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What Some Patients Will Do For Drugs: A Strange Phone Call Late At Night

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9:00 pm:

Hello. It’s Mrs. Mumbledimumbler; I need the doctor to call me right away. My hip is driving me crazy. Please call me.

I listen to the message three times so I can sort of make out the name. The problem is that even though I think I can understand it, I don’t recognize it at all. But I call her because she said she needed me to call her right away.

Hello. I need you to call me in some tramadol right away.

“What was your name again?”

She repeats it clearly enough for me to confirm that I really don’t recognize it.

“Have I ever seen you in the office?”

No.

Let me get this straight: it’s 9:00 at night and your hip is hurting, so you call a doctor who’s a complete stranger and insist that they call you in a powerful painkiller without ever having seen you, taken your medical history, or examined you? I don’t think so.

“Um, I’m sorry ma’am, but I really can’t do that unless you’re an established patient in my office.”

Oh, okay; never mind.

I suppose I should count my lucky stars that she didn’t want vicodin.

*This blog post was originally published at Musings of a Dinosaur*

Confessions Of A Former Child With Diabetes And Unusual Eating Habits

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Growing up, we had these large, potted plants in our dining room, within throwing distance from the dining room table.  (Stick with me – this is an important detail.)  The plants were big and had wide, draped leaves and they made the corner of the dining room look like a veritable jungle.

Also, these suckers were really convenient for hiding food.

When I was little, the “diabetic diet” school of thought was based on the exchange program.  This meant that my meals were structured around my calorie needs and the needs of my (then) peaking insulin doses.  An average dinner would include one meat exchange, two starch exchanges, a dairy exchange, a fat exchange, and a fruit exchange.  (Exchange, exchange, exchange.)  When I was on insulins like Regular, NPH, and Lente, I needed to consume these portions in proportion, or I would end up with a very high, or very low, blood sugar.

So my mother (bless her anecdotal-medical-degree’d heart) would carefully measure out these exchanges and that would be my dinner.  EXACTLY one meat exchange, and those two starches, etc.  She worked very hard to make sure my meals were calculated and well-balanced.

And in response, I would hide my vegetables – aka “gross things” – in the dining room plants. Read more »

*This blog post was originally published at Six Until Me.*

Swearing In Moderation May Ease Pain

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Swearing really can relieve pain, but only if one doesn’t do it daily.

Researchers at Keele University in England have considered this topic before, and most recently, they studied whether people who swear more often in everyday life get as much pain relief from cursing as those who swear less frequently.

My Hand, 1992 by styro via Flickr and Creative Commons licenseResearchers recruited 71 participants who completed a questionnaire that assessed how often they swore. Pain tolerance was assessed by how long participants could keep their unclenched hand in icy water (5° C, capped at 5 minutes) while repeating a chosen word. The word was either a swear word (self-selected from a list of five words the person might use after hitting their thumb with a hammer) or a control word (one of five they might use to describe a table). Interestingly, one person was excluded from the study because they did not list a swear word among their five choices.

Results appeared in NeuroReport.

Swearing increased pain tolerance and heart rate, and decreased perceived pain compared with not swearing. But, the more often people swear in daily life, the less time they were able to hold their hand in the icy water when swearing compared with when not swearing. Read more »

*This blog post was originally published at ACP Internist*

When A Surgical Superhero Has To Cut… Wind?

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Yes, I have an alter ego. Yes, I dress in funny clothes with a cap covering my head and a mask covering my face. And yes, dressed as such I try to fight the powers of evil (mainly sepsis and bleeding and cancer and the like). I am … a superhero. But there is often little understanding for what goes on under the paper thin masks and baggy gowns we wear. certain …um…occurrences, well, occur with us just as much as with other people.

A common cold behind a theatre mask is no small thing. Remember you can’t blow your nose. Sniffing loudly only works for a while and attracts all sorts of strange stares. Just leaving it is really the only option. The positive side of this is you suffer less from the mild dehydration that accompanies massive loss of …mucus. There is, after all, fluid replacement (it is a very short trip from your nostrils to your mouth over your upper lip). ‘Nuf sed. Somehow this never appealed to me though. So, for all you budding surgeons out there, when you have a cold, plug your nostrils with tissue before scrubbing up. once you’re scrubbed, it is too late. The side effects are only a slight change in voice which is a small price to pay to avoid the constant lip licking and salty taste throughout the operation. Read more »

*This blog post was originally published at other things amanzi*

Deep Thoughts: Wisdom From The ER

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If you’re alleging assault, don’t get loud with the Officer there to take a report. Especially if you have Felony warrants.

*This blog post was originally published at GruntDoc*

Latest Interviews

The Surprising Economic Burden Of ADHD (Attention-Deficit Hyperactivity Disorder)

If you can read this you need to download a more recent browser It is estimated that as many as million U.S. adults have ADHD Attention-Deficit Hyperactivity Disorder A recent research study publication-pending suggests that the economic burden of ADHD on America could be as high as billion annually. I…

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Is The Adderall Shortage A Harbinger Of Future Drug Supply Problems?

If you can read this you need to download a more recent browser Today most- if not all- Doctor’s offices are strained by the shortage of some prescription medication or vaccine. A month ago President Obama signed his executive order directing the FDA to take steps to reduce drug shortages…

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Latest Book Reviews

Book Review: The First Step To Improve Health Care Is A Close Examination Of How It’s Delivered

My friend and former Chair of the CFAH Board of Trustees Doug Kamerow has written a book that I think you will like. Besides being a mensch and witty as heck Doug is a family doctor and a preventive medicine specialist. In his new book Dissecting American Health Care Commentaries…

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“Your Medical Mind” Explores Factors That Influence A Patient’s Medical Decisions

Recently I had a conversation with Shannon Brownlee the widely respected science journalist and acting director of the Health Policy Program at the New America Foundation about whether men should continue to have access to the PSA test for prostate cancer screening despite the overwhelming evidence that it extends few…

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Book Review: Food Truths, Food Lies

Food Truths Food Lies written by family physician Eric Marcotte M.D. may be the most refreshingly evidence-based diet book of the decade. You will not find a single mention of super-foods magical berries or supplement must-haves in the entire book. What you will find is the cold hard truth about…

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