Two Cases of a Cool Skin Condition (Erythrocyanosis, Pernio or Chilblains, Anyone?)
BY HANS DUVEFELT
A month ago an oncologist called and asked me to see one of my heart failure patients whose chronically swollen legs seemed unusually blue but not cold.
Before I could get him in to see me, he ended up seeing a colleague, who called me up and said the man’s legs were cool and there was no Doppler in that office to check for pedal pulses. The man was sent for an urgent CT angiogram with runoff.
The test was perfectly normal. He had clean arteries.
When I saw him, the legs were less blue than they must have been and they felt OK but he had what looked like a shingles rash around his right elbow...
Source: The Health Care Blog - April 19, 2023 Category: Consumer Health News Authors: Ryan Bose-Roy Tags: Medical Practice Chillblains Cool Skin Condition Erythrocyanosis Hans Duvefelt Source Type: blogs
Two Patients With More Than One Diagnosis
BY HANS DUVEFELT
I have written many times about how I have made a better diagnosis than the doctor who saw my patient in the emergency room. That doesn’t mean I’m smarter or even that I have a better batting average. I don’t know how often it is the other way around, but I do know that sometimes I’m wrong about what causes my patient’s symptoms.
We all work under certain pressures, from overbooked clinic schedules to overfilled emergency room waiting areas, from “poor historians” (patients who can’t describe their symptoms or their timeline very well) to our own mental fatigue after many hours on the...
Source: The Health Care Blog - March 16, 2023 Category: Consumer Health News Authors: Ryan Bose-Roy Tags: Medical Practice Hans Duvefelt neuralgia sinusitis Source Type: blogs
One family ’s disastrous experience with a growth-driven long-term care company
by “E-PATIENT” DAVE DEBRONKART
Continuing THCB’s occasional series on actual experiences with the health care system. This is the first in a short series about a patient and family experience from one of America’s leading ePatients.
I’ve been blogging recently about what happens in American healthcare when predatory investor-driven companies start moving into care industries because the money’s good and enforcement is lax. The first two posts were about recent articles in The New Yorker on companies that are more interested in sales and growth than caring. I now have permission ...
Source: The Health Care Blog - January 10, 2023 Category: Consumer Health News Authors: matthew holt Tags: The Business of Health Care ePatient Dave Patient Experience Respite care Source Type: blogs
How patient education can save lives
A patient undergoing chemotherapy for breast cancer was diagnosed on April 20th with profound secondary adrenal insufficiency (hypophysitis: ACTH undetectable, cortisol 0.2) caused by immunotherapy (pembrolizumab). She was started on corticosteroids and sent home from the hospital on April 24th with a prescription for only five days of prednisone. After completing the five days ofRead more …How patient education can save lives originally appeared inKevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - June 4, 2022 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/post-author/david-m-mitchell" rel="tag" data-wpel-link="internal" > David M. Mitchell, MD, PhD < /a > < /span > Tags: Conditions Endocrinology Hospital-Based Medicine Source Type: blogs
How is treatment for myasthenia gravis evolving?
Myasthenia gravis (MG) — a medical term that translates as “serious muscle weakness” — is a rare neuromuscular disease. An estimated 30,000 to 60,000 people in the United States have this disorder, which affects people of all ages, sexes, and ethnicities. Recently updated consensus guidelines have added to our knowledge of different forms of myasthenia gravis and improved approaches to treatment.
What are the symptoms of myasthenia gravis?
Myasthenia gravis impairs the transmission of signals from nerves to muscles at a site called the neuromuscular junction (NMJ), where nerves make contact with muscle. This causes...
Source: Harvard Health Blog - April 12, 2021 Category: Consumer Health News Authors: Pushpa Narayanaswami, MD, FAAN Tags: Autoimmune diseases Neurological conditions Source Type: blogs
Understanding Leprosy on World Leprosy Day
Leprosy is a chronic and progressive disease that primarily affects the skin and peripheral nervous system. Leprosy has been with us for thousands of years. There is evidence of the disease as far back as 4000 BC, in ancient Egypt.[1] In 1873, Norwegian physician Dr. Gerhard Armauer Hansen discovered that leprosy was caused by a bacterium. [2] Today, we call this bacterium Mycobacterium leprae, and we often refer to leprosy as Hansen’s Disease, in honor of Dr. Hansen. While leprosy caused significant morbidity and mortality in the past, cases today are rare and are curable with proper treatment.
How Is Leprosy Transmitte...
Source: GIDEON blog - January 28, 2021 Category: Databases & Libraries Authors: Uri Blackman Tags: News Leprosy Source Type: blogs
I Cured My Patient, But What Was His Diagnosis?
By HANS DUVEFELT
He cancelled his followup appointment because he was feeling fine. He didn’t see the point in wasting a Saturday to come to my clinic when he had lawns to mow and chores to do.
Less than two weeks before that he was sitting on the exam table in my office, again and again nodding off, waking up surprised every time his wife prodded him. The stack of printouts from the emergency room illustrated all the normal testing they had done.
He had experienced a brief episode of numbness in the left side of his face and felt tired with just a slight headache. When I saw him the headache was a bit more ...
Source: The Health Care Blog - August 14, 2020 Category: Consumer Health News Authors: Christina Liu Tags: Medical Practice Physicians Primary Care Hans Duvefelt Source Type: blogs
Epinephrine is the only effective treatment for anaphylaxis
Anaphylaxis is a severe allergic reaction that can potentially lead to death if not promptly treated. Allergic reactions typically begin suddenly after exposure to an allergen, which may be a food, medication, insect sting, or another trigger. Anaphylaxis can occur in anyone at any time; it can sometimes be triggered by allergens that a person has only had mild reactions to in the past — or to which they have never reacted to before.
