geekydoc

Medical Secrets in Reader’s Digest

geekydoc — Sat, 14 Jun 2008 12:50:48 +0000

I’m sort of back from a long respite from blogging. Busy, busy, busy. I missed a lot of opportunities to blog about medical news but I had to recharge.

Anyway, I sifted through my RSS feeds and found an article in the online Reader’s Digest entitled “41 Secrets Your Doctor Would Never Share.” It’s a misleading title, I think, but the “article” is a collection of quotes from two dozen doctors told to share the truth about medical practice.

I enjoy Douglas Farrago’s quips, but my absolute favorite of the bunch is:

In many ways, doctors are held to an unrealistic standard. We are never, ever allowed to make a mistake. I don’t know anybody who can live that way.

– James Dillard, MD

Read the rest of the article and tell me what you think about it.

DIY Wheelchair

geekydoc — Fri, 16 May 2008 10:45:17 +0000

One of our stroke patients wheeled herself into our conference room in an interesting wheelchair:

The wheelchair is made up of — from what I can discern — bicycle parts and a white monobloc plastic chair with the legs sawed off. It was donated to her by a group whose name escapes me at the moment. I wonder how much it costs to make one of these. Granting that the parts are recycled from old bicycles and chairs, it must be far less than a regular wheelchair.

Following My Own Advice

geekydoc — Mon, 05 May 2008 03:37:28 +0000

Mrs. Andal stares at me from across the desk, nearly in tears. She’s tried limiting her portions, she says. She has steered clear from pork, from salty foods, from her favorite pastries. She doesn’t understand, she says, why she keeps gaining weight, why her blood pressure is still through the roof. She’s already on a beta blocker and a low dose statin. She’s retired and recently widowed: she can’t afford to take any more medications. She’s beginning to sob.

I give her the standard speech. She needs to exercise more, to eat more vegetables, to cut down on pork. I know it will take a great deal of will power on her part. I know waking up to exercise in the morning will be a sisyphean task. I know because I’m going through what she’s going through. Not the hypertension or the dyslipidemia, thank God. I may have a few more years before I have to tackle those problems. But I have been having trouble living a healthy lifestyle. Regular exercise, low fat diets, keeping an ideal bodyweight — it’s all just part of the script.

I got away with being a couch potato in early adulthood because I had little money and what little money I had, I used to buy books. I played sports when I could. I ate just enough to stave the hunger. Fast forward a decade later. I’m still a couch potato. I have more money but less time to read. What little free time I have, I spend sleeping or eating. Food, I’ve discovered, relieves stress. So does excercise, I know — that’s in the script too. But give me the choice between wolfing down lechon kawali and hiking up Mt. Makiling, and I’ll ask you to hand me the bottle of Mang Tomas and to tell Mariang Makiling not wait up for me.

I’ve gained so much weight I’m nearly twice the size of my twenty-year-old self. I’ve tried to cut down on food, steered clear of cola drinks. But I don’t jog or play badminton as regularly as I need to. I still binge eat when I feel stressed. I am exactly like Mrs. Andal. No, actually, I’m worse. I’m a doctor who can’t follow his own advice.

The standard script delivered, I pat Mrs. Andal on the shoulder. I tell her it’s going to be alright and that I was there to help. I want her to have hope. I want myself to have hope.

Next time we meet I’ll tell her all about my morning jogs, my weekly badminton games, how I was a couch potato and how I struggled like her. Next time, I’ll have more than the usual script to deliver.

—
This post was made with a trial version of BlogPlanet, a photo blog client for mobile phones. For more information visit www.blogplanet.net.

Web 2.0 Noise

geekydoc — Sat, 26 Apr 2008 22:58:58 +0000

Erick Schonfeld of Tech Crunch writes about the information overload associated with services like Twitter and Friendfeed.

I need less data, not more data. I need to know what is important, and I don’t have time to sift through thousands of Tweets and Friendfeed messages and blog posts and emails and IMs a day to find the five things that I really need to know.

When some medbloggers suggested that social networks and services like Twitter can be used in medical practice I immediately said nay. We need an efficient information filter before services like this can be used in medicine efficiently.

