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International Patients, Seeking Cures in the States

December 18, 2018

Are they taking up beds that could be used for vulnerable domestic patients or are they bringing money that could be used toward other programs?

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International Patients, Seeking Cures in the States

Tuesday, December 18th, 2018

By Richard Leiter, MD

“I need you to do everything for him,” the young man told me through an Arabic interpreter.

We were at an impasse. We had many tools available to treat our patient’s pain and ease his suffering. But the young man wanted something more — a cure for his father, my patient. I backed away from the marble-topped table and left the bright, well-appointed family meeting room on the hospital’s top floor. Heading to see my other patients, I worried about what the next few days would hold for my patient.

He was a middle-aged man from a large city in Saudi Arabia. Over the course of a few months, his belly became swollen and painful. He lost weight and his skin turned a vibrant shade of yellow. He was eventually given a discouraging diagnosis: widely metastatic cholangiocarcinoma, a cancer of the gallbladder. It is an incurable disease with an average survival of only months.

…continue reading ‘International Patients, Seeking Cures in the States’

Image: By FoxDon – Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=21692070

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NY Times

Two Nurses Died of Overdoses Inside a Dallas Hospital. What Went Wrong?

December 3, 2018

The nurse lay in a bathroom stall, a syringe in her hand and track marks on her arm. She died from an overdose of fentanyl, a potent painkiller meant for patients

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Two Nurses Died of Overdoses Inside a Dallas Hospital. What Went Wrong?

Monday, December 3rd, 2018

It was a rare accident two years ago at UT Southwestern Medical Center’s Clements hospital in Dallas.

Until it happened again.

Some 16 months later, a second nurse was found in a different bathroom at Clements, with a syringe in her arm. She had overdosed too, dying from the same drug.

UT Southwestern has released few details about the nurses’ deaths and says it can’t say for sure where the drugs came from. But experts say that when health care workers abuse drugs, they almost always steal the medicines from their workplace. The hospital’s own reports and medical examiner records show that’s a likely explanation, according to an investigation by The Dallas Morning News.

…continue reading ‘Two Nurses Died of Overdoses Inside a Dallas Hospital. What Went Wrong?’

Thumb image via Dallas Morning News/Nathan Hunsinger, Staff Photographer

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Dallas Morning News

Watching My Patient Die, Remotely

November 29, 2018

As more and more hospitals have adopted electronic medical records, their records have become linked and you can follow your patients, virtually, hundreds of miles away

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Watching My Patient Die, Remotely

Thursday, November 29th, 2018

When I first met my patient, three years earlier, a woman in her mid-70s from Western Pennsylvania, she had just been given a diagnosis of myelofibrosis.

This disease is classified as a myeloproliferative neoplasm, in which a genetic abnormality revs up the inner machinery of cells in the bone marrow (“myeloid” cells), causing them to divide at a rate that far exceeds what is normal. As the cells proliferate, they secrete a chemical that causes the bone marrow to fill with scar tissue (“fibrosis”).

The remaining normal myeloid cells evacuate to safer territory in the spleen, and the spleen swells, squashing the nearby stomach but making the abdomen look overly full. Consequently, the person with the disease becomes progressively malnourished from an inability to take in enough calories. My patient had lost 25 pounds in the preceding six months as a result, even as her waistline expanded and made her feel uncomfortable, even unwieldy from her new girth.

…continue reading ‘Watching My Patient Die, Remotely’

Image via Flickr Some rights reserved by NEC Corporation of America

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NY Times

Grief as My Guide: How My Sister Made Me a Better Doctor

November 14, 2018

Even when she was gone, she was present in the patient sitting before me and in the way I was newly able to comfort and reassure her

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Grief as My Guide: How My Sister Made Me a Better Doctor

Wednesday, November 14th, 2018

The razor had a familiar thrum. Only this time, I wasn’t the one doing the shaving. I was watching as my sister’s remaining hair fell away.

She was putting on a brave face, joking with the hairdresser. Her defiant look said: “Leukemia’s not going to get me.” But in her eyes, I also saw terror. I wanted to rescue her, but there was nothing I could do.

Eighteen months younger than me, Victoria had always been there, someone I took for granted. When we played as children, she tried to keep up, to convince me she was cool and worthy of attention. We had weathered much together: a move to London, our parents’ divorce, a health crisis of my own. She always had my back. But with college, marriages, moves across the country, kids of our own, we grew apart. She became an actress; I became a neurosurgeon.

…continue reading ‘Grief as My Guide: How My Sister Made Me a Better Doctor’

Thumbimage via NYT/ Joseph Stern

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NY Times

How a Simple ‘Thank You’ Could Improve Clinical Trials

November 13, 2018

Everyone would benefit if researchers did more to make participants feel part of a study

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How a Simple ‘Thank You’ Could Improve Clinical Trials

Tuesday, November 13th, 2018

When researchers at the drug giant Pfizer wanted to improve their clinical trials, the people who had taken part had a clear suggestion: researchers should say thank you.

