Friday, 15 Feb 2019

Blog

When To Give Up

He would have died. About 4 weeks ago, my 74 year old father-in-law, “Pops” was admitted to a small community hospital for delirium and worsening congestive heart failure. He was seen by a caring hospitalist and a local cardiologist who was deemed good by all the locals, but they could not get him better. Despite the delirium, Pops pleaded he wanted to live to see my 8 year old son graduate high school. My husband, who is an internist, respected the other doctors’ decision and did not want to interfere with his dad’s medical care. With tears in his eyes, he whispered, “I wish we could do more.” My heart was heavy as I did not want to go against my in-law’s wishes to get a second opinion. Trying to make the right decision, I talked to my colleagues, I talked to my patients, and I talked to my own family: what should I do? Go against my in-law’s wishes and transfer him to Dallas for a full evaluation or be complicit in the Do Not Resuscitate Order?

How to Best Use RheumNow

This “How to Use RheumNow” blog is intended to help those of you who would like to get better use and quick hints on consuming RheumNow content. This is also a good opportunity to get some feedback from you on what we could do better or how we could serve your interests and online education. What keeps you up at night? We would really like to know.

Why Rheumatologists are the Happiest

It’s hard work wearing a crown. The dermatologists have been dethroned as Medscape’s happiest specialty after years at the top. While studies only detail that we are the most satisfied outside of work, I argue we are the happiest working, too. With an N of 1, here are my 10 observations.

10 Things To Do in 2019

Resolutions are about the new and better you. Yet most people discard resolutions, largely because they are satisfied with the status quo or are afraid of change. Here's are some suggestions for being the best version of yourself in 2019.

Best of 2018: Rheumatology Dead Word Cemetery 2019

I recently heard of a secondary school assignment wherein students were challenged to “bury” a word that was no longer useful or appropriate. Their exercise has now evolved into an unofficial RheumNow task force to retire diagnostic terms that have grown into misuse in rheumatology and medicine. How did we decide which words should perish? And by what criteria? Who has the final say?

Best of 2018: 5 Mistakes When Diagnosing Adult-Onset Still’s Disease

Adult-onset Still's presents an interesting and diagnostic challenge when encountered. Here are 5 tips to improve your diagnostic acumen for this febrile disorder.

Best of 2018: The Millennial Doctor- Mighty or Mediocre?

A 3rd year medical student started his rotation with me this past week and the rotation was a challenge for us both.

Best of 2018: Dealing with Drug Reps - Dead or Alive

Several years ago, long before promotional lectures, I traveled for a series of lectures. I flew north for 4 days and 4 lectures, 2 at major university programs and 2 dinner lectures to local rheumatologists.

The first lecture went well but the weather turned bad, with a snow storm in the overnight forecast.  Hence my host, a local drug rep, suggested we drive at night to beat the snow and get to the next city for the 10 am University lecture the following morning.

The one-hour drive felt like a week in Cleveland. 

Best of 2018: Death of the Dinner Meeting

Many years ago, rheumatologists would assemble with lunar regularity to discuss cases, journal articles or listen to a great visiting speaker or le

Best of 2018: The Delayed Diagnosis of Spondyloarthritis

You see them from the corner of your eye, standing with a kyphosis in the waiting room. They are filling out their paperwork, standing up because sitting is just not pleasant. You are the rheumatologist with an  interest in ankylosing spondylitis (AS) and spondyloarthritis, so more likely than not, the patient with the bent spine is going to be your next new patient. In the back of your mind you are hoping that they are not so far along so that the therapy you may prescribe can make a difference in their life.

Advice for Young Rheumatologists

You may not want my advice, but I’m going to give it to you anyway. 

Pain: Objectifying a Subjective Symptom

My typically pleasant 76 year old male was livid when I walked into the exam room. He was pacing back and forth with furrowed eyebrows.