The implantable cardiac defibrillator (ICD) is a life saving therapy. But, like any medical treatment there are potential adverse effects. With ICDs, we are trying to prevent this…(a slide from the 1980s) But in doing so we sometimes get this… Which is supposed to look like this…(same patient–hours later, with no intervention) ICDs have been […]
It happened. Guilty. I confess. Reading about Dr Berwick’s recess appointment to lead CMS induced me to watch a Fox news clip. Gosh, I feel bad about it. It felt good, though. Patients–that’s you and me–should know that CMS controls doctors, nurses and especially hospital/practice managers. They are ten times more scary than the radar […]
It is the day after a long weekend. Invariably, there are procedures to add to an already busy schedule, colleagues are on summer vacation and of course, there are many “action tags,” or “tasks,” or other likewise unreimbursed chores to check off the to-do list before clicking in the pedals for a pre-dinner ride. And so it […]
It is a holiday weekend, the decibels of medicine and bike racing are tuned down low, so I ask myself, “why do I have this blog?” Then, as if on cue, Dr Ves’ tweet about personality traits of bloggers appears. The study said that only openness to new experiences was predictive of being a male […]
This week I traveled to a major “arrhythmia institute” in the southern US. For a specialist in a rapidly evolving field, venturing out of the protected cocoon of one’s routine, to see other’s approach, especially those at major referral centers, is immensely helpful. Although trips like this do not count for CME, they are just […]
The implantable defibrillator (ICD) is an amazing life-saving device. Â When used in the appropriate patient, the scientific data supporting its benefit is rock solid. The sudden death-averting appropriate ICD shock in the middle of the night, allows the patient to enjoy breakfast with his spouse, rather than admission to the morgue. ICD function seems simple: […]
What’s wrong with this picture? Look closely; make like “a trained observer.” It’s a helpless feeling. You are rested, fed, watered and mentally focused. The whistle blows and you are off. The legs respond, air moves through the thorax effortlessly, and here is the best part: there is separation. Yes, you are off the front. […]
We all know about “Doctor Time.” No matter how hard I try, the clock seems to out sprint me. Morning rounds in the hospital go longer than expected, a colleague stops you with a question, a son forgot his lunch, or something else. The list is long. In fact, as a very well educated patient, […]
The interview, such as it was, happened on the walk in from the doctor’s parking lot. As early morning approachability of doctors varies widely, one is especially cautious about starting conversations at this time of day. He had recently changed his very busy Internal Medicine practice to a concierge style practice. Maybe because of this, […]
Today was one of those days where you are hopelessly behind schedule, always thinking 3 tasks ahead, and wondering when the finish line will appear. After bemoaning the misuse of ICDs yesterday, today I found two pretty sweet examples of how implantable titanium and silicone can enhance and extend the lives of real patients. The […]
At the risk of exposing my naivete, or being too much like the geeky student who sits in the front of the classroom, I can’t help but welcome the upcoming policing of cardiac device implants. As recently written by Dr Wes, government policing agencies, the DOJ and RAC folks, are planning to focus on […]