“I don’t like taking medicines.”
All physicians hear some form of this opinion very frequently. Even more frequently, patients don’t state this view outright but rely on it to completely subvert their doctor’s plans.
When I was new to practice such an utterance would shock and confuse me.
“I don’t want to take any medicines,” a patient would declare.
“That’s fine,” I would reassure my interlocutor. “It’s a free country. No one is going …
On March 10, I found myself at the front gate of the Florida State Prison, stethoscope and blood pressure cuff in hand, to examine Robert Henry at the request of his public defender.
Henry is scheduled to be executed Thursday evening by lethal injection. His crime was the murder of two people during a robbery more than 30 years ago.
He’s a 55-year-old African-American man with hypertension, elevated cholesterol, and a history …
Opioids are a family of pain medications chemically related to opium and heroin. They include morphine, fentanyl, codeine, hydromorphone and others. Opioids have unique properties that make them both indispensable for pain management and extremely dangerous.
Unlike virtually any other family of medications, opioids have no maximum effective dose. If any dose, no matter how high, is ineffective at controlling pain, a higher dose can give more pain relief. Most other …
We can now add vitamin B12 deficiency to the growing list of risks of long term use of the proton pump inhibitors (PPIs).
The New York Times had an article outlining the evidence that prolonged use of both proton pump inhibitors (PPIs) like Prilosec, Protonix, Prevacid and others, as well as the less potent H2 blockers like Zantac and Pepcid, can lead to vitamin B12 deficiency. This is in addition …
Ever get confused over the names of medicines?
I do.
There’s Zantac and Xanax. Zanaflex and Zaleplon.
But Zanaflex is also known as tizanidine. Tizanidine functions very differently than Zantac and its other name, ranitidine, even though they sound alike.
Every drug has (at least) two names — one proprietary, and one generic. Proprietary names are created to sound catchy by the original manufacturer, almost always under a patent. The generic names are more like chemical …
The intestines, particularly the large intestine, are teeming with bacteria. They are piled on each other as dense as the above photomicrograph shows. The huge majority of them are what we call friendly bacteria: they live inside us, feeding off the rich stew of food we eat, but cause no disease. In fact, their presence is important to our health because they crowd out bacteria that cause disease — the …
Do you want to know if your doctor has been eating pizza for lunch that was purchased by Pfizer as she listened to a drug rep describe a new medication? Do you want to know if your endocrinologist has been paid $1,500 to give a brief talk about a new injectable diabetes medication to his colleagues as they gobble down filet mignon? If the answer is “yes,” then you are …
It is increasingly difficult to find real ice cream. When reading the ingredient list it is discouraging how many cheap fillers, consistency modifiers, and shelf life extenders are included. One ingredient, namely guar gum, seems fairly ubiquitous. So what is guar gum, and why is it found in so many products including ice cream? Is it “bad” to eat?
Herbal medicines make most doctors cringe, laugh, or want to put blinders on and pretend they don’t exist. This is understandable. While allopathic medical education hammers pharmaceutical formulas and mechanisms of action into our brains, we learn little-to-nothing about herbs in medical school. Quite the opposite – we are most often told to uniformly discourage our patients from taking herbs out of concern for safety; a conversation stopper with little …
As the saying goes, “With great power comes great responsibility.” That applies to physicians when prescribing medications, but it also should apply to pharmacies when they’re dispensing medications.
In December, after seven years of exams, lectures and rounds, I received my medical license. Finally, I had the power to prescribe medications without the co-signature of my supervisor. “Be careful,” she advised, “remember the …
In America, the conventional wisdom is that we don’t ration health care. But we do, and there’s no better example than patients rationing themselves when it comes to the medicines they take.
Recently, a young twenty-something I know had a nagging cough—seasonal allergies, her doctor said and prescribed a generic medicine for asthma and allergies. She did not fill the prescription—the $160 price tag was too steep. Although she had health …
Text message: “John, This cough and congestion is killing me. It’s turning thick and green. Can you write me a Z-pak? It always works for me.”
If you write a blog on medical decision-making and heart rhythm matters, it seems an incredible omission not to opine on the FDA warning concerning the commonly used antibiotic azithromycin (the drug in a Z-pak). Quoting directly from the FDA warning:
[Azithromycin] can cause …
An article from Sweden was recently published showing that in a very large group of women, over 60,000 of them, followed for 19 years as part of an also very interesting study of the effectiveness of mammograms, women who get more calcium, in their diet or as supplements, had a higher risk of dying of anything, but especially of heart attacks. It is …
The FDA issued a warning about the antibiotic azithromycin (Zithromax). The media stories have some patients terrified and some of them are calling me convinced that azithromycin is poison, a reliable agent for suicide.
What’s the hubbub about?
Azithromycin is in a family of antibiotics called macrolides, which also includes erythromycin and clarithromycin (Biaxin). Erythromycin and clarithromycin have long been known to very rarely cause fatal abnormal heart rhythms. It …
A recent meta-analysis published in the American Journal of Clinical Nutrition suggests that coenzyme Q10 is of benefit in congestive heart failure. For those who like the idea that food and nutrients can be excellent medicine, this paper is interesting at the very least. But there is a case to be made that it is far more than that. There is a case to be made …
Think you know something about oncology? Ok then, pop quiz: If you are giving chemotherapy to a patient who does not have cancer, how can you tell if it works? Ridiculous question? Not at all. The answer to that question is; “hopefully, we will never know,” and it is at the core of modern cancer care.
In the 1960s, breast cancer surgeons had a serious problem. They were doing large complex …
I recently received this email message from one of my residents who has moonlighted in a local commercial urgent care center. This message is reprinted with his permission just as I received it, except I removed the brand name.
Hey Dr. Young, I’m looking for some basic mentoring advice. I’ve been moonlighting at ZZZ Urgent Care for about a year. Not my favorite work, but oh well. I don’t routinely prescribe antibiotics …
A version of this column was published on February 3, 2013 in USA Today.
I’m seeing more patients than ever consume so-called “energy drinks,” a rapidly emerging class of beverage which promise to increase energy, improve alertness, and boost attention span. The energy drink business is booming, with more than $12 billion sold last year, eclipsing established beverage categories like iced tea …
Former Boston Red Sox closing pitcher Jonathan Papelbon may have opened up a can of worms with his remarks about his frequent use of the injectable anti-inflammatory drug Toradol (ketorolac) during his time with the Red Sox.
Papelbon, who now plays for the Philadelphia Phillies, told ESPNBoston.com that several Red Sox players were frequently injected with the drug:
“It was kind of …
Let’s talk a little about health accountability. Two news items have provoked the following rant: why is it always someone else’s responsibility?
The first item was on NPR. The FDA, reacting to the epidemic of prescription drug abuse in this country, is offering incentives to the pharmaceutical company that can come up with a less addictive painkiller. Such a drug would be a gold-mine for that pharma company because it could …
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