It is a simple request, but a revealing one. When a clinical trial is completed, many participants walk away empty-handed. Most never hear from the investigators or the trial’s sponsor again. Many do not learn the results of the study in which they took part. It’s not good enough — and it indicates a deeper problem.

As we discuss in a News Feature this week, clinical-trial participants and the people who care for them are increasingly seen as partners in research. They are more informed than ever about their conditions and their medical options. And they are demanding — and receiving — more of a say in how clinical trials are designed and conducted. Some of this activity has been boosted by social media, which has allowed people with medical conditions and their carers to band together, share their experiences and advocate for change.

…continue reading ‘How a Simple ‘Thank You’ Could Improve Clinical Trials’

image via Flickr Some rights reserved by woodleywonderworks

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Nature Editorial

A Profusion of Diagnoses. That’s Good and Bad

November 6, 2018

With millions of Americans taking risky medications for questionable diagnoses, have we medicalized everyday life?

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A Profusion of Diagnoses. That’s Good and Bad

Tuesday, November 6th, 2018

By Dhruv Khullar, M.D.

I recently cared for a hairdresser who had gone through a year of vague and varied symptoms. What started as a few unpleasant aches soon became debilitating pain throughout her body. A heavy fatigue settled into her bones: Holding scissors or sweeping the floor became too much. She slept fitfully; her memory flagged. Frustrated by many symptoms and few answers, she grew anxious and depressed.

Our medical team, after a battery of unrevealing tests, settled on a diagnosis of fibromyalgia. Tears welled in her eyes as I explained the diagnosis, and I worried I’d been too brusque. But these were tears of relief, she said, not because the symptoms had ceased, but because she finally had an answer, a name for her pain.

Those who suffer without a clear understanding of its cause experience a unique form of torment. There is great power in diagnosis: It can be comforting, terrifying, and sometimes, even healing.

…continue reading ‘A Profusion of Diagnoses. That’s Good and Bad.’

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NYTimes

Dementia And Guns: When Should Doctors Broach The Topic?

October 12, 2018

Some patients refuse to answer. Many doctors don’t ask. As the number of Americans with dementia rises, health professionals are grappling with when and how to pose the question: “Do you have guns at home?”

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Dementia And Guns: When Should Doctors Broach The Topic?

Friday, October 12th, 2018

While gun violence data is scarce, a Kaiser Health News investigation with PBS NewsHour published in June uncovered over 100 cases across the U.S. since 2012 in which people with dementia used guns to kill themselves or others. The shooters often acted during bouts of confusion, paranoia, delusion or aggression — common symptoms of dementia. Tragically they shot spouses, children and caregivers.

Yet health care providers across the country say they have not received enough guidance on whether, when and how to counsel families on gun safety.

Dr. Altaf Saadi, a neurologist at UCLA who has been practicing medicine for five years, said the KHN article revealed a “blind spot” in her clinical practice. After reading it, she looked up the American Academy of Neurology’s advice on treating dementia patients. Its guidelines suggest doctors consider asking about “access to firearms or other weapons” during a safety screen — but they don’t say what to do if a patient does have guns.

…continue reading ‘Dementia And Guns: When Should Doctors Broach The Topic?’

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KHN

The Importance of Medical Touch

October 8, 2018

It can show gentleness and compassion or carelessness and incompetence

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The Importance of Medical Touch

Monday, October 8th, 2018

It started, as it does for thousands of women every year, with a routine mammogram, and its routine process of having my breasts — like a lump of dough — manipulated by another woman’s hands and placed, albeit gently, into tight compression. It’s never comfortable, but you get used to it because you have to.

Unlike previous years, though, my next step was a biopsy, for which I lay face down, my left breast dangling through a hole in the table. Several hands reached for what’s normally a private and hidden body part and moved it with practiced ease, compressing it again into position for the radiologist’s needles, first a local anesthetic and then the probes needed to withdraw tissue for sampling.

I was fearful of the procedure and of its result and, to my embarrassment, wept quietly during the hour. A nurse gently patted my right shoulder and the male radiologist, seated to my left and working below me, stroked my left wrist to comfort me. I was deeply grateful for their compassion, even as they performed what were for them routine procedures.

…continue reading ‘The Importance of Medical Touch’

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NYTimes

Page 5 of 12« First «...3 456 7...10...»Last »

International Patients, Seeking Cures in the States

International Patients, Seeking Cures in the States

Two Nurses Died of Overdoses Inside a Dallas Hospital. What Went Wrong?

Two Nurses Died of Overdoses Inside a Dallas Hospital. What Went Wrong?

Watching My Patient Die, Remotely

Watching My Patient Die, Remotely

Grief as My Guide: How My Sister Made Me a Better Doctor

Grief as My Guide: How My Sister Made Me a Better Doctor

How a Simple ‘Thank You’ Could Improve Clinical Trials

How a Simple ‘Thank You’ Could Improve Clinical Trials

A Profusion of Diagnoses. That’s Good and Bad

A Profusion of Diagnoses. That’s Good and Bad

Dementia And Guns: When Should Doctors Broach The Topic?

Dementia And Guns: When Should Doctors Broach The Topic?

The Importance of Medical Touch

The Importance of Medical Touch

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