Conditions

Diabetes and liver disease: urgent screening needs highlighted by personal tragedy

Conditions
September 5, 2023

The American Diabetes Association recently released screening guidelines for liver disease in individuals with type 2 diabetes. Notably, 70 percent of people with type 2 diabetes have liver disease, and the most common form is non-alcoholic fatty liver disease. Ultimately, this can lead to cirrhosis and cancer. According to the American Cancer Society, the rates of liver cancer have tripled since 1980. Currently, one in 10 Americans has diabetes, …

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Medical gaslighting: a growing challenge in today’s medical landscape

Conditions
September 5, 2023

Chances are, you or someone you know has fallen victim to medical gaslighting at some point, especially as we see an increase in this unfortunate practice in today’s modern health care system. Maybe you have experienced medical gaslighting without even realizing it. What exactly is medical gaslighting? It’s a term given to a practice stemming from our medical community where doctors and specialists alike make patients feel a multitude of …

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Zurzuvae: a beacon of hope for postpartum depression or a superficial solution?

Conditions
September 5, 2023

The FDA approval of Zurzuvae (zuranolone), the first oral medication, has offered new hope to mothers who have exhausted all other treatment options to cope with their postpartum depression. This is a milestone in recognizing the maternal mental health crisis that plagues our country. The benefit of this drug is that it offers a new approach to treating postpartum depression and brings postpartum health into the spotlight. With Zurzuvae …

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Surgical decision-making: Navigating catastrophic scenarios

Conditions
September 4, 2023

Let me describe what it’s like to operate in a potentially disastrous situation. Notwithstanding having one’s faculties and wits gathered and finely honed, being as in command of yourself as you can possibly be, it may test and demand everything you can bring to bear. I’ve been in war, where I feared daily for my life. It’s not pleasant, but in some way you can get used to it. In …

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Misunderstandings about opioid use disorder

Conditions
September 3, 2023

At a recent scientific conference on narcotics, a researcher mused, “Honestly, opioids make me feel gross. I don’t see how anyone could get addicted.” This is a little like a doctor in the delivery end of a needle saying, “Honestly, you’re a wimp. This doesn’t hurt.” Both examples reveal a lack of empathy and a fundamental misunderstanding of current neuroscience.

The contributions or fear, reward, fight, and flight are a complicated …

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Ragweed allergy peaks during college football season

Conditions
September 2, 2023

Not only is it kickoff time for college football season, but it’s also prime time for fall allergies. For the 50 million Americans who suffer from ragweed allergy, the late summer and early fall signal the onset of runny noses, sneezing, congestion, cough, itchy watery eyes, and in more severe cases, sinus infections and asthma exacerbations.

Seasonal allergies are a huge source of frustration and fatigue for many of us, causing …

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5 things that are helping us through a miscarriage

Conditions
September 2, 2023

In March 2023, I had a miscarriage when I was 10.5 weeks pregnant. I am blessed to have a wonderful husband and loving family, two healthy sons, and supportive friends, though I still grieve at times. I share what is helping us below, in the hope of helping others:

1. Early pregnancy assessment clinic (EPAC) and caring providers at my OB office. My obstetric office has an EPAC (also called Pregnancy …

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Biological weapons: a history and emerging risks

Conditions
September 1, 2023

Biological weapons are not new. Their use by armies has taken place for centuries. Take the Plague, for example. The pandemic was reportedly first introduced to Europe during the siege of the Genoese trading port of Kaffa in Crimea by the Golden Horde army of Jani Beg in 1347. It decimated 30 percent of the European population. Paradoxically, the resultant labor shortage and lack of faith in the prevailing order …

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What is intersex? What do you know about your patient’s sexual development?

Conditions
August 31, 2023

I don’t know about you, but I learned very little about variations in sexual development during my medical education over a decade ago. Commonly presented topics were usually of a genetic nature—this person has XXY or XO chromosomes and the “abnormalities” such chromosomal variations can bring. That’s about the extent of my education regarding sex development and gender, with the impression conveyed that these were minor topics.

Fast forward to now, …

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Unveiling a journey marked by talents and turmoil

Conditions
August 31, 2023

His 5-year-old daughter asked her mom, “Today is daddy’s birthday. Can we have a picnic at his grave?”

