It’s been a while since I did a Cycling Wednesday topic. As I was skimming thorough the Journal of the American Medical Association last night, I came across this review article on spinal injection therapy for low back pain. It was a shocker. Two factors brought my attention to the article: First, almost all the […]
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Admit it: You were surprised a legitimate study came out in support of Coenzyme Q10 supplements. You probably looked away at first, nervous a colleague would notice your interest in something complimentary or alternative. It’s shocking, isn’t it? What if the purveyors of supplements are right about something? Part of me so wants it to […]
Here is an edited email I received from an athletic colleague: John, Quick question…. A 50 year-old male healthy athlete has the new problem of occasional periods of premature beats. He (or she, it doesn’t matter) has visited the doctor and an ECG shows PVCs, or premature ventricular contractions. Otherwise the history, exam, ECG, ECHO […]
It’s time to do an update on the treatment of atrial fibrillation. It’s been a while, and there are worthy things to report from the real world. Stroke prevention in AF: Always start with basics: The most important aspect of treating atrial fibrillation is preventing stroke. Although there are some innovative devices and procedures in […]
Look at this sample question from the American College of Cardiology self-assessment. Tell me whether you see the problem. (It came in a mass advertisement-email, so I don’t think it is a secret.) Sample Question A 75-year-old woman is referred to you with a murmur. She has had the murmur for many years and has […]
The older I get, the less sure I become of basic cardiac issues. Consider the changing role of ICDs, non-statin cholesterol drugs, vitamins, and fish oil. All of these were once darlings of the field. Now, not so much. And it is not just cardiology, other areas of medicine have their uncertainties: breast and prostate […]
How should doctors behave online? This is a funny question, isn’t it? Medical establishment loves rules and hierarchy. Social media does not. Social media levels the playing field of who gets to talk; it gives real caregivers a voice. That’s very cool. This is just a guess, but I suspect there are many more acts […]
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Trying to understand ICDs
Hey all, A couple of months ago I got a call from Dr. Rich Fogel, an electrophysiologist from St. Vincent’s Hospital in Indiana. He is an old friend from training days; I used to moonlight for his group. Now, Rich is on the leadership track in the Heart Rhythm Society and this year he is […]
I receive a lot of emails from people afflicted with atrial fibrillation. It is humbling that another person would share such highly personal information with me, a stranger. Thanks for that. It goes without saying that I cannot give specific medical advice. Though it is tempting. I’ll read a detailed story and think to myself…OMG, […]
Sorry this took most of the week to get out. (There was a good reason.) Better late than never I suppose. On Day 3 of the 2013 American College of Cardiology meeting, I woke up well rested and inspired to squeeze in as much learning as possible. The first order of business was putting the […]
The ultimate goal in medicine: protect the patient from stroke. Even a heart doctor has to admit the dominance of the human brain. Always think about preventing stroke. It’s one of the worst outcomes that can happen to a person. Life as a ‘normal’ human requires a healthy brain. A stroke irreversibly kills off part […]