Hospitals run short of critical medications after loss of production in Puerto Rico facilities.
“Doc, you mind switching that to an oral preparation?”, our clinical pharmacist inquired during multi-disciplinary rounds as intravenous infusion devices beeped annoyingly in the background. Taking care of ICU patients can be extraordinarily complicated, so doing it as part of a team helps make sure that all bases are covered. ICU’s like ours have a BEEP BEEP BEEP. Excuse me, for a moment, Staci, can you get that thing to stop, please? BEEP, BEEP, BEE– Thanks, Staci!. As I was saying, like many hospitals, ours uses a multidisciplinary model which makes rounds on all patients in the ICU. An ICU nurse, clinical pharmacist, dietitian, social worker, pastoral care, respiratory therapist, each provides important insight and perspective that guides patient care in the right direction.
As a pulmonary, critical care doc, I’m lucky to have a great team, so my ears perked up when I heard the suggestion. This was now the third patient he had made a suggestion to switch a medication to the oral route from the intravenous route. “What gives, Scott?” Over the past few years, we’ve been experiencing alot of spot medication shortages either because of inadequate supply, or because of precipitous price increases; we can usually change to an alternative. But today was different. Today we were switching a number of different medications, all of which were intravenous to oral formulations of the same or similar medicines.
“It’s not the medicines,” he replied, “It’s the bags they’re in”. Continue reading “Devastation in Puerto Rico leads to hospital shortages in U.S.”
If you’re reading this, chances are that you are familiar with EPIC EMR, as well my ongoing love/hate thing with EMR’s since I first started writing about them a few years ago.
If you recall, I called most early EMR systems “overpriced, sub-standard, half-baked systems designed by polytech school dropouts”. Ok, so maybe that was a bit harsh. Continue reading “EMR Review: Epic EMR 2017”
When I worked as a physician in Michigan, I had been recorded by patients several times during their visits. Some of them asked for permission, but in most cases I was only informed by one of my staff after the fact. Continue reading “Can I record my doctor without permission? Not in these 11 states.”
Republicans have been waiting a long time for this moment. They have tried, time and again, (and again and again!) to repeal Obamacare. Now at long last, after sixty previous attempts to overturn the Affordable Care Act, commonly known as Obamacare, their moment has arrived. Continue reading “7 Reasons Why President Trump Can’t Repeal Obamacare.”
Being an Indian American doctor who happens to be Hindu, I hear a lot from patients, staff, and in the public sphere about my apparent “worship” of cows. This characterization represents a misunderstanding of the complex role that the cow has played in Hindu mythology. Continue reading “Top 5 Things That Indian People Hold Sacred (besides cows).”
Recently I read an article in the NY Times by Elisabeth Rosenthal. She’s the same author of the enlightening article “My doctor charged me $117,000 and all I got was this lousy hospital gown” That may not have been the exact title of the article. Continue reading “Why Doctors Don’t Like to Send You Test Results.”
Like a lot of people, I get pretty numbed to gun violence on television. I stopped watching the local news because all they seem to show is news about shootings. The general public’s perception about gun violence is that it’s always somebody else, that the person who was shot had somehow been involved in crime. The numbness we feel to gun violence often ends for most of us when things hit close to home, when you or someone you know is affected. Continue reading “Doctors’ Prescription to Reduce Gun Violence”
I enjoy fielding questions from patients. Yes, I sense you’re rolling your eyes, but really, anything that I can answer that helps keep them out of the hospital is, I feel, time well spent. Recently though, I’ve been fielding a number of questions that have me concerned. These questions often have a leading tenor about them like, “are you using stem cells for COPD yet?” The questions imply that stem cells are the de rigeur treatment for COPD. Now I may not be at the leading edge of any fashion, but being unfashionable in my treatment regimens? Never!
I can’t blame anyone for wanting to seek out treatments for COPD. It is after all, a leading cause of death and illness in the U.S. And it’s widely regarded that the changes caused by COPD/emphysema in the lungs are permanent. While there are now several different treatment options for emphysema/COPD, very few can prolong life. So if I had a family member with emphysema, I might naturally seek out treatments for COPD that go beyond the usual treatments, and with all the hype surrounding stem cells, why not take a look?
What people find when they google “stem cells and COPD” is in a word, distressing. It’s a fantasy world full of promises of health, healing, and better breathing. Equally distressing are the things that people who visit these sites aren’t recognizing: the greed, lies, lack of ethics, illusions, and misleading claims. Continue reading “Stem Cells and COPD: What You Need to Know.”
As a sleep physician, I spend a lot of time educating patients about what sleep is and how it works. Sleep, as I often explain, is not simply the lack of being awake; anymore than landing a plane is simply the lack of flying. It’s becoming increasingly understood that sleep is an actively generated state, created by a series of neuro-hormonal changes which work in concert to nudge the brain into the sleep state. To stretch the plane analogy further, if being asleep were like the plane being on the ground, then falling asleep is like the act of landing the plane. And just like when you land a plane, there are a lot of variables that are involved. There are numerous events that must happen in succession, each affecting and triggering other events which ultimately induce the brain to sleep. A recent study demonstrates just how watching too much television can wreak havoc in this delicate process. Here’s just a few of the ways that television can ruin your sleep.
5. Watching television makes you go to bed later.
Television watching has steadily increased in our society, and its migration into our bedrooms marked a time when it began to disrupt our collective sleep and sleep habits. The most obvious effect that this might have is the most simple; we stay up later watching a program that has our attention. This few minutes a night may seem innocent enough. But our brains have a pre-determined amount of sleep they need to function well. When we miss that sleep we build up a “sleep debt” that can make us tired all of the time. Even if we catch up on a bit of sleep the next day, unless that sleep debt is paid back, the brain will still be fatigued.
4. Watching television alters your brain’s bedtime habits. Continue reading “Top 5 Ways That Television is Ruining Your Sleep.”