In recent years, progress in the field of cardiology has been painfully incremental. We have enjoyed small gains–a better ablation catheter and mapping system, a couple of new anti-platelet drugs, maybe better stents, and even the highly touted anticoagulant drugs are within 99% in efficacy and safety of warfarin. Major breakthroughs, though, are non-existent. (And […]
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More than a few commenters recently noted something disturbing in my writing. They said my words are increasingly taking a blame-the-patient tone. That bothers me. Of all people, I know about making imperfect health choices. These comments got me thinking about striking the right balance in writing about health, say, between apathy and defeatism, (oh […]
When Dr Eduardo Hernandez Castillo (@CardioLeaks) asked me to come to Mexico to speak with a group of physicians about the power of social media, I paused. Should I go to Mexico? I have been traveling a lot; it was a long trip; I was just starting to get fit again, and the atrial fibrillation/anticoagulation […]
The thing about US healthcare that bothers me most is the waste: the nuclear stress tests on demented patients in diapers, the MRIs for every case of back and knee pain, the egregious pre-op tests for low-risk surgeries, the mega-workups for simple cases of AF, the disease mongering in the name of prevention, and most […]
I receive many emails about AF. I don’t often answer them because it is bad practice to doctor without seeing the person. Recently, however, I received a note with more general questions. The sender suggested I could use the response as a blog post. The reason I am posting these two cases along with my […]
Patterns. As a doctor, you learn to see patterns. Biologists call the patterns of organisms phenotype–as opposed to genotype, the genetic makeup. For twenty years, I have observed the phenotypes (patterns) of people afflicted with AF, and have come to believe, and data are beginning to confirm, that the disease doesn’t just happen. It’s not […]
Let’s talk about success. At first glance, knowing whether a medical or surgical intervention achieves success seems quite simple. An antibiotic clears an infection–or it does not. A surgery removes a tumor with clean margins–or it does not. An angioplasty and stent open an artery during a heart attack–or it does not. In the case […]
It happened while I was leaving a grocery store in the southeastern United States. The young girl who asked me if I wanted to buy Girl Scout cookies was strikingly perfect. She was thin, happy, and well spoken. So were her colleagues. The moms, too, were of healthy weight and cheer. It was as if […]
Atrial fibrillation is a mysterious disease. We know a lot but surely not enough. We look at AF but are we really seeing it? I believe there are hard truths to this disease. Hard in a way that neither patients nor doctors like. More on that later. First to some news on a major AF […]
Now that the ‘healthiness’ of products sold at CVS stores is a matter of public discourse, it seems a perfect time to mention the common pain relievers known as Non-Steroidal Anti-inflammatory Drugs (NSAIDs). It just so happens that two FDA advisory committees are meeting today and tomorrow to discuss the cardiovascular risks of NSAIDs. The […]
Yesterday, CVS Caremark announced that its 7600 stores will stop selling tobacco products. Company leadership said that selling tobacco is not consistent with being a health company. This decision, which takes effect in October 2014, will result in 2 billion less revenue. I am no business person, (though, as an observer of humans, I follow […]