Friday, 15 Dec 2017

Blog

The IL-6 Wars

In the years to come, the availability of numerous new IL-6 inhibitors it will either complicate treatment decisions, alter existing treatment paradigms, or result in an all-out war against TNF inhibitor dominance. Data, differences and time will tell.

The Pain of Funerals and Suicides

Recently, I went to one of my patient’s funeral. It was sad. Patient funerals are always sad for me. Fortunately, there aren’t many.

It's All in the Name

I got onto flight #610 from Atlanta to Dallas the other day and was greeted by a flight attendant in first class. After introducing himself, he said, “That’s my name and you can imagine how it’s gone for the past 25 years.”

The Paradox and Value of Choice

I’m sitting with a patient discussing moving to an advanced therapeutic (i.e., medication that costs a lot of money). I started thinking about what I would choose and given my busy lifestyle a quick injection or tablet would seem preferable to an intravenous infusion. I assume that my patients are probably like me and would make similar choices. I am a little taken aback when this patient chooses an IV medication. She tells me her rationale in terms of her feelings, ideas, fears, and expectations and it makes complete sense. I may have misjudged her and without asking may have suggested a treatment that would not have been the best for her in terms of her lifestyle or beliefs.

The Rheumatologist’s Rubaiyat: A Mug of Coffee, a Loaf of Bread and Thou Beside Me (Part 2)

In my last article, I said that coffee, not wine, would be the libation of choice for rheumatologists. Why coffee? you may ask. After all, the language of coffee is not dissimilar to that of wine and writers of coffee (as well as the label descriptions) use the same vocabulary and analogies as does the writing about wine. Often, from the description-with words like spice, cocoa or nuts-it is not clear whether the beverage is a Cotes-de-Rhone or an Americano. Certainly coffee is better hot than cold and appropriate for all meals although some argue that champagne can be quaffed all day long.

The Rheumatologist’s Rubaiyat: A Mug of Coffee, a Loaf of Bread and Thou Beside Me (Part 1)

In my experience, rheumatologists are very fine people. Since they are cognitive specialists, they are scholarly, thoughtful and prudent. Furthermore, they are sensitive to the vicissitudes of human existence. Rheumatology is probably the first subspecialty to consider the impact of a chronic painful illness on the spirit and soul and emphasize quality of life as an outcome. Seeking wisdom and knowledge from great minds, rheumatologists are also interested in culture, mindful that masters like Renoir and Klee were among their patients.

Cannabis Arteritis

LKelmenson
Following the November elections, there are now 29 states and the District of Columbia that have legalized marijuana (aka cannabis) for medical use. Of these, eight states and the District of Columbia have also approved laws legalizing marijuana for recreational use. Regardless of the stated benefits associated with marijuana use, there are potential health risks. One of these which rheumatologists may see more of in the future is cannabis arteritis. The following is a recent case we saw at the University of Colorado.

Early Rheumatology: The Contributions of Max Hirsch, MD

Many readers of RheumNow know of my interest in the history of our discipline, and some of the writings and discoveries which have resulted from them. In the past three years, I have had the opportunity to explore the contributions of Max Hirsch, MD to our field.

Food and Wine and the Rheumatologist: The Microbiome and Natural Wine

Is the microbiome influenced by wines "terroir" (“the complete natural environment in which a particular wine is produced, including factors such as the soil, topography, and climate”)? Len Calabrese believes so.

What I'm Looking Forward to at #ACR16

The ACR Annual Meeting (#ACR16) is such a huge event that it’s worth your time to spend an hour or two planning your time at the meeting. Here's my tentative #ACR16 session schedule.

Prescribing Hope

Everything will be alright in the end; and if it’s not alright, then it’s not yet the end. – Suni Kapoor (from the Best Exotic Marigold Hotel)

Reboot Your Digital Self: Part Two

Yesterday's blog reviewed why you need a digital reboot. Let's talk about the most important digital must-do's: