Two women, two cancers, two different pathwaysI sometimes wonder what I would do if I was told I had cancer. How much would I subject myself to in order to survive, or to achieve remission? As a parent, I can answer only that I would likely go through hell and back if it meant being there for my kids -- to watch them grow up, graduate ...

Read more...

August 17, 2010. Maris is a 57-year-old woman in excellent health.  She has not seen a doctor in years. Divorced, she lives by herself, but spends occasional evenings with her daughter and son-in-law.  A successful businesswoman, Maris gardens, serves on the board of a community theater and plays a mean game of bridge. It is 10:11 a.m. when Maris presents to the emergency room. Three hours earlier, her legs became wobbly while ...

Read more...

Sex or death: The difficult decisions of prostate cancer treatmentAs part of my role as a clinical nurse specialist in a busy prostate clinic, I see men (with their partner) as part of their decision-making process for active treatment for prostate cancer. The purpose of the appointment is for me to explain the results of their prostate biopsy, dispel any misinformation they may have about what those results mean, ...

Read more...

Top stories in health and medicine, September 12, 2014From MedPage Today:

  1. Price Tag on Old Insulin Skyrockets. Retired nurse Mary Smith was having trouble controlling her type 2 diabetes on her regular insulin regimen, so her doctor decided to put her on something stronger.
  2. Bedside Ultrasound: Sorting Shadows. In medicine, we frequently propagate half-truths and unsubstantiated certainties. Thus, truth is ...

    Read more...

7:00 a.m. Lights on.   Coffee, black and a banana. Paperwork.  27 patient visits, 3 emergencies, 35 phone calls.  Lots of computer time. Some laughs and a few tears. Paperwork.  Last family meeting.  Coffee, black.   In between: Thursday. Was not completely successful in explaining to my frantic patient with the multi-page lab printout, how the problem was not that her tests were bad, but that the computer had used the wrong “normal” range ...

Read more...

Top stories in health and medicine, September 8, 2014From MedPage Today:

  1. Dialysis Drug OK'd for Marketing. A new phosphate binder has been cleared to treat hyperphosphatemia in chronic kidney disease (CKD) patients on dialysis.
  2. Medicare ACOs See Benefits Despite Issues. Participants in Medicare's accountable care organization (ACO) programs have had their share of frustrations, but their enthusiasm for the ACO ...

    Read more...

Health screening is part of good preventive care, though over-screening can lead to increased costs, and potential patient harm. Health care professional societies have recently developed excellent public service announcements describing the dangers of over-testing, and new research suggests that though additional medical interventions are associated with increased patient satisfaction, they also lead (ironically) to higher mortality rates. And so, in a system attempting to shift to a “less is more” ...

Read more...

Top stories in health and medicine, September 5, 2014From MedPage Today:

  1. Potent Statin Offers No Help After Cardiac Surgery. The powerful lipid-lowering drug rosuvastatin (Crestor) -- also purported to be an effective anti-inflammatory agent -- was powerless to prevent postoperative cardiac surgery complications such as atrial fibrillation.
  2. Questioning Medicine: The Pain Management Fiasco. I spent my intern year at a ...

    Read more...

Does owning cancer equipment change treatment patterns? Today’s article follows the money trail to expose a different form of bias: the kind that takes place when doctors own their own diagnostic and therapeutic equipment. For people living with cancer, this kind of bias can have a particularly painful impact. Radiation therapy brings out medical bias In the United States, cancer is the second most common cause of death, killing nearly 600,000 ...

Read more...

I have a new favorite doctor show, “The Knick” on Cinemax, airing on Friday nights.   The show stars Clive Owen as the charismatic cocaine-addicted chief of surgery Dr. John Thackery at a fictitious New York City hospital called The Kickerbocker at a time when surgery was one foot out of the barbershop.  The tagline is, as they say, priceless: “Modern medicine had to start somewhere.” On the third episode, last Friday ...

Read more...

153 Pages