I sat in my car, anxiously watching the minutes tick by as I ruminated over and over the words, I had prepared for this crucial meeting. I had arrived much earlier than the appointed time, knowing I would need a few moments to calm my nerves before walking into a room to face a panel of eight legal, medical, and insurance professionals. I was pregnant with my sixth baby and was ...

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SNF is the acronym we use in health care for “skilled nursing facility.” Fittingly, it is pronounced “sniff,” a fact that became fitting as I watched my father die in one this past week. My parents, 86 and 89, bought into a beautiful retirement community 10 years ago. Included was a lovely apartment, full-service dining facility, gym and health center, the last of which included an SNF. In the past three months, ...

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Today, I am a 40-year old with type 2 diabetes. I have been on glyburide since I was diagnosed four years ago and am otherwise healthy, although my blood pressure today is 140/96. I don’t check my glucose levels at home because I don’t have a monitor. Typically, I avoid sweets, but my diet is high in natural sugars, carbohydrates and starches. The only exercise I get is walking around ...

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"Why don't you talk loud enough for the whole damn hospital to hear you?" I've just greeted my eighty-four-year-old grandmother, and now this irascible voice has erupted from behind the curtain that separates us from whoever is sharing Grandma's room. The nursing assistant whfo showed me in glares across the curtain at the other inhabitant. "You shut up," she tells the person firmly, "or I'll smack you with a bedpan." Then, she leaves us ...

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Pacing refers to spacing out your activities during the day so that you’re able to stay within the limits of what your body can handle without exacerbating your symptoms. Another way to think of it is that pacing is a way to keep you inside your “energy envelope” -- the envelope that contains your energy stores for any given day. First, an admission: Even though pacing may be the single best ...

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I’m convinced this will be a year of reflection for our family  --  as we’ve witnessed so many transitions in the past year I find myself deep in thought. As I reflect, I’m full of appreciation for the journey we’re on. I’m full of gratitude for so many of the people who have helped us along the way  --  especially the amazing doctors who have become like family.  This past ...

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Everyone immersed in the culture of medicine knows that physicians sometimes defer the discussion about prognosis to patients who are battling a life-threatening illness.  Everyone, that is, except the patient.   We arrive on your doorstep believing that our presence indicates the obvious.  So, how are we to know that we have to ask for something as life altering and important as a prognosis?  Deferring to the patient for prognostic discussion ...

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Once upon a long 18 years ago, I got sick. I was sick from a growth in my brain. The growth was found after I'd shuttled from doctor to doctor, from appointment to appointment, from X-ray to scan. It took a year. By then, my pain was clothed in shame. Undiagnosed pain does that: It draws the gaze of friends, family and providers. Everyone looks for the cause. "Soul pain," said one doctor. ...

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One of the first things they teach in medical school is that if you haven’t pretty much figured out the diagnosis by the time the patient finishes sharing their history, your doctor hasn’t done his or her job well.  Certainly, this is a bit of an exaggeration, as many diseases cause similar symptoms. As you share your background, your doctor is creating a list of possibilities of the most likely conditions ...

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When Donna Helen Crisp, a 59-year-old nursing professor, entered a North Carolina teaching hospital for a routine hysterectomy in 2007, she expected to come home the next day. Instead, Crisp spent weeks in a coma and underwent five surgeries to correct a near-fatal cascade of medical errors that left her with permanent injuries. Desperate for an explanation, Crisp, who is also a lawyer, said she repeatedly encountered a white wall of ...

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