NPO guidelines; or, A simple request of my fellow doctors, and some patients too.

Most people know that they cannot eat anything after midnight if they have a procedure scheduled the next day. However, what about when a procedure is not actually scheduled? Sometimes a little bit of common sense and a little foresight needs to be applied to avoid having a procedure delayed an entire day because of the NPO rules. Here are two common situations that I encounter (without exaggeration) several times per week:

The Rectal Bleeding Rainbow

The purpose of this article is to define a few terms and clarify some common misconceptions about rectal bleeding.

A family member has just been diagnosed with C. diff. Now what?

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

The little white one

“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

Cleaning out the colon, or tips on surviving the bowel prep.

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

There is nothing to gain by not telling your doctor the truth

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