We, as a society, can’t ignore these numbers: over 47,000 human lives lost prematurely in one year from drug overdoses, a 7 percent spike over the previous year, with opioid painkillers and heroin driving much of this tragic surge. If this trend isn’t disturbing enough, four out of five new heroin abusers began their habit by abusing painkillers. These numbers have faces. Caring for patients who abuse and overdose ...

Read more...

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 59-year-old woman is evaluated for continued substernal chest pain. She presented with exertional chest pain 6 months ago that occurred with minimal ambulation. She was evaluated with a stress nuclear medicine myocardial perfusion study that showed no ST-segment changes but a small area of inducible ischemia in the lateral area of ...

Read more...

On any given night in the United States, according to the Department of Housing and Urban Development, over half a million people are without a home. That number may have decreased nationwide in the past few years, but California remains on the forefront of the problem, accounting for 20 percent of the country’s homeless in 2014. With the winter’s freezing temperatures and El Niño’s massive rainstorms, what to do about the ...

Read more...

It’s January 2016. News stories have inspired significant anxiety about Zika virus. It’s a scary topic because news about the outbreaks are just unfolding, and this affects an already anxious group: pregnant mamas and expecting families. I want to share with you real-time information and data to try to alleviate anxiety and educate the best I can. I suspect with time some of this will change. I’ve curated the most common questions and answers ...

Read more...

There is no doubt that Zika is causing worldwide hysteria as a rapidly spreading virus with potential of pandemic proportions. The virus is transmitted by the Aedes aegypti mosquito, which also carries both dengue fever and yellow fever. While a relatively innocuous virus with 80 percent of those affected being asymptomatic, mild symptoms of illness such as fever, rash, joint pain, and conjunctivitis are associated. The most worrisome outcome of this ...

Read more...

When my twin sons were born prematurely at 26 weeks’ gestation, my family’s lives were thrust into the whirlwind of the NICU and living daily with the reality of the babies (William and Elliott) being on life support. Having had no prior intense and prolonged experiences with the hospital, and watching helplessly and fretfully as my tiny two-pounders fought for their lives, it’s almost impossible to put into language what ...

Read more...

A patient came to the office and refused to see me, although I was quite willing to see him. I’ll present the scenario followed by the patient’s reason he took an abrupt U-turn. Then, if you are inclined, you may offer your own advice and comment. I performed a colonoscopy on this patient and found a large polyp in the upper part of the large intestine, or colon. The upper part ...

Read more...

Everywhere you go, you can see people from all walks of life sporting some pretty cool tattoos. Tattoos are so popular nowadays that they’re almost conformist. I consider myself really hip since I don’t have any tattoos; how avant-garde! However, that doesn’t mean I don’t appreciate good ink when I see it. As a matter of fact, I even dabble as a tattooist sometimes. It is common practice to leave a permanent tattoo at ...

Read more...

I woke up to someone forwarding this tweet. Yes, some company is selling tiny bags of herbs (they call them pearls) to stuff in the vagina for three days to cleanse your uterus or shrink your fibroids or treat bacterial vaginosis or tighten your vagina. This is not only pointless it could be very dangerous. Here’s why. Your uterus and vagina want you to leave them alone. Your uterus isn’t tired or ...

Read more...

asco-logo I run a dilator program for women with rectal or anal cancer where I educate patients about the need for and correct use of vaginal dilators to mitigate the effects of radiation on the vaginal wall. Many women don’t understand the need for dilators after radiation for this cancer, so I always start with a description of the anatomy and ...

Read more...

Most Popular