Bryan was 49 years old. He could really do anything. He could do renovations, carpentry, electrical work, play music, be a father and a husband, a son, an uncle, a brother, and a brother-in-law. He had an incredible sense of humor, was down-to-earth, and a big teddy bear to his children. No one …

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Balancing health care worker immunization and patient safety

Conditions
August 30, 2023

Recently, I heard a news report regarding several states’ attorneys general suing the federal government to eliminate the requirement that health care providers be immunized against COVID. They argued that as fully immunized individuals still contract COVID, and that allowing unimmunized people to be rehired would relieve provider shortages, the regulation was unhelpful.

Initially, I agreed that rehiring these individuals would generate some relief for those staff members who have worked …

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Empowering health care professionals: the art of saying “no” and more

Conditions
August 30, 2023

Setting limits, asking for help, delegating, or even saying “no” are important assertiveness skills. Health care professionals should be proficient in assertiveness because of the potential impact on patient safety, patient experience, workforce health, and cost-effectiveness.

Assertiveness examples

How might these assertive statements influence outcomes?

  • “I haven’t had training in using that IV pump and need help.”
  • “Stop! Don’t make that incision! It is the wrong leg.”
  • “I cannot keep seeing patients …

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Unveiling alcohol’s health paradox: heart benefits and detrimental effects

Conditions
August 30, 2023

Tons of ink have been expended on the health effects, both positive and negative, of alcohol consumption. Beneficial effects on the heart were discussed in the 1990s based on the “French paradox.” A paper published in 1995 noted that there was less ischemic heart disease in France compared to the U.S., despite higher saturated fat intakes and a higher prevalence of smoking.

The relatively lower incidence of ischemic heart disease in …

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Rising longevity and cognitive health: Navigating dementia and treatment

Conditions
August 29, 2023

The comedian George Burns once quipped, “By the time you’re eighty years old, you’ve learned everything. You only have to remember it.” With the average life expectancy in the United States up from 54 a century ago to 74 today, the damage that can be done by aging and mental decline is more prevalent than ever. We see evidence of it all too often in our world leaders, families, and …

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Is a PSA test right for me? A urologist answers.

Conditions
August 29, 2023

“Should I get a PSA?”

It depends. Who is asking, and why?

If the question is being asked by a 45-year-old man, the answer is going to be different than if it’s being asked by a 75-year-old. If a primary care clinician is asking, he/she may be confused about current recommendations regarding screening for prostate cancer. The answer is complicated and fraught with bias. Unfortunately, the controversy over PSA screening for prostate …

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Essential postpartum care: lessons from 30 years in OB/GYN

Conditions
August 24, 2023

Almost 30 years ago, as an OB/GYN intern at a large urban medical center, I was privileged to learn from exemplary doctors and midwives. After 4:30 a.m. postpartum rounds one day, a midwife said, “I saw your note. You listened for bowel sounds and examined her abdomen.” I replied, “I did.” She asked, “Did you also check her bottom?” I responded, “No. Why?” She explained, “She delivered the baby through …

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Terminal illness: Navigating the struggles of acceptance

Conditions
August 23, 2023

Reality knocked me for a loop one evening when my father-in-law called from his home in another state and asked for help. This kind of request was very uncharacteristic for him. We responded immediately and drove to his home. After much conversation and many questions from both sides, we eventually came to the hard truth. His cancer had progressed and, to my mind, was most likely terminal. I dug in …

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For orthopedic surgeons, an all-of-the-above approach lowers liability risks

Conditions
August 22, 2023

During a total hip replacement, a patient experienced a brisk bleed and a drop in blood pressure that required intervention from the anesthesiologist. There was a discrepancy in the documented estimated blood loss, with the surgeon noting 30 0cc while the anesthesiologist recorded 1100 cc. The patient was hypotensive in the PACU and had a discolored leg with no pulse. The patient decompensated, and the orthopedic surgeon consulted a vascular …

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Explore the rise in facelift options and embrace the trending popularity

Conditions
August 21, 2023

The facelift procedure was first described in 1901 by Eugene Hollander and in 1916 by Erich Lexer. Over the last century, the facelift has become the gold standard for facial rejuvenation and continues to grow in popularity. One of the reasons we can attribute this growth spurt to is the options and advancements in how facelifts are handled. Let’s delve into the fascinating realm of modern facelifts, exploring the incredible …

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CME Spotlights