“I don’t like taking medicines.” All physicians hear some form of this opinion very frequently. Even more frequently, patients don’t state this view outright but rely on it to completely subvert their doctor’s plans. When I was new to practice such an utterance would shock and confuse me. “I don’t want to take any medicines,” a patient would declare. “That’s fine,” I would reassure my interlocutor. “It’s a free country. No one is going ...

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In the contest to get a creative name, few pathogens have done worse than hepatitis C. In the 1970s there were two known viruses that caused hepatitis: liver inflammation. You might have already guessed that these two viruses were called hepatitis A and hepatitis B. It was known at that time that people sometimes developed hepatitis after blood transfusions and that the majority of those patients tested negative for hepatitis ...

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The danger of diabetes is not only the immediate risk of very high blood sugar. Diabetes also has many dreaded long-term complications. (In this post I am referring to both type 1 and type 2 diabetes mellitus.) Diabetes greatly increases the risk of stroke, heart attack, and amputation. In the US it is the leading cause of kidney failure and of blindness in adults. A study performed by researchers at the ...

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Most humans have spent most of human history nearly starving to death. So it’s no surprise that we spend a lot of time thinking about food. And it’s no surprise that food has acquired cultural, social, and religious significance in almost every society. Because food is so important, and because it’s nearly impossible for us not to ascribe powerful effects to anything important to us, every society imbues special health ...

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When I meet a new patient, I’m frequently astounded by the health care he has received. I’ve met patients with absolutely no cardiac symptoms who have been receiving EKGs every six months for years. I’ve had patients brag to me about their annual executive physicals in which myriad tests including treadmill stress tests and chest x-rays were routinely performed. Patients get head-to-toe CT scans under the mistaken hope that they ...

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Opioids are a family of pain medications chemically related to opium and heroin. They include morphine, fentanyl, codeine, hydromorphone and others. Opioids have unique properties that make them both indispensable for pain management and extremely dangerous. Unlike virtually any other family of medications, opioids have no maximum effective dose. If any dose, no matter how high, is ineffective at controlling pain, a higher dose can give more pain relief. Most other ...

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Those of us who believe in the unvarying beneficence of Mother Nature have yet to contemplate Neisseria meningitidisN. meningitidis is a bacterium that can live harmlessly in the throats of healthy people. But about 500 times a year in the US it causes bacterial meningitis, a life-threatening infection in which the membranes lining the brain and spinal cord become inflamed. Bacterial meningitis is treatable with antibiotics but even with treatment patients sometime suffer ...

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If you remember the 1950s you probably remember the terror of polio. Polio, short for poliomyelitis, is a disease caused by a virus which can cause severe inflammation of the spinal cord. Though most infected people have no symptoms, a small fraction of patients are left with permanent paralysis and deformities. The disease is sometimes fatal. In the US, the 1952 polio epidemic killed over 3,000 people and left over ...

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To understand the Vicodin story we first have to understand how habit-forming medicines are currently prescribed in the U.S. The Drug Enforcement Agency divides potentially addictive substances into different schedules. Schedule II controlled substances are prescription medicines that have a high potential for abuse and severe dependence. They include all the opiate (narcotic) pain medicines, like morphine, oxycodone, and fentanyl. These medications must be prescribed on a paper ...

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A sudden life-threatening illness is every family’s nightmare. A loved-one suddenly develops an overwhelming infection or is in a terrible accident. She is rushed to the intensive care unit (ICU) and is put on a ventilator (breathing machine). Many medications are started or she is rushed to surgery for her traumatic injuries. To the family, the first day or two is a blur of life-saving treatments, painfully waiting for the next ...

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