Cebu Hospital swamped by bad publicity

geekydoc — Sat, 19 Apr 2008 23:47:21 +0000

What the heck is wrong with the Vicente Sotto Medical Center (VSMMC)?

Just a few days ago, the surgical staff was in the news for allowing the videotaping of a surgical procedure and letting the video be distributed via email and YouTube. Now, an employee of the same hospital is being investigated because a woman complained that he asked her to have sex with him in exchange for a birth certificate.

I’m sorry. This is stuff for the tabloids, but I can’t help commenting on it. I mean, the administrators in the VSMMC are either doing a piss poor job of keeping their employees in line or they are just getting a streak of bad luck. I hope for their sake it’s the latter.

Still no news as to what administrative and institutional penalties will be meted out to the doctors and nurses who are involved in the video scandal. What is taking so long? The Department of Health should get off their asses and start handing out some beat downs. The hospital administration seems satisfied with mere wrist-slapping. The DOH and Philippine Medical Association (PMA) should be sterner. Make examples of these people. Suspend their licenses, at least.

Here’s a video of the press conference at the VSMMC:

Oooh. “Sternly warned.” I bet they are shaking in their boots.

Statins Lower Blood Pressure

geekydoc — Sat, 19 Apr 2008 07:02:35 +0000

Image via Wikipedia

The University of California San Diego Statin Study confirms that statins have a modest blood pressure lowering effect, which may contribute to the reduction of cardiovascular events seen in other studies. The study employed 973 individuals without major cardiovascular risk factors. It was demonstrated that subjects randomized to the statins arm had a 2.2 mmHg reduction in systolic blood pressure. Since it well known that little changes in blood pressure provides significant risk reductions for cardiovascular events, the link between the BP lowering effect — however modest — and the cardiovascular benefits appears clear.

The mechanism for the BP lowering?

In terms of mechanism, the investigators suggest that statins might
lower blood pressure through upregulation and/or activation of
endothelial nitric-oxide synthase as well as through improvements in
endothelial function and flow-mediated vasodilation. The antioxidant
effects of the lipid-lowering medications are believed to bring about
the latter two improvements… [from Medscape]

Screencast: How to use Pubmed Search RSS

geekydoc — Sat, 19 Apr 2008 01:10:27 +0000

The first ever Geekydoc screencast tackles Pubmed Search’s ability to create RSS feeds out of your searches. If you need to keep tabs on particular subjects, just input your search terms and create RSS feeds out of these saved searches. This video walks you through the process.

Thanks to Morten Meyer for the workaround.

Must Reads

geekydoc — Fri, 18 Apr 2008 23:11:10 +0000

A few must read articles around the web:

From the Journals

Productivity

Features / News

Patient Privacy and Youtube

geekydoc — Wed, 16 Apr 2008 15:55:11 +0000

A colleague of mine sent me an email about a video making the rounds in the internet (some doctors have received the said clip through email; some have seen it in Youtube). The video features a group of Filipino surgeons, nurses and, I assume, medical students laughing boisterously during an operation to retrieve a can of body spray from a patient’s rectum. The media has made a big deal about the doctors’ behavior during the operation, but c’mon, let’s face it, trying to retrieve any foreign body from a male patient’s rectum is something to laugh about. Let’s all get down from our high horses: the boisterous laughter was a normal reaction.

Now, allowing people to videotape the operation and spread it around the net is a different thing altogether. This was a major violation of the patient’s privacy, and it should not go unpunished.

And just to correct a few people commenting on this story: patient privacy is very important even in Third World countries such as ours. Just because a few of us behave like dickheads doesn’t mean all of us are dickheads.

A suggestion to hospital administrators: do not allow any cameras or cellphones in the operating room. Unless, of course, the pictures or video to be taken will be used in a scientific manner (e.g. a case report.) The doctors who will use the images must have the patient’s informed consent.

(I purposely did not link to the video. I refuse to propagate links like that. If we medbloggers link to or embed this video, aren’t we also being unethical? We become participants in the violation of this patient’s privacy. I think doctor bloggers who have posted the video on their sites should take it down.)