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Considering A Non-Fatal Patient’s Quality Of Life

Why is it easier to talk about quality of life with patients who are dying? Why don’t we factor these considerations into the decision-making for patients with conditions that aren’t fatal?

The presence of a terminal illness serves to focus everyone’s attentions. Widespread cancer metastases? Concerns about tight blood glucose control fade away. End-stage liver disease? Blood pressure control doesn’t matter so much any more. Bony pain from prostate cancer? Narcotic and sleeping pill addiction doesn’t even occur to anyone. I find it far more problematic to deal with patients with debilitating but non-fatal conditions when treatment options are perceived as limited because of co-existing diseases that produce so-called contraindications to certain medications.

I have a patient in his mid-70s with severe pain from osteoarthritis. Several fractures and a couple of unsuccessful joint replacement surgeries haven’t helped matters. Several years ago he found that a little drug called Vioxx worked extremely well for him, reducing his pain considerably and allowing him to do pretty much watever he wanted. As we all know, however, that drug was pulled from the market because of an unacceptable increased risk of heart attacks and other untoward cardiovascular events. Interestingly, Read more »

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

CDC Reports Increased Deaths From Prescription Pain Medications: Should We REALLY Blame Doctors For This Trend?

The overdose death rate from prescription opioids, referred to as “narcotics”, has reached “epidemic levels” in the US according to a report just released by the Centers for Disease Control and Prevention (CDC).  The report further states that the intentional misuse and abuse of popular opioids such as OxyContin, Vicodin, methadone and others now cause more deaths than those caused by heroin and cocaine combined.

Dr. Thomas Frieden, CDC Director told reporters that “Narcotics prescribed by physicians kill 40 people a day.” He continued by stating “Prescription painkillers are meant to help people who have severe pain. They are, however, highly addictive.”

The report states that increased prescribing of pain medications by doctors is a significant cause of this growing number of deaths. However, the situation is far more complicated than this report presents. Poor pain management and prescription drug abuse has become Read more »

Avoid Surgeons Without Accredited Training: It Could Save Your Life

Three young mothers under the age of 40 are dead because they wanted to be beautiful. Kellee Lee-Howard wanted a slimmer body. Ditto Maria Shortall and Rohie Kah-Orukatan. Shortall worked as a housekeeper; Lee-Howard was the mother of six kids and Kah-Orukotan died at the same place where she received manicures. What do these women have in common besides being minorities? They had liposuction procedures performed by men who offered a discounted price for an elective surgical procedure. These men professed to be competent in performing the procedures but never had accredited training.

I knew this day was coming. I saw the storm long before the clouds emerged. As the insurance payments for professional medical services decreased and declined, physicians began to look for alternative ways to earn money. But was it ethical? Read more »

*This blog post was originally published at Dr. Linda Burke-Galloway*

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*

How Cancer Survivors Are Picking Themselves Up And Moving Past The Worry

Thank God television and movie script writers are starting to “get it.” Cancer, “The Big C,” doesn’t always kill people, or maim them, or steal their dreams. Lately there have been new TV shows acknowledging cancer as part of life that many can live through. There’s a new movie coming called 50/50 about a young adult man with cancer (important to acknowledge it in this age group!). I hope he doesn’t die in the end. But from the preview, it’s clear he talks to people about it – including young women he is trying to date. It’s a comedy. On Showtime on cable TV there’s a series, The Big C, where actress Laura Linney plays a teacher with melanoma and a year to live. The good news is they had a second season!

My point is there are now nearly 12 million cancer survivors. Three of work them at Patient Power (one is me, almost 61, one is in her 50’s, one is just 18). More and more of us do not have just months or a year to live. We are true survivors. We have to start watching our cholesterol and taking baby aspirins, we have to watch our weight, plan for retirement or manage a fixed income. For the young one, it’s plan for college. We have to think about who we might vote for in the next election. We are LIVING! Maybe for a full lifespan, maybe not, but living each day with purpose.

Yes, it’s true there could be “another shoe” that drops, 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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