December 31st, 2011 by ChristopherChangMD in Opinion, Research
Tags: Anesthesia, da Vinci Robot System, Efficiency, ENT, Intuitive Surgical, New Jersey, OSA, Otolaryngology, Robot, Robotic Surgery, Safety, Sedated Endoscopy, Sleep, Sleep Apnea, Surgery
1 Comment »
I came across this article the other day regarding use of the daVinci robot to perform base of tongue surgery for obstructive sleep apnea.
For those who don’t know, the daVinci robot system made by Intuitive Surgical is a robotic system whereby the surgeon directs the arms of the robot to perform surgery in difficult-to-access areas of the body.
My feeling is that using a robot to perform sleep apnea surgery is way overkill akin to using a $50,000 sniper rifle to kill an ant on the wall.
Everything the daVinci robot can do can also be done without the robot with equivalent patient outcomes. In fact, Read more »
*This blog post was originally published at Fauquier ENT Blog*
December 30th, 2011 by John Mandrola, M.D. in Opinion, Research
Tags: Cardio, Cardiology, Endurance, Exercise, Extreme race effort, Heart Health, Inflammation, Injury, Iron Man, Marathon, Physical Activity, Right Ventricular Damage, Running, Triathalon, Unhealthy
1 Comment »
It is risky.
Stay fresh. Avoid repeating yourself. Don’t rant. Never preach. These would be the ‘rules’ of supposedly good blogs.
And, of course, doctors that dare to take a stance on health issues risk being perceived as pretentious. I get this.
So it is with trepidation that I write a follow-up to last week’s CW post about right ventricular damage immediately after an extreme race effort. Notwithstanding the pompousness concern, I also wish to avoid being labeled anti-exercise. Few believe more strongly in the healing powers of exercise.
But last Wednesday’s comments (both on the blog, Facebook and here on Dr. Val Jones’ BetterHealth blog) were just too good to let rest.
On the assessment of studies: Read more »
*This blog post was originally published at Dr John M*
December 30th, 2011 by BruceCampbellMD in Opinion
Tags: Cancer, Cancer Care, Cancer care providers, Christmas, Diagnosis, Healers, Holidays, Hospitals, Life disruption, Pace, Surgery
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“Do any human beings ever realize life while they live it? —Every, every minute?”
-Thornton Wilder
His cancer was growing and his symptoms were progressing alarmingly. As holiday music played in the background, I searched the calendar to see how rapidly his surgery could be scheduled. The young man and his wife first looked relieved when we found a surgical opening in the coming week, but their faces fell as they realized that he would spend December 25th in the hospital. Family plans were to be put on hold that year. The future was uncertain.
It has always seemed to me that “cancer” causes more life disruption during this time of year. The quickened pace of life and the family expectations, particularly when small children are involved, push people to their limits.
On the other hand, Read more »
December 30th, 2011 by Steve Novella, M.D. in Opinion, Quackery Exposed
Tags: Alternative Medicine, Antivaccine, Antivaxer, Attitudes, Effectiveness, Evidence, Fear Mongering, Labels, Mercury, Misinformed, Opinions, Propaganda, Safety, Scare Tactic, Science Based Medicine, Skeptical, Vaccinations, Vaccines
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Labels are a cognitive double-edged sword. We need to categorize the world in order to mentally capture it – labels help us organize our mental maps of the overwhelming complexity of things and to communicate with each other. But labels can also be mental prisons, when they substitute for a thorough, nuanced, or individualized assessment – when categorization becomes pigeon-holing.
We use many labels in our writings here, out of necessity, and we try to be consistent and thoughtful in how we define the labels that we use, recognizing that any sufficiently complex category will be necessarily fuzzy around the edges. We have certainly used a great deal of electrons discussing what exactly is science-based medicine, and that the label of so-called alternative medicine is really a false category, used mainly for marketing and lobbying (hence the caveat of “so-called”).
We get accused of using some labels for propaganda purposes, particularly “antivaccinationist” (often shortened to “antivaxer”). Also “denier” or “denialist”, as in germ-theory denier. Even though we often apply labels to ourselves, no one likes having an unflattering label applied to them, and so we have frequent push-back against our use of the above terms.
As with many such terms, Read more »
*This blog post was originally published at Science-Based Medicine*
December 29th, 2011 by KerriSparling in Opinion
Tags: bottle, Cost, Diabetes, Endocrinology, Expensive, healthcare, Humalog, insulin, Insurance, Money, pricey, Pump, three month supply, Type 1
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Back when I was a young bird with type 1 diabetes, insulin cost about $70 dollars per bottle. (And I had to walk uphill both ways to the endocrinologist’s office.) I had no concept of this cost, or how it played into my family’s finances, at the time. I would just open the fridge door, grab the bottle, uncap the orange top to a 1cc syringe, and take the units my mom would yell to me from the kitchen sink.
“Two. Two of Regular should do it. Rotate to your right arm this time, okay?”
“Okay!” (And then I’d proceed to jab it into my left arm because I’m right-handed and also stubborn.)
Now, twenty-five years later, insulin has taken a bit of a price hike. I just ordered a three month supply of Humalog from Medco and the total for the insulin came to six hundred and ninety-seven dollars. For six bottles of Humalog that will be all gobbled up by early March. (And thanks to a high, but manageable-on-paper deductible, we’re responsible for the full cost this round.) Almost seven hundred dollars worth of insulin.
We’re lucky that we’re able to pay for that cost without panicking, but knowing what these bottles cost without the assistance of insurance makes me look at everything through a diabetes lens. When three days are up on my insulin pump site, I am very aware of Read more »
*This blog post was originally published at Six Until Me.*
