Reliable, Trustworthy Reporting, Capturing The Heartbeat Of Our Community
Reliable, Trustworthy Reporting, Capturing The Heartbeat Of Our Community
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Lately my teenager has been fascinated by medical dramas. Although my “doctor self” is usually rolling my eyes throughout the program, it’s often a good conversation starter. One recent show featured a pregnant woman who experienced one medical crisis after another. Her kidneys, liver, and lungs failed in succession as the team raced to identify the underlying obstetrical problem and find a treatment. At the climax of the episode, her heart stopped. Of course, being television, the corre...
During our most recent family movie night, we watched one of my favorites: Encanto. At one point in the movie, a character who has been gifted supernatural strength confesses that she fears she will crumble under the weight of all that is expected from her. Although she accomplishes amazing things, it never feels like enough. She never feels like she, herself, is enough. Popular culture suggests she should prioritize "self-care," which is usually represented by manicures or massages and long...
I confess that occasionally even doctors get squeamish. Or perhaps more honestly, this doctor does. My personal list has gotten pretty short, but one of the things that still makes me squirm is something I nevertheless frequently recommend to my patients. So what is this mysterious and rather ominous medical recommendation? Nasal saline irrigation. The practice of rinsing the nose out with liquid probably originated centuries ago in India and it remains part of spiritual ritual as well as...
I learned a lot of statistics back in medical school, many of which are outdated and long since forgotten. A few still haunt me, though. One example: over 50% of seniors who suffered a broken hip would be in a nursing home, or in their grave, within a year. The odds are somewhat better today, but a hip fracture is still a very serious event, especially if your health, or your independence, is already compromised. We may be better at helping people recover, but the best strategy is not break...
Aristotle is said to have referred to the female as a mutilated male, and this philosophy seems to have carried forward into much more modern times. In 1977, official FDA guidelines recommended that women of “childbearing potential” be excluded from early stage clinical trials. Men, particularly white men, were considered the ideal model, from which the success and side effects of any particular treatment could be judged. Somehow, women’s menstrual cycles made them too difficult to study, while...
My mother had six siblings, 16 aunts and uncles and innumerable cousins. She was the first of them all to be diagnosed with breast cancer. I think of my mom every time one of my patients tells me they aren’t concerned about breast cancer because it doesn’t run in their family. Unfortunately, that is true of most people who are diagnosed with the disease. I also think of my mother every time I do a breast exam or teach someone else how to do a self exam. Her breast cancer was one not det...
If I asked you to name a chronic disease, you would probably think of conditions like high blood pressure, diabetes, cancer or dementia. The odds are, one of the most common chronic diseases would never cross your mind. Worldwide, this condition affects more than 3 billion people and causes significant physical and emotional suffering. Annually, it costs the American economy upwards of $45 billion in productivity. Our children miss nearly 35 million hours of school. Our emergency rooms field...
When I was a young physician, we talked with almost religious zeal about the "Golden Hour." Early on, this principally focused on the idea that within the first hour after an injury, a patient needed to receive definitive treatment in order to maximize the chances of survival and recovery. We usually interpreted this to mean that the patient needed to be in the hands of the trauma surgeon before this hour was up. We took ATLS classes so we could make sure that the patient in our emergency room g...
At my house, classic TV is a given. My 93-year-old father-in-law enjoys watching reruns of westerns, Perry Mason, Andy Griffith and Gomer Pyle. With these old favorites come commercials targeting an aging population: Medicare Advantage plans, reverse mortgages, and miracle solutions for neuropathy, with free consultations for the first 250 people who call. Every time we see one of these neuropathy advertisements, my father-in-law looks at me hopefully. His neuropathic foot pain has been...
My son is one of the many Americans with cleft lip and palate. The specifics of each affected individual’s situation vary, but one thing they have in common is that they will be having surgery. Lots of surgery. Although most individuals with orofacial clefts, including my son, are otherwise healthy and lead normal lives, the process of restoring a normal smile, normal speech, normal chewing, involves many steps from birth into adulthood. Most of his surgeries have blurred together in my mind, h...
Recently, while visiting from out of state, my father had a "health hiccup." As we navigated getting this problem investigated and addressed, he was very concerned that we keep his primary care doctor informed. As my dad has said repeatedly, "I give him more grief than any of my other doctors, but I also listen to him more than any of my other doctors. He's the only one looking out for all of me!" Like many Americans, particularly older Americans, my dad has a whole host of specialists he sees...
