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*
Perhaps the greatest thrill in attending a summer meeting of the Wilderness Medical Society (WMS) is listening to new, enthusiastic and exciting speakers. They bring new insights and opinions to numerous topics and discussions, which is an essential part of the educational process. This past summer, at the 2010 Annual Meeting of the WMS held in Snowmass, Colorado, Dr. Drew Watters from the Indiana University School of Medicine approached the audience with his observations about neurobiology and survival. It was an innovative approach to a very common topic within wilderness medicine. How does one account for and handle emotions in a time of stress, including the most stressful situation of all—namely, a survival situation? When is it better to think, rather than to react? The objectives of his presentation were to understand to a certain extent survival, the anatomy of thought and perception, the neurobiology of emotions, behavior, emotive and cognitive decisions, and implementation of interventions in situations dominated by emotion.
Anyone who has practiced wilderness medicine knows that bad things happen, sometimes despite the best preparations and intentions. People make bad decisions that can too often be characterized as dumb. If they follow with more bad decisions, the situation Read more »
This post, Handling One’s Emotions In A Survival Situation, was originally published on
Healthine.com by Paul Auerbach, M.D..
Based on their experience during countless schleps to the market, moms know that kids pick cereals whose boxes have cartoon characters on them. Previous research by Yale scientists explained the phenomenon: kids say that the stuff poured from such boxes tastes better than the same stuff when poured from a cartoon-less box. The same thing happens when kids pick graham crackers, carrots and gummy fruit snacks.
Pictures of Shrek, Dora the Explorer, Scooby Doo and their kin make just about anything taste yummier, it seems.
Can this observation be leveraged to encourage kids to select healthier foods? Yes, it turns out. But the story isn’t as straightforward as you’d think.
To study the impact of licensed media spokescharacters and other nutrition cues on kids’ taste assessment of food products, scientists at the University of Pennsylvania fed cereal from a box that had been labeled either “Sugar Bits” or “Healthy Bits” to 80 kids. Half the boxes in each “brand category” were adorned with cute cartoon penguins, while the other half were not. The kids were between 4 and 6 years old. Read more »
*This blog post was originally published at Pizaazz*
I was recently listening to an audiobook about diet, written and read by a “famous” doctor who gets people healthy through dietary changes.
Since my podcast pushes me a little into the mainstream (more than this blog does), I thought it would be good to hear what the “average” person is reading about health. Plus, I am not exactly the most compliant patient when it comes to diet, so I thought I could possibly get something out of it personally.
I did my best to listen with an open mind, ignoring what I thought were gimmicks and trying to glean the valuable information from what this doctor was saying.
I had to stop, however, before finishing the book. It wasn’t the content so much that gave me cause to feel the desire to smash my iPod, it was the hype. The author was constantly using words like “amazing,” “magical,” and “miraculous.” Read more »
*This blog post was originally published at Musings of a Distractible Mind*