis patients. CloudCath is incorporated into the drain line of peritoneal dialysis systems, and wirelessly transmits data to the cloud, with proprietary algorithms then highlighting issues, such as infection, to clinicians.
At present, abnormalities with peritoneal dialysis patients may not be flagged in a timely manner. For instance, patients are advised to check their dialysate using the “newspaper test,...
Source: Medgadget - July 14, 2021 Category: Medical Devices Authors: Conn Hastings Tags: Exclusive Medicine cloudcath peritonealdialysis Source Type: blogs
A woman in her 60s with VFib arrest and no STEMI on her post-ROSC ECG.
This study had a fatal flaw: they did not keep track of all the " Non-STEMI patients " who were NOT enrolled, but instead were sent for immediate angiogram. It was done in Europe, where the guidelines suggest taking all shockable arrests emergently to the cath lab. So it is highly likely that physicians were very reluctant to enroll patients whom they suspected had Occlusion MI (OMI), even if they didnot have STEMI. These physicians did not want a patient with an OMI that was not a STEMI to be randomized to no angiogram. This strong suspicion is supported by their data: only 22 of 437 ...
Source: Dr. Smith's ECG Blog - November 17, 2020 Category: Cardiology Authors: Pendell Source Type: blogs
A Deeper Dive: How Vulnerable Can a Therapist Be?
For as long as I can remember, “Peeling off the layers to reveal the real” has been my credo. In a dream, the words “Bare Boldly,” echoed through my sleeping but ever so active brain.” When messages come through that insistently, they can’t be ignored. My inner and outer work as a hybrid therapist-journalist prepare me to take this on every day. When that happens, I question if I am too self-revealing.
Last year, I penned an article for Psych Central called When A Therapist and Journalist Comes Clean About Her Self Doubt. It takes a confessional tone as I admit that the way I present isn’t always an accurate ...
Source: World of Psychology - January 17, 2020 Category: Psychiatry & Psychology Authors: Edie Weinstein, MSW, LSW Tags: Aging Personal Authenticity Shame Vulnerability Source Type: blogs
Tropical Travel Trouble 007 Mega Malaria Extravaganza
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog
aka Tropical Travel Trouble 007
When you think tropical medicine, malaria has to be near the top. It can be fairly complex and fortunately treatment has become a lot simpler. This post is designed to walk you through the basic principals with links to more in depth teaching if your niche is travel medicine, laboratory diagnostics or management of severe or cerebral malaria. If you stubbled on this post while drinking a cup of tea or sitting on the throne and want a few basi...
Source: Life in the Fast Lane - April 5, 2018 Category: Emergency Medicine Authors: Neil Long Tags: Clinical Cases Tropical Medicine malaria Plasmodium plasmodium falciparum plasmodium knowles plasmodium malariae plasmodium ovale plasmodium vivax Source Type: blogs
What I learned as a house call physician
As doctors, we simply want to spend more time with our patients. As a doctor for 13 years, and someone who now recruits doctors as a large part of my job, I’m witnessing the battle for more time with patients wage on, but there are no winners. Patients are waiting longer for hurried appointments. We spend more of what little time we have, prescribing and referring out because we’re racing to meet minimum visit numbers. Time is at the crux of so many of the issues we see in primary care, and throughout the care continuum.
In taking time with our patients to educate them, listen to them, connect with them, we can prescri...
Source: Kevin, M.D. - Medical Weblog - December 17, 2017 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/renee-dua" rel="tag" > Renee Dua, MD < /a > Tags: Physician Diabetes Endocrinology Primary Care Source Type: blogs
In Rural States Policy Changes To Improve Access To Home Dialysis Are Vital
By its very nature, chronic kidney disease can rob individuals of their independence. It gradually causes a person to lose the ability to filter wastes from the body, and should kidneys fail entirely, a patient must rely on renal replacement therapy (dialysis) to live. An estimated 26 million Americans have chronic kidney disease of varying degrees; more than 600,000 have end-stage kidney failure. In my home state of West Virginia, some 3,500 patients were on dialysis in 2013, and for most of the past two decades, our state has led the nation in per capita numbers of patients starting dialysis.
Dialysis can be provided thr...
