September 18th, 2008 by Dr. Val Jones in True Stories
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I love my new blog web designer. She is incredibly talented, and has the uncanny ability to capture concepts with images. In fact, if you’d like to comment on this post to offer her a “high five” for this website design, I’m sure she’d appreciate it. Her name is Beata.
When Beata and I sat down to try to figure out how to express my “style” she asked me what kind of visuals I was drawn to. I showed her the Medi-mation website since I have a soft spot for 3-D science animation. She said she’d like to start with some microscopic images and stylize them for me so that they were suggestive of medical images, but not too literal.
Beata offered me a series of background patterns to choose from for my landing page. I did an abrupt halt over this one though: Read more »
September 17th, 2008 by Dr. Val Jones in Celebrity Interviews
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Many members of Phylicia Rashad’s family have had peripheral artery disease (P.A.D.), strokes, and heart attacks. In a candid interview with me, she describes how her healthy lifestyle (regular exercise, no smoking, and a Mediterranean diet) has helped her to beat the odds and avoid the disease. To listen to our conversation, please click here. Ms. Rashad begins speaking at about minute 10:30 of the podcast.
Dr. Val: I’m so sorry to hear that 8 of your relatives have suffered stokes or heart attacks. What was that like for you?
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September 17th, 2008 by Dr. Val Jones in Expert Interviews
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Peripheral Artery (Arterial) Disease (P.A.D.) is an under-recognized and under-diagnosed condition, yet it serves as an important warning sign for those at high risk for stroke and heart attack. Even though we have an inexpensive and non-invasive test for P.A.D. very few people have the test done. I interviewed Dr. Gary Schaer, Director of the Cardiac Cath Lab at Rush University Medical Center in Chicago, about P.A.D. and also spoke with actor Phylicia Rashad about her family’s trials and tribulations with P.A.D. This post is devoted to Dr. Schaer’s insights on the medical aspects of the disease, and the next post focuses on Ms. Rashad’s personal story. To listen to the entire podcast of our interview, please click here.
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June 13th, 2008 by Dr. Val Jones in Medblogger Shout Outs
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Some bloggers’ clinical vignettes speak volumes about why doctors are exasperated with their day-to-day work lives. Here are a few good ones:
From White Coat Rants:
A patient from a nursing home was transferred by ambulance to our ED with the following chief complaint:
Mental status changes not responsive to albuterol [an asthma puffer].
Of course now we’re stuck trying to figure out how much this patient’s mental status has actually changed. I never could figure out how in the heck nursing homes can determine that an essentially non-verbal patient is having a mental status change. She sat in the bed, watched me walk around the room and smiled. So was she blinking less, or what?
I was waiting patiently on the next ambulance run for a patient with nasal congestion unresponsive to Ex-Lax.
From Ten out of Ten‘s Medical Jeopardy:
Answer: Massive Diarrhea
Question: What is the end result of eating nothing but beans and peaches all day?
People are so weird.
From Musings of a Dinosaur’s Anything Else?:
The perils of the open-ended question in a new patient interview:
Me: Tell me about your health.
Patient: I have hypertension and a little arthritis in my knees.
M: Anything else?
P: No, that’s all.
M: What medications do you take?
[presenting bag full of bottles, we find:]
Cozaar
Hydrodiuril
Lipitor
Zoloft
Ativan
Ultram
Celebrex
M: Why do you take the Zoloft and Ativan?
P: Oh, the Zoloft is for anxiety and the Ativan helps me sleep.
M: Anything else?
P: No, that’s all.
M: What about this Lipitor?
P: Oh, I stopped that about three years ago. It’s just for people who eat a lot of fat in their diet. I don’t think I need it.
M: Ok. When did you last have blood work done?
P: About four years ago.
M: And when did you last see a doctor?
P: About four years ago.
M: Any other medical problems?
P: No, that’s all.
M: Are you allergic to any medicines?
P: I get a rash with penicillin, and oh yeah! I have this weird rash that comes and goes. I’ve seen all the specialists downtown and no one knows what it is.
M: Anything else?
P: No, that’s all.
M: Anything run in the family?
P: My brother had a heart attack when he was 42, and oh yeah! I have a 30% blockage.
M: When did you find this out?
P: About four years ago.
M: Anything else?
P: No, that’s all.
M: Do you need any of these meds refilled?
P: Just the Celebrex.
M: Most of these other bottles also say “no refill” on them.
P: Oh, I have more at home. I just dumped them out and brought the bottles.
M: How much more do you have at home?
P: About two weeks.
M: How about if I write refills for all of them.
P: Ok.
M: Anything else?
P: No, that’s all.
M: Can I do some blood work on you today?
