In a word, yes. And this is a difficult concept for many doctors to get because we have long been taught that the gold standard is culture. Let’s back up a little. These are the symptoms of a bladder infection: needing to empty your bladder a lot (urinary frequency), when you gotta go, you gotta go (urgency), pain just over the pubic bone, blood in the urine, burning when you empty your ...

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“I have a 20-year-old with what I can only describe as a poorly repaired heart defect and, uh, suboptimal follow-up,” the cardiologist’s voice was rushed. “That’s no good,” I said. “Yeah, well, it gets worse. She had baby two years ago. Went into heart failure around 36 weeks. I’ve got the records. I have no idea how she made it home.” And then he added, “She had a c-section, but no one ...

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As a doctor, I appreciate that I am at an advantage when I seek medical care. Knowing terminology and basic medical principles helps a lot. In addition, when you’ve been practicing medicine for a while you get a feeling from how a doctor discusses options if the care seems valid or if a second opinion is in order. Other things I look for are board certification and a doctor ...

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Full disclosure. I have 4 board certifications and dutifully do all of the required reading, continuing medical education (CME) and recertification exams to maintain my status (I am board certified in OB/GYN in both the US and Canada as well as board certified in pain medicine by both the American Board of Pain Medicine, ABPM, and the American Board of Physical Medicine and Rehabilitation). I would never go to a non-board ...

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This weekend I tried to buy Plan B over the counter at a Rite Aid and was denied. Let me explain. It wasn’t for me, I have a Paraguard and my boyfriend had a vasectomy. Basically, the chance of me getting pregnant is so astronomically impossible that we’d be pimping the story out to every tabloid and we would aim for a reality show, which we would call The Second Coming. What ...

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She knew she was supposed to be careful about getting pregnant, although truthfully she didn’t think it could happen because of her blood pressure and kidney problems. The nurses at the county clinic started her on the pill, but her blood pressure went all crazy. They asked her to come back on a Wednesday night when the doctor was there. The doctor asked lots of questions and spent a lot ...

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Thump. There is a strange sound emanating from the hallway. It’s more of a series of sounds, of thuds, punctuated by an odd, louder noise. The hallway is narrow, not much room for a five-year-old to create too much havoc. I close my eyes, and as I try to visualize the corresponding sequence of events the rhythm is interrupted by a much louder sound and the house shakes. A child has fallen ...

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Many people think that tests (blood work, x-rays, scans, etc.) mean their doctor is doing something constructive and working hard to figure out what is wrong. But tests are a double-edged sword. When I trained most diagnoses were derived from careful history and a physical exam. Perhaps because our province did not have funds to have enough CT scanners and we didn’t have an MRI, those tests were on a ...

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My mom is sick. Because of what can only be described as my crazy family dynamics I did not find out for 24 hours that she was taken by ambulance to the hospital in septic shock from pneumonia. She was hypotensive on arrival (not good) and pancytopenic (low white cell count, low hemoglobin, and low platelets – not good either). A CT scan showed multiple large, irregular lymph nodes in her ...

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When you think about giving a premature baby the best possible start in life, it is important to consider the hospital where they are born. The care an extremely premature baby receives immediately after birth makes a big difference in outcomes. A premature baby who is less than 32 weeks gestation or weighs less than 1500 g at birth should be cared for in a level III NICU. These babies also ...

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How did the idea that vaccines are dangerous, toxin-filled CDC experiments metastasize so quickly from the fringe to the mainstream? Keep in mind that not only have vaccines been scientifically proven to be safe, but that some of the arguments against vaccines are so scientifically incredulous they are the equivalent of saying there is a UFO sitting in Central Park right now. So let’s begin at the beginning. In 1998 Andrew Wakefield ...

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October is breast cancer awareness month. There are pink ribbons and wristbands to wear, pink products to buy, and pink races to run -- all to improve awareness about screening and raise money for a cure. And rightly so, because breast cancer affects 250,000 American women every year. Fewer people know that October is also intimate partner violence awareness month. Purple is the color representing the more than 1.3 million women ...

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An excerpt from The Preemie Primer. There’s a well-entrenched theory that OB/GYNs have the most complicated pregnancies. In reality most of us probably do not, but doctors remember complications most vividly when they happen to people they know and love. My pregnancy was, unfortunately, a good example of that old adage. Many of my colleagues who looked after me during that time have said, “It was the worst night of my life.” ...

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