Here are a few thoughts about the latest chapter in the never-ending debate about antibiotics vs. surgery for the treatment of uncomplicated appendicitis. You will recall the randomized controlled trial from Finland published in 2015 that found a 27% rate of failure of antibiotics within the first year. Now that the patients have now been followed for five years, 100 (39%) of the 246 patients treated with antibiotics have experienced persistent ...

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A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. It is not uncommon for my patients and their family members to ask for my credentials at the end of our preoperative interview. Despite reaching my forties, my Asian genes have allowed me to maintain a youthful appearance – often causing apprehension about ...

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If you have been following my writing, you know I have been out of the surgical workforce for a year and a half. I have settled into a much more relaxing lifestyle as an author who can set his own work schedule. This week I got a flashback of what my old life was like as a general surgeon when I attended a four-day conference called FinCon. Each morning of the ...

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Combating loneliness as a non-medical spouse to a surgical resident is my current struggle. I do not just mean the absence of his physical self -- which do not get me wrong is frustrating-- but the complete absence of his mind when he gets home from a long day at the hospital. Absolutely no one gave me the proper and direct heads up that I needed as to what it would feel ...

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I flash a smile as I look up from my notes. “Do it again,” I say, encouraged by his progress, “but this time start with the physical exam.” I am the internal medicine resident leading our “twilight” admitting team, and Vikram, a student on the first day of his medicine clerkship, sits across from me. It is his third time practicing the presentation of Ms. R, a 56-year-old woman with ...

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I have a confession. I didn’t enter my profession to help people. I know. It’s shocking. Don’t get me wrong. I take my professional responsibility extremely seriously. I’m only admitting that the primary reason for choosing my profession was not altruistic. I made a practical decision to go down this path because of a junior high career day event. Otherwise, I had no real connection to any health care profession other than ...

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“There’s no heartbeat.” Three words no one ever wants to hear. Three words no one ever wants to deliver. And yet, as a community of physicians, we deliver those crushing words on a daily basis. None of us would ever take the task of bearing this piece of news lightly, but for me, it was not until I was on the receiving end of them that I truly grasped how profoundly a physician ...

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Being self-aware sometimes to the point of turning self-critical — I, as a constituent of an anesthesiologist’s society, am writing this freestanding letter to bring forth our ethical questions and concerns regarding a shortage of not only medications but also skills, funds and time. Scenario 1: Patient requests for spinal anesthesia for cesarean section, but a shortage of hyperbaric spinal anesthetics warrants epidural anesthesia as its replacement. What must be done? ...

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As we follow the national opioid epidemic, with its greater than five deaths per hour from opioid overdoses, the focus is shifting to methods for limiting an individual’s exposure to these drugs. For most of us, our first contact with these highly addictive medications is after surgery. Studies now reveal that 60 percent of pills prescribed for pain after surgery go unused. These opioids often make their way to other family ...

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It was a sunny morning in July, and I was scheduled at the outpatient center with the oral and maxillofacial surgeons for teeth extractions. One of my patients was your son, an athletic teenager, whose only medical history was asthma. According to you and him, he had not experienced any recent asthma attacks and had never been hospitalized or intubated. In terms of breathing, he said he felt “perfectly fine” ...

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