When cancer comes to call you, rise up and fight the good fight
A patient story tonight, from Jackie:
It was one of those days. I had been to the gynecologist the week prior because I somehow knew the sporadic bleeding, which I had experienced, was not a simple urinary tract infection for which I had been treated three times. My doctor did the scrapings and biopsies and had me run down the hall for an ultrasound. I’d had lots of ultrasounds during my pregnancies — especially with my twins — but this one wasn’t fun. There was no cute baby to smile at. This time it was a transvaginal ultrasound which involved the insertion of a rather large tube into “...
Source: Kevin, M.D. - Medical Weblog - January 13, 2015 Category: Journals (General) Authors: Miranda Fielding, MD Tags: Patient Cancer OB/GYN Source Type: blogs
People who looked at this article, also looked at...
In my previous post Ok, I admit it, I'm stuck (a title people seem to really like) I highlighted the difficulty in finding meaning in our clickstream data (the data generated by users interacting with the site). One thing that I had thought about and a couple of people have subsequently raised is an Amazon style 'People who looked at this article, also looked at this one..', a feature I find really interesting and frequently useful.So, taking some earlier work on mapping UTI data I started doing further analysis but it was based on this graph.I I started with an article that looked in an interesting place and p...
Source: Liberating the literature - January 8, 2015 Category: Technology Consultants Source Type: blogs
Cases: Benign Prostatic Hypertrophy (BPH) as a hospice diagnosis?
Conclusion: In this case, a simple condition that is easily treatable in most men became one that we expected to lead to Mr. K’s death. However, the diagnosis that led it to become life-limiting was Mr. K’s dementia, and the heavy burden which BPH treatments would have placed on him. Mr. K’s daughter based her decision on Mr. K’s values, saying that if the father she was raised by was able to see himself in his current condition, he would have wanted both to stay in place and to be allowed to die with dignity. Forced catheterization and antipsychotic treatment might have prolonged his life by years but would have ...
Source: Pallimed: A Hospice and Palliative Medicine Blog - January 6, 2015 Category: Palliative Carer Workers Tags: cases childers emergency care hospice medications POLST urology Source Type: blogs
Sometimes Medical Care Requires More Than Just A Minute (Clinic)
The truth is, I know it's easy to go to the Minute Clinic. I know the enticement of not needing an appointment, of being able to shop while you wait, of having the prescription ready to pick up by the end of your appointment. Who doesn't like convenience and a friendly smile to add? Who doesn't like the customer service offered at CVS, Target, or your local pharmacy? I certainly do. And I know that the doctor's office can be a pain. I also loathe the annoying phone tree that leads to a tired nurse or secretary, and possibly the hours of waiting to have the physician call you back and tel...
Source: In My Humble Opinion - January 3, 2015 Category: Primary Care Authors: Jordan Grumet Source Type: blogs
How to Solve the Problem of Urinary Tract Infection in Persons Living with Dementia
One of the harshest problems that Alzheimer's and dementia caregivers face are frequent unidentified urinary tract infections. UTIs can worsen memory loss, make patients seem confused and listless, and sometimes make them seem like they are "just not there".By Bob DeMarco Alzheimer's Reading RoomResearchers have found that undetected urinary tract infections are common in dementia patients. UTIs go undetected because the symptoms are hard to spot in dementia patients, and most patients cannot tell us they are feeling ill or out of sorts.As a general rule of thumb you should suspect a urinary tract if you see any of ...
Source: Alzheimer's Reading Room, The - August 26, 2014 Category: Dementia Tags: urinary tract infection alzheimer disease urinary tract infection information urinary tract infection alzheimer's urinary tract infection dementia urinary tract infection patient education UTI Source Type: blogs
4 things I learned in medical training that still apply today
Four adages I learned in medical training that I still speak of today:
“Common things are common.” (The alternate version of this that might have more appeal to zoologists: “When you hear hoofbeats, think horses, not zebras.”)
