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Many Physicians Don’t Identify Red Flags In Teen Athletes’ Health

Before reaching for tests like EKGs to screen teen athletes, we should first ask ourselves if we’ve taken a careful history:

The new study consisted of Madsen and his fellow researchers sending out surveys to every pediatrician and family practice doctor in Washington State. They received a good response–surveys were returned by 72 percent of pediatricians and 56 percent of family practitioners.

The results were disheartening:

  • 28 percent of doctors surveyed failed to always ask if a teen experienced chest pain during exercise.
  • 22 percent of doctors surveyed failed to Read more »

*This blog post was originally published at Dr. Wes*

Man Dies In An Attempt To Remove His Own Pacemaker

A 47-year-old Chicago man died after trying to remove his own pacemaker. He’s not the first to try self-surgery, as it turns out.

The Chicago Tribune described this most recent attempt at self-surgery:

“Chicago Fire Department paramedics were called after the man told a worker in the home that he was experiencing chest pains and asked them to call an ambulance.

“The man returned to his room, where he remained until paramedics arrived, police said. When they did, he complained to them about chest pains and was taken to the ambulance where he fell unconscious, police said.

“As paramedics were trying to revive him, they discovered Read more »

*This blog post was originally published at ACP Internist*

Dealing With Acute Pain: What Are The Treatment Options?

Whether caused by injury, surgery or a toothache so bad it slams you awake in the middle of the night, acute pain is difficult.  Receiving prompt and helpful treatment can make all the difference in the world.  But lack of care or inadequate care means that the acute pain may develop into chronic agony.

Fortunately, acute pain is not always long lasting or overwhelming, such as when you have a short severe cramp or multiple bee stings that can be handled with time, over-the-counter medication and other home remedies [See: Pain Treatment Options].

Since individuals’ tolerance for pain varies widely, the question of when pain itself requires urgent medical attention is difficult to answer.  Chest pain should prompt a visit to the emergency room, of course—but other types of pain are trickier to call. Read more »

*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*

Why Are Antibiotics Prescribed So Casually And So Frequently?

A good friend of mine and Whistleblower reader contracted the sniffles and received a prescription for antibiotics at a local urgent care center. Nothing newsworthy here. So far this quotidian event sounds like a ‘dog bites man’ story. Had antibiotics been denied, this would have been ‘man bites dog’, as this denial would be a radical departure of standard medical practice, particularly in the urgent care universe.

No doubt, my friend was not assigned the dismissive diagnosis of ‘the sniffles’, but was likely given a more ominous diagnosis of ‘acute upper respiratory infection’, a term that sounds so serious that he might have feared that a 911 call had already been made.

Why are antibiotics prescribed so casually and so frequently? Read more »

*This blog post was originally published at MD Whistleblower*

Pulmonary Embolism: If It Can Strike Serena Williams, It Can Ace Anyone

News that tennis star Serena Williams was treated for a blood clot in her lungs is shining the spotlight on a frightfully overlooked condition that can affect anyone — even a trained athlete who stays fit for a living.

Williams had a pulmonary embolism. That’s doctor speak for a blood clot that originally formed in the legs or elsewhere in the body but that eventually broke away, traveled through the bloodstream, and got stuck in a major artery feeding the lungs. (To read more about pulmonary embolism, check out this article from the Harvard Heart Letter.) Pulmonary embolism is serious trouble because it can prevent the lungs from oxygenating blood — about one in 12 people who have one die from it.

“No one is immune from pulmonary embolism, not even super athletes,” says Dr. Samuel Z. Goldhaber, professor of medicine at Harvard Medical School and one of the country’s leading experts in this clotting disorder.

Pulmonary embolism tends to happen among people who have recently had surgery, been injured, or been confined to bed rest for some time. It can also strike after long-haul flights.

Signs of a PE

How do you know if you’re experiencing a pulmonary embolism? The most common symptoms include shortness of breath when you aren’t exerting yourself, along with chest pain and coughing up blood. If you experience any of these symptoms, see a doctor immediately. Other worrisome signs include:

  • Excessive sweating
  • Clammy or bluish skin
  • Light-headedness
  • Fast or irregular heartbeat

The tennis star’s pulmonary embolism could have been the result of the perfect storm. After having a cast removed from a foot she cut at Wimbledon, Williams flew from New York to Los Angeles. It was in LA, after an appearance at the Oscars ceremony on Sunday, that she underwent emergency treatment at Cedars Sinai Hospital for a blood clot in her lungs.

A call to action by the U.S. Surgeon General says that pulmonary embolism and a related condition — deep-vein thrombosis — affect an estimated 350,000 to 600,000 Americans each year. Together, they account for somewhere between 100,000 and 180,000 deaths each year.

To learn more about pulmonary embolism, check out this information from the North American Thrombosis Forum.

- P.J. Skerrett, Editor, Harvard Heart Letter

*This blog post was originally published at Harvard Health 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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