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The Best Time To Be Treated For A DVT

You know I am a cancer survivor – 15 years down the road from a leukemia diagnosis and enjoying a 10 year remission. So whenever something seems weird about my health it’s cancer coming back, right? Wrong! Just how wrong was proven last night. I am writing this from my hospital bed in Seattle.

The first symptom of a possible problem came three days ago when I had soreness in my right calf. A pulled muscle? Maybe. But I had not noticed straining it. Back at the gym the next day I had soreness again but thought it was no big deal. Last night it was worse. It hurt some to walk. I got home and, after my wife and son were asleep, got ready for bed. I had a slight fever and then noticed the right calf was not only sore, but swollen and warm. Very strange. I’d never seen that before.

Trying not to be stupid I called the 24-hour consulting nurse. She immediately began to focus on deep vein thrombosis (DVT), a worrisome condition that affects about two million Americans a year and can lead to a life threatening situation. She had a doctor call me. Normally those doctors would rather make a house call then send you to the more costly emergency room. But not this time. “Dr. Steve” urged me to go to the ER rather than let a DVT progress and endanger my life. An ultrasound exam would determine if it was really a DVT. Read more »

*This blog post was originally published at Andrew's Blog*

Helpful Breast Cancer Q&A

Preya Ananthakrishnan, MD

Attendees of the breast cancer awareness symposium “Bridging the Gap: Promoting Breast Cancer Prevention, Screening and Wellness” were given the chance to submit questions on breast cancer in the minority community. This is the first part of these questions answered by Dr. Preya Ananthakrishnan, Assistant Professor of Clinical Surgery and a host of the event.

Q: I am a 51 year old Black women, whose mother died 13 years ago from breast cancer & her sister was diagnosed last year. I had a mammography 2 weeks ago and got the dreaded come back letter. Should I get genetic counseling?

Dr. Ananthakrishnan: I would suggest that your sister with the breast cancer get tested first, and if her test result is positive then you should get tested. Furthermore, it is likely that even though you got a “call back” letter after your mammogram, it is very possible that you don’t actually have a breast cancer. I would advise you to go in as soon as possible to work up whatever abnormality was seen. If you do in fact have a breast cancer, then you should certainly undergo genetic testing yourself.

Q: What is considered “early detection” of breast cancer?

Dr. Ananthakrishnan: Early detection is finding a breast cancer before symptoms actually occur. This could be by finding it on a mammogram before actually feeling a lump in the breast, or by finding a small lump before it becomes a big lump. Early detection can sometimes allow for less aggressive treatments and improved outcomes.

Q: Is radical mastectomy surgery still performed? I hear little about it now. Read more »

*This blog post was originally published at Columbia University Department of Surgery Blog*

Is The Young Pharmaceutical Rep Right?

I loved my old status. Perhaps, reveled in it would be a better description. I was a crotchety, generic medicine-only doctor.** Sadly, my status changed today. Dabigatran (brand name Pradaxa) was the culprit.

It was a little nerve racking. I wrote the order, looked at it, thought it out again, talking to myself: “John, are you sure you don’t want to do it the old way? [pause to think] No, I am embracing the new.”  And then, I closed the chart and handed it to the nurse.

“What’s that? Pradaxa?” asked the nurse. “Stop the Lovenox? You sure?” My face must have told the story.

Eight days had passed since dabigatran’s approval. “That’s plenty of time to mourn warfarin’s demise,” I thought. Enough studies, enough blogs — it was time for the rubber to hit the road. Read more »

*This blog post was originally published at Dr John M*

A 32-Year-Old Had A Stroke: Could It Happen To You?

The Shermans

Deanna and Rebecca Sherman

As many as 15% of Americans have a blood disorder (called anti-phospholipid antibody syndrome - APS) that can increase their risk for blood clots and stroke. While these antibodies are especially common in people with certain auto-immune diseases like SLE (systemic lupus erethematosis – or “lupus”) quite a few people have them without ever knowing it. In fact, most people with APS remain asymptomatic their entire lives – but for an unlucky few, the disorder can cause devastating consequences.

I interviewed Rebecca Sherman about her recent stroke caused by APS. Listen to the podcast here.

Dr. Val: Tell me about the events leading up to your stroke.

Sherman: I was a young, healthy 32-year-old with no idea that I had anti-phospholipid antibodies in my blood. One morning when I was washing my face at my boyfriend’s house I suddenly noticed that one side of it was frozen. I was standing in front of the bathroom sink and I fell to the floor with the washcloth in my hand. I couldn’t walk or talk – the whole right side of my body didn’t do what I wanted it to do. So I threw the washcloth at my boyfriend’s head (with my left hand). Luckily my aim was good (he was asleep in bed) and the bed was near the door to the bathroom -  the cold, wet object caused him to jump out of bed and find me. Read more »

Latest Interviews

The Surprising Economic Burden Of ADHD (Attention-Deficit Hyperactivity Disorder)

If you can read this you need to download a more recent browser It is estimated that as many as million U.S. adults have ADHD Attention-Deficit Hyperactivity Disorder A recent research study publication-pending suggests that the economic burden of ADHD on America could be as high as billion annually. I…

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Is The Adderall Shortage A Harbinger Of Future Drug Supply Problems?

If you can read this you need to download a more recent browser Today most- if not all- Doctor’s offices are strained by the shortage of some prescription medication or vaccine. A month ago President Obama signed his executive order directing the FDA to take steps to reduce drug shortages…

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Latest Book Reviews

Book Review: The First Step To Improve Health Care Is A Close Examination Of How It’s Delivered

My friend and former Chair of the CFAH Board of Trustees Doug Kamerow has written a book that I think you will like. Besides being a mensch and witty as heck Doug is a family doctor and a preventive medicine specialist. In his new book Dissecting American Health Care Commentaries…

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“Your Medical Mind” Explores Factors That Influence A Patient’s Medical Decisions

Recently I had a conversation with Shannon Brownlee the widely respected science journalist and acting director of the Health Policy Program at the New America Foundation about whether men should continue to have access to the PSA test for prostate cancer screening despite the overwhelming evidence that it extends few…

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Book Review: Food Truths, Food Lies

Food Truths Food Lies written by family physician Eric Marcotte M.D. may be the most refreshingly evidence-based diet book of the decade. You will not find a single mention of super-foods magical berries or supplement must-haves in the entire book. What you will find is the cold hard truth about…

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