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There’s Nothing More Important Than Your Health

I don’t do well with pain. I learned that lesson all too well during the birth of my first son when, after 10 hours of labor jump-started by a pitocin drip, I finally got an epidural. Nothing — and I mean nothing – has ever felt as good as the ebbing of that pain. I relearned the lesson during the birth of the second son, this time determined to go natural all the way when, after a few hours, I told the doula to “shut up” and ordered my husband to hunt down the anesthesiologist and “Get me an epidural — NOW!” He listens well.

By the time the third son was born, I had the drill down pat. I was admitted to the hospital to be induced again but this time, as soon as the IV was hooked up and before the first labor pain hit, I had the anesthesiologist in the room putting in the epidural. It was a completely painless birth — and a lot of fun.

My issues with pain extend to my issues with being sick. I simply do not like not feeling ill. I’ve been very lucky and extremely blessed in my life — the most serious thing I’ve ever had wrong with me was strep throat or a stubborn sinus infection. As a medical writer, I’m far too familiar with all the things that could go wrong with me, so I feel guilty even complaining about my minor issues. Read more »

*This blog post was originally published at A Medical Writer's Musings on Medicine, Health Care, and the Writing Life*

When Hearing Loss Has A Simple Fix

“Hey doc,” the patients says, “I think I got wax in my ear.” I reply, “Well, that makes it hard to hear me, then, huh?” “WHAT?” – the patient yells. Oh yeah, I say to myself. “I’ve been having this ever since I was a kid. Every few months, I need my ears cleaned out.” So, I look in there, and it’s the most amount of wax I’ve seen in a long time.

“Sir, do you use q-tips to clean our your ears?” I ask the patient. “Well, yeah, I think I’ve been doing a good job at keeping things clean, don’t you think?” “Well, I wouldn’t recommend that because it looks like you’ve been pushing the wax further in there.” “WHAT?”

So, we’re able to get some of the wax out of there only to find a lot of redness and irritation in the ear canal. “Doc, I still can’t hear. Are you sure that you got all the wax out of there?” “Well, sir, there is no more wax in there now. It looks like there is an infection underneath, and that’s what causing the problem now.” “WHAT?” Read more »

*This blog post was originally published at Doctor Anonymous*

How To Remove Water From Your Ears Safely

Swimmer’s ear (otitis externa) is an affliction that affects scuba divers, swimmers, windsurfers, surfers, kayakers and many others who spend considerable time in the water. The prevailing opinion is that the most effective measure to prevent swimmer’s ear is to dry out the ears after each entry into the water, to eliminate the moisture that promotes maceration of skin and proliferation of infection-causing bacteria. This can be done mechanically by blowing warm air into the external ear canal, or by instilling liquid drops (such as a combination of vinegar and rubbing alcohol) that change the pH within the ear canal and evaporate readily, leaving behind a relatively dry environment. It is generally advised to not stick any foreign object, such as a cotton-tipped swab, into the ear, avoid traumatizing the external ear canal or, worse yet, the eardrum.
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This post, How To Remove Water From Your Ears Safely, was originally published on Healthine.com by Paul Auerbach, M.D..

Getting Sick “After Hours” Costs Billions

During a recent emergency room shift, I treated a 12 year old boy for a swimmer’s ear. During the visit, I learned he was from the South and was in the area visiting relatives before starting school in a couple weeks. It turns out he’s been battling this pain for a couple weeks and his mom is convinced it’s because of all the swimming he’s done this summer. Instead of rushing him to his own pediatrician at home, she has been “riding it out” to see if the pain resolved on it’s own.

This was true music to my ears! Most parents rush their kids to the doctor at the first sign of ear pain, even though the current recommendations are to not use antibiotics in this age group unless the pain persists or worsens past the first few days. So, if his exam were abnormal, my decision making process would be much simpler.

What wasn’t music to my ears was learning I was the second physician to see the boy that week. The grandmother took him to see her physician when she had a scheduled appointment a couple days earlier, “just for a curbside” and learned that he did in fact have “an ear infection”. No medications were given or appointment facilitated with a pediatrician or other physician. This was truly just a curbside. The family was left with no alternative but to use the ER.

The ER often ends up being our only option when visiting an area out of town, isn’t it? If staying at a hotel, many do have a cool option that provides a physician call service so a physician will come to you, as I learned a couple year’s back in Disneyland. And, some cities do have free-standing urgent-care centers that can help with these sorts of non-911 situations. But, by and large, the ER is it in most areas and for most people.

What a backwards situation! The majority of sick people have situations that do not need the ER yet find themselves having to because there are simply no other options. Think about how much time and money would have been spared for this family and the system had that first physician just seen the child as an office visit and written the same prescriptions I wrote 2 days later during the ER visit. Think about the healthcare savings to the system and personal savings to families if we had the same theoretical options to the hundreds of thousands of annual after-hours urgent care visits our system sees each year but is current seeing in the wrong setting!

In the big picture, seeing a basic sick visit after hours in the ER is like trying to crack a nut with a sledgehammer. It makes about as much sense, too. The truth is we just have no place for the after hours regular sick people, which, by the way, are the majority of people who get sick after hours, especially if their doctor is in another state!

It’s really not a shock ER wait times are so long…ERs are over loaded with patient’s just like this boy. Until we find a better system, better take along your iPod and a good book should you find yourself heading to the ER. You’ll be in very good company waiting to be seen so may as well come prepared for the wait.

*This blog post was originally published at Dr. Gwenn Is In*

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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