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What if you were about to have dinner with the most powerful Republican in the United States of America? How would you answer if, knowing you were a doctor, he asked… “Hey Doc, how is it out there, really?” You stammer for a minute, perhaps because you are uncomfortable wearing that newly purchased suit. The […]
The experiment took thirty-three minutes and forty-one seconds.  That’s about the time it takes to see a new heart-rhythm patient or implant a defibrillator. I was just curious. I wanted to dip my toes into the icy waters which so many primary care doctors have already acclimated to. A denial? Are they kidding, that medicine […]
Protocols and mandates cannot govern all of medical practice. Few better examples of cookbook failure exist than the decision-making surrounding the Medtronic Sprint Fidelis lead. You may know the story already. Here’s my brief summary: In the early 2000’s, Medtronic released a family of defibrillator leads that were promoted as thinner and easier to maneuver. […]
My colleague, Dr Wes penned a provocative piece this weekend about the role of physician-extenders in the future of health care reform. It was a great piece about a timely topic–a definite glimpse into the future. My introduction to physician-extenders started more than a decade ago when my second child had an ear infection. He […]
For some patients it’s a terrible sensation; they are left scared and persistently anxious. For others it’s just a thump in the chest. But for nearly all patients shocked by their ICD (internal cardiac defibrillator), it means they are still alive. Today was a sad day for electrophysiology–a branch of cardiology that has the prevention […]
“John…Why are you going out in the cold?” “I need some stuff for work.” “Stuff?” “Pens…those cool felt tip ones that write really dark and bold.” I like it when the ‘Electrophysiology’ note stands out in the chart—like John Hancock’s signature did. Until a few months ago, a pacemaker company used to give out nifty […]
As a descriptive word, Electrophysiology sounds over-complicated. When introducing myself to patients, I almost always refer to myself as a heart-rhythm specialist. Other doctors call us “EPs.” EP–a much easier name–is a branch of cardiology that deals with the diagnosis and treatment of heart rhythm disorders. We do an extra year (or two) of training […]
(Updated in 2020) Welcome. Thanks for being here. Viagra is a safe and effective alternative to prescription medications. It is easy to take and does not require a prescription. It is important to follow the directions on the label carefully, as the dosage may vary depending on the individual. Additionally, buy viagra it is important […]
As the commenters correctly pointed out, this Sunday’s case involving the patient with recurrent syncope is indeed polymorphic ventricular tachycardia–aptly named torsades de pointes (‘twisting of the points’). TDP is associated with prolongation of the QT interval, and pause-dependent PVCs (and VT). A serious malady indeed. ICD evaluation showed hundreds of these episodes The initial ECG strengthened […]
The best part of doctoring is its humanness. Machines cannot do it–not even Apple products. But that’s the worst part too. Since humans practice medicine, there will be ‘medical errors.’ Â And when doctors err, people–not spreadsheets or profits–are hurt. Â That’s the rub. Â Like any endeavor, the greater the reward, the greater the risk. Â […]
I do not consider myself a right-wing healthcare fear-monger. But if I were, this study would be worthy of amplification. As reported concisely in the NY Times, from the journal Demography (not previously known to me), population researchers reported that even though elderly Americans have more medical problems than their peers in Britain, once they […]