A Domain-Based Approach to the GRAPPA Psoriatic Arthritis Treatment Recommendations

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With their publication in June 2022 (1), the 3rd iteration of the Group for Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) Treatment recommendations for Psoriatic Arthritis (PsA) may have set a record or sorts.

I Need a Nemesis

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A nemesis is so much more than the "enemy". Your nemesis defines what matters most to you and how you will overcome. Seth Godin once said, “Pick your enemies, pick your future”.

A Rare Disease Doctor

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Yesterday was national “Rare Disease Day” in the USA, with many tributes to the patients, doctors and researchers dedicated to these disorders.  Moreover, it was a great opportunity to shout about the many rare conditions that don’t often get enough press, praise or funding.

Rheumatology Valentine

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My uncle is going through medical hell.  As a committed iatrophobic (fear of doctors), any mention of phlebotomy, tests, needles or a clinic visit evokes flop-sweat.  Since being slapped with a cancer diagnosis, he has overcome a lot, and much to my surprise has bravely done so. When I asked how he has adapted so well to the medical onslaught he now leans into, his answer was quick and poignant.

A Guide to Self Care of (Mild) COVID19

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There is guidance published on how to manage moderate to severe cases, but very few blueprints detail what to do with “mild” infection.  The first day, I developed congestion and cough, with a sore throat.  As the day progressed, I started to have chills, low grade fevers, and myalgias.  The postnasal drainage was overwhelming, and when I tried to swallow, it felt like swallowing broken glass.  Isolating in my room, I was left to deal with my symptoms.

Freeze Tag

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A beloved childhood game I enjoyed was Freeze Tag. Players would run to avoid being tagged by the person who was “It”.  If you were tagged, you had to “freeze” in your spot until someone was brave enough to come un-tag you.  The game ends when everyone is frozen or if people quit. For over 2 years, I have been living in a real-life “Freeze Tag” game and able to dodge COVID19, until now. Sitting in my room symptomatic and frozen in isolation, I ruminated about my patients who had COVID19 and their experiences. I wanted to share with you three stories of three variants.

Who is Your Glue?

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I’ve often talked about the nurses in my clinic as being the glue, the clinic glue, my personal glue. Without them, the day and task would never go as well and just might crash and burn, if not for their steadying influence.

Best of 2021: Drug Safety Risk Communication- The 800 lb Gorilla Approach

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Discussions on drug safety can be as treacherous as quicksand for the patient and physician. What the physician knows and what the patient perceives may not be in sync.

Best of 2021: 20,21 Whatever it Takes

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Amazingly, we made it through 2020, a most forgettable year.

Life was great in the first 3 months of 2020, and then COVID hit the fan and a pandemic steamroller derailed life as we knew it.

Best of 2021: Zoomatology – Present in Absentia

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Are you a zoomatologist or a doomsatologist? Zoom has replaced the meeting, the teleconference or the board meeting. If your old meetings were bad, then your replacement zoom meetings will also be bad, if not worse. Largely because you have failed to master the medium. Here are the rules of Zoom.

Best of 2021: My Personal Delta COVID-19 Breakthrough Infection

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As many of you are aware, I have written and spoken on COVID-19 extensively over these past 20 months, and just last month wrote about the dangers of the delta variant. In July, things took an unexpected turn when I developed a breakthrough infection with the delta variant.

Best of 2021: Consults in Cars

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In this episode of Dialing for Doctors (aka, Tales of Telehell), we consider a growing subset of telehealth seekers connecting from their cars. This has happened several times and it always catches me surprise. While I've had "live" televideo visits with patients walking the dog, waking up in bed, and from the waiting room of another doctor's office, consults in cars is about the nuttiest. What is the patient's role in telehealth?