Dr. Paul Rousseau from Arizona State University has written an interesting summary of the problem of denial of terminal illness, published in the Journal of Clinical Oncology, May, 2003.
Below are selections from the article, which should pique one's curiosity:
"Although denial may produce a focus of concern, it may also serve as a protective and adaptive mechanism to absorb deleterious and life-threatening information in a manageable and ...
February 2005
All Stories
When patients deny illness
Much denial-blogging today. Alisha's mother-in-law won't accept physical limitations imposed by her cancer. Orac tries to help a patient who rejects her malignant biopsy results. What is denial, and how should we approach it? (Pause for a quick check - has the Cheerful Oncologist posted about this yet? No? I'd love to know what he thinks!) Here's Dr. Simon Wein, MD, of Memorial Sloan-Kettering ...
Using Rituximab, a highly specific monoclonal antibody, to treat non-Hodgkin lymphoma
The role of targeted therapy in non-Hodgkin lymphoma (NHL) is being explored, tested, reported and argued about almost continuously in the medical oncology literature. Rituximab, a highly specific monoclonal antibody that binds to an antigen called CD20 on B-lymphocytes, is commercially available and has been studied extensively. It is quite active against both indolent and aggressive NHL.
Whether rituximab prolongs survival in this disease is still to be determined. ...
Blog Plugging
My alter-ego, The Cheerful Oncologist, has written a little post on the first and most important responsibility of the cancer specialist. To find out what this is, point your mouse here.
After you read it, feel free to commit floccinaucinihilipilification.
65,000 Pounds Lost in Iowa!
Who says it is impossible to lose weight? By simply walking more (and eating a more healthy diet) 20,000 Iowans have lost over 65,000 pounds over the past three years.
The subjects are grouped in teams and record their steps by wearing a pedometer. The total distance walked by the group thus far: 4.8 million miles.
Many people think that in order to lose weight they must ...
Fatal crashes of medical helicopters
Accident rates are rising (NYT):
...the industry's rapid, competitive growth may also be exacting a toll. Federal regulators and some doctors worry that the pool of skilled helicopter pilots has become drained and that some of those flying are making poor decisions. In addition, some companies are flying older helicopters that lack the instruments needed to help pilots navigate safely. Of the ...
Skipping breakfast can lead to higher sugar and cholesterol levels
Researchers at the University of Nottingham, U.K., have released a study showing that normal weight women who skip breakfast have higher fasting levels of total and LDL cholesterol, and have impaired insulin sensitivity to a test meal - which raises serum glucose levels. The implications of this study are that women may not only gain weight, but increase their risk of heart disease and stroke by avoiding eating first ...
Global Anti-Smoking Pact Goes Into Effect
"A global treaty aimed at dissuading children from smoking and helping adults kick the habit came into force on Sunday with the United Nations saying it could save millions of lives." (via Yahoo Newsbv) The US has not yet signed the treaty.
Symptoms of nicotine withdrawal include:
(1) dysphoric or depressed mood
(2) Insomnia
(3) irritability, frustration, or anger
(4) anxiety
(5) difficulty ...
Treating non-small cell lung cancer (NSCLC) after it becomes resistant to chemotherapy
Treating non-small cell lung cancer (NSCLC) after it becomes resistant to chemotherapy has been the subject of intense scientific and clinical research. The study of targeted therapy, in which a drug or biological agent attaches only to a specific receptor on a malignant cell, led to the approval and release of the anilinoquinazolines gefitinib (Iressa) and erlotinib (Tarceva), for the treatment of patients with NSCLC who have failed or can ...
Overmedicating the Elderly
A new study from the Journal of the American Geriatrics Society states that almost one in three seniors are receiving medications "deemed potentially inappropriate for older people".
Medicines on the list included antispasmodic drugs and propoxyphene. Several solutions to the problem are mentioned, all centered around good communication between doctor and patient, and knowledge of drug side effects in the elderly.
Can a Book Inspire One to Become a Doctor?
Greetings to all of Kevin's readers (and I know you are many)!
Have you ever run into a high school or college student who is interested in becoming a doctor? It would seem that the opportunities for young people to "shadow" a practicing physician or scientist are readily available, and from my experience such exposure can push a youthful mind over the edge into a love and passion for ...
The ethics of "Million Dollar Baby"
...and the right to refuse medical treatment, at Bioethics Discussion Blog.
Where was the patients physician? Where was the ethics committee to help educate the patient and physician (and, by the way, the viewing public) on the well established ethics and law? Where was the advocate of the disabled, the rehabilitation therapist to provide the patient with factual information of what could yet be done to help her live maybe ...
Controlling chronic pain: One woman’s story
Pain meds weren't enough:
Darcie Prestegard has spent much of her life coping with chronic pain, the result of a childhood accident. For years she tried to block it out, competing on the rodeo circuit despite constant sharp pains in her leg. Eventually she sought medical help for her discomfort. Surgery and various medications brought some relief, but the pain always returned. Her doctors said it might never go away completely. ...
Welcome, Cheerful Oncologist
He's joining me here, guest-blogging till Thursday. (Thanks, C.O.!)
Intueri hosts the next Grand Rounds
Please send your submissions to me at maria at intueri dot org with a title of "Grand Rounds Submission". And send them in before 6:00PM PST (that's 9:00PM for you Eastern Seaboard peeps) on February 28th, 2005.
