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FDA Requires Label Changes For The Patch

After cautiously clearing Yaz for continued use Thursday, an FDA Advisory Panel Friday addressed post-marketing data showing similarly increased blood clot risks among users of the contraceptive patch.  The committee, after having been clearly quite  extensively briefed,  heard testimony from Ortho Evra’s  manufacturer and experts in epidemiology, gynecology and hematology. They also heard moving testimony about  a young woman who died from a massive pulmonary embolism while using the Nuvaring, whose parents argued that not only the Patch, but most of the newer methods carry an increased clot risk that no woman should be allowed to take without being adequately informed.

The committee ruled that despite limitations of the data, the patch most likely carried a 1.5 times relative risk of blood clots compared to 2nd generation levonogestrel pills, but not necessarily higher than that of newer pills containing 3rd and 4th generation progestins and drosperinone.  With a few dissenters, the committee voted to allow the Patch to stay on the market, but asked for Read more »

*This blog post was originally published at The Blog That Ate Manhattan*

Pediatric Ventricular Assist Device Is Gaining Wider Use In The U.S.

Ventricular Assist Devices (VADs) are small pumps that take over the work of the heart in pumping the blood through the body. Patients who need a heart transplant, but for whom there is no donor heart available, might be given a VAD for what’s called a bridge-to-transplant while they wait for a donor.

PediMag, the pediatric version of the adult device, CentriMag, is an external device designed for short-term use in infants with heart failure. PediMag can also be used to support children after heart transplant surgery if they experience organ rejection and need time for their hearts to rest and heal, according to Jonathan M. Chen, MD, Surgical Director of Pediatric Heart Transplantation at Morgan Stanley Children’s Hospital of New York. Dr. Chen has extensive experience treating children with heart failure and has recently authored an account of his first successful use of the PediMag as a biventricular bridge-to-transplant in an infant.

The PediMag ventricular assist device is Read more »

*This blog post was originally published at Columbia University Department of Surgery Blog*

Ten Things You Might Not Know About Afib

September is Atrial Fibrillation Awareness Month. Lots of folks don’t know too much about the condition, which is an irregular heart beat that can lead to serious complications such as dementia, heart failure, stroke or even death. To help spread the word, presents these 10 afib facts and figures that will probably surprise even

some healthcare professionals:

  1. Afib affects lots of people. Currently up to 5.1 million people are affected by afib. And that’s just in America. By 2050, the number of people in the United States with afib may increase to as much as 15.9 million. About 350,000 hospitalizations a year in the U.S. are attributed to afib. In addition, people over the age of 40 have a one in four chance of developing afib in their lifetime.
  2. Afib is a leading cause of strokes. Nearly 35 percent of all afib patients will have a stroke at some time. In addition to leaving sufferers feeling weak, tired or even incapacitated, afib can allow blood to pool in the atria, creating blood clots, which may move throughout the body, causing a stroke. To make matters worse, Read more »

*This blog post was originally published at Atrial Fibrillation Blog*

Would You Be Able To Recognize Chest Pain As Heart Disease?

Most people are pretty good judges of what’s going on with their own bodies. But telling a heart attack from other causes of chest pain is tough stuff—even, it turns out, for highly trained doctors. That’s why I thought this personal story, written by a Harvard doctor who has heart disease, would make an interesting read. It’s an excerpt—the full version can be found in Heart Disease: A guide to preventing and treating coronary artery disease, an updated Special Health Report from Harvard Medical School.

Early one spring, I noticed a burning sensation high in my abdomen whenever I walked up a hill or worked out on the treadmill. I felt perfectly healthy otherwise. I had lots of energy and could do high-level exercise on the treadmill—once the burning sensation went away—without becoming short of breath. I thought it was just heartburn, so I started taking powerful acid-suppressing pills. They didn’t help.

Sometimes when I would feel the burning in my chest, I would remember an old saying to the effect that “A doctor who takes care of himself has a fool for a patient.” Still, I hesitated; I didn’t want to waste the time of a cardiologist if all I had was heartburn.

But one morning as I walked across the street from the garage to my office in the hospital, Read more »

*This blog post was originally published at Harvard Health Blog*

The Best Time To Be Treated For A DVT

You know I am a cancer survivor – 15 years down the road from a leukemia diagnosis and enjoying a 10 year remission. So whenever something seems weird about my health it’s cancer coming back, right? Wrong! Just how wrong was proven last night. I am writing this from my hospital bed in Seattle.

The first symptom of a possible problem came three days ago when I had soreness in my right calf. A pulled muscle? Maybe. But I had not noticed straining it. Back at the gym the next day I had soreness again but thought it was no big deal. Last night it was worse. It hurt some to walk. I got home and, after my wife and son were asleep, got ready for bed. I had a slight fever and then noticed the right calf was not only sore, but swollen and warm. Very strange. I’d never seen that before.

Trying not to be stupid I called the 24-hour consulting nurse. She immediately began to focus on deep vein thrombosis (DVT), a worrisome condition that affects about two million Americans a year and can lead to a life threatening situation. She had a doctor call me. Normally those doctors would rather make a house call then send you to the more costly emergency room. But not this time. “Dr. Steve” urged me to go to the ER rather than let a DVT progress and endanger my life. An ultrasound exam would determine if it was really a DVT. Read more »

*This blog post was originally published at Andrew's Blog*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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