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Many Women Remain Unaware Of A Non-Surgical Treatment For Uterine Fibroids

[image:  iStockphoto]

Ladies imagine planning your daily events based around the timing of you menstrual cycle.

Some women suffering from uterine fibroids have a menstrual flow so heavy that it can impede their life.

“Everything must be planned around their menstrual, and it can be very draining physically (from the anemia of blood loss), as well as, mentally from the resulting stress this creates,” says Dr. John Lipman, Director of Interventional Radiology & Center For Image-Guided Medicine, Emory-Adventist Hospital, Atlanta, Georgia.  “This can imprison women such that their entire life is tied to the menstrual cycle. They may not work or even be able to leave the house for several days each month. Even if they can work, the frequent interruptions throughout the day often makes this time very unproductive,” he adds.

“Uterine fibroids are the most common non-cancerous tumors in women of childbearing age. Fibroids are made of muscle cells and other tissues that grow in and around the wall of the uterus, or womb. The cause of fibroids is unknown. Risk factors include being African-American or being overweight.”

According to The National Women’s Health Information Center – U.S. Department of Health and Human Services Office on Women’s Health, about 20 percent to 80 percent of women develop fibroids by the time they reach age 50.

Dr. Lipman writes: Read more »

*This blog post was originally published at Health in 30*

The Boundaries Between Doctor And Patient

This post from Kelly Young on Howard Luks’ blog asks when patients cross the line with respect to their own advocacy.  It’s worth a peek.

The question of boundaries between doctor and patient is interesting.  All of my patients are empowered in some way.  The extent and level of that empowerment is personal.  On our own there are few lines and little with respect to boundaries.  We have effectively unlimited access to information and resources.  And how far we go to look after ourselves and our kids has few limits.

But when we enter into a relationship with a provider, we’re no longer alone.  It’s unreasonable for a provider to tell a patient Read more »

*This blog post was originally published at 33 Charts*

Tips To Reduce A Physician’s Risk Of Being Sued

A few pearls from a session on legal risks and mitigation strategies from an HM ‘11 session by Harvard’s Allen Kachalia, MD, JD:

–A relatively small number of injured patients actually file claims and get compensation.
–Many filed claims do no have actual errors in them, but the majority do.
–Poor outcomes are correlated with claims, and so is patient satisfaction. Satisfied patients are less likely to file.
–There is no evidence that hospitalists’ risk of having claims filed against them is higher than primary care internists.

To protect yourself against claims, document well. Don’t go back and change a record (you can addend, but don’t alter). Document as contemporaneously as possible. Also, “as simple as it sounds, don’t abandon your patient, and don’t stop providing necessary care,” he said. Read more »

*This blog post was originally published at ACP Hospitalist*

Cardiac Defibrillators: Is Research Supporting Their Use Tainted By Financial Interests?

I’ve been working for a couple of months on an in-depth article on personal defibrillators that are implanted beneath the skin of a person’s chest to shock a heart that starts shaking, thereby restoring its normal beating and preventing sudden death.  Discussing these defibrillators is extremely complex, which is why I am spending so much time on researching and writing the article intended to help patients and their families make an informed decision by learning the truth about the devices known as implantable cardioverter defibrillators (ICDs) — the good and the bad, your life saved vs nothing happening or the accompanying risks and harm you may receive.  So when I heard that a new study would be presented at the annual scientific meeting this week of the Heart Rhythm Society, a professional organization of cardiologists and electrophysiologists who use cardiac devices in their patients, I made sure to get an advance copy of what would be presented and interview the lead author.

Potentially such a study would be of interest to physicians and to patients considering getting an ICD because it looked at all shocks the defibrillators gave the heart in patients who took part in the clinical trial, including those sent for life-threatening rhythms and in error.  For several reasons, I felt the study is not ready to report to the public.  It is only an abstract.  The full study has not yet been written, let alone published in a peer-reviewed journal or even accepted for publication.  Patients with defibrillators who received shocks were matched to only one other patient who was not shocked, but the two patients were not matched for what other illnesses or poor quality of health they had.  Yet they were matched to see who lived the longest and the study looked at death for all causes, not just heart-related. One critical question the study sought to answer was this:  Do the shocks themselves cause a shortened life (even if they temporarily save it) or is a shortened life the result of the types of heart rhythms a person experiences? Read more »

*This blog post was originally published at HeartSense*

When Prescription Directions Are Unclear

“Take one to two pain pills by mouth every 4 to six hours”

To me that is clear.  I was reminded recently that it isn’t to all patients.

A patient complained of lack of relief from her pain medicines after surgery.  Her description of the pain didn’t suggest any complications so I ask how she was taking them.  I was looking for a way to safely use NSAIDS or Tylenol as a boost rather than giving her something stronger.

“I take one pain pill and then wait an hour to take another one.”

I prompted her to tell me when she took the next dose.

“I wait four hours and then take one pain pill, but I wait for six hours to take the next one.”

Ah!

I had mentioned to her and her caregiver that due to her small size she should begin with just one, then wait for 30 minutes to an hour to see if she needed the second one.  They were doing that, but the other part wasn’t clear. Read more »

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

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

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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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