June 7th, 2011 by Lucy Hornstein, M.D. in True Stories
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Say you’re a bariatric surgeon. You’d think Americans would be beating a path to your door. After all, this is the land of Instant Gratification! Who wants to just eat less for the better part of a year to lose 50 lbs when one can be cut open and have one’s gastrointestinal anatomy rearranged — resulting in the necessity of eating less, but why quibble — to lose that same 50 lbs (or more)? Changing lifestyles is boring; surgery is exciting!
Funny how it turns out that in order for the surgery to succeed long-term, patients have to commit to lifestyle changes anyway. In fact, before any reputable bariatric surgeon will operate, patients have to demonstrate their dietary commitment by actually losing some weight on their own, prior to surgery. What I don’t understand is why people then go ahead with the damn surgery anyway? Logically, it’s almost like you have to prove you don’t need it before you can have it. Hey, I’ve never said I understand people.
Perhaps overcoming this paradox is the explanation for the behavior of a certain bariatric surgeon, brought to my attention by a mutual patient. Read more »
*This blog post was originally published at Musings of a Dinosaur*
June 4th, 2011 by ChristopherChangMD in Health Tips, Opinion
1 Comment »
Without going into TOO much detail of how I know this… I have personally observed that the TRIA Laser Home Removal System
does work after observing its use and its effects over a 6 month period of time. And before anybody asks… no… I was not paid to write this nor did I get a free one to try. Rather, someone I am close to bought it off Amazon.com and I was a skeptic on-looker.
In any case, the caveat being that I know it works (admittedly anecdotal) as long as the hair is dark (ideally black or brown) on very light colored skin (ideally white).
The way laser hair removal works is Read more »
*This blog post was originally published at Fauquier ENT Blog*
May 16th, 2011 by Lucy Hornstein, M.D. in Health Policy, True Stories
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Insurance companies are supposed to pay for health care, although they do everything they can think of to avoid doing so. One company in particular (a small player here though a much bigger gorilla in other markets) does so by playing with words, even when another behemoth lost a lawsuit over the same issue.
The topic involves paying for preventive services while a patient is in the office for care of an acute illness or management of a chronic condition. The way we communicate with insurance companies about what we do in the office is by way of codes; CPT codes, to be precise. There are separate codes to differentiate between preventive services and the so-called Evaluation and Management (E/M) services. The latter are your basic office visit codes covering all the “cognitive” services I offer — as opposed to procedural codes, where I actually do something to you other than talk with and examine you. Read more »
*This blog post was originally published at Musings of a Dinosaur*
May 12th, 2011 by GruntDoc in Humor, True Stories
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Laugh if you want, this helps my life, at least at work.
For months after starting my current gig, I would sometimes get to work with everything in all my pockets, and sometimes not.
I’d forget my ID, or my pen, or my phone, or my…well, there you go.
Then my OCD started to kick in, and, a Mental Checklist was born.
I now have to get 6 things, and set them on the table or I screw it up every time.
- ID
- stethoscope
- my phone
- work phone
- pen
- sharp stick (I’ve written about this before, but cannot find it. You should search an ER blog for the word ‘knife’ and then wonder why you bothered).
Last week I apparently went against the checklist, and halfway through the shift realized I’d lost my ID. Of course, after about a combined half-hour of fruitless search I gave up, and found it in my bag on the way out. Geez.
Yeah, it sounds stupid. But if it’s stupid and it works, it’s not stupid.
*This blog post was originally published at GruntDoc*
May 9th, 2011 by GruntDoc in News, True Stories
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Absent other information, the referred to ‘rodent poison’ is probably a superwarfarin. It’s like regular people-coumadin, but superconcentrated. It kills rodentia by causing them to bleed to death.
Which makes the ‘gas effect’ seem really odd, but possibly explainable.
A patient who apparently ingested rodent poison and is emitting potentially harmful gasses has created a hazardous material situation at St. Joseph Mercy Hospital in Ann Arbor.
The man is isolated in his room in the medical intensive care unit on the hospital’s sixth floor, 5301 McAuley at East Huron River Drive, hospital spokeswoman Lauren Jones said this afternoon.
via Patient emits potentially harmful gas; hazmat called to Ann Arbor hospital | Detroit Free Press | freep.com.
Two thoughts: 1) I sincerely hope this patient recovers, and 2) if this is just upper GI bleed smell someones’ going to have rotten egg smell on their face.
I looked up superwarfarins, found a couple of interesting case reports, but none that talk about abnormal gases.
(For the uninitiated, the smell of digested blood is amazingly awful. It’ll make experienced, hard ED staff retch). I can understand why the smell would set off alarms, except that it’s not that uncommon, so it shouldn’t be a surprise.
It’ll be interesting to see what come of this.
Lighting matches in the hospital is a nono, by the way.
*This blog post was originally published at GruntDoc*
