Doctors use laboratory values to interpret your medical condition.  With respect to kidney disease, the BUN and the creatinine help your nephrologist (as well as your internist and family physician) determine if your kidneys are working correctly. These two tests are commonly ordered for many reasons and are invaluable tools to help your doctor assess your condition. Let's define what BUN (pronounced by spelling out the letters "B", "U", ...

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Medical care in  America isn't doing so well when compared to other developed nations. Historically physicians did not want to take ownership of their  patients' problems. Patients have  free will. They can "choose" to be non-adherent. They can choose to not take the medication the doctor prescribes -- even if the one prescribed is $70 dollars a month when there is a $4 dollar Read more...

I decided to dedicate a medical blog on  smoking cessation after realizing that too many people in Douglas County (Omaha, Nebraska) smoke. Did you know that despite a smoking ban in restaurants and bars, 18.3% of people in Nebraska are smokers? That's one in five people. And this number contributes to Omaha's health ranking of 142 out of 182 cities in ...

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During my training at Hennepin County Medical Center (HCMC) in Minneapolis, MN, my mentor would use the following teaching pearl during rounds: "When you hear hoofbeats, think of horses not zebras!" He would also frequently use: "If it looks like a duck, swims like a duck, and quacks like a duck, then it probably is a duck." What did my mentor, the Sage of HCMC, mean by this? From Wikipedia: "Zebra ...

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Here's the scenario: on the 2nd of the month, a patient with diabetes on metformin and high blood pressure on benazepril sees her family physician for a routine follow up. The patient's blood pressure is elevated and the decision is made to add carvedilol to help get the blood pressure to goal. The patient's metformin and benazepril "drop" (are renewed) at the pharmacy on the 18th of every month, a date ...

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Doctors, both generalists and specialists, have constraints on their time. New practices and new approaches need to happen in order to maximize everyone's time. In addition to bringing your co-payment, you should "invest" in the visit and do your part, so that by the time the visit has ended, a successful plan of care is developed. Here are some helpful tips to make the most of your medical appointments.

I have helped scores of women with frequent, recurring urinary tract infections (UTIs) over the years. First, involvement of your primary care provider is critical. "Must not miss" disorders need to be considered prior to going forward with the recommendations given below. Second, how do you define recurrent urinary tract infection? Most define recurrent UTI when a woman has 2 or more symptomatic urinary tract infections in 6 months or 3 or ...

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Diamonds are forever. However, kidney dialysis may or may not be forever. It just depends. Patients who are hospitalized who suddenly lose the ability to make urine or detoxify their blood may only need kidney dialysis for a short period of time. Dialysis is considered a bridge so that the kidneys, which are stunned, can wake up and start working again. On the other hand, patients who have a slow, worsening progression ...

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