August 14th, 2009 by Toni Brayer, M.D. in Better Health Network, True Stories
Tags: Eyelash, Eyelash Growth, Lumigan, Photos
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Last year I blogged about a new FDA approval for Lumigan (Bimatoprost) ophthalmic solution for glaucoma to be used as a safe way to grow eyelashes. I thought the readers of EverythingHealth would enjoy seeing if it really worked.
You be the judge..the before photo shows eyelashes (with mascara, of course) before using Lumigan. The 2nd photo shows eyelashes after 6 weeks of use. The manufacturer states it takes 8 weeks for full benefit.
*This blog post was originally published at EverythingHealth*
August 12th, 2009 by Happy Hospitalist in Better Health Network, True Stories
Tags: Attitude, Diabetes, Endocrinology, Internal Medicine, Obesity, Success, Weight Loss
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Day in, day out, it’s like a broken record. Patient comes in with uncontrolled diabetes. Patient gets sick. Patient gets patched up. Patient could care less about their health. Patient goes home to live another day, before coming back in a month. Everyday you just accept the reality of reckless self destruction, do your best to help them while they pretend to care and then send them on their way.
Except when a patient actually shows some interest in their health. Let me give you an example. I was asked to consult on a woman with shortness of breath, unbearable heartburn, aches and pains, low energy and sleep apnea. This woman weighed close to 400 pounds. Her husband was close to that as well. Together I sat them down and talked to them for darn near an hour. We talked about all the complications that come with folks in their age group. I asked them if they had a plan for success. What their motivations were. What their goals and expectations were.
They talked about how their exercise regimen. When I tried to pin down exactly what they were doing and how much and how often, it turns out that the twice a week walk around the lake was their idea of trying. They swore up and down about the their appropriate food choices, until they admitted that their biggest problem was not what they eat, but how much they eat. For an hour I heard about how hard it was. About how frustrating it was not to see any success. About how life wasn’t fair.
And then I met their polar opposites. A man and his wife both pushing 300 pounds. He was admitted with cellulitis of the leg. But both had lost a combined 220 pounds in just seven months. I was floored. 220 pounds? That put the biggest smile in the world on my face that day. I congratulated them probably 20 times.
I asked them, “I have so many patients who just can’t find a way to lose weight. How and why did you do it?” The answer was exactly what I expected.
“We had to. We were always tired. I was always hurting. I could barely walk. My wife could barely move. We considered gastric bypass but they wouldn’t do it without first doing six months of diet and exercise. Now I’m not even considering surgery. We went through our cupboards and we got rid of all processed foods. We eat healthy. We control our portions.”
Their motivation was their own. They realized they didn’t want to live their current reality. They took the initiative to make positive change in their lives and were basking in the glory of their success. What was the difference between these two couples? It was their attitude. One couple chose to make excuses for their plight. The other was doing something about it.
*This blog post was originally published at A Happy Hospitalist*
August 11th, 2009 by Dr. Val Jones in True Stories
Tags: Blink, Blinking, Ear Pain, Eyes, Paranoia, Psychiatry, Schizophrenia
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I was coming to the end of my ER shift and realized that a fairly large list of patients still waiting to be seen. I scanned the chief complaints listed on our white triage board to see if there was a straight forward case that I could handle quickly before I went home. Since it was early in the morning, we had the typical extremes of patients – those who were badly injured (drunk driving is more common in the wee hours) and those who were really weird.
ER nurses are amazingly adept at capturing the seriousness of a complaint with their choice of words. Reading between the lines is a bit of an art form – and part of the natural communication in a busy ED. I understood the art fairly well, though this night I missed a big clue. Here were some of the chief complaints that I could choose from:
1. Crushing substernal chest pain x1hour
2. Butt twitching x3 months
3. Head vs. light post
4. Ear pain x2 days
First of all I made sure that a colleague was with patient #1, which left me a choice between patient #2 – clearly weird and doubtful that I’d be able to resolve his problems any time soon, patient #3 – probably going to take a lot of sutures and more time than is left in my shift, and patient #4 – a fairly innocuous-seeming issue, probably otitis media.
Needless to say, I chose patient #4… though I hadn’t recognized the subtle distinction between “ear pain” and “ear ache.” I was about to figure this out the hard way.
As I drew back the curtain to patient #4’s room, I saw a tall, thin man sitting bolt upright in the chair next to the stretcher. He was polite and respectful – but there was something odd about him. A few minutes into our interview about his ear pain, I finally put my finger on it. The guy never blinked.
After several more minutes of what could only be described as fairly straight forward answers to medical history questions – and a fully negative review of systems – I had this sneaking feeling that Patient #4’s pain wasn’t otitis media.
“I’d like to ask you a question that might seem kind of strange…” I said, peering intently at his face.
