My iPhone vibrated with an urgent message that read: Please call…The INR on your atrial fibrillation patient scheduled for cardioversion is too low. He is on that new blood thinner, Pradaxa. What do you want to do?” I responded, sounding like an expert: “It’s Ok. Pradaxa thins the blood adequately, it just doesn’t change the […]
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Happy Valentines Day
The good news is that the efficiency of modern living affords us many treasures, like Apple products and carbon-fibre bikes, for instance. The bad news is that this same modern-ness immerses us in a sea of inflammation. That’s unfortunate because more times than not, Heart Disease occurs as a result of excess inflammation. One of […]
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What would you say?
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 […]
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Junk food in a can
It tastes sweet. It’s pleasurably fizzy. And free of calories. What’s more, the FDA says Nutra-sweet is safe. So what’s not to like about diet soft drinks? A bunch. The ongoing debate about the healthiness of diet soft drinks reminds me of the old-adage, if something sounds to be true, it probably is. Artificially-sweetened “diet” […]
This Wednesday, I’d like to talk about how rodents, relationships, and riding relate to intelligence and overall wellness. This idea comes from a nicely written NY Times piece entitled, Does Loneliness Reduce the Benefits of Exercise? Here, Ms Gretchen Reynolds reviews a few intriguing studies about how relationships may affect exercise, stress hormone levels and […]
There was important news concerning the short shelf-life of the novel new blood-thinner, dabigatran (Pradaxa) reported today. Once dispensed, most medicines expire after a year. Dabigatran, however, is far from the usual pill. It’s packaged in pellet form within a capsule. These pellets are highly susceptible to water and humidity. So when dispensed in a […]
To celebrate women’s health, our office was awash in red today. It’s true, despite the vigor of the pink-ribbon campaign, heart disease remains the number one cause of death for women. That stinks, because like in men, death from heart disease is so preventable. Notwithstanding my free socks, in promoting heart health, I am redder […]
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 […]
On Wednesdays I like to mesh cycling, healthy living and medicine. In this regard, the conflicts surrounding drinking alcohol work well. What other organic chemical is more debated? Here goes. Let’s start with the cyclists’ view of alcohol. Mountain-bikers’ love of beer is axiomatic. Cyclocross riders also fancy beer, this, primarily because they worship all […]
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Seriously?
There used to be only single society guidelines: AHA Guidelines. Or, ADA Guidelines. Then we progressed to two organizations:Â AHA/ACC Guidelines. Soon the heart rhythm boys wanted in:Â AHA/ACC/HRS Guidelines. But last night, I saw the this: ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS Guidelines. (For the treatment of blood vessels in the neck.) Geez. JMM
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. […]