September 17th, 2011 by John Di Saia, M.D. in Opinion, True Stories
Tags: Botox, Botulinum Toxin, Canada, Great Britain, Myobloc, Northwest Pharmacy, Pharmacy, Review, Shipping, Temperature, Warning
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Looking to obtain a break on my practice’s botulinum toxin of choice (Myobloc) I yielded to curiosity and ordered from a Canadian Pharmacy…Northwest Pharmacy.com. I figured we would try to break the price point of this popular product. Thankfully I used my credit card.
Botulinum toxin must be kept cold to retain its potency. We traditionally receive this product on dry ice and have never had much of a problem with effectiveness. I was promised by the pharmacy rep that this product would arrive cold within 2-5 days of shipping. Only after I gave her my credit card information did she share with me that the product would be coming from Great Britain. This was not welcome news. I was reassured that the product would be cold and usable.
The product arrived Read more »
*This blog post was originally published at Truth in Cosmetic Surgery*
September 14th, 2011 by Jessie Gruman, Ph.D. in Opinion, True Stories
Tags: Cancer, Certainty, Final Days, health care, Health-related numbers, Illness, Jessie Gruman, Markers, Numbers, Quantifiable, Technology, Time, Time Remaining, Tools, Treatment
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“My doctor can titrate my chemotherapy to the milligram but can’t tell me when I am going to die,” a friend who was struggling with his treatment for cancer complained to me a couple years ago.
Had he lived, he might have been reassured by the announcement last week of a new scale that allows clinicians to estimate the time remaining to people with advanced cancer. He was spending his final days “living by the numbers” of his white blood cell count, the amount and size of his tumors and suspicious lesions, the dosage of various drugs and radiation treatments. And he was peeved about what he saw as a critical gap in those numbers. He believed (hoped?) that because his cancer was quantifiable and the treatment was quantifiable, that the time remaining should be similarly quantifiable. He needed that information to plan how to use the time that remained.
Many of us would make a different choice about knowing how long we will live when we are similarly ill. But most of us are attracted to the certainty we attach to the numbers that precisely represent aspects of our diseases.
It is not just when we are seriously ill that numbers dominate our experience with health care. Advances in technology have made it possible to quantify – and thus monitor – a seemingly infinite number of physiological and psychological health-related states. For instance: Read more »
*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*
September 13th, 2011 by PJSkerrett in Health Tips, True Stories
Tags: American Journal of Health Promotion, Cardiac Health, Diet, Health, Healthy, Healthy Aging, Heart Health, Heavy Drinking, High Cholesterol, Inspirational, Kevin O'Donnell, Men's Health, Overweight, Prevention, smoking cessation, Transformation
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It isn’t easy to get rid of a harmful habit like drinking too much, or to make healthy changes like losing weight and exercising more. Media stories about people who run marathons a year after surgery to bypass cholesterol-clogged arteries or who climb Mt. McKinley after being diagnosed with diabetes are interesting, but they don’t resonate with me. Mostly it’s because they often leave out the hard work needed to change and the backtracking that invariably accompanies it.
I ran across a truly inspiring story the other day in the American Journal of Health Promotion—one that shows how most of us ultimately manage to make changes that improve our lives. The journal’s founder and editor, Michael P. O’Donnell, wrote a moving essay about his father, Kevin O’Donnell. Once an overweight workaholic who smoked and drank heavily, ate mostly meat and potatoes, and didn’t exercise—and who eventually needed a double bypass—Kevin O’Donnell gradually made changes to improve his health. Now, at age 85, he has the cardiovascular system of a 65 year old and is working on a house-building project in North Korea.
How did Kevin O’Donnell engineer such a remarkable transformation? Read more »
*This blog post was originally published at Harvard Health Blog*
August 31st, 2011 by Bryan Vartabedian, M.D. in Opinion, True Stories
Tags: Digital Age, Doctor Patient Relationship, Doctor-Patient Communication, Doctors, Health 2.0, Information, Information show of force, Informed Patient, Patients, Texas Medical Center
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Sometime around 1998 in the Texas Medical Center:
DrV: (enters exam room) Hey, How are you? I’m Bryan Vartabedian (extends hand).
Father: (arms crossed, smiling, leaning against wall) Oh I know who you are, Doc. And I know where you went to school, where you’ve lived, if you’ve been sued and a few other things. And I’m fine, by the way.
DrV: Um, Okay. (Shakes hands with father. Looking to child, scruffing his hair). And this must be Caleb.
An odd moment, for sure. When it happened I didn’t know what it was about. After similar encounters I understood. It was about where patients found themselves in the early days of the information revolution. And there was the father who wheeled into the exam room two large boxes of printouts perched on a dolly. Inkjet validation of his role in the decision about his son’s surgery.
These situations illustrate Read more »
*This blog post was originally published at 33 Charts*
August 25th, 2011 by Shadowfax in Research, True Stories
Tags: Abdominal Pain, Children, CT Scan, ED Visits, Emergency Department, ER, Optimum Rate of CT, Peak Utilization, Pediatrics, Radiation Exposure, Radiation-minimizing technique, Trauma Center
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Well, this is satisfying. Over the years, in our ER we have mirrored the nationwide trend and have significantly increased the utilization of CT scans across the board. The reasons are manifold. Some cite malpractice risks, and indeed in our large group we have had one lawsuit for a pediatric head injury and another for a missed appendicitis which probably did contribute. But, in my opinion, there have been many other drivers of the increased use. For one, CTs have gotten way, way better over the last 15 years, which quite simply has made them a better diagnostic tool. They’ve also gotten way faster. As the facilities have invested in CT scanners, they have increased their capacity and increased their staffing, so the barriers to their use have rapidly diminished. I am so old that I remember when ordering a CT involved calling a radiologist and getting their approval! No more of that, I can tell you.
But a couple of years ago, we really started paying attention (perhaps belatedly) to Read more »
*This blog post was originally published at Movin' Meat*
