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Patient Remains On ECMO Machine For 13 Days And Survives

On September 21, 2008, 26-year old ML started feeling short of breath. It quickly got worse; she began to feel dizzy and started sweating profusely. Her family called an ambulance and she was rushed to NewYork Presbyterian’s The Allen Hospital, where her condition worsened. Her lungs were failing. Corey Ventetuolo, MD, her first pulmonologist, knew that ML needed to be transferred to NewYork-Presbyterian/Columbia University Medical Center, but feared that she would die during the brief journey. Her family decided to take the risk.

ML did indeed flatline during the ambulance ride, but she did not die. Her survival despite severe lung failure is due Read more »

*This blog post was originally published at Columbia University Department of Surgery Blog*

Some Asthma Inhalers Can Cause Fungal Laryngitis (Thrush Of The Voice Box)

It is a big bummer to be an asthmatic. Not only is breathing a problem, but even the treatment for asthma can cause problems.

Take for example steroid inhalers like advair, symbicort, fluticasone, etc.

All asthma patients know to rinse their mouth out after inhaler use due to risk of oral thrush, but what about from the back of the mouth down to the vocal cords??? This nether region can’t be gargled very easily. One can swallow water to rinse this area out, but the vocal cord region would still not be addressed (otherwise aspiration would occur).

And that leads to potential vocal problems… like fungal laryngitis (or thrush of the voicebox). Here’s a picture of what that looks like. To compare, normal is shown in the smaller picture.

Note the white patches indicative of fungal growth. This fungal infection can lead to symptoms of a mild (if any) sore throat, but most patients complain of hoarseness as their only symptom. Read more »

*This blog post was originally published at Fauquier ENT Blog*

Scary Images On Cigarette Packages Do Make People Think About Quitting

The World Health Organization (WHO) says graphic health warnings on tobacco packages are a powerful “best buy” in decreasing tobacco use and its many health consequences.

Photo by Bill Branson, National Cancer InstituteThe Centers for Disease Control and Prevention outlined the research in the MMWR.

The World Health Organization (WHO) created a treaty for tobacco product labels that many countries have ratified. Among other requirements, these warnings are expected to appear on at least 30%, and ideally 50% or more, of the package’s principal display areas, and preferably use pictures.

To assess how cigarette package labels impact quitting smoking, researchers used data from the Global Adult Tobacco Survey (GATS) in 14 countries from 2008 to 2010 that had ratified WHO’s tobacco control treaty. Current smokers of manufactured cigarettes were asked whether they had noticed health warnings on a cigarette package in the previous 30 days, and whether the label led them to think about quitting smoking.

Among men in 12 of the countries and women in seven countries, more than 90% of smokers reported noticing a package warning in the previous 30 days. Read more »

*This blog post was originally published at ACP Internist*

Actual Living, Breathing Lungs On Stage At TEDMED 2010

Dr. Shaf Keshavjee, a thoracic surgeon and director of the Toronto Lung Transplant Program, showed the amazing miracle of modern lung transplantation at TEDMED 2010. Here’s his fascinating talk where an actual living, breathing set of porcine lungs were brought on stage for hands-on inspection by the audience:

Here’s a quick interview we were able to get with Dr. Keshavjee just after the talk: Read more »

*This blog post was originally published at Medgadget*

When Patients Are Empowered By Serious Diagnoses

I am really excited about serving as the emcee for next week’s Personalized Medicine World Conference in Mountain View, California near San Francisco. I also will be the moderator of a panel discussion on patient empowerment. As I prepare, I am interviewing the panelists and their stories are very inspiring.

One panelist is Bonnie Addario. Bonnie had been an oil company executive in the Bay Area. She began having chest pain. Was it her heart? No. Was it a nerve problem? No. Doctors were stumped. Bonnie was frustrated, but she was also a woman of action — a “powerful patient.” She went on her own for a full body scan. The news was not good. A lung cancer tumor was wrapped around her aorta and other vessels. It was inoperable. But, fortunately, chemotherapy and radiation shrunk the tumor and loosened the stranglehold it had on her blood vessels. Surgery was then possible. It took 17 hours and she even had more radiation before she left the operating room.

Bonnie’s life was saved. But what then? She was a changed woman who wanted to do more to advance care in lung cancer. She organized a conference, first to help UCSF, where she was treated, but it immediately became clear it should be bigger. Bonnie found herself forming the Lung Cancer Foundation. Read more »

*This blog post was originally published at Andrew's Blog*

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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