"Will the longevity granted to us by modern medicine be a curse or a blessing?"
Dr. George Vaillant, MD, directs the Study of Adult Development at Harvard University. He's searching for "a theoretical framework, as well as data, for understanding how older people end up fulfilled or not." Among his findings:
* It is not the bad things that happen to us that doom us; it is the good people who happen to us at any age that facilitate enjoyable old age.
* Healing relationships ...
Thanks, Dr. Kevin!
I'm a psychiatrist who blogs from Eugene, Oregon. I'm surprised to be over here! (I've never "guest-blogged" before.) I think I'll be posting the way I usually do, but I'll have an eye out for more medically-oriented topics. (I'm especially interested in how people cope with all sorts of things, including medical problems...)
In absentia
I will be away for a few days. But fear not, loyal readers - our favorite blogging psychiatrist, shrinkette, will kindly be guest-blogging in my absence. Enjoy!
Update:
Dr. Craig Hildreth, The Cheerful Oncologist, will also be guest-blogging. Enjoy both of these unique medical blogging voices in the next few days.
A woman who had suffered a massive heart attack died after hospital personnel moved her out of a trauma room to accommodate a flu-stricken Michael Jackson
Big surprise, the family is now suing Jackson and the hospital. Chris Rangel comments:
The problem is that like the majority of medical lawsuits this case has little if any merit. It is standard procedure to disconnect the patient from the ventilator and ventilate ...
In the trauma room: Columbus man kills his two children, then kills himself
Dr. Bard-Parker was there. Incredible.
Kevin Pho, MD
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How I approach ovarian cancer screening with patients
Ovarian cancer screening clearly touches a nerve. No one doubts that ovarian cancer is a devastating diagnosis, often found when the disease...
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Why more primary care doctors are referring patients to specialists
According to a recent study from the Archives of Internal Medicine, primary care physicians are referring more patients to specialists than ever...
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Should Google censor anti-vaccine claims?
One of the reasons there is such a movement against vaccines is the democratization of information, perpetuated by search engines like Google....
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Radiologists who cheat on their board exams: Who’s to blame?
In a widely circulated CNN article, many radiologists have been found to cheat on their board exams: "Doctors around the country taking an...
Physician
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Why an anesthesiologist would be needed for organ donation
I've only had to declare death a couple of times. Once in a three-year-old and once in an adult. In each case...
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5 ways to avoid a misdiagnosis
Billionaire Teddy Forstmann had been diagnosed with a serious form of brain cancer. There’s a tragic twist to the story: according to...
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Benefits of the Medicare Adult Wellness Visit
One of the things I love about family medicine is that I get to care for people of all ages. I almost...
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Cancer has a way of teaching us poignant life lessons
I just finished reading George’s recent post on Evelyn Lauder, who recently passed away from ovarian cancer, and am still stirred by...
Patient
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In love there is a life giving force
Here is a toast to the miracle of love. Not to the romantic, chocolate, dance club nightlife type of love. Not warm...
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How to get ready for death
No one wants to die. Even people who want to go to heaven don't want to die to get there. And yet...
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The long term cost of a pain in the neck
One morning this May, I woke up with a stiff neck. I applied hot and cold therapy all day and took an...
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Preparing for your visit with someone in hospice care
Visiting someone who is dying or critically ill is an experience many of us will have in the course of our lives....
Policy
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AMA: Advocating for Medicare, military and fiscal responsibility
A guest column by the American Medical Association, exclusive to KevinMD.com. This week, I’m joining hundreds of physicians and medical students in Washington, DC...
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A critical look at value driven health care
Everyone in the world is talking about “value-driven health care.” Or so it might seem if you pick up a medical journal...
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Surviving the new landscape of physician reimbursement
CNN recently posted an article titled "Doctors Going Broke." It described several cases of independent physicians who are near bankruptcy although they once...
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Doctors lobby Congress to repeal the SGR
One of the things that I like most about my job is engaging with ACP’s physician leadership—the internal medicine doctors who dedicate...
Tech
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There is a patient attached to that implantable defibrillator
As a follow-up to my post on why patients with implantable defibrillators should have access to their device’s data, I am going...
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The pitfalls of email communication with patients
A recent article in the Wall Street Journal reviewed the emerging role of email in healthcare, arguing that doctors should more aggressively...
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Why adoption of EHRs is a transformational event for physicians
Paul Conslato, MD, director of clinical affairs for Lancaster General Medical Group, recently was quoted in the PAMED Better Health Network eZine...
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Why EMR is a dirty word to many doctors
Don’t get me wrong, EMRs (electronic medical records) are inevitable. Over the long-run they are almost certainly good for physicians, patients and...
Social Media
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Using Twitter to deliver health improvement messages
I have decided to spam for public health. Phone calls, text messaging, and even apps have been shown to help improve health...
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Addressing comments on your medical practice’s Facebook page
Does your medical practice allow anybody to post links and comments on your Facebook page? The short answer is yes. We do....
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The Internet is where patients go for pre-visit consultations
As a physician, technology cannot replace you, but it can make you more efficient and effective. This was the message from Richard...
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5 ways doctors can benefit from professional connections
Looking ahead to the next several months, I’ve found myself frequently wondering how many physicians will make this their year to take...
