The cardiac dangers of excess exercise

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Regular exercise is essential for health. I’ve taken to prescribing daily exercise as a drug. I’ve even written it on a prescription pad for effect. I see exercise as medicine, a safe medicine, an effective medicine. That means, like all drugs, exercise can be overdosed. The challenge is knowing the upper limit. How much is […]

Update: Baltimore, Safety in AF ablation, Podcasts, and some personal notes

On Baltimore: Human beings rioting in the streets of an American city forced cancellation of an important cardiology meeting. This is a vivid example that doctors do not practice in a vacuum. We are connected to this world. Here in Louisville, just a few miles north, an HIV crisis runs amok because of IV drug […]

An update on cycling and writing and video (gulp)

Hi all, Things have changed for me. I have taken on a larger role at theheart.org | Medscape Cardiology. This means I have less time for hefty original posts here. (This site is not closing–just changing.) I write and read a lot more, though. Almost every day. Writing has morphed into what cycling was: a […]

Does exercise have to look a certain way? Can Yoga deliver heart health?

One of my good friends, a guru of sorts, once told me during a ride that things change. He was 50 years-old at the time and the change he was referring to was cycling abilities and priorities. At the time, I was at the peak of my cycling prowess; we were part of strong masters […]

Will wearables and other gadgets make us healthier?

Is good health really all that digital? I am not so sure. I am a skeptic. I realize this is a risky thing to say these days. It’s hard to bet against Apple. And It was only seconds after Tweeting such doubt that John Nosta, an expert in digital health technology, tweeted back: @drjohnm Health […]

The year in Cardiology 2014 — a top-10 list

When the editors at Medscape asked me to put together an essay on the Top 10 stories in cardiology in 2014, I thought it would be an easy project. I was wrong. It turns out there was a lot to say about the happenings in cardiology this year.  In the end, the final essay had 37 references–a […]

Sudden death and a common antibiotic

The longer I practice medicine, the more nervous I get about medications, especially when patients are already on other drugs for chronic diseases. I much prefer deprescribing. A recent study on the common antibiotic cotrimoxazole, which is a combination of sulfamethoxazole and trimethoprim, and often referred to by its brand name, Bactrim or Septra, lends […]

Public health is on the ballot this Election Day

Credit: High Mark Foundation

The election I am going to watch today is in San Francisco. On the ballot there is Proposition E, an initiative to add a 2-cent tax for every once of sugary beverage. Choose Health SF, a group supporting the tax, estimates it would raise $54 million, which would go towards, get this: “funding active recreation […]

Transforming the human heart with the best medicine

This is a short intro to my latest column over at Trials and Fibrillations on theHeart.org Medscape|Cardiology. —- I am not sure why doctors so often look past the best medicine. It’s right there before our eyes. Yet somehow we get sidetracked by the culture of pills and procedures. Modern-day caregivers fail to master the […]

Let’s stop the unnecessary treatment of heart disease

There are many reasons doctors suffer from burnout and compassion fatigue. One of the least-mentioned of these reasons is that much of what we do is so damn unnecessary. In the US, the land of excess everything, caregivers, especially cardiologists, spend most of our time treating human beings that didn’t need to have disease. Let’s […]

Endurance exercise and the heart — a mention in the New Yorker

Do you exercise a lot? Have you been at it for years? Are you the type that rides around the neighborhood to make a 98-mile ride into a century? Do you get squeamish if you can’t exercise for 24 hours? Are you curious about that beautiful machine in your chest? You know, the rhythmic coordinated […]