Scenerio:
55 year old Hispanic male brought to a local hospital with complaints of chest pain. He's given a battery of tests. He's nervous as hell. Wait, here comes the doctor to explain things to him.
Doc: " Mr. Gonzalez?"
"Yes, that's me", the patient answers
"Well sir we performed a bunch of tests. Your EKG showed elevation in at least 3 leads; your Troponin has cone back positive and you chest xray shows congestion throughout your lower lower lung fields. I would like you to sign this consent to undergo a cardiac catherization"
The patient readily signs the form and the doctor quickly leaves the room.
A moment later the patient's frantic daughter calls
"Dad! Oh my God how are you?
"Well I'm in the hospital with chest pain"
Daugther" God dad are you OK. Have you seen the doctor yet?"
"Yeah, he was just in here"
Father" Well, I don't know. He said something about a lot of tests and he's sending me for more"
While this is a fictionalized account I've heard similar ones more times than I can remember. What's up with this guy? He's having a heart attack, that's what. Why didn't the doctor ensure the patient understood the cause of the patient's symptoms and test results? Who the Hell knows but it is the doctors responsibility to ensure that the patient has complete understanding of his/her condition no matter what.
So the next time you see you doctor and he speaks to you as if he's quoting from a medical book do not be embarrassed to say " Doc, I don't understand. Could you try speaking in plain English".
Good day and good health
Tuesday, November 18, 2014
Playing With Fire: Not Carrying Your Asthma Inhaler
In my practice I treat many people with asthma, a life threatening condition that causes constriction of the lungs making hard, and at times impossible to breathe Millions of people in this country have this condition that if, treated at the time of onset can mean the difference between life and death.
The first line treatment of choice is an asthma inhaler that a person can use at the onset of symptoms to quickly control they're symptoms and save them from more serious consequences.
But what I find time and time again is my patients neglect to carry their inhalers with them. Most leave them home or in the car or God knows where else. This is an extremely dangerous habit and I try to impress that to them in the strongest terms possible. Why risk a hospital visit, intravenous medications, a breathing tube forced through their vocal cords, even death because they could not carry an inhaler half the size of a pack of cigarettes ( which incidently the never seem to forget). Who knows but it's common enough to be troubling and a practice that needs to expressed with every single asthmatic patient.
If you have asthma keep your inhaler on you at all times. It could be a matter of life and death.
Good day and good health
The first line treatment of choice is an asthma inhaler that a person can use at the onset of symptoms to quickly control they're symptoms and save them from more serious consequences.
But what I find time and time again is my patients neglect to carry their inhalers with them. Most leave them home or in the car or God knows where else. This is an extremely dangerous habit and I try to impress that to them in the strongest terms possible. Why risk a hospital visit, intravenous medications, a breathing tube forced through their vocal cords, even death because they could not carry an inhaler half the size of a pack of cigarettes ( which incidently the never seem to forget). Who knows but it's common enough to be troubling and a practice that needs to expressed with every single asthmatic patient.
If you have asthma keep your inhaler on you at all times. It could be a matter of life and death.
Good day and good health
Diabetic foot: Catch it early and avoid the consequences
According to the Centers for Disease Control there are over 29 million diabetics in the USA. Diabetes is a terrible disease that attacks virtually every organ in your body.Diabetics are at greater risk of developing heart attacks, stroke, blindness. But there is one debilitating side effect that as a clinician drives me a little batty. What is it and why does it drive me batty? It's severe diabetic foot infections which could lead to significant morbidity up to amputation of toes , feet, even legs. What bothers me is that this condition can be readily identified by taking a few simple steps ( no pun intended) in the home that can save you from a lifetime of misery:
Never, ever walk without shoes. The slightest break in the skin could all in invading organisms. Taking a trip to the bathroom at 4am? Put on your slippers. Diabetics suffer from nerve damage and decreased blood flow to the legs and feet thus limiting the flow of oxygen and infection fighting cells to the area. What happens is the infection starts and you don't feel it until one morning you wake up and your foot is the size of a football and red as fire and you end up spending a week or more in the hospitaL depending on the treatment, from IV antibiodics to amputation.
As a corollary, take two minutes a day to inspect your feet. If you see any break in the skin, areas of redness or anything out of the ordinary get in touch with your doctor quick. I cannot stress how important this exam is both because of its ability to identify problems before they get out of hand and and the simplicity which they can be found
Say your niece comes over and says " Auntie, your toenails look terrible, let me cut them for you". Tell her that you dropped the nailclipper just outside the door to the apartment. When she goes out to retrieve it lock her out and don't let her back in. Do not let anyone, including yourself cut your toe nails. They should be trimmed by a podiatrist who is trained in the procedure.
Diabetic foot infections are a significant cause of morbid in diabetics but most effects can be greatly minimized by following the suggestions outlined above.
Good day and good health
Never, ever walk without shoes. The slightest break in the skin could all in invading organisms. Taking a trip to the bathroom at 4am? Put on your slippers. Diabetics suffer from nerve damage and decreased blood flow to the legs and feet thus limiting the flow of oxygen and infection fighting cells to the area. What happens is the infection starts and you don't feel it until one morning you wake up and your foot is the size of a football and red as fire and you end up spending a week or more in the hospitaL depending on the treatment, from IV antibiodics to amputation.
As a corollary, take two minutes a day to inspect your feet. If you see any break in the skin, areas of redness or anything out of the ordinary get in touch with your doctor quick. I cannot stress how important this exam is both because of its ability to identify problems before they get out of hand and and the simplicity which they can be found
Say your niece comes over and says " Auntie, your toenails look terrible, let me cut them for you". Tell her that you dropped the nailclipper just outside the door to the apartment. When she goes out to retrieve it lock her out and don't let her back in. Do not let anyone, including yourself cut your toe nails. They should be trimmed by a podiatrist who is trained in the procedure.
Diabetic foot infections are a significant cause of morbid in diabetics but most effects can be greatly minimized by following the suggestions outlined above.
Good day and good health
Subscribe to:
Posts (Atom)