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Research Shows A Large Number Of Women Have Experienced Domestic Violence

domestic violence, CDC, reporting on healthDomestic Violence: 25 percent of women surveyed by the government say they were violently attacked by their husbands or boyfriends in a finding one federal official called “astounding,” the Associated Press reports.

C-Sections: The number of births by Cesarean section in Calif. has risen 50 percent in the past 10 years, new research shows, but it isn’t because of the health benefits over vaginal delivery. Researchers cite financial incentives for doctors and an “awareness gap” of the procedure’s risks among the explanations, Stephanie O’Neill reports for KPCC public radio.

Health Reform: South Carolina Gov. Nikki Haley predetermined the findings of a state committee working on health reform even before Read more »

*This blog post was originally published at Reporting on Health - The Reporting on Health Daily Briefing*

Dealing With Cyclic Vomiting Syndrome Given How Little Is Known About The Condition

I have been working as an ER doctor for over a decade, and in that time I have come to recognize that there are certain complaints, and certain patients who bear these complaints, that are very challenging to take care of. I’m trying to be diplomatic here. What I really mean is that there are certain presentations that just make you cringe, drain the life force out of you, and make you wish you’d listened to mother and gone into investment banking instead. Among these, perhaps most prominently, is that of the patient with cyclic vomiting syndrome.

The diagnosis of cyclic vomiting syndrome, or CVS, is something which is only in recent years applied to adult patients.  Previously, it was only described in the pediatric population. It has generally been defined as a disease in which patients will have intermittent severe and prolonged episodes of intractable vomiting separated by asymptomatic intervals, over a period of years, for which no other adequate medical explanation can be found, and for which other causes have been ruled out.

That is not much in the way of good literature about this disease entity, which is surprising, because it is something that I see in the emergency department fairly regularly, and something with which nearly all emergency providers are quite familiar. These patients are familiar to us in part because we see them again and again, in part because they are memorable because they are so challenging to take care of.

Some things about the cyclic vomiting patient that pose particular challenges: Read more »

*This blog post was originally published at Movin' Meat*

Decreasing Jail Time, Treating Drug Abuse As A Public Health Issue

A couple of years ago, I served for several weeks on a grand jury for the Superior Court of the District of Columbia. Mine was designated a RIP (Rapid Indictment Protocol) jury, assigned to efficiently hand down indictments for small drug-related offenses. These cases usually involved undercover officers posing as customers making purchases from street dealers, or uniformed police stopping suspicious vehicles and searching them for drugs. Although rarely we heard testimony about defendants caught with thousands of dollars of contraband, the vast majority of offenses were possession of small amounts of marijuana, heroin, or cocaine for “personal use.” Many of the latter defendants had multiple such offenses, which had resulted in probation, “stay away” orders (court orders to avoid certain neighborhoods where drugs were highly trafficked), or brief stints in jail. Few, if any, had received medical treatment for their addictions.

After a few weeks of hearing these cases, my fellow jurors and I grew increasingly frustrated with this state of affairs. We felt like a cog in a bureaucratic machine, fulfilling a required service but making little difference in anyone’s lives. A young man or woman caught using drugs would inevitably return to the street, violate the terms of his or her probation or “stay away” order, and be dragged before our grand jury again for a new indictment. We openly challenged the assistant district’s attorneys about the futility of the process. They would just shrug their shoulders and tell us Read more »

*This blog post was originally published at Common Sense Family Doctor*

Teens Who Smoke Pot: At Risk For Mental Illness Later?

Teenagers and young adults who use marijuana may be messing with their heads in ways they don’t intend.

Evidence is mounting that regular marijuana use increases the chance that a teenager will develop psychosis, a pattern of unusual thoughts or perceptions, such as believing the television is transmitting secret messages. It also increases the risk of developing schizophrenia, a disabling brain disorder that not only causes psychosis, but also problems concentrating and loss of emotional expression.

In one recent study that followed nearly 2,000 teenagers as they became young adults, young people who smoked marijuana at least five times were twice as likely to have developed psychosis over the next 10 years as those who didn’t smoke pot.

Another new paper concluded that early marijuana use could actually hasten the onset of psychosis by three years. Those most at risk are youths who already have a mother, father, or sibling with schizophrenia or some other psychotic disorder.

Young people with a parent or sibling affected by psychosis have a roughly one in 10 chance of developing the condition themselves — even if they never smoke pot. Regular marijuana use, however, doubles their risk — to a one in five chance of becoming psychotic.

In comparison, youths in families unaffected by psychosis have a seven in 1,000 chance of developing it. If they smoke pot regularly, the risk doubles to 14 in 1,000. Read more »

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

A Humorous ER Admission For Marijuana Use

Whenever drugs are involved in a patient’s admission, the outcome is either craziness or comedy.  Methamphetamines and cocaine seem to be the popular drugs of choice requiring admission. These people are usually angry and agitated.  However, it seems like pot humor always adds a little touch of the unexpected to an otherwise boring admission.

Take for example the 27 year old truck driver who was brought in by his roommate for “acting weird’. What happens when you mix a little marijuana and a little alcohol?  You get Happy’s pot humor post of the day. Read more »

*This blog post was originally published at The Happy Hospitalist 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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