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Latest Posts

Dealing With Acute Pain: What Are The Treatment Options?

Whether caused by injury, surgery or a toothache so bad it slams you awake in the middle of the night, acute pain is difficult.  Receiving prompt and helpful treatment can make all the difference in the world.  But lack of care or inadequate care means that the acute pain may develop into chronic agony.

Fortunately, acute pain is not always long lasting or overwhelming, such as when you have a short severe cramp or multiple bee stings that can be handled with time, over-the-counter medication and other home remedies [See: Pain Treatment Options].

Since individuals’ tolerance for pain varies widely, the question of when pain itself requires urgent medical attention is difficult to answer.  Chest pain should prompt a visit to the emergency room, of course—but other types of pain are trickier to call. Read more »

*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*

The State Of Drug-Seeking In America: Nothing Should Hurt

101-homepage-merthiolate

This might sting a little…

When I was a child, I was often painted orange with Merthiolate.  My grandmother, like every good grandmother, kept a bottle handy at all times.  Merthiolate was an antiseptic, containing Mercury, that was marketed for cuts and scrapes.

A fall on the gravel, a slide on the pavement, a run through the briar patch and you’d be sitting on the kitchen table while grandma colored you orange with the magical elixir, which incidentally burned like fire!

On a recent emergency department shift, we were colluding about the general state of drug-seeking in America, which has been enabled by our ‘nothing should hurt’ ideology.   One of my dear friends, Nurse Nancy, had a realization; an epiphany, really. Read more »

*This blog post was originally published at edwinleap.com*

Battling With The Insurance Company

A few months back, while we were on vacation in Washington, D.C., my 17-year-old son Noah sustained an injury at 1:00 a.m. I was asleep, but this is usually a few hours earlier than he typically retires. In our hotel room’s bathroom, he dropped a glass and then managed to step in the wrong place. A sharp shard sliced through the soft skin between his great and second toes. Blood was spurting wildly and he woke me up with a shout. He was spooked.

We gastroenterologists are experienced at stanching bleeding, although I was uncertain how to do so without some kind of scope in my hand. I reflected on my ACLS training, which is a comprehensive 2 hour course that my partners and I take every 2 years. In between those sessions, I neither think about nor practice any advanced life saving procedures. It doesn’t seem rational that a community gastroenterologist should be schooled in temporary pacemakers, when most of us haven’t interpreted an EKG in decades.

I still remember the fundamentals of life support, the famed A, B, Cs, standing for airway, breathing and circulation. I decided to apply this to the hemorrhage at hand.

Airway: the windpipe was open and functioning

Breathing: the kid was breathing

Circulation: BINGO!

After going through this brief but critical checklist, I now knew where to focus. Read more »

*This blog post was originally published at MD Whistleblower*

Fourth Of July: Top Tips For Fireworks Safety

As the 4th of July approaches, I’ve begun to hear fireworks exploding in my neighborhood.  It’s been dry here, so in addition to the risk of injuring a person, there is a risk of setting the fields on fire.  I sure hope my neighbors are being responsible.

I hope you will all have a safe and happy July 4th.  Be safe and stay out of the ER.

Please use the following tips:

  • Never allow children to play with or ignite fireworks.  A responsible adult should be in charge.
  • Read and follow all warnings and instructions.
  • Be sure other people are out-of-range before lighting fireworks. Small children should be kept a safe distance from the fireworks; older children that use fireworks need to be carefully supervised.
  • Do not smoke when handling any type of “live” firecracker, rocket, or aerial display.
  • Keep all fireworks away from any flammable liquids, dry grassy areas, or open bonfires.
  • Keep a bucket of water or working garden hose nearby in case of a malfunction or fire.
  • Take note of any sudden wind change that could cause sparks or debris to fall on a car, house, or person. Read more »

*This blog post was originally published at Suture for a Living*

Domestic Violence Has Become One Of The Top Public Health Issues Facing US Women

Domestic violence knows no boundaries: cultural, socio-economic, religious, level of education, gender or age. It can occur in any relationship and to anyone, but especially to women. In fact, roughly 25 percent of women will become a victim at one time or another during her lifetime.

Abuse is defined as any act used to gain power and control over another person, which can take on many forms. It can include physical, sexual, emotional, economic, coercion, threats, isolation and/or intimidation.

Domestic violence is abuse that occurs within interpersonal relationships and has become one of the top public health issues facing women in the United States. It is a leading cause of injury to women between the ages of 14 and 44 in this country.

There are risk factors that may increase the likelihood that a person becomes a victim to domestic violence. These can include: history of violence or abuse in a past relationship, physical or mental disability, unemployment, poor living situation, substance abuse, unplanned pregnancy, recently separated or divorced, social isolation and witnessed abuse as a child. Read more »

*This blog post was originally published at Society for Women's Health Research (SWHR)*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

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…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

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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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

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…

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