Doctors

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Everyday health advice. If I read any more “health advice,” mental or physical, that is supposed to be practical advice but is totally wrong and built on mythology, I might explode. Given the “mainstream” unproven drivel that gets reproduced in popular magazines, I think it is pretty amazing any Americans are still alive at all. A little relaxation (deep breathing and focused meditation) — I am doing a lot better.  After all, we still have freedom of speech, although it sometimes gets fragile and needs loving protection.  And you have me, the Renegade Doctor, to tell you what is truthful and right. I didn’t start out to trash “Reader’s Digest” (RD).  My parents of blessed memory had some kind of lifetime subscription, and kept it with a very few cherished books by their bedside, on top of my mother’s premarital “Hope Chest,” which she told me contained clothes she could only “hope” she would fit into again one day. She never did. Read more on Everyday health advice drives me nuts!…

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Fifteen years after.  That means there are sentient, living teenagers who are (I hope) somewhere in school learning about this devastating event in some kind of secondary school curriculum, or perhaps witnessing public patriotic events. — But they don’t remember it, because they weren’t born yet.

Read more on 9-11 15th Anniversary…

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Anaphylaxis is frightening — it can and does kill people. It is an acute allergic reaction that affects about 0.5  to 2% of the population, at some point in life, and the frequency seems to be rising as we speak. Symptoms include hives and itches and swelling, which about 20% of the time can affect the upper breathing system and close the windpipe.

In theory any substance that is not included as part of the body can cause it.  I have heard about it being caused by bee stings, snake bites, foods and drugs and such. I have actually treated people for post-traumatic stress disorder caused by an allergic attack.  It is a serious stress to find your windpipe closing up and not know why. The lifesaving immediate emergency treatment is injected epinephrine (adrenaline) and getting the victim to a medical center to follow up with antihistamine and steroids as needed. My own allergies have given me some weird things over the years — lots of positive skin tests.  I used to suffer through “desensitization” protocols — allergen injections that made me sick, and prize-winning hay fever attacks. Read more on The EpiPen Mess and How To Work Around It…

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I was chatting with an M.D. woman friend, and told her my medications and my natural supplements and herbs and my “numbers” — my blood sugar and my blood pressure — when I still was convinced that I had those things.

My blood sugar was 120 mg/dL. My blood pressure with medications was around 140/85.

She surprised me with her reaction. Read more on What The Heck Has Happened To Medicine?…

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The ketogenic diet is a high-fat content diet in which carbohydrates are nearly eliminated so that the body has minimal dietary sources of glucose. After depleting carbs consumed in food, the body metabolizes body fat, converting it to glucose — which is the true fuel of the body and especially the brain. However the metabolized fat also produces ketones, which are the most efficient fuel for the body and brain. The ketogenic diet has been in clinical use for over 80 years, primarily for the symptomatic treatment of epilepsy.

Read more on Neuroprotective and Disease-Modifying Effects of the Ketogenic Diet…

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I enjoyed a social evening with a respected colleague who is one of my closest friends.  He and his wife are great conversationalists, and during the course of the dinner he wondered about the dangers of Benadryl (diphenhydramine) in precipitating dementia.

Read more on The Dangers of Benadryl…

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I idolized the American medical establishment. When I was a mere Blue Cross number-collecting lackey working at the front desk of the Emergency Room of Massachusetts General Hospital, I sometimes saw, slipping into the doctors’ lounge, notable people — doctors whose surname in footnotes graced the basic core medical textbooks I was using as parallel reading in France, to prepare myself for my American examinations in medicine. I never wanted to penetrate more than the lowest echelons of the American medical establishment when I returned from France.  I mean I doubted the Harvard-types would open their world to me easily, no matter how clever I was. I proved to be right.  At a Harvard-associated residency program, I was actually asked at the interview if anyone in my family was a Harvard University trained physician. I still remember the program chairman’s barely muffled laughter when I told him my father held a graduate degree from the Harvard University School of music. Read more on Drug Misuse in American Medicine Leads to Possible Catastrophe…

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He was just 18. He had been followed by child psychiatry with a diagnosis of depression. He had long refused to take any pills.  As far as this poor, agricultural county was concerned, I was just seeing him so I could bill MediCal and fatten up the county coffers. The previous psychiatrists had simply noted he was depressed, was not suicidal, and refused any participation in his own treatment.

He was a young man of few words, with a common Hispanic name.  He sat there and twirled one of his lush curls. It became pretty obvious he wasn’t going to give me a complete history.  He said he would never take pills, not ever. To his credit, he did say I could talk to his mother, if I wanted to, but he had to be in the room and hear what she said. Someone brought her to me, from the waiting room.  She spoke only Spanish; fine with me. I learned my Spanish mostly from my patients, who in that time and place could rarely communicate well in either Spanish or English. His mother was charming, really grateful that I wanted to talk to her. She kept complimenting my clothes and elegance. I told her it was all thrift shop.  I doubt she believed me. Read more on Diagnosis From The Guts…

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My telephone was cradled between my left ear and my shoulder, as I pounded the keyboard of the sluggish rural county computer with one of the requisite patient visit fill-in-the-blanks atrocities — er, I mean “reports.” Finally, I heard the person I was waiting for pick up the other end.
“Hello,” I said. “Is this doctor A…….(name unpronounceable to native speakers of English)?”
-“Yes,” he answered, “I am the only doctor here.”
“This is Doctor Goldstein. I am one of the psychiatrists at the county mental health clinic.”
-“Really? And you call me?” Read more on The County Mental Health Clinic’s Referral…

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One of the themes that keeps coming up in those little “newslets” for 15 minutes of Continuing Medical Education each is that systematic screening for several serious diseases, like cancers, is simply not as efficient as one wishes it were. At the very least, in terms of cost, it rarely pays. Sometimes people try to identify a subset of people who should be screened; but all too often, even that is a daunting task.

Some stalwart and doubtless realistic physicians sometimes suggest–screen patients who ask for it. This seems strikingly similar to the young doctor in Amiens who told me, that if he wanted to build a practice and feed his family, he had to give everyone antibiotics. It is that ancient trend of anti-intellectualism, patients who second-guess the doctor, people who are worried about their health– And yet, these people could argue that (they have paid their health insurance and earned what they think is good care), and they are individuals and not statistics. Read more on When To Screen For Things Medical That Could Kill…

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