October 19th, 2011 by John Mandrola, M.D. in Opinion
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One of the best things about writing a blog is when life provides Eureka moments. I read an essay this weekend that literally jolted the blogger in me.
If you are an athlete seeking a pinnacle; (That about covers all of us.)
Or a doctor striving to be the best that you can be–for humanity;
Or a parent wanting to provide the best for your children;
Or a learner wishing you could some day be smart enough to work in a think tank; (Ever wonder what a think tank looks like?)
Or perchance, Read more »
*This blog post was originally published at Dr John M*
October 14th, 2011 by John Mandrola, M.D. in Opinion, Research
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The news wires for atrial fibrillation were abuzz this last week. The vigor and speed with which health news travels is striking.
Since 2.6 million Americans live with AF, my guess is that many are looking at the release of the Medtronic-sponsored TTOP-AF trial with anticipation. Here is a link to the press release. The trial purported to show benefits of Medtronic’s novel phased RF ablation system in treating persistent AF.
The study was small and released at a relatively small symposium in Venice, Italy. The TTOP-AF trial randomized 210 patients with persistent AF (including flutter) to either ablation with Medtronic’s ablation system or conventional therapy with drugs and cardioversions.
They found, not surprisingly, that AF ablation reduced AF burden. AF ablation significantly reduced AF burden in 55.8% percent of patients versus only 26% of those treated with conventional medical treatment. Editorial comment: That kind of data is pretty typical.
The problem with the study Read more »
*This blog post was originally published at Dr John M*
October 8th, 2011 by John Mandrola, M.D. in Health Tips, Opinion
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I recently wrote about the incredible sensations that come with vigorous exercise. Perhaps it was the post ride cannabinoid flurry, but it’s possible that I went too far in suggesting that ‘we’ (doctors, patients, the whole of Western Society) default first to pills before healthy living.
Two commentors called me out on this snark. They wrote about valid points.
One comment focused on the fact that her AF medicines were causing side effects that made vigorous exercise difficult. The second objected to my inference that exercise alone could substitute for the many benefits of modern medicine.
To the idea that medicine Read more »
*This blog post was originally published at Dr John M*
October 2nd, 2011 by John Mandrola, M.D. in Opinion
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You have probably read that experience makes for better doctors.
And of course this would be true–in the obvious ways, like with the hand-eye coordination required to do complex procedures, or more importantly, with the judgment of when to do them.
There’s no news here: everyone knows you want a doctor that’s been out of training awhile, but not so long that they have become weary, close-minded or physically diminished. Just the right amount of experience please.
But there’s also potential downsides and struggles that come with experience. Tonight I would like to dwell on three ways in which experience is causing me angst.
But first, as background…
It was the very esteemed physician-turned-authors, Dr. Groopman and his wife, Dr. Hartzland, who wrote this thought-provoking WSJ essay–on how hidden influences may sway our medical decisions–that got me thinking about how I have evolved as a doctor. They were writing from the perspective of the patient. But in the exam room, there are two parties: patient and doctor.
# 1) The sobering view that experience brings: Read more »
*This blog post was originally published at Dr John M*
September 26th, 2011 by John Mandrola, M.D. in Opinion, True Stories
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Whenever a patient asks whether they can exercise, or go here, or there, I liken it to them asking whether they can live life. My answer is always the same…YES. The alternative seems terrible.
In this regard, moving on in the face of illness, let me share with you the writings of a very famous twitteratti, my friend, Melissa T (or @drSnit). Her post today about “doing sick well” struck my optimistic neurons.
You may wonder, how it is possible; putting sick and well together in the same sentence? Let me share her writings…
Dr Snit, author of the blog, “Living with Lupus–But Dying of Everything Else,” should know. She lives with the disease called Lupus–a mysterious ailment known for its flares of inflammation. These spasms of joint, muscle and overall body aches make a post-ride soreness feel like nothing. It’s a tough lot having Lupus.
But yet, Dr Snit stomps forward in life–in defiance of the most inflamed of the inflammatory diseases. She writes Read more »
*This blog post was originally published at Dr John M*
One of the best things about writing a blog is when life provides Eureka moments. I read an essay this weekend that literally jolted the blogger in me.
