Thursday, November 19, 2009

Teenage Children and Other Abnormalities - Laughable Excerpts from Actual MD Notes

Teenage Children and Other Abnormalities - Laughable Excerpts from Actual MD Notes

This list is reproduced from MDs' actual writings on charts, published in the Mpumalanga Hospital Register (South Africa), courtesy of Veven Bisetty.

It contains a memorable thyroid notation.


1. The patient refused autopsy.

2. The patient has no previous history of suicides.

3. Patient has left white blood cells at another hospital.

4. Patient’s medical history has been remarkably insignificant with
only a 11 kgs weight gain in the past three days.

5. She has no rigors or shaking chills, but her husband states she was
very hot in bed last night.

6. Patient has chest pain if she lies on her left side for over a year.

7. On the second day the knee was better, and on the third day it disappeared.

8. The patient is tearful and crying constantly. She also appears to
be depressed.

9. The patient has been depressed since she began seeing me in 1993.

10. Discharge status: Alive but without my permission.

11. Healthy appearing decrepit 69-year old male, mentally alert but forgetful.

12. Patient had waffles for breakfast and anorexia for lunch.

13 She is numb from her toes down.

14. While in ER, she was examined, X-rated and sent home.

15. The skin was moist and dry.

16 Occasional, constant infrequent headaches.

17. Patient was alert and unresponsive.

18. Rectal examination revealed a normal size thyroid.

19. She stated that she had been constipated for most of her life,
until she got a divorce.

20. I saw your patient today, who is still under our car for physical therapy.

21. Both breasts are equal and reactive to light and accommodation.

22. Examination of genitalia reveals that he is circus sized.

23 The lab test indicated abnormal lover function.

24. Skin: somewhat pale but present.

26. Large brown stool ambulating in the hall.

27. Patient has two teenage children, but no other abnormalities.


Note: This information may not have been evaluated by the FDA.

Monday, October 26, 2009

What Exactly Are They Teaching in Medical School?

What Exactly Are They Teaching in Medical School?

Dateline: 05/05/97
In the May/June issue of Health magazine, there's a familiar but frightening story. The article by Barbara Bailey Kelley describes a woman who had constant fatigue, constipation, constantly feeling cold and difficulty swallowing. According to the article, this group of symptoms had the woman "hopping from doctor to doctor. None could identify a medical problem." Three years after her symptoms appeared, the woman was checked into a hospital, where a coterie of specialists -- an allergist, heart specialist and psychiatrist -- examined her. The psychiatrist wondered if she was suffering from depression. After a battery of tests which, WHEW, finally included a thyroid-stimulating hormone (TSH) test, they FINALLY discovered that she was very hypothyroid, in fact, her thyroid had almost shut down completely.

Okay, calling Dr. Kildare! Marcus Welby! The entire staff of St. Elsewhere, Chicago Hope and ER! Where are the doctors who recognize thyroid disease's symptoms quickly?

On an AOL chat a few weeks ago, a group of us were speculating what would happen if a woman with a basketball-sized goiter walked into the ER at "ER." We decided she'd be told she was stressed out, and sent home with a prescription for Prozac, AND a big fat bill from the emergency room (that her insurance company would probably deny!!!) Now how bout that storyline for dramatic tension? (Of course we all agreed we'd keep the goiter if it meant George Clooney'd be our endocrinologist!)

In any case, doesn't it seem like anyone who's spent more than five minutes reading anything about thyroid disease would have a problem recognizing the familiar litany of symptoms the poor woman in the article described? In fact, I sometimes have to watch about becoming too evangelical myself when friends say, "you know, I've been feeling a bit tired and run-down lately, and..."

"COULD BE YOUR THYROID!!!" I announce.

Continues at Link

Sunday, October 25, 2009

Planetree: Patient-Centered Care

Monarch Butterfly Pictures, Images and Photos

Patient-Centered Care Awareness Month


"Patient-Centered Care Awareness Month is an international awareness-building campaign that occurs every October to commemorate the progress that has been made toward making patient-centered care a reality and to build momentum for further progress through education and collaboration. Hospitals and health care organizations around the world are encouraged to celebrate by empowering patients, strengthening their patient-centered practices, and publicly proclaiming to their patients and communities their commitment to patient-centered care.

For the past two years, health care organizations around the United States, Canada and the Netherlands have celebrated Patient-Centered Care Awareness Month. In addition, fourteen state governors commemorated the month signing proclamations officially recognizing the importance of patient-centered care to their states’ citizens.

What is “Patient-Centered Care”?

Although the phrase “patient-centered care” is defined and used in a variety of ways, the essential theme is the importance of delivering healthcare in a manner that works best for patients. In a patient-centered approach to health care, providers partner with patients and their family members to identify and satisfy the full range of patient needs and preferences.

Organizations practicing patient-centered care recognize that:

A patient is an individual to be cared for, not a medical condition to be treated.

Each patient is a unique person, with diverse needs.

Patients are partners and have knowledge and expertise that is essential to their care.

