According to the release, “We are seeking video entries that tell about the impact diabetes has on our lives through one of the five senses: sight, hearing, taste, touch and smell. Diabetes affects our lives in ways we may not always realize. We smell insulin, savor glucose tablets, feel the poke of our lancing devices, react to our doctor’s words and see the life ahead of us.”
They’re looking for video submissions, and there are some really cool prizes on tap for winners. Not to mention the emotional boost that creativity like this can provide – which, in my mind, is huge in helping us deal with diabetes. For details on how, and what, and when, to submit, check out this entry on TuDiabetes. Read more »
*This blog post was originally published at Six Until Me.*
Here’s an interesting case. A young woman drinks antifreeze to commit suicide, writes a note saying she does not want any medical treatment and calls an ambulance so she can die peacefully with the help of medical support.
I read a lot on Happy Hospitalist about a patient’s right to demand what ever care they feel is necessary to keep them alive and the duty of the physician to provide whatever care the patient feels they require, no matter how costly or how miniscule the benefit. Readers like to say it’s not a physician’s obligation to make quality of life decisions for the patient.
So let’s analyze this situation. Does a patient have the right to demand medical care and the services of physicians to let them die without pain? Does a patient have the right to demand a physician order morphine and ativan to keep a depressed but physically intact patient comfortable as they slip away in a horrible antifreeze death under the care of medical personel? Read more »
Some put the figure for defensive medicine at 10% of medical expenses a year. That’s $250 billion dollars. Others claim it to be 2-3% per year or about $60 billion dollars a year.
Now ask any physician what it is. I’d say it’s closer to 30% a year. That’s $750 billion dollars a year. Why? Because I know what is going through the minds of physicians when they put the pen to the paper. In America, we strive to exclude the long tail diagnosis. Why? Because getting sued for 67 million dollars because you treated a torn aorta when all the evidence pointed to an emergent MI has a way of making doctors evaluate the possible, instead of focusing on the probable.
Defensive medicine is not about losing a lawsuit. It’s about getting sued and the lack of boundaries that protect a physician from having bad outcomes with competent medicine, even if that competent medicine was the wrong medicine for the wrong patient at the wrong time, a fact known only after the fact when a bad outcome occurs. Read more »
To be a great internist you have to be great at blood gas interpretation. And you have to be able to do it quickly and efficiently. You have to understand what all the numbers mean and you have to get a good clinical sense of how to interpret them and how to change management based on their result. And you have to be able to do it without pulling out your formula books. In six years as a hospitalist I have never calculated what the compensatory responses should be. I just know.
Sometimes blood gases change your management or your medical opinion on what’s happening. Take for example my patient with advanced MS. She presented through the emergency department with “oropharyngeal bleeding of unclear etiology”. Her original BMP:
Na 137
K 4.0
CL 99
HCO3 36
BUN 35
CR 1.0 Read more »
If you just snapped a quick picture, you wouldn’t see it. Not unless you were looking for the small signs, like my insulin pump. Or my spotted fingertips.
Type 1 diabetes isn’t something you can see on me. It’s not an illness that, at this point in my life, comes with any constant external symptoms. I am fortunate enough to not use a wheelchair or need vision assistance devices. You can’t see my disease, even though it’s something I manage every day.
I seem “normal.” (Stop laughing. Let me use the word normal for the sake of this blog post, at the very least!) I seem like your average 30 year old professional woman (again, stop laughing), recently married, inspired to achieve, and happy.
And I am happy.
But my good health is not without great effort.
Type 1 diabetes is a chronic illness, and one that has required daily maintenance and effort from me, and from my caregivers, for the last 23 years. Every morning starts with my meter. Every meal I’ve eaten in the last two plus decades has been preceeded by a blood sugar check and an insulin dose. And every night has my finger pricked by a lancet before my head hits the pillow.
This isn’t a pity party. Not by a long shot. My life is healthy and I have a very fulfiling existance, even if days are bookended by diabetes and even if I’m now wearing medical devices 24 hours a day, every single day. And back when I was a fresh-faced litttle kiddo, people seemed to want to cure my disease because they didn’t like the idea of a small child dealing with this disease.
Kids are fun to cure. They’re cute. And their futures seem worth investing in.
What confuses me is how quickly people forget. Type 1 diabetes became a part of my life a long time ago, and I don’t remember even a snippet of “the before.” But even though I’ve lived very well with this disease and kept it from defining me in any way, it’s still here. And it’s still something I deal with every day, regardless of how well or poorly controlled. But just because I’m no longer a little kid with the bright, shining future, am I any less diabetic? Any less deserving of that cure? Just because you can’t see my disease, and because I seem to have it under physical and emotional control, does not mean it’s past the point of deserving a cure.
Here is a vlog post that I did back in February about vlogging during a low blood sugar and how “diabetes can look so normal yet feel so rotten.” It’s a video that shows how invisible diabetes can be, but how visible it feels from the perspective of those who live with it:
Children with diabetes grow up to be adults with diabetes. And all the while, we’re still ready for progress. And for hope. And for a cure.
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…
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…
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…
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…