This cautions physicians to remember that it is more likely that the patient has a common condition than a rare one. Although it is prudent to consider all the possible diagnoses that might match a given clinical presentation, one should not seek confirmation for an exotic condition first.
Urinary tract infections are more common than bladder cancers. High blood pressure is more common than ...
Source: Kevin, M.D. - Medical Weblog - August 22, 2014 Category: Journals (General) Authors: Maria Yang, MD Tags: Education Medical school Residency Source Type: blogs
Why Come To The Doctor In The First Place?
William was doing great. His C Diff was finally gone after a month taper of vancomycin. He was stronger. The nursing home staff reveled in how much progress was being made over such little time. It seemed every one was ecstatic, except for, of course his family. Every step this octogenarian took forward was accompanied by a litany of concerns and complaints from his daughter.If he was not gaining weight, she wanted to know why. If he then put on a few pounds, she wanted his diet restricted. Through each "emergency" I calmly talked her down. I often spent thirty minutes ...
Source: In My Humble Opinion - August 12, 2014 Category: Primary Care Authors: Jordan Grumet Source Type: blogs
FDA Approves New Oral Drug for Type 2 Diabetes
By Diane Fennell
On August 1, the US Food and Drug Administration (FDA) approved the oral diabetes drug Jardiance (generic name empagliflozin) for use, along with a healthful diet and exercise, in adults with Type 2 diabetes. The medicine, a joint development of Boehringer Ingelheim Pharmaceuticals and Eli Lilly and Company, joins Invokana (canagliflozin) and Farxiga (dapagliflozin) as a member of the class of drugs known as sodium-glucose cotransporter 2 (SGLT2) inhibitors.
In the process of filtering the blood, the kidneys typically reabsorb all the filtered glucose and return it to the bloodstream. One of the main pr...
Source: Diabetes Self-Management - August 8, 2014 Category: Diabetes Authors: Diane Fennell Source Type: blogs
What to Know about Children’s Nighttime Bedwetting
Toilet training can be a stressful process. This is particularly the case for children who achieve daytime dryness but continue to wet themselves — and the bed — overnight. It may leave you wondering what’s normal and what you can do to help your child.
Nighttime wetting is one of the most common urologic conditions in childhood. The vast majority of cases are not related to a physical cause. Most commonly, nighttime wetting happens in children who are very deep sleepers; their brains and bladders aren’t communicating as they should while they sleep. It is not your child’s fault.
One of the most valuable...
Source: World of Psychology - July 30, 2014 Category: Psychiatrists and Psychologists Authors: Katie Gawerecki Tags: Children and Teens General Health-related Parenting bedwetting bladder Dehydration enuresis toilet training Source Type: blogs
Me and My Alzheimer's Shadow
Shadowing causes the Alzheimer's caregiver to feel like their personal space is being violated. They feel smothered. Caregiver attempts to separate themselves from the person with dementia can lead to the perception on the part of the patient that they are being rejected or worse.By Carole B. Larkin +Alzheimer's Reading RoomSome people start exhibiting a behavior I call “shadowing” in the mid-stages of Alzheimer’s and other dementias. Those who are able to walk or roll in their wheelchairs will literally follow their loved one or caregiver around the house trying to be as close as they physically can to the other per...
Source: Alzheimer's Reading Room, The - July 30, 2014 Category: Dementia Tags: alzheimer's alzheimer's caregiving alzheimers me alzheimers shadowing dementia health dementia shadowing life news Source Type: blogs
Dealing with Difficult Behavior Caused by Alzheimer's Disease and Dementia
I often get asked questions about how I dealt with my mother when she engaged in difficult to manage behaviors.By +Bob DeMarco +Alzheimer's Reading RoomI read these six coping strategies for dementia-related behavior problems some time ago.Dr. Peter Rabins is a Johns Hopkins neurologist. He touches on the following behaviors: outbursts, agitation, aggression, wandering, vocalizations, hoarding and hiding things, and inappropriate sexual behavior.The 36-Hour DayPeople living with dementia often exhibit aggression and behaviors that are frustrating, embarrassing, and sometimes even dangerous to the Alzheimer's car...