Patients’ family and friends are also partners.

Access to understandable health information is essential to empower patients to participate in their care and patient-centered organizations take responsibility for providing access to that information.

The opportunity to make decisions is essential to the well-being of patients and patient-centered organizations take responsibility for maximizing patients’ opportunities for choices and for respecting those choices.

Each staff member is a caregiver, whose role is to meet the needs of each patient, and staff members can meet those needs more effectively if the organization supports staff members in achieving their highest professional aspirations, as well as their personal goals.

Patient-centered care is the core of a high quality health care system and a necessary foundation for safe, effective, efficient, timely, and equitable care."

Link - at the bottom of the pagte you can download their patient-centered care Toolkit.

Friday, October 16, 2009

DHEA, Adrenals and the Thyroid

DHEA is an endocrine hormone necessary for the function of adrenals. If thyroid is given without taking this into consideration, an adrenal crisis may result.
Does your endocrinologist know and understand DHEA?
Link
Link

Thryoid Awareness: The Akita




A new American film based on the story of a loyal dog may help raise awareness of human thyroid problems. Dogs of this breed, the AKITA, frequently have problems with low thryoid, resulting in health and temperament problems.
http://www.petpublishing.com/dogken/breeds/akita.shtml

Just as the dog Hachiko waited faithfully for his master, human thyroid patients often wait a long time to get help from the doctors they rely on. Let us hope that their long wait will not be in vain.

Saturday, October 10, 2009

Memory Loss and Thyroid Function

From Great Smokies Diagnostic Laboratories
Memory Loss and Thyroid Function
Every cell in the body, including cells in the brain, contains receptors for thyroid hormones. Thyroid hormones can stimulate and change the structure of particular regions of the brain, such as the hippocampus, the area primarily responsible for learning and memory.1,2 They also modulate enzymes that regulate the metabolic rate of brain cells.

Temporary memory loss is a classic symptom of hypothyroidism, a condition arising from inadequate production of hormones by the thyroid gland, or from decreased peripheral conversion of the thyroid hormone thyroxine (T4) into triiodothyronine (T3) in the kidney or the liver.

Fortunately, memory loss caused by thyroid hormone imbalances can often be effectively treated. As a recent case study illustrates, proper diagnostic testing is crucial, because memory loss may be the only symptom of thyroid insufficiency, and may occur without any other physical signs of thyroid imbalance.3

Even sublinical thyroid imbalances can affect mental ability. Evidence indicates that as levels of thyroid hormone thyroxine decrease, cognitive function generally declines.4 Researchers from the Karolinska Institute in Stockholm, Sweden found that levels of thyroid stimulating hormone (TSH) correlate with episodic memory performance in healthy men and women over the age of 75.5 They speculated that TSH may actually help the brain encode and store memory. Another study reported that memory loss was the only cognitive symptom of subclinical hypothyroidism in a group of female patients with goiter, and was effectively alleviated with thyroid hormone treatment.6

For these reasons, optimizing thyroid function is considered an important tool for anti-aging therapies designed to safeguard memory and cognitive function.7

Link

On GDSL thyroid assessment
http://web.archive.org/web/20060328012531/www.gsdl.com/home/assessments/thyroid/index.html

The company has changed its name to Genova Diagnostics and the site is
here.

Tuesday, September 29, 2009

Justice - a course at Harvard

Kirkus Review: A Harvard law professor explores the meaning of justice and invites readers on a journey of moral and political reflection, “to figure out what they think, and why.” Does a veteran suffering from post-traumatic stress disorder “deserve” the Purple Heart? Should the U.S. government formally apologize and make reparations for slavery? Is it wrong to lie to a murderer? Following the taxpayer bailout of the company, are executives at insurance giant A.I.G. still entitled to their bonuses? Should a professional golfer afflicted with a severe circulatory condition be allowed to use a golf cart during tournaments? Are you obliged to surrender your criminal brother to the FBI? Although Sandel (The Case Against Perfection: Ethics in the Age of Genetic Engineering, 2007, etc.) concedes that answering the many questions he poses, bound up “with competing notions of honor and virtue, pride and recognition,” is never easy and inevitably contentious, it’s necessary for a healthy democracy. “Justice,” he writes, “is inescapably judgmental.” Using three approaches to justice—maximizing welfare, respecting freedom and promoting virtue—the author asks readers to ponder the meaning of the good life, the purpose of politics, how laws should be constructed and how society should be organized. Using a compelling, entertaining mix of hypotheticals, news stories, episodes from history, pop-culture tidbits, literary examples, legal cases and teachings from the great philosophers—principally, Aristotle, Kant, Bentham, Mill and Rawls—Sandel takes on a variety of controversial issues—abortion, same-sex marriage, affirmative action—and forces us to confront our own assumptions, biases and lazy thought. The author has a talent for making the difficult—Kant’s “categorical imperative” or Rawls’s “difference principle”—readily comprehensible, and his relentless, though never oppressive, reason shines throughout the narrative. Sparkling commentary from the professor we all wish we had.

Link