“Ok,” said the young man.
“Have you ever thought that your pain is related to a transistor radio of some sort in your ear?”
His eyes grew as large as saucers.
“Yes! How did you know?!”
And there it was – a young man with schizophrenia, experiencing his first psychotic break. It took me a few hours to get him a full work up and a discharge plan to the inpatient psych unit… and I was very late getting home from this shift. So much for a straight forward case…
I wonder what would have happened if I’d chosen patient #2?
August 11th, 2009 by DrWes in Better Health Network, Opinion, True Stories
Tags: Anger, Frustration, Healthcare reform, Protests, Town Hall Meetings
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It was a remarkable day in clinic yesterday.
Not because of the number of people I saw (12) or the clinical diversity seen, but rather how many people (4) asked me what I thought of the current health care reform bill before Congress.
The political spin being posed by Democrats is that people are staging town hall protests about their displeasure about the current health care reform efforts underway.
I don’t think so.
Rather, I think people are finally realizing that the health care reform proposal on the table is no longer about the “47 million” uninsured, but rather, “Hey, this health care reform thing, why, it’s about ME!”
-Wes
*This blog post was originally published at Dr. Wes*
August 9th, 2009 by KerriSparling in Better Health Network, True Stories
Tags: Endocrinology, High Risk Pregnancy, Obstetrics And Gynecology, Pregnancy, Type 1 Diabetes
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I stood there with my best friend as she rubbed her pregnant belly. The whole waiting room was filled with these lovely women and their round beachball bellies of varying sizes.
And I felt oddly self-conscious with my lack of roundness.
Last Friday was my first official appointment at the Joslin pregnancy clinic. It’s located at Beth Israel in Boston and is a beautiful hospital, different from the Joslin Clinic across the street that feels like home at this point. I’m not pregnant, and we aren’t trying to become pregnant YET, but this appointment puts things into full swing to bring me to a safe level of pre-pregnancy health.
Sigh. This all sounds redundant, even to me. I’ve talked the Big Talk before. “Oooh, look at me! I’m going to really wrangle in my numbers and have an A1C you can bounce a quarter off!” And I’m all gung-ho for a week or two, armed with my little log book and my good intentions, but within a few days, Other Things start to creep in. Like work. And stress. And getting to the gym. And social stuff, like hanging out with my friends and going to RI on weekends. Eventually my good intentions end up in the spin cycle, and my log book starts to gather dust. My workload piles up. And my stress levels skyrocket.
I’m so frustrated because I want to have a career. And I want to have a baby. (I’d also love some tight control of my diabetes, too.) These things would be excellent, but it feels like tightly managing type 1 diabetes is a full time job unto itself. Slacking off is easy, and frustrating, and not healthy for me or any baby I’d like to have.
But I also realize this is one of my biggest hurdles when it comes to pregnancy planning – the whole “sticking with the pre-program.” This becomes more and more obvious to me when I go back and re-read old blog posts where I’m so excited to get back into better control, only to be derailed by those Other Things. So during the course of my appointments on Friday with the endocrinologist, the registered dietician, and the certified diabetes educator, I admitted my faults freely.
“I need help being held accountable.”
They didn’t quite hear me at first. “We can do some tweaking, and in a month or two, we can revisit your A1C and see if it’s lower and then we can give you the green light for pregnancy.”
I knew I needed more than that. I had to be completely honest.
“Guys, I really need to be held accountable. I know this sounds crazy and I seem very compliant, but I have trouble following through. I’m great out of the gate, but I lose steam after a few weeks and I’m at the point where it isn’t good enough anymore. I’m out of excuses. And I’d really like to join the ranks of those pretty pregnant ladies out there. Please help me?”
And they listened. We spent the rest of the day working out a plan for me. One that will actually make a difference. One that will get me there.
I’ll be in Boston every three weeks until I’m pregnant. This is a huge commitment but I need to make diabetes a priority without fail. I want this. I want to succeed at this more than anything else. I’ll have my blood sugars logged for those three weeks and we (my husband and my diabetes team and I) will all review them together. Chris is in charge of my meals, in that he’ll be helping me plan my day, food-wise, and he’ll be counting carbs and measuring things for me. I’ll be eating relatively similar items every day so I can manage the trends and control them. I’ll continue to test all the live long day and wear the pump and the CGM, but I’ll actually use these devices to their fullest potential, instead of just going through the motions.
With these appointments spaced just a few weeks from one another, I hope I can stay tuned in to intense diabetes management for three week stints. Being sent out for three or four months is too much for me. Obviously, because I burn out well before my follow-up appointments. I just plain can’t pay rapt attention for that long. But three weeks? Can I do that?
I have to do that.
I will do that.
*This blog post was originally published at Six Until Me.*
