Dr. Elaine Schattner's notes on becoming educated as a patient
Dr. Elaine Schattner's notes on becoming educated as a patient
© Elaine Schattner, 2009, 2022 By : Template Sell.
So many others have written on Wakefield’s fraud, and considered the role of the press in perpetuating the notion that vaccines cause autism, I wasn’t going to cover it here on ML. But I do think there are a few instructive points from this “lesson” about medical communication and news:
1. People aren’t always rational in their decisions about health care. (This is an understatement.)
The Obama administration will cut a new Medicare provision to compensate providers for discussing end-of-life care, according to the New York Times. This is an unfortunate reversal. Too-often, doctors fail to have these discussions with their patients. This happens for many reasons including some physicians’ discomfort with the topic, their not wanting to diminish patients’ […]
The findings show that it’s safe for women who’ve had breast cancer surgery to work out in a way that includes a careful, progressive upper body strengthening. Weight lifting is not only safe; it can reduce lymphedema in women at risk. But “old wives’ tales” still persist in some doctors’ minds and established medical resources. These need be dispelled.
This evening, after I finished cleaning up the kitchen after our family dinner, I glanced at the current issue of the Economist. The cover features this headline: the Joy of Growing Old (or why life begins at 46). It’s a light read, as this so-influential magazine goes, but nice to contemplate if you’re, say, 50 years old and are wondering about your future.
The article’s thesis is this: Although as people move towards old age they lose things they treasure—vitality, mental sharpness and looks – they also gain what people spend their lives pursuing…
Dear Readers, I am sad to learn of the death of Elizabeth Edwards, who died earlier today of metastatic breast cancer at the age of 61. She has taught countless people about what it’s like to live with cancer. My thoughts are with her family now. -ES Related Posts:No Related Posts
On the hematology front – Last weekend at the annual meeting of the American Society of Hematology (ASH), researchers presented data on a new kind of blood thinner. Rivaroxaban (Xarelto) is a pill that works by blocking the activated form of human clotting factor X (Xa). The NEJM published the EINSTEIN* findings on-line ahead of […]
A perspective in this week’s NEJM considers the Emerging Importance of Patient Amenities in Patient Care. The trend is that more hospitals lure patients with hotel-like amenities: room service, magnificent views, massage therapy, family rooms and more. These services sound great, and by some measures can serve an institution’s bottom line more effectively than spending […]
Here’s a partial list of why some thoughtful, articulate patients might be reluctant to mention symptoms to their doctors:
1. Respect for the doctor – when the patient feels what he’s experiencing isn’t worth taking up a physician’s time, what I’d call the “time-worthy” problem;
2. Guilt – when the patient feels she shouldn’t complain about anything relatively minor, because she’s lucky to be alive;
3. Worry – when patient’s anxious or afraid the symptoms are a sign of the condition worsening, and so
A link to a video, the Too Informed Patient came my way several times lately. You can find the curious clip on NPR’s Marketplace site: The Too Informed Patient from Marketplace on Vimeo. — The skit depicts the interaction between a young man with a rash and his older physician. The patient is an informed […]
Over the long weekend I caught up on some reading. One article stands out. It’s on informed consent, and the stunning disconnect between physicians’ and patients’ understanding of a procedure’s value.
The study used survey methods to evaluate 153 cardiology patients’ understanding of the potential benefit of percutaneous coronary intervention (PCI, or angioplasty)…
When I practiced oncology, I relished time talking with patients and their loved ones about tough decisions – when an indolent condition accelerated and it seemed time to bite the bullet and start treatment, or when a cancer stopped responding to treatment and it seemed right to shift gears and, perhaps, emphasize palliation instead of more chemo, and at every value-loaded decision checkpoint in between.
These conversations weren’t easy; speaking of levels of care, palliation and end-of-life wishes are discussions that many doctors, even oncologists, still avoid.
