The Podcast by KevinMD

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Climate change, cardiac arrest, and the price of inaction Jan 02, 2021

Show notes

"We have to start understanding these as the real costs of climate change. We are paying these costs now. In my state of Oregon, people are going to start getting sick and dying in the next few days of the wildfire smoke choking the air. When they show up to the hospital with a severe heart attack, or stroke, or respiratory exacerbation, maybe it will be attributed to the wildfires, but probably everyone will just be focusing on getting through their shift, and the context of this one death, this one illness, will be missed. But make no mistake, the coming wave of hospitalizations, ER visits, and deaths is not random; it is due to climate change."

Erika Maria Moseson is a practicing, board-certified pulmonary and critical care physician.

She shares her story and discusses her KevinMD article, "Apocalypse now: climate change, cardiac arrest, and the price of inaction." (https://www.kevinmd.com/blog/2020/09/apocalypse-now-climate-change-cardiac-arrest-and-the-price-of-inaction.html)

COVID-19 vaccines: Channeling the 7 habits to get from vaccines to vaccinations Jan 01, 2021

Show notes

"As we get excited about vaccine news and results, we need to evaluate our messaging and how we can get to high enough COVID-19 vaccination rates to achieve herd immunity. This requires broad and frequent education on the safety and efficacy of the vaccines. It also requires active listening to address concerns so people can make informed decisions. The 7 Habits of Highly Effective People by Stephen Covey are relevant to the task ahead of us to combat COVID-19."

Toyin M. Falusi is an infectious disease physician.

She shares her story and discusses her KevinMD article, "COVID-19 vaccines: Channeling the 7 habits to get from vaccines to vaccinations." (https://www.kevinmd.com/blog/2020/12/covid-19-vaccines-channeling-the-7-habits-to-get-from-vaccines-to-vaccinations.html)

Bottles and pacifiers: advice from a Latinx pediatrician Dec 31, 2020

Show notes

"Growing up in Puerto Rico, 'babas' (bottles: biberón/botellas) and 'bobos' (pacifiers: chupetes/chupón) were very common among the families and children of the island. I still remember our Abuelita giving us milk in our "babas," so my younger sister and I were sure to fall asleep better. From the time of our births, to when my sister was three years old, the "bobo" was also consistently being used in our home.

Now, as a pediatrician, one of the conversations I have most frequently with my Latino families is regarding the proper use of both 'babas' and 'bobos' for their children. Were you aware that children should begin using training cups (commonly referred to as 'sippy cups') as early as nine months of age? It is also very important that your child gradually ween off the use of bottles between the ages of 12 to 15 months. Continued use of bottles after one year of age has been repeatedly documented to increase the risk of tooth decay in children."

Johanna Vidal Phelan is a pediatrician.

She shares her story and discusses her KevinMD article, "Bottles and pacifiers: advice from a Latinx pediatrician." (https://www.kevinmd.com/blog/2020/07/bottles-and-pacifiers-advice-from-a-latinx-pediatrician.html)

Why COVID is so emotional for physicians Dec 30, 2020

Show notes

"These encounters made my evening shift much more emotional than usual. I am still not sure what it was exactly that evoked such strong feelings of sadness. Was it having a patient who was a health care worker? Was it the rapidity in which all three patients' conditions deteriorated? Was it realizing that without timely, expert care, all three would die very quickly?

Or, was it hearing people wanting to relax the measures and not wear masks, without insight into how quickly things can go wrong and end up deadly?

Or, was it the cost of empathy, and just feeling the pains of my patients way too deeply?

Or, was it talking to the family members of patients and trying to answer their many questions: How will it be in the ICU? Will it be lonely? Can you please let us visit? Just one time? What can we expect? When will they recover?

Or, was it my inability to answer some of these questions? My lack of a crystal ball? Or, was it being already emotionally exhausted from managing everyday challenges of keeping life as normal as possible, with remote learning, running a household, and helping elderly in-laws with lots of medical, emotional, and personal needs?"

Jasminka Vukanovic-Criley is a hospitalist and can be reached on Twitter @criley_md.

She shares her story and discusses her KevinMD article, "The emotional side of being a doctor during the COVID-19 pandemic." (https://www.kevinmd.com/blog/2020/07/the-emotional-side-of-being-a-doctor-during-the-covid-19-pandemic.html)

Think you have an iodine allergy? You may want to reconsider. Dec 29, 2020

Show notes

"Iodine-based contrast agents are widely used for CT and other X-ray studies. They light up blood vessels and enhance perfusing tissue. These agents are essential for diagnosing everything from clots, to tumor, to bleeding. Unfortunately, many patients do not get contrast studies they may benefit from, due to unnecessary confusion about allergies.

The most important step to avoiding confusion is to start calling contrast agents by their names, as you would do for any other drug, and to remove 'iodine' from your allergy vocabulary. Like antibiotics, there is more than one kind of contrast agent. Radiologists routinely dictate the name of the agent used in their study reports, so if a reaction occurs, the information is readily available. The problem comes when we do not distinguish one agent from another. Most patients with a prior reaction were never told the name of the drug they received, and they incorrectly assume that an allergy to one means allergy to all. Not so, just like with other classes of medications."

