There is a very nice review article in the “throw away” journal Advances in Skin & Wound Care (full reference below) which discusses the causes and management of peristomal skin complications. The photo (credit) to the right shows normal, healthy skin around a stoma.
Peristomal complications are one of the most challenging aspects of living with ostomies. The purpose of this review article was stated to be “to illustrate practical approaches to prevent and treat common peristomal skin conditions.” Read more »
Last week someone posted on Twitter that they had swallowed a plastic toothpick. What to do? So they turned to the hive for help. “What should I do?” I thought as I read my Twitter feed. I was paralyzed in a way. I wanted to share my experience with hundreds of patients had swallowed pins, toothpicks and other pointy things. I specialize in just this sort of thing. But short of a random comment about gastric emptying, I kept to myself. Why? Because once I lend a hand I’m all in.
The simple offer of patient-specific advice constitutes a relationship in the eyes of the law.Once involved, I potentially share responsibility in whatever happens to someone.Crazy but true.It’s just a matter of time before slip-and-fall lawyers hold physicians accountable for helping out in the social sphere.
Doctors aren’t the only ones wearing targets. Read more »
*This blog post was originally published at 33 Charts*
I can spend 20 minutes interviewing a parent about their child and still not really understand them.During a consult, my interview centers on the objective elements in a child’s history.When evaluating a child for abdominal pain, for example, I have a panel of questions that cover what I need to know to generate a starting hypothesis.
But none of it helps me understand Mom.
Understanding where the parents are at is critical to both understanding a child’s problem as well as pitching a plan of care.Whether it’s revealed to me or not, parents often come to me with an agenda.If my plan doesn’t meet with their view of the situation, it’s going to be much harder for me to help that child get what she needs.
So at the end of my interview (usually when washing my hands) I launch one or all of the following questions: Read more »
*This blog post was originally published at 33 Charts*
Recently I had a moment to reflect on adrenaline and adrenaline inducing sports. It was a bloody moment. But I’m getting ahead of myself.
Bleeding peptic ulcers occasionally cross the path of general surgeons. Usually they stop bleeding with conservative treatment. But sometimes they don’t. Then you need to whip out the trusty knife. Even then usually the operation is little more than routine. This case, however was exceptional.
He was white as a sheet. He had been bleeding for three days but only decided to come to the hospital when he started falling over. It seemed he could at least recognise falling over as not normal. The initial gastroscopy showed a penetrating duodenal ulcer with no active bleeding. the body had managed to curtail the bleeding, partially because of vasoconstriction, but mainly due to a low blood pressure which in itself was due to loss of blood. Read more »
The BBC is reporting on a wirelessly controlled “spider pill” being developed somewhere in Italy. The device supposedly has eight legs and reportedly can crawl through intestines. With an attached video camera, the device might actually become a diagnostic modality for imaging the intestinal tract. The big question is whether it is more unpleasant to have a colonoscope defile you or a robotic gerbil crawl through the insides.
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I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…
I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…
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I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…
There is a very nice review article in the “throw away” journal Advances in Skin & Wound Care (full reference below) which discusses the causes and management of peristomal skin complications. The photo (credit) to the right shows normal, healthy skin around a stoma.
