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Small Study Looks At The Use Of Abdominal Panniculectomy In Patients Awaiting Kidney Transplants

There is an interesting article in the current edition of the Plastic & Reconstructive Surgery Journal (December 2011). The focus of the article is a small subset of renal patients who need kidney transplants but whose abdominal panniculus excludes them due. A significant panniculus creates an infrapannicular area prone to increased moisture, skin maceration, and elevated bacterial counts, predisposing the patient to postoperative wound infections, necrosis, and dehiscence. Not good for anyone, but really not for someone on immunosuppression.

The article discusses the use of abdominal panniculectomy in these patients in preparation for the transplant. Nine patients, 3 men and 6 women, with a mean age of 54.5 years and a mean BMI 28.3 are the focus of the article. The focus is not Read more »

*This blog post was originally published at Suture for a Living*

Manufacturer Upgrades Its Alcohol Consumption Monitoring Device

BI, Inc. a manufacturer of compliance monitoring technology for community offenders, has announced an upgraded version of the company’s BI-TAD alcohol consumption monitoring bracelet.

The BI-TAD is an ankle-worn bracelet which measures an offender’s alcohol consumption levels through vapors and perspiration passing through the skin. The device also features radio-frequency circuitry to detect the presence of the offender in their own home at a given time. The upgraded BI-TAD sensor now includes wireless functionality allowing it to transmit compliance data through the cellular network to a remote base station. The device log can then be checked against an offender’s profile to see if he is adhering to specific curfews or drinking restrictions.

From the press release: Read more »

*This blog post was originally published at Medgadget*

Recent High School Graduate Receives Life-Saving Graduation Gift

This has been a busy time for my family as my daughter, Ruthie, has just graduated from high school. Because we live in a close-knit, fairly small town, we were all zipping around in the days afterward attending graduation parties. We knew many of the 400 or so young people who graduated. In most cases they are blessed with good health and the prospect of a fun summer followed by a college education. But the health picture isn’t sunny for all of them.

I heard this story at one of the parties this weekend: A leader of the senior class, who had leukemia as a child and received many heavy-duty medicines to cure it, is now facing a kidney transplant. His kidney function numbers have taken a nose dive. Usually the wait for a transplant would be a couple of years or more and dialysis for a teenager. In the meantime, this would totally disrupt his life. But there is another way. We’ve talked about it very recently in our videos about kidney transplant: receive a donated kidney from someone who is living.

That is exactly what is happening. The young man will receive a kidney from Read more »

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

Watching A Man Die

The myth of the glory of war is perpetuated in part due to the fact that the stories are only told by survivors. If the guy that took one through the neck in no man’s land in world war one and then slowly faded away in a mess of saliva mixed with blood, lying in his own stools, crying for his mother were to tell his story from beyond the grave it wouldn’t look so glorious at all. It would maybe be a better reflection, though, of the reality of it. In a certain sense we run the risk of glossing over medicine too. I would hope this blog does not.

I am extremely affected by the patient calling out to me to save him in strained monosyllabic speech at the last moment of his life. It is almost too much to bear. And yet I am the survivor. I walk away to live another day or to tell the story or to enjoy a sunrise in the African bush. Read more »

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

You Can Have An Organ Transplant, But You Can’t Have The Drugs You Need To Keep It Healthy?

kidney_unc_470pixIn a provocative analysis of a 30-year old Medicare coverage loophole, John Schall explained the following (at the Medicare Policy Summit event):

1. Medicare covers kidney transplants for patients with end stage renal disease (ESRD). Transplant patients, of course, require life-long immunosupressive drugs to keep their bodies from rejecting the new kidney.

2. Medicare only covers immunosupressive drugs for 36 months total. These drugs are too expensive for most patients to afford out-of-pocket.

3. Many kidney transplant patients covered by Medicare are unable to continue their immunosupression regimen after 36 months, and slowly go into organ rejection.

4. Once they have rejected their transplanted kidney, they are eligible to receive a new one, fully covered by Medicare, with (you guessed it) 36 months of immunosuppresive drug coverage to follow.

Wouldn’t it just be cheaper to cover immunosuppresive drugs for the lifetime of the patient who receives an organ transplant? Yes, and that’s what lobbyists have been arguing for 30 years now, without a change in the rules.

Government-run healthcare can have its challenges… and this is only the beginning.

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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