July 4th, 2011 by ChristopherChangMD in Health Tips
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One June 20, 2011, NPR aired a great story about how a person may not “see” a person getting beat up on the side of a jogging path when they are focused on a task (pursuing another jogger)… even if they pass RIGHT BY THE FIGHT!!!
In fact, only a third of the subjects reported seeing this mock fight when the experiment was conducted at night. Even more surprisingly, broad daylight didn’t improve the statistics (only 40% noticed the fight).
Though the situation and circumstances do not exactly correspond, there is a lesson to be learned here that applies to a medical visit.
As an ENT, I often see patients for a very specific complaint…
“My right ear hurts.”
“I have a bad cough.”
No matter what the complaint, unless it is for a specific task (there is earwax… can you remove it), I most always still do a complete ear, nose, and throat exam no matter the complaint.
Why??? Read more »
*This blog post was originally published at Fauquier ENT Blog*
May 26th, 2011 by Paul Auerbach, M.D. in Health Tips
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One of the most feared infectious diseases for outdoor travelers—particularly children and young adults—meningitis caused by the bacterium Neisseria meningitidis (meningococcus). The infection can appear in outbreaks, most commonly abroad, particularly in sub-Saharan Africa and China.
The infection is spread in the respiratory secretions of humans. The disease appears in many forms, the most common of which are meningitis, pneumonia, and disseminated bacterial infection. The typical presentation of meningitis is fever, headache, and a stiff neck. If the cause is meningococcus, the victim may develop a skin rash, which consists of red dots or bumps, or a flat, more patchy dark red discoloration.
If the dark red dots begin to enlarge and coalesce into large purplish bruise-like discolorations, this is a bad sign. In the worst cases, a victim can develop shock, respiratory failure, diffuse bleeding, and death. Approximately one in 10 victims of meningococcal meningitis dies. Read more »
This post, Do You Know How To Recognize Deadly Bacterial Meningitis?, was originally published on
Healthine.com by Paul Auerbach, M.D..
May 2nd, 2011 by Glenn Laffel, M.D., Ph.D. in Health Policy, Opinion
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For the first time in 30 years, an expert panel has updated guidelines for the diagnosis of Alzheimer’s disease. The long overdue facelift should favorably impact care for millions and accelerate badly needed research on the disease.
The guidelines were produced by representatives from the National Institute on Aging and the Alzheimer’s Association. They portray Alzheimer’s for the first time as a three-stage disease. In addition to ‘Stage 3,’—the full-blown clinical syndrome that had been described in earlier versions of the guidelines—the new guidelines describe an earlier ‘Stage 2,’ of mild cognitive impairment due to Alzheimer’s, and a ‘Stage 1, or preclinical’ phase of the disease. The latter can only be detected with biochemical marker tests and brain scans.The guidelines legitimize years’ worth of observations by the family members of Alzheimer’s patients, who recognize in retrospect that Grandpa had a slowly progressive cognitive disorder long before he was diagnosed. The guidelines also reflect progress on the research front, where it has now been established that the disease begins years before patients become symptomatic.
Alzheimer’s patients and their families, and the teetering US health system that supports them, would have been better served by the publication of these guidelines 2-3 years ago. Read more »
*This blog post was originally published at Pizaazz*
April 20th, 2011 by Dr. Val Jones in Humor, True Stories
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Every once in a while we physicians make an astute (or perhaps lucky) observation that becomes a turning point in a patient’s life.
I’ll never forget the time that I placed a hand on an elderly woman’s belly after she said that she felt a little bit dizzy – the pulsatile abdominal mass that I discovered set in motion a cascade of events that resulted in life-saving surgery for an disecting abdominal aortic aneurysm (AAA). It was incredibly gratifying to be involved in saving her life – and now anyone who so much as swoons in my vicinity gets a tummy rub! (Yes, Dr. Groopman I know that’s not necessarily a rational response to one lucky “exam finding.”)
Last week I made a fortunate “catch” on the order of the AAA discovery from years ago. I was giving a close friend of mine a hug (he’s significantly taller than I am) when I noticed that his heart was beating rather quickly through his shirt. I instinctively grabbed his wrist to check his pulse, and voilà – it was irregularly irregular. My friend had new onset atrial fibrillation – and although he was initially resistant to my idea of going straight to the ER, I eventually convinced him to come with me. An EKG confirmed my clinical diagnosis, and blood thinners (with Pradaxa) and a rate control agent were administered. He will undergo cardioversion in a couple of weeks. We were both relieved that our intervention may well have averted a stroke, heart failure, or worse.
My peers at the hospital have been poking fun at me for my hug diagnosis, and my reputation as the “hug doctor” now preceeds me. I continue to protest that I do know how to use a stethoscope – but alas, there have been more requests for stat hugs from me than cardiopulmonary exams.
I don’t know if I’ll ever be able to top this clinical diagnosis, but a life of trying to find my next case of atrial fibrillation through hugging will likely make a few people smile.
April 18th, 2011 by Dinah Miller, M.D. in Opinion
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From time to time, our readers comment that they are distressed with a diagnosis a psychiatrist has given. They’ve met with a doctor, talked for a while (half an hour, an hour, maybe two hours) and based on whatever information the psychiatrist has, a diagnosis is made. Maybe it’s right, maybe it’s not, and maybe the diagnosis will change over time. Some readers have commented that they object to the idea that psychiatrists must assign a diagnosis to be paid, when in fact there is no diagnosis, and they think that’s wrong. The psychiatrist should work for free?
Since I don’t accept insurance, I’m not obligated to make a diagnosis, but if I don’t put one on the statement, the patients won’t get reimbursed. Some tell me that they aren’t submitting psychiatric claims to an insurance company, others don’t have insurance, and many do submit claims. I’m left to wonder why someone with no psychiatric diagnosis would consult a psychiatrist to begin with, especially since some diagnoses (Adjustment Disorder, for example, or Anxiety Not Otherwise Specified) are not particularly stigmatizing. Read more »
*This blog post was originally published at Shrink Rap*
One June 20, 2011, NPR aired a great story about how a person may not “see” a person getting beat up on the side of a jogging path when they are focused on a task (pursuing another jogger)… even if they pass RIGHT BY THE FIGHT!!!