It’s tempting to blame the pandemic for the dizzying rates of mental health concerns among American teens. We are all familiar with the impact Covid is having on our lives and the disruption it continues to cause in the lives of young people. Kids witnessed vehement disagreements between neighbors, friends and family over the decisions that had to be made in response to the pandemic, and felt the stress at home as parents faced economic and work changes, all without many of their usual s...
One summer during my college years, I had a roommate who suffered from suicidal thoughts. She’d attempted suicide before we met, and been hospitalized, but continued to struggle. Back in the late 80s, there was very little public understanding of mental health issues and the stigma was even stronger than it is today. Our other roommate and I didn’t know what to do or where to turn. Not surprisingly, we didn’t handle it well. However, we did one thing right: we restricted access to lethal means....
The annual wellness exam is one of my favorite things to do as a doctor. It’s a chance to talk about one of my passions: health promotion. As most patients expect, our health-promotion discussion includes smoking cessation, diet and exercise. Perhaps more surprising is our conversation regarding personal safety. We talk about sunscreen, seatbelts, helmets, distracted driving or driving under the influence. And I ask if their guns are locked up. I grew up in Iowa and I live in South Dakota. B...
It’s been a long time since I’ve worked in the ER, but some stories stay with me. One such story belongs to a woman in her early 30s. After a year of trying to conceive, she was finally pregnant. Then she started spotting. When she developed severe pain and almost fainted while putting their toddler to bed, her husband brought her to the emergency room. It didn’t take long for us to identify an ectopic pregnancy. The fertilized egg had implanted in her fallopian tube. Our obstetrician took...
For the past few months, I’ve been fielding questions about the baby formula crisis. Make no mistake, the shortage of baby formula is indeed a crisis. Babies are delicate. Their immature bodies rely on having just the right intake of water and salts, and just the right composition of proteins, fats, and carbohydrates. Their organs can’t keep that balance independently, the way healthy older children and adults can. Formula is carefully designed for this. Breastmilk is the ideal food for bab...
I don’t know how you feel, but in my opinion, parenting is hard. Someone must have forgotten to hand me the instruction manual when my children came home. I have yet to meet a parent who wouldn’t appreciate one. New parents can count on getting lots of advice from well-meaning friends and relatives and, sometimes, even perfect strangers. Some of that advice is welcome and useful. Some, not so much. And sometimes that advice is downright dangerous. Many grandparents raised their own children at...
Skin is the largest organ in the human body, but it’s easy to take it for granted. Unless we notice pain or itching or funny spots, most people don’t give it much thought. However, the skin is critically important. It helps regulate our body temperature and fluid and electrolyte balance. It provides us critical information about our environment, and it protects us from invasion by the sea of germs we encounter every day. Some of the sickest patients doctors ever treat are those who have had sig...
Lately my teenager has been fascinated by medical dramas. Although my “doctor self” is usually rolling my eyes throughout the program, it’s often a good conversation starter. One recent show featured a pregnant woman who experienced one medical crisis after another. Her kidneys, liver and lungs failed in succession as the team raced to identify the underlying obstetrical problem and find a treatment. At the climax of the episode, her heart stopped. Of course, being television, the correct diagn...
One of my favorite parables describes the difference between heaven and hell. In both places, hungry people sit at tables laden with delicious food. In hell, people suffer and starve because they cannot eat with the long utensils provided. In heaven, people are happy and thrive because they use the utensils to feed each other. Many cultures and religions have some variation of this story. It illustrates a universal truth: we depend on each other. The current pandemic has starkly illustrated...
Obesity affects approximately 40% of American adults and I've been one of them for nearly as long as I can remember. There are innumerable schemes that promise effortless, or nearly effortless, weight loss, and many diets that claim to be the best approach. Most of us recognize that if something seems too good to be true, it probably is. It's much simpler to identify the miracle potion advertised on our social media feed as snake oil, than it is to sort through all the conflicting and seemingly...
In medicine, we routinely ask people about their family health history. Knowing that your mother had diabetes, or that your grandfather battled alcoholism, helps us be alert for health conditions to which you may be predisposed. Sometimes, though, what is revealed by those histories isn't a medical problem, but a family tragedy. Earlier in my career, my older patients commonly told me that their grandmother, or even their mother, died in childbirth. Today, it is all too easy to forget just how p...
