Well over a year ago, I advised my 80-year-old patient and her children that due to progression of her Parkinson’s disease.  Because of her frail nature, she needed a higher level of assistance and care if she wished to remain in her home.  She was extremely unsteady walking and several courses of physical therapy had not improved the situation. The patient was feisty and would only allow help to come ...

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I recently attended the University of Miami Miller School of Medicine graduation for the class of 2013. It had special meaning for me since this was the last group of students at the University of Miami Miller School of Medicine-Charles M. Schmidt Florida Atlantic University (FAU) joint venture to pass through my tutelage prior to the Boca Raton program becoming solely an FAU program. One of the graduates visited my office ...

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“J.T.” is 92 and clearly a soul who lives to the beat of a different drummer. She has no children and her closest relative is a niece who she despises. Despite this the niece oversees her care, sending in a full time aide and her personnel assistant to run the household. J.T. will not come to the office for a visit. If I call and make an appointment to see ...

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We are frequently reminded by the General Accounting Office and CMS that a great proportion of Medicare health costs are incurred in the last three months of a patient’s life. Health care policy experts have tried to reduce these costs by encouraging end of life planning.  Living wills, health care directives and the availability of hospice and palliative services will not put a dent in these costs because of human ...

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A doctor for the elderly: What to look for My elderly and infirm parents live 15 minutes south of my home in an assisted living facility.  They moved there after it became apparent that they could not manage their affairs in their own home, have some degree of independence and socialization with friends and receive the care and supervision they needed to stay out of the hospital.  Their cognitive impairment ...

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The state legislature in Florida decided it is legal and appropriate for pharmacists and pharmacies to begin administering vaccines against multiple diseases.  Their list of adult vaccines includes seasonal flu shots, Pneumovax (pneumonia vaccine) and Zostavax (vaccine to prevent shingles).  The rationale of the legislature is that access to doctors to receive these preventive vaccines is limited and difficult. By refusing to administer vaccines in their office because it is time ...

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As school bells ring out announcing a new school year and pigskins fly through the air announcing the arrival of a new football season, the Center for Disease Control and Prevention (“CDC”) begins its annual influenza vaccine campaign.  “Flu” or influenza is a viral illness associated with fever, severe muscle aches, general malaise and respiratory symptoms.  Most healthy children and adults can run a fever for 5 – 7 days ...

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The Center for Disease Control and Prevention (CDC) has requested that all individuals born between 1945 and 1965 be tested for the presence of the hepatitis C virus.   This is a clear cut change in their policy which had previously asked that only high risk patients be tested. Hepatitis C is a viral infection usually transmitted by blood to blood transmission.  High risk patients include intravenous drug users who share needles, ...

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Research radiologists at the Massachusetts General Hospital in Boston evaluated the accuracy and detail of imaging the colon (a virtual colonoscopy or colonography) with no laxatives as preparation and comparing it with traditional colonoscopy.  There are clear evidence based guidelines suggesting that all low-risk men and women have a screening for colon cancer with a colonoscopy at age 50.  If that study is normal they are directed to repeat it ...

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An investigative newspaper article published in the Milwaukee Journal Sentinel, in cooperation with online periodical MedPage Today, chronicles the increased use of narcotics for chronic pain relief in the elderly. The article highlights how in 2009 the American Geriatrics Society put together a panel of geriatric pain specialists who published geriatric narcotic pain relief guidelines that have led to the dramatic increase in use of narcotics in the elderly. There is apparently ...

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