“I don’t want to get sicker trying to get better and then just end up dying anyway” – Cathy, the 42 year old protagonist, with advanced melanoma, on the Big C.
Spoiler alert: Don’t read this post if you don’t want to know what happens to Cathy in the Big C…After months of unusual and comfort zone-breaking behavior, Cathy
I’m a bit puzzled by all the excitement about Merck’s new drug, Anacetrapib (MK-0859), that’s said to lower risk for cardiovascular disease by lowering bad cholesterol. Earlier this week at the annual meeting of the American Heart Association, researchers presented promising findings on the drug, including results from the phase III DEFINE trial. The list of disclosures for that abstract is long and fairly shocking. On Wednesday, the results were published on-line in the NEJM.*
The new drug interests me, as an oncologist, because it’s an enzyme inhibitor …
Last night I stayed up late to see the season finale of the Big C. For the first time in watching this series about a 42 year old woman with advanced melanoma, in a near-final scene involving the protagonist Cathy’s teenage son, I cried.
The storyline is moving, finally, in a real and not necessarily happy direction.
I’ve been wondering, lately, why so many of the medical blogs cover the same topics, like last week’s lung cancer detection trial, which are often the exact same studies as are reported by conventional news outlets. I’ve been trying, here, to sometimes consider new published articles that seem important to me but, for whatever reasons, don’t get so much attention.
Here’s one:
Yesterday’s NEJM includes an article Romiplostim or Standard of Care in Patients with Immune Thrombocytopenia.* It’s about a drug, manufactured and sold by Amgen as NPlate, that received FDA approval for treatment of chronic immune thrombocytopenia purpura (ITP) in August, 2008. Some consider ITP a rare disease, and
Franklin’s story starts like this: She was born in 1920 to a Jewish family in London. She excelled in math and science. She studied physical chemistry at Cambridge, where she received her undergraduate degree in 1941. After performing research in photochemistry in the following year on scholarship, she joined the British Coal Utilisation Research Association (BCURA) and carried out basic investigations on the micro-structure of coal and carbon compounds, and so earned a Ph.D. from Cambridge University. She was a polyglot, and next found herself in Paris at the Laboratoire Central des Services Chimique de l’Etat, where she picked up some fine skills in x-ray crystallography.
You get the picture: she was smart, well-educated and totally immersed in physical chemistry before, during and after WWII. Single-minded and focused, you might say –
I was saddened yesterday to learn of the death of Jill Clayburgh. The 66 year old actress died on Friday in her Connecticut home. According to ABC news and the LA Times among other reports, she’d had chronic lymphocytic leukemia (CLL) for 21 years. This means she lived with CLL for nearly a third of […]
Today’s Annals of Internal Medicine includes new results for the CLOTS (Clots in Legs Or sTockings after Stroke) Trial. Not-quite acronyms aside, it’s an interesting study with implications for many patients at risk for deep venous thrombosis (DVT). This U.K.-based study, involving 3114 patients in 112 hospitals in 9 countries, used ultrasound to evaluate possible […]
Why am I blogging about this drug, a pill, that works imperfectly in perhaps most of 5% of non-small-cell lung cancer patients and, maybe, in some other rare tumors? Because this is the future of oncology and, ultimately I think, will provide cost-effective medicine that’s based in evidence and science. The key is that the investigators tried the experimental drug in lung cancer patients with a specific genetic profile, one that predicts a response to this agent…
How drugs like crizotinib could save money: 1. This drug is a pill; slash the costs of IVs, pumps, bags of saline, nurses to administer…2. Don’t give it to patients without a relevant genetic mutation; 3. Monitor patients for resistance and stop giving drugs when they no longer help the individuals for whom their prescribed.
The Santiago Times reports that the rescued Chilean miners donned suits and pink ribbons, the latter in honor of breast cancer awareness month, at a ceremony at the the presidential palace, la Moneda. Sure, the pink scene’s getting to be a bit much around here. But I don’t belittle this gesture; the miners’ intentions are […]
