Disease

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Sexual harassment has been making the news lately.  Dozens of powerful men in Hollywood (especially) and business and government are being accused of misconduct by vulnerable young women (and men in some cases).

Post Traumatic Stress Disorder can result from any trauma. Car accidents, animal attacks, a bad fall — not just sexual assault or war.

A high-school student doing a report for school recently wrote to me asking about PTSD.  I thought my answers might be of interest to others, so I’m sharing them with you. Read more on Student Questions About PTSD…

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He was in his mid-fifties, quiet and fairly good-looking.  I did suspect he was balding or maybe just plain bald as few men would wear a turn-of-the-last-century newsboy-type cap indoors these days. He sat on my couch and told me he thought he had ADD (attention deficit disorder). I interrupted him right there, as I do everyone who comes into my office thinking they have this disorder. Most people professing this diagnosis who are adults and walk in alone to a psychiatrist’s office are looking for stimulants — the amphetamines and the Ritalins of life. I don’t prescribe these.  I used to — at least as long as it took to get people weaned off them.  But nobody wants to get off them, not ever.  I have seen people who have been on them from earliest childhood through middle age, for no clinical reason I can discern.  Usually they were just being kids and bugging the adults, so they were put on drugs to control them. Read more on The Regular Looking Guy…

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Many illnesses have support groups and even official organizations that help sufferers and families understand and cope with that illness.  You know, like The Arthritis Foundation and the Diabetic Association. Read more on “Accomodating” or “Taking Advantage Of?”…

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I just did one of those continuing medical education courses — in psychiatry, my very own field no less. It says that people who get a bout of depression are twice as likely to get a bout of back pain. What I read is a meta-analysis.  That means some clever person who probably needed the publication on his (or her) resume did a statistical (and critical) analysis of research other people did. This a noble attempt to asymptotically approach “the Truth and the Light” on a subject. It is also a delightfully erudite way to do research and get a publication without using a lot of time and money that the author had to scrape up.

Look, the relationship between depression and low back pain is something I have seen from every imaginable angle. As a neurosurgeon, it did not take me terribly long to figure out that surgery was not a very good solution for back pain. Of course, we rigorously restricted ourselves to operating focalized sciatica.  Cases where we could reasonably infer that an intervertebral disc seemed to be compressing a distinct (lumbar) nerve root that formed part of the sciatic nerve (plexus) that descended from the spinal cord to the leg and foot. There was the physical examination.  If someone were lying flat on his (more rarely, her) back and their straight leg was raised toward the ceiling, pain would appear on a trajectory anatomically consistent with one of those nerves. This was the sign of Laseque.  And we took it to be as solid as money in the bank. Read more on Depression and Low Back Pain…

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She was an active patient, who I am still trying to see once a week until I direct her in how to survive and flourish in the universe. She was in her forties, depressed and anxious.  She had “a little panic attack,” some chest pain and the feeling her breath was cut off. I wasted no time sending her to an Emergency Room, (or, if she really did not feel it was that bad, to an Urgent Care — what we used to call it a “doc in a box”) because it is cheaper, sounds less foreboding, and any doctor who is sentient and has a pulse and is on duty would send her to an Emergency Room if anything was really wrong.

Chest pain or tightness or shortness of breath or a “tight feeling, like a vice” could always be a heart problem, and could always be life threatening until proven otherwise.  I tend to send  even the most mild discomforts of this nature, that people had for years to primary physicians for a “cardiocentric examination.”  For “auscultation,” the old fashioned Latin-origin word for a good listening to the well as generally an electrocardiogram and sometimes even an echocardiogram.

Read more on Don’t Ignore Chest Pain…

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Too many Americans can’t afford to and simply do not–take their medicines as prescribed. That estimate is based on information from the (American!) Centers for Disease Control). I have had patients come into my office who take their medications –in both cases, for life-threatening infectious diseases — only every other day, simply because that is all they can afford. I explained to each one individually the idea of the half-life of a drug. They only stay in your body for a certain length of time, then they leave your body in waste products.  That is why taking a drug every other day is not really effective. They both gave me almost exactly the same response — It was all they could afford, and it was probably better than nothing. Read more on Big Pharma Is Capitalism Out Of Control…

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I was about three years old when I enjoyed tending our backyard with her.  I had been a marvel to her, since she was a little girl, earning her keep as an agricultural worker in the Ukraine, it what was then known as Russia.

Read more on What You Eat Makes You Who You Are (Smart!)…

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I think I was in my teens when I heard the playwright Edward Albee interviewed.  It was one of those interviews that sears your soul and that you remember over 40 years later. He said something about people who get older, like when their children who are adults and start having families of their own.  They all ask themselves the same question, which is “Did I do it right?” — meaning “Life” definitely with a capital “L.”

Read more on Don’t Live A Life Of Regrets…

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Lots of trees in the great Golden State seem to have Dutch Elm Disease. I said “seem” because I only see them from my automobile window as we are whizzing by on some highway. The trunks are smooth and grayish and they are not palm trees.  Maybe they are elms.  I don’t know — trees are decidedly outside of my scope of practice. When you see a smooth gray tree, a fungus carried by a “bark beetle” has killed the outer bark, which is the living part of a tree that transports nutrients and water to the places that need it: leafy twigs and fruits and such.

Read more on Dutch Elm Disease For People…

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What you have been through makes you who you are.
A man abused by his father told me he all too often finds that he has abused his own son.  He did not want to.  He did not mean to.  He realized he was becoming his father and he trembled.

Read more on Breaking The Chain Of Abuse…

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