Another day, another pacemaker, at least so it seemed at first. The usual greeting the patient, answering the last questions, consent signing, placement of the IV, EKG leads, prepping of the surgical site and initiation of the preoperative antibiotics were all recent memories.  He laid there, smiling, knowing he'd made the right decision after years of struggling with his arrhythmia in other ways.  His heart was showing signs of slight weakening and ...

Read more...

A physician undergoes hip surgery: 10 observations from bedside It finally happened. After years of sitting at John’s bedside through multiple serious bike crashes, I had one of my own. I’ve had plenty of time to build up a ridiculous amount of smugness about why he crashes and I don’t. “John is reckless; Staci is cautious. John rides like an airplane engine on a shopping cart; Staci uses her head.” I ...

Read more...

The mind body association with back painThe mind body association with back pain An excerpt from The End of Back Pain: Access Your Hidden Core to Heal Your Body. The evolution of our species has been powered and guided by a survival advantage. Our unique adaptation for survival lies in the development of a brain that can plan, worry, and abstract. Perhaps the most ...

Read more...

Mrs. D was my last patient. I retired several months ago, and for some time prior I informed my patients so as to give them time to decide where they would like their follow-up care. Mrs. D was an elderly lady who I first met in the ER several years prior after a fall resulting in a displaced ankle fracture. She was pleasant and alert, understanding everything I was explaining after ...

Read more...

She was having excruciating pain in her pelvic area.  I pulled the sheets down cautiously and noted the bruising encircling the waist and inching towards the thighs.  I finished my exam and retreated to the nursing station of the skilled nursing facility to comb through the chart.  ER records, floor notes, consultations, but no x-ray of the pelvis. There was no mention of pelvic pain. The emergency room physician had dutifully ...

Read more...

She seemed awfully angry and at the very least dubious that I couldn’t do more for her father. After 7 hours of surgery trying to salvage her father’s leg, I tried patiently to explain that this new (third) bypass we had just successfully completed was unlikely to provide her dad with a long-term solution. Ultimately, he would lose the leg, if we were lucky he’d have it for another year ...

Read more...

Family physician Mike Evans is famous for his terrific whiteboard videos, where he distills complex medical ideas to its most understandable essence.  Here, he tackles low back pain, a condition that most adults will experience sometime during their lives. Watch and learn how more tests for back pain isn't necessarily better.

As an early Google Glass explorer, I see many ways this and other wearable technologies will soon enhance patient care. Google Glass is “smart” eyewear that offers features similar to a “smart” phone: It can take photographs, video, make phone calls, display Internet-based information. The data is transposed onto the glass lens in the wearer’s field of vision. The device is activated by voice command or a touch to the tiny ...

Read more...

I recently got back from a brief trip to Florida. I went down there to celebrate my mother’s 85th birthday. As you might expect, her social circle has shrunk in recent years, but she did get a number of cards and calls from friends and family members. The cards were on display in her kitchen, and a few calls came in while I was there. One in particular pointed out some ...

Read more...

The patient was a 78-year-old businessman who acted and looked about half his age. He was very pleasant and talked freely about his lower back pain and the pain down the side of his left leg, which had been a problem for about six months. It was consistently more severe when he stood or walked on it, and it immediately disappeared when he sat down. His MRI scan revealed that ...

Read more...

5 Pages