It’s well known that the new blood thinner, dabigatran (Pradaxa) can cause stomach pain and reflux symptoms. It occurs in slightly more than one in ten patients who start the drug. Yesterday, I learned of another potential gastrointestinal adverse effect of the new drug. A GI colleague called me about a patient taking dabigatran (Pradaxa) […]
It’s 2012 already. Time flies; doesn’t it? It seems like just yesterday when… I started this business more than two decades ago. A time when cell phones hadn’t even graced James Bond movies; we got up to change the channel on TV and the world health concern of the moment was a Hunger Games-like scenario […]
Slightly over a year ago, the Department of Justice (DOJ) launched an investigation of a large number of institutions regarding concerns that implantable cardiac defibrillator (ICD) procedures were performed for reasons outside of the criteria set forth in Medicare’s National Coverage Decision (NCD). This investigation occurred just after Al-Khatib and others published a report January […]
Categories
I’m back…Barely
Wow. That was something. My last post described riding all day in the local canyons of Orange County California. If only the trip had stayed that docile. The mental and physical stress only increased, so much so that this is the first moment I have had enough energy to even open the browser. An old […]
The first day that the 6-man group convenes is always the toughest. We ride like medical residents eat–as if there will be no food tomorrow. After riding into clouds and through rain storms on the first few pre-camp days, the sun powered us. It begged us to ride more. We obliged. We left the hotel […]
Categories
Sun and fun
Don’t read my blog this week. That is, if you are looking for sound medical information, or insight gained from the daily practice of medicine. This week, I am on vacation in Southern California. This yearly quest used to be called a “training camp.” Now, saying such would constitute true overstatement. Merely we seek daily […]
My friend Bill is an ER doctor and a bike racer. He’s like me in that he has rediscovered the beauty of being a learner. His most recent area of inquiry is the blood clotting cascade and the use of reversal agents for the novel new blood thinners, (dabigatran, rivaroxaban and the soon to be […]
A recent trial suggesting that men who drink sugary beverages increase their heart attack risk by 20% was covered extensively in the mainstream media. There’s a lot of liquid sugar consumed around here. I have two rules about drinking this stuff… My criteria for indulging: greater than three hours on the bike, or after any […]
For 57 years, doctors and patients have eagerly awaited an adequate substitute for the maligned blood thinner, warfarin. Now they are here. Boy are they ever. There has been oodles written about the new blood thinners, dabigatran (Pradaxa), rivaroxaban (Xarelto) and apixaban (soon to be Eliquis). As you might expect, thinning the blood with a […]
I am hoping for some input with this case because I really don’t know the right answer. The case: A 52 year-old male endurance athlete seeks my opinion about whether to continue taking statins. His primary care doctor says yes. He is not so sure. Neither am I. He exercises regularly, maintains both a high […]
Tough week. Sometimes the catheter falls into place easily, and sometimes it does not. This week, ‘not’ dominated. I wish it was just the procedures. Difficult cases that string together–and for some reason they tend to come in clumps–was not the hardest part of the week. Hardly. The real tension-inducer was fending off, dealing with, […]