Recognizing anaphylaxis
A mild allergic reaction may consist of hives, itching, flushing, swelling of the lips or tongue, or some combination of these.
However, throat swelling or tightening...
Source: Harvard Health Blog - July 9, 2020 Category: Consumer Health News Authors: Parul Kothari, MD Tags: Allergies Emergency Planning Source Type: blogs
What you need to know about fibromyalgia
Fibromyalgia can be an incapacitating condition for many people with diffuse aches and pains that generally do not respond well to drugs. Prescription drugs for this condition are also plagued by substantial side-effects, as well as costs.
There are a handful of natural strategies that have yielded extravagant successes for many people, lessons learned from the worldwide Wheat Belly and Undoctored programs.
The post What you need to know about fibromyalgia appeared first on Dr. William Davis. (Source: Wheat Belly Blog)
Source: Wheat Belly Blog - May 9, 2020 Category: Cardiology Authors: Dr. Davis Tags: Open fibromyalgia Lyrica microbiota pain meds prebiotic prednisone probiotic sibo small intestinal bacterial overgrowth undoctored wheat belly Source Type: blogs
Thou Shalt Not Try to Outsmart Me
By HANS DUVEFELT, MD
Medical researchers and their groupies – early adopters, thoughtleaders, those easily influenced or whatever you want to call them – never seem to learn that when you try to outsmart Mother Nature or Our Heavenly Father, whichever appeals more to your world view, you usually get your hand slapped.
When I was a resident (1981-1984), I got penalized if I didn’t offer postmenopausal women estrogen-progesterone replacement therapy because it seemed obvious that if women with endogenous estrogen didn’t get many strokes or heart attacks and women without estrogen did, all we needed to do was ma...
Source: The Health Care Blog - December 20, 2019 Category: Consumer Health News Authors: Christina Liu Tags: Medical Practice Physicians Primary Care Hans Duvefelt Source Type: blogs
Curcumin and myeloma: a new patient study
A very small Indonesian study came up with some interesting conclusions about curcumin given to myeloma patients who were also taking melphalan and prednisone (MP): http://bit.ly/348vHwY
The study evaluated two groups of myeloma patients, a control group of 16 patients who took only the MP, and a treatment group consisting of 17 people who also took 8 grams of curcumin in addition to the MP.
After 28 days, as we can read in the study, “There was a significant decrease of NF-KB, VEGF, TNF-?, LDH levels in the treatment group compared with control. There was a decreasing trend of IL-6 levels in the treatment group sig...
Source: Margaret's Corner - November 20, 2019 Category: Cancer & Oncology Authors: Margaret Tags: Blogroll curcumin curcumin and myeloma Source Type: blogs
A Sting, then Blisters and Pain
A 25-year-old woman presented with a rash, and reported that she was in South Carolina when she felt a stinging sensation. That was followed by blisters on her foot.She noticed swelling of her foot, and had continued pain. She took pictures of the bite on days two and six. (Below.) She reported that she had a similar sting the previous summer. She said she had no fever, shortness of breath, or dizziness. Her vital signs were a temperature of 98.6°F, a heart rate of 80 bpm, a blood pressure of 100/60 mm Hg, a respiratory rate of 16 bpm, and an SPO2 of 100% on room air.She was alert and in no distress. Her oropharynx was...
Source: The Tox Cave - September 3, 2019 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
What Was the Cause of the Excruciating Pain in His Shoulders and Hips? - The New York Times
As the physician prepared to leave the exam room, the patient's wife spoke up:"Doctor, my husband won't tell you this, but he is suffering," the woman said, her voice cracking. Dr. Timothy Quan, a rheumatologist in central Connecticut, looked at the 69-year-old man he'd been caring for over the past several months. The man gave a brisk nod. It was true. The past few weeks had been a nightmare of pain.Six months earlier, the patient woke up with a sore, swollen right hand. He figured he must have injured it a few days before when he cleared out a pile of wood in his backyard. He mentioned it to his pri...
Source: Psychology of Pain - June 5, 2019 Category: Anesthesiology Source Type: blogs
Prescription Drugs That Block Weight Loss
A number of drugs prescribed to treat common conditions, such as hypertension, allergies, depression, inflammation, and diabetes, block your ability to lose weight. Several of these drugs actually cause weight gain, and most doctors fail to inform their patients of such side effects. Among the drugs that block weight loss are:
Beta-blockers: metoprolol, atenolol, carvedilol, and propranolol
Antidepressants: amitriptyline (Elavil), nortriptyline (Pamelor), doxepin, paroxetine (Paxil), trazodone, and others
Steroids: prednisone and hydrocortisone (but not inhaled or nasal steroids for allergies)
Antihistamines: diphenhydr...
Source: Wheat Belly Blog - May 7, 2019 Category: Cardiology Authors: Dr. Davis Tags: News & Updates blood sugar drugs failed weight loss fatigue weight loss hypertension insulin prescription drugs undoctored wheat belly Wheat Belly Total Health Source Type: blogs
Single dose dexamethasone almost as affective as a five day prednisone regimen in acute asthma
(Source: Notes from Dr. RW)
Source: Notes from Dr. RW - March 19, 2019 Category: Internal Medicine Tags: pulmonary Source Type: blogs
