My 86 year-old mother, who is generally in good health, slipped and fell recently and suffered a fractured femur. She was unfortunate to have suffered the accident, but had the good fortune to be discovered quickly, treated promptly and well by the paramedics who responded to her, and then to have a swift and skillful operation by an orthopedic surgeon to repair the fracture. Almost miraculously, she was standing upright (with a considerable amount of pain) the next day and had begun the rehabilitation process.
At her age—indeed at any age—a fractured femur is a very significant injury. This past year, I have learned of friends and others who have suffered falls and broken their legs, ankles, or backs, as well as others who suffered “pathological fractures.” The latter group had the bones break from normal daily stresses, without a traumatic incident, because the bones were weak and/or osteoporotic. More than a few of these injuries occurred outdoors, associated with stumbles on the trail or falls.
All of this highlights features of an excellent review article that was published this past year in the New England Journal of Medicine. Authored by Murray Favus, MD, it is entitled “Biphosphonates for Osteoporosis” (New England Journal of Medicine 2010;363:2027-35). Anyone who is contemplating taking or administering this therapy would benefit from reading this article. Read more »
On Saturday, while thousands of Boston Bruins fans gathered at Government Center to celebrate the team’s recent Stanley Cup victory, a hundred or so true die-hards met a few blocks away at a Massachusetts General Hospital conference to talk about complementary and alternative medicine for psychiatric disorders. While I hated to miss the Bruins parade, I’m glad I attended the MGH conference.
I’ve always been a bit of a skeptic about so-called natural therapies for one simple reason: they don’t have to go through the same rigorous testing in clinical trials that medications do. At the same time, I realize that FDA-approved drugs don’t work for everyone. One in three adults with major depression, for example, can’t completely improve their mood and other symptoms even after trying multiple antidepressants.
Clearly, we need better options for treating mental health disorders. The MGH conference convinced me that some types of complementary and alternative medicine—or CAM, for short—might be worth trying. The presenters, all psychiatrists who treat patients at MGH, backed up their recommendations with scientific evidence. Several of them also contributed to the American Psychiatric Association’s recent report on CAM therapies.
We’ll be doing a story on CAM therapies for psychiatric disorders in an upcoming issue of the Harvard Mental Health Letter. For now, here are some things I learned on Saturday: Read more »
When people talk about prescription medications, everyone is familiar with the concept of side effects from medication. But, did you know that there are things in your diet that may interfere with your prescription medication?
In addition, your prescription medication may interfere with over the counter medications. In this video, there are two interviews recorded on Wednesday, June 8, 2011 on local TV news. If you find the information above helpful, I invite you to check out other TV interviews on medical/health issues at MikeSevilla.TV
I sat in a dingy pharmacy near the Seattle airport over the holidays, waiting for an emergency prescription. For over two hours I watched a slow-moving line of people sign a book, pay and receive their prescription(s). The cashier told each customer picking up more than one prescription or a child’s prescription to wait on the side. In minutes, the harried white-haired pharmacist came over to ask the person if they were familiar with these medications, described how to take them, identified the side effects to look out for and demonstrated the size of a teaspoon for pediatric medications. Then he asked the person to repeat back – often in broken, heavily accented English – what he or she had heard and patiently went over the parts they didn’t understand.
I was impressed. This is what every pharmacy should be like – except, of course, for the dinginess, the creeping line and the fact that it was so crowded I could overhear these conversations. Maybe if we got federal legislation enacted requiring pharmacists to offer counseling with each prescription filled, this kind of attention would be the norm, adherence to medication regimens would improve and drug-related injuries would be reduced.
Wait a minute. Someone already had that good idea. It was Read more »
A couple of health journalism gems you shouldn’t miss just because they were published over the holiday weekend:
Natasha Singer of the New York Times had an important piece, “When Patients Meet Online, Are There Side Effects?,” about privacy concerns when social networking sites like CureTogether.com and PatientsLikeMe.com offer online communities for patients and collect members’ health data for research purposes.
John Fauber of the Milwaukee Journal-Sentinelpublished another in his “Side Effects” series on conflicts of interest in healthcare. This one was about doctors vouching for the drug Multaq for treating atrial fibrillation without ever having seen all of the data.
The Minneapolis Star Tribune began a “Too Much Medicine” series. Health editor Dave Hage informs that they’ve been working on this project for nearly a year with plans for a few more installments in coming months, each covering different ailments and procedures that are over-used or under-proven. (Unfortunately, I think the series is only available in the print editions.)
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…
My 86 year-old mother, who is generally in good health, slipped and fell recently and suffered a fractured femur. She was unfortunate to have suffered the accident, but had the good fortune to be discovered quickly, treated promptly and well by the paramedics who responded to her, and then to have a swift and skillful operation by an orthopedic surgeon to repair the fracture. Almost miraculously, she was standing upright (with a considerable amount of pain) the next day and had begun the rehabilitation process.
I sat in a dingy pharmacy near the Seattle airport over the holidays, waiting for an emergency prescription. For over two hours I watched a slow-moving line of people sign a book, pay and receive their prescription(s). The cashier told each customer picking up more than one prescription or a child’s prescription to wait on the side. In minutes, the harried white-haired pharmacist came over to ask the person if they were familiar with these medications, described how to take them, identified the side effects to look out for and demonstrated the size of a teaspoon for pediatric medications. Then he asked the person to repeat back – often in broken, heavily accented English – what he or she had heard and patiently went over the parts they didn’t understand.