P: Sure. Oh, and I see a cardiologist, rheumatologist and orthopedist too. Can you send copies to them?
M: No problem.
Anything else?
P: No, that’s all.
M: Are you sure?
P: Yes.
Do you know why dinosaurs have no hair? It’s because I pulled it all out this morning.
We really do need a common, interoperable medical record system.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
May 19th, 2008 by Dr. Val Jones in Patient Interviews
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I met Patty Smith and her husband Jay at the Alzheimer’s Association gala in Washington, DC. Patty was diagnosed with early onset Alzheimer’s at the age of 51, and has devoted her life to raising awareness of her condition. She agreed to deliver a short message to the large audience, including political celebrities like Nancy Pelosi, Chris Matthews (of Hardball) and Newt Gingrich. I was able to spend some 1:1 time with Patty in a quiet press room prior to the event.
What struck me most about Patty was her courage and determination. Although her symptoms were troublesome to her (she had some difficulty concentrating, remembering details of her past, and couldn’t offer robust answers to questions) she was prepared to be vulnerable in a very public way. I was moved by Patty’s bravery, and her willingness to sacrifice personal comfort for public education. Of all the important donors and benefactors at the event, Patty was (in my opinion) the one who sacrificed the most- because she was the one who was willing to expose her frailty to us all. I became quite misty-eyed during this interview, as I witnessed a beautiful and brilliant woman slowly being robbed of her faculties (as was my own grandmother) by a relentless disease. I am honored that Patty took the time to tell me a little bit about what it felt like to be living with Alzheimer’s. My prayers are with her and her family.
Dr. Val: How were you first diagnosed?
Patty: I was working downtown on K Street for BB&T as one of their top consultants (I was 49 years old). But I slowly started missing some things and forgetting to follow through with my work. I remember being devastated when I was written up by my superior for poor performance. I decided to take some time off to figure out what was going on with my brain.
I went to see a neurologist who ordered an MRI. The MRI was normal because it was too early in the disease process to see changes. The neurologist then sent me to a psychiatrist to check me for depression. After several sessions, the psychiatrist sent me back to the neurologist saying “If this woman doesn’t have a neurological problem, I’ll eat my hat.” Then I had a PET scan which showed the Alzheimer’s disease. It took a really long time to get the diagnosis because no one thought of Alzheimer’s as a possibility for someone so young. Also there’s no history of Alzheimer’s in my family and my father is one of 17 kids.
Dr. Val: Did you undergo any genetic testing to find out if you carry a gene for Alzheimer’s?
Patty: Well, the neurologist ordered some tests on my spinal fluid, but unfortunately the person who tried to do the spinal tap missed so many times that we gave up because it was painful. [Patty’s husband adds: In the end the test results don’t make that much of a difference. You either have it or you don’t.]
Dr. Val: What is the most difficult part of being diagnosed with early onset Alzheimer’s?
Patty: The thing that frustrates me the most is that I lose my thoughts for a moment. They come back relatively quickly still. It’s hard to see it affecting my children. They’re 22 and 20. My diagnosis has been difficult for them but they’re taking it pretty well I think.
Dr. Val: If there’s one thing you’d like others to know about early onset Alzheimer’s disease, what would that be?
Patty: I’d like doctors to consider it as a possibility when they’re seeing patients with complaints like mine. It shouldn’t take years to get diagnosed. We have to break the stereotype of Alzheimer’s being exclusively a disease of the elderly. Younger people with Alzheimer’s get diagnosed with “stress” or depression, even though the symptoms are the same whether you’re 85 or 50 years old.
Also, I’d like more research funding for drug development. I’d like the FDA to move a little faster on getting the drugs out as well. I’m willing to volunteer for clinical trials, but I’m afraid that I’ll be placed in the placebo group, and I’d really like to get the drug.
Dr. Val: Are you taking any drugs now?
Patty: Yes, I’m on Aricept, Wellbutrin, and Namenda.
Dr. Val: Are you bothered by any side effects?
Patty: At the beginning we had to adjust the dosage of the Aricept because I was getting “night terrors.” I’d wake up in the middle of the night and sit bolt upright in bed and scare my husband half to death. Of course I didn’t remember any of it because I was still asleep. We cut the dosage of Aricept in half and the problem resolved.
Dr. Val: What are your plans going forward?
Patty: I’m going to continue helping the Alzheimer’s Association to raise awareness about the disease. Our healthcare system is not equipped to handle all the additional people who will be diagnosed with Alzheimer’s in the near future. We must get the message out so that we can prepare better. I’ll continue on giving speeches across the country for as long as I can do this.
*USA Today profiled Patty and Jay in an article published last year.*This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
