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Latest Posts

Promising New Pressure Treatment For Keloids Of The Ear Lobe

I have written of keloid treatment (general, not site specific) previously.  I have always tried to include pressure treatment as part of the plan when treating keloids of the ear lobe.  This pressure treatment came in the form of pressure earrings  — clip-on, disc-shaped.

The recent article (full reference below) in the Archives of Facial Plastic Surgery journal introduces a new pressure device which looks like it will work better than what has been available (photo credit)

and as can be seen in this photo, the upper ear can be treated with pressure which has not been possible with the clip earrings: Read more »

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

Powerful Acne Drug Forced Off Market By Lawsuits

Effective-Acne-Treatment-Severe-Nodular-AcneThe physical scars will be nothing compared to the emotional scars that will haunt the children.   I recently read  that the effective acne treatment Accutane was pulled off the market this summer quietly ending access to an excellent and effective acne treatment for millions of self conscious teens and young adults.  Accutane, or isotretinoin as it’s known, was used to treat severe nodular acne.

It turns out that Accutane was linked to inflammatory bowel disease, and other side effects resulting in thousands of lawsuits.  It spent twenty five years on the market embroiled in controversy.

Approved by the Food & Drug Administration (FDA) in 1982, Accutane has been the subject of controversy for years. It first garnered attention in the late eighties for causing severe birth defects. It has also been known to cause psychiatric problems, and has been linked to hundreds of cases of suicide in the United States. Accutane has also been associated with problems of the liver, kidneys, central nervous system, and pancreas, as well as the cardiovascular, musculoskeletal and auto-immune systems.

Read more »

*This blog post was originally published at The Happy Hospitalist*

Two Little Girls Mauled By Dogs: How They Healed

pitbullA surgeon friend of mine recently told me a story about a little girl who wandered into the territory of some pit bulls. These dogs were tied up with leashes in the neighbor’s back yard – specifically because they couldn’t be trusted to run loose near children. Tragically, the two year old wandered within their grasp after slipping through a protective kiddie gate and out of the house.

The dogs attacked her viciously, dragging her deeper within their territory and attempted to eat her alive. They tore off both her ears and shredded her chest and limbs. By the time she was discovered she was near death. The girl was rushed to the nearest trauma center – where my friend took her to the OR immediately. He spent the entire night putting the pieces back together, as it were.

A couple of days later, my astute friend noticed her having problems turning her head towards her mothers’ spoon during meal times. That observation triggered him to test her vision – and low and behold the girl was completely blind. A brain CT confirmed the clinical team’s worst fears: at some point during her resuscitation, the girl had a massive stroke, and her entire occipital lobe (the back of the brain) was damaged.

Wondering if there was anything he could do to help the girl, and devastated by what he assumed was a grave prognosis (a lifetime of blindness), my friend called a neuro-ophthalmologist for advice. Much to his amazement, the neurologist told him that her visual deficits were likely to resolve completely, because her brain would simply adapt. Children at very young ages can recover from otherwise devastating strokes because of neuroplasticity – the ability of the brain to rewire itself, and recruit healthy neurons to take over for damaged tissue.

True to the neurologist’s predictions, the little girl regained her site within a year. Fortunately, her body healed extremely well too – and despite thousands of stitches, her scarring turned out to be quite minimal. Today it’s hard to tell that she’s had surgery at all.

This story holds special interest to me, as I too was mauled by a dog when I was a little girl. Although I was bitten in the face, and nearly lost my left eye, I can’t remember the last person who noticed my scars or asked about them. They simply faded with time.

The extraordinary healing powers of young tissue cannot be matched in adulthood. However, some degree of neuroplasticity lives on in each of us, offering hope for brain rehabilitation for everyone – from the forgetful to those with major impairments.

Whether you (or a loved one) have internal or external scars – healing is always possible.

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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