Source: Health Affairs Blog - April 12, 2016 Category: Health Management Authors: Rebecca Schmidt Tags: Costs and Spending Health IT Health Professionals Public Health Quality chronic disease dialysis kidney disease nephrology rural health Telehealth Source Type: blogs
Beneficial Effect of Coffee in Dialysis Patients
its impact on renal disease is largely unknown and its effect on dialysis patients is even more obscure.
There have been many claims of medicinal or health benefits for drinking coffee. Studies have shown apparent reductions in the risks of:
Alzheimer’s disease
Parkinson’s disease
Heart disease
Diabetes mellitus type 2
Cirrhosis of the liver
Gout.
Recently a small study has reported that dialysis patients who drink coffee were more likely to have lower cholesterol. Of the 30 patients studied 26 were on peritoneal dialysis and only 4 were on hemodialysis.
The patients were divided into two groups. Group I patients dr...
Source: All Kidney News - September 29, 2015 Category: Urology & Nephrology Authors: jadhavbca Tags: Kidney News HDL LDL Source Type: blogs
Query: Asking for altruistic organ donor via Facebook
We had this query via the MMR Facebook page
Hello Dr, may I enquire if it’s legal to put on FB to look for altruistic kidney donor in Malaysia ? I have come across in the UK n USA that they put FB site to locate generous people to help either as a family or by previous kidney recipients to help others. My mum is in dire need as she’s in kidney failure
In Malaysia, altruistic non-related kidney donors are not allowed without special permission from the UTAC (Unrelated Transplant Approval Committee), and even so this is exceptional. See section 5 of the MOH guidebook on organ transplants which you can view here:
...
Source: Malaysian Medical Resources - May 3, 2015 Category: Global & Universal Authors: palmdoc Tags: - Ethics - Feedback Source Type: blogs
Equipment Overload: 5 Tips for Nurses to Master the Unfamiliar
By Aaron Moore, MSN, RN-BC, travel nurse expert
Did you know that there are more than 10 companies that make IV infusion pumps? Just think how many pumps you might have to figure out how to use if you work as a travel nurse for a while--especially if you go across the country like I did.
In the modern healthcare setting, we have electronic equipment for everything from peritoneal dialysis to (Source: NurseZone Blog: Ask the Expert)
Source: NurseZone Blog: Ask the Expert - February 10, 2015 Category: Nursing Authors: NurseZone Source Type: blogs
Equipment Overload: 5 Tips for Nurses to Master the Unfamiliar
By Aaron Moore, MSN, RN-BC, travel nurse expert
Did you know that there are more than 10 companies that make IV infusion pumps? Just think how many pumps you might have to figure out how to use if you work as a travel nurse for a while--especially if you go across the country like I did.
In the modern healthcare setting, we have electronic equipment for everything from peritoneal dialysis to (Source: NurseZone Blog: Ask the Expert)
Source: NurseZone Blog: Ask the Expert - February 9, 2015 Category: Nursing Authors: NurseZone Source Type: blogs
The last visit: Turning off the defibrillator
He had called the other day to update me up on his condition. He did not sound upset, but resolute. “They offered me peritoneal dialysis,” he said, “but I decided against it and figured I’d just let nature take its course. The hospice people are so wonderful — I’ve got things all set here at home, but I have two questions. What should I do about my warfarin? You know, I just don’t want to have a stroke. And what I do about my defibrillator?”
Continue reading ...
Your patients are rating you online: How to respond. Manage your online reputation: A social media gu...
Source: Kevin, M.D. - Medical Weblog - October 9, 2014 Category: Journals (General) Authors: Wes Fisher, MD Tags: Physician Heart Palliative care Source Type: blogs
The Last Reprogramming
He had called the other day to update me up on his condition. He did not sound upset, but resolute. "They offered me peritoneal dialysis," he said, "but I decided against it and figured I'd just let nature take its course. The hospice people are so wonderful - I've got things all set here at home, but I have two questions. What should I do about my warfarin? You know, I just don't want to (Source: Dr. Wes)
Source: Dr. Wes - September 25, 2014 Category: Cardiology Authors: Westby G. Fisher, MD Tags: defibrillator doctor-patient relationship Life medicine teaching Source Type: blogs
