There’s a lot of evidence that to prevent many serious health conditions, including diabetes, obesity, heart disease, and stroke, making healthy lifestyle changes are just as good, if not better than, taking medications. Lifestyle changes may consist of stopping unhealthy behaviors such as tobacco and excessive alcohol use, or starting healthy behaviors such as moderate daily exercise and eating adequate amounts of fresh fruits and vegetables. As anyone who has ever ...

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I’ve worked in hospitals since I was 16 years old — 42 years ago now. I was first an orderly, then a nurse’s aid, then a practical nurse, and a finally a surgical technician before I became a physician. When I started, female nurses wore caps, the details of which identified which nursing school they had graduated from, as well as a pin that gave the same information. They wore starched, ...

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Dealing with an incurable illness or terminal condition is an inevitable reality of the practice of medicine. Not uncommonly, especially in the intensive care unit, we care for the patient with no chance for recovery and survival. Keeping that patient comfortable and allowing him or her to die with dignity becomes the priority of care. Occasionally, I hear requests from the family members of the dying patient – “Can you give ...

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A few years ago, a patient of mine was diagnosed with lung cancer.  A metastatic work up revealed a small mass in his liver that had the radiographic appearance of a benign liver cyst.  But in the setting of a newly diagnosed lung cancer, we couldn’t be sure it wasn’t a metastatic lesion, so we decided to biopsy it.  Due to scheduling issues, we couldn’t get it done for seven ...

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by Brad Stuart, MD Atul Gawande’s brilliant essay in the New Yorker sums up the dilemma we face, whether we’re patients, families, and/or clinicians, as we near the end of life. His point is that we have to face it together: “People die only once. They have no experience to draw upon. They need doctors and nurses who are willing to have the hard discussions and say ...

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As an e-Doctor, one with some IT literacy, I welcome the e-Patient movement. I think patients should be equipped, enabled, empowered, engaged, equals, and emancipated, as Wikipedia explains.  The link also adds “and experts” and here I have a problem, not because I don’t think patients should have access to knowledge or know a lot about their own disease, but because knowing one pattern of pathology, i.e. your own, does not make you an expert. No more ...

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by Edward Stevenson One of the things that drew me towards medicine was the fact that I personally value health and the sense of well being. I would expect that if I inquired of my colleagues that a similar statements of values would echo this fact. Yet despite this near universal affirmation of value for health and well-being, a considerable amount of hypocrisy exists in the ...

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When I ran into Paul S. not knowing he had cancer, I barely recognized him and struggled with what to say. “What happened?” didn’t seem appropriate, although it was my initial reaction. I believe I said, “I barely recognized you,” which was true. I’ve been in many situations where I wasn’t sure what to say to someone who was ill or in distress; I wanted to be supportive ...

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by Devin Gross Here’s a question. It’s not a 5¢ or $5 question that anybody can solve on their own without much thought or effort. It’s a $100 ask-an-expert or think-about-it-for-a-second question. What’s the point of patient empowerment? Much of the current discussion of empowerment deals with patients who for one reason or another have had to fight for their care. CNN’s Elizabeth Cohen opens her book, ...

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Grandmother Pat LaColla, 82, was lured by the hype—"get in shape without setting foot in a gym"—when she bought a pair of Skechers last year, wincing at the $100 price tag. Toning shoes like those she bought are the newest craze in athletic footwear, projected to grow 500 percent to become a $1.5 billion market this year. Although the designs vary, toners typically have strongly curved, thickened soles. From the moment ...

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