Source: Alzheimer's Reading Room, The - July 19, 2014 Category: Dementia Tags: 36 hour day alzheimer's alzheimer's behavior Alzheimers aggression Alzheimers Dementia alzheimers dementia stages health life news Source Type: blogs
Hospitalist Group Uses “Altered Mental Status” Code For All Inpatient Testing
Richmond, VA – In an effort to simplify inpatient medical billing, one area hospitalist group has determined that “altered mental status” (ICD-9 780.97) is the most efficient code for use in any patient work up.
“When you enter a hospital, you’re bound to have some kind of mental status change,” said Dr. Fishbinder, co-partner of Area Hospitalists, PLLC. “Whether it’s confusion about where your room is located in relationship to the visitor’s parking structure, frustration with being woken up every hour or two to check your vital signs, or just plain old fatigue from be...
Source: Better Health - July 11, 2014 Category: American Health Authors: Dr. Val Jones Tags: Friday Funny Humor Altered Mental Status Dementia Fake News Geriatrics Healthcare Costs Hospitalists ICD-9 Medicine Mental Status Changes Nurses Over-testing Parody Satire Side Effects Urinary Tract Infection UTI Source Type: blogs
The Price of Compassion - Commercialized Hospices and the Mistreatment of Vulnerable Patients
Introduction - Commercialized Hospices We have occasionally written about the rise of the commercialized hospice industry, and concerns that commercialized hospices may not be providing the compassionate care they promise. As we have discussed before, the hospice movement began with small, non-profit, community based organizations meant to provide compassionate palliative care to the terminally ill. However, in the US, the hospice movement has been co-opted by commercial hospices, often run by large corporations, which may put profit ahead of compassion.Several long investigative articles have appeared this yea...
Source: Health Care Renewal - July 10, 2014 Category: Health Management Tags: Carlyle Group deception Fillmore Partners Gentiva Golden Living HCR ManorCare hospices marketing private equity Vitas Source Type: blogs
Healthy Entertaining Ideas for the Fourth of July!
Nothing says 4th of July like watching fireworks and getting together with family and friends for a delicious barbecue! I recently appeared on Let’s Talk Live with fun and healthy food ideas to make your Fourth of July celebration taste great. Read on to learn how to flavor up your celebration the healthy way with quality foods and ingredients, or watch the full clip below.
Surprise Your Guests with an Unexpected Burger
Did you know that over 90% of American households have a jar of peanut butter? Peanuts and peanut butter do more than just add fabulous flavor to our favorite snacks and meals — they also ad...
Source: Balanced Health and Nutrition Rebecca Scritchfield's Blog - July 3, 2014 Category: Nutritionists and Food Scientists Authors: rebeccascritchfield Tags: cooking eating healthy food life nutrition recipes bbq cranberries july 4th Kind Bars peanuts Pirates Booty Real Deal All Natural Snacks sunkist Source Type: blogs
We should value quality when we shop for health care
Over the years, my husband’s parents, Helen and Dave, have both suffered unnecessarily from bad medical care. They are not alone.
A botched cataract surgery left Helen with a torn iris. One of her eyes can’t adjust to light, and for the last several years she’s worn sunglasses indoors. Her urologist kept treating her with the same antibiotic for urinary tract infections without testing to see what bacteria she had. When her symptoms persisted for months, I finally intervened. I ordered urine testing myself — I’m an internist and infectious disease specialist — and prescribed the right antibiotic.
Contin...
Source: Kevin, M.D. - Medical Weblog - June 21, 2014 Category: Journals (General) Authors: Celine Gounder, MD Tags: Physician Primary care Source Type: blogs
