Overtesting and over treatment are big problems in modern medicine. It sometimes goes like this: Have a minor complaint? It's probably nothing, but we should do an exhaustive workup because there is a 0.00001% chance it could be cancer, maybe. However,
I call this the "Attribution Sign" and once you notice this is happening it is important to remain objective about the history and not fall into the trap that the patient is (inadvertently) setting for you. That is, don't place too much weight on the patient's attribution and don't let it skew your judgement.
I find that using a shaker bottle really helps to quickly mix the fiber with water, and also allows for easy re-mixing after you start drinking. These shaker bottles are usually marketed for bodybuilders as a quick and portable way to mix protein powder
Clostridium difficile (C. difficile) has become the most commonly hospital acquired infection in the US, and also occasionally causes infection in people in the community without any traditional risk factors. C. difficile infects the colon and causes inflammation called colitis. The symptoms are usually diarrhea, abdominal pain, fever, and sometimes nausea and vomiting. C. difficile is treated with specific … Read more
“Are you still taking lasix?” I asked the patient. He was new to the office, here for a routine post-hospital follow up visit after recently being admitted for decompensated cirrhosis with ascites and fluid overload. His dose of lasix was resumed prior to discharge, and he was supposed to be taking 80 mg daily. “I … Read more
As a patient, you only have control over a few parts of your colonoscopy. Usually you have a choice of which doctor does the procedure. You have a choice of showing up on the day of the procedure vs. running in the other direction. And finally, you have control on how well you are “prepped” … Read more
I believe in transparency and open communication. I tell my patients the truth and expect the same in return. The truth seems to have a way of coming out eventually anyway. Establishing a complete and accurate history early on in our relationship will lead to less unnecessary testing, less office visits, and far less uncertainty. … Read more