Cullen Ruff is a radiologist and author of Looking Within: Understanding Ourselves through Human Imaging. (https://amzn.to/3qEL23Z)

He shares his story and discusses his KevinMD article, "Think you have an iodine allergy? You may want to reconsider." (https://www.kevinmd.com/blog/2018/08/think-you-have-an-iodine-allergy-you-may-want-to-reconsider.html)

Behind the scenes of a hospital's COVID response Dec 28, 2020

Show notes

"In the midst of a COVID-19 pandemic, getting a flu shot has never been more important.

Many people are staying indoors, wearing a mask, and washing their hands frequently. In this environment, patients ask me, "With all this social distancing, do I really need a flu shot this year?" The answer is unequivocally, "Yes!" Even the safest practices do not guarantee that a person won't catch the flu or the coronavirus. For people who are at high risk of becoming seriously ill from either the flu or from COVID-19, it is critical that they get their flu shots before the start of the flu season in the fall.

A bad flu season could combine with the coronavirus pandemic in the fall and winter. And because both illnesses present with the same symptoms, it is possible that physicians will have to test sick patients for both."

Grace Lozinski is an internal medicine physician and chief quality officer, Hoag Memorial Hospital Presbyterian, Newport Beach, CA.

She shares her story and discusses the KevinMD article, "The flu shot is more important this year than ever." (https://www.kevinmd.com/blog/2020/09/the-flu-shot-is-more-important-this-year-than-ever.html)

Food allergies are not funny Dec 27, 2020

Show notes

"If we do not raise objections to this kind of comedy, we are teaching those around us that food allergies can be funny. It is no that surprise that data indicates kids and adults are anxious, embarrassed, and bullied due to food allergies. When we make light of anaphylaxis, we perpetuate the misleading stigma regarding food allergies.

It has been my steadfast belief that in educating the greater public on the potential severity of food allergies, we will reach a point where it will be taboo to make these kinds of 'jokes' publicly. I hope for a day that it is simply unacceptable to joke about food allergies. Clearly, we are not there yet."

Lianne Mandelbaum is founder, the No Nut Traveler, and can be reached on Twitter @nonuttraveler.

She shares her story and discusses her KevinMD article, "Food allergies are not funny." (https://www.kevinmd.com/blog/2020/07/food-allergies-are-not-funny.html)

Surgical smoke evacuators and inertia in the time of COVID Dec 26, 2020

Show notes

"Early in the pandemic, in thinking of and discussing possible solutions to help protect health care workers, two of my former colleagues and I recalled a device called the Surgical Smoke Evacuator (SSE), which we used extensively since the 1990s when we worked together at the University of Pittsburgh to collect and safely dispose of the papillomavirus-containing smoke and aerosol cloud generated during the laser or electrocautery removal of laryngeal, cutaneous, and genital warts (papillomas). These FDA-approved air suction devices are still in routine use today in operating rooms around the world. They have been vigorously advocated by organizations such as the Centers for Disease Control (CDC), the Association of periOperative Registered Nurses (AORN), and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES).

SSEs utilize a very powerful suction pump and the most effective small-particle filter, the ultra-low particulate air (ULPA filter) used in clinical medicine. ULPA filters are much more effective at trapping particles the size of coronavirus (which are only approximately 0.1-0.12 microns in diameter) than are the better-known and more commonly-used and better-known HEPA filters."

Rene' M. Gonzalez is an anesthesiologist.

He shares his story and discusses his KevinMD article, "Surgical smoke evacuators and inertia in the time of COVID." (https://www.kevinmd.com/blog/2020/11/surgical-smoke-evacuators-and-inertia-in-the-time-of-covid.html)

Talking politics in the exam room Dec 25, 2020

Show notes

"The medical profession now understands that social determinants of health are probably the most important driver of a patient's overall health, and these determinants are largely the result of political decisions. Clearly, we have a professional responsibility to teach our patients the science underlying their health issues. Don't we also have a professional obligation to ensure that our patients understand the health ramifications of their political choices? If that is the case, do we not have a professional obligation to initiate a conversation about the political issues which impact our patients' health?

If we fail to breach the taboo of 'talking politics' in the exam room, are we not shirking our professional responsibilities to our patients and society?"

Hayward Zwerling is an endocrinologist who blogs at I Have an Idea.

He shares his story and discusses his KevinMD article, "Talking politics in the exam room." (https://www.kevinmd.com/blog/2020/09/talking-politics-in-the-exam-room.html)

Why corruption is ruining your health care Dec 24, 2020

Show notes

"Doctors help patients, and they love us for it. We fix bones, replace joints, cure killer infections, and control diabetes with insulin. We use painless scans for diagnosis. Liver, kidney, and heart transplants are now routine. Some patients get cured of lymphomas, leukemia, Hodgkin's disease, and testicular cancer. Lives are prolonged for myeloma and amyloidosis. Vaccines have saved millions worldwide.

We have complex technologies such as the heart bypass machine and dialysis. We replace diseased heart valves with artificial ones that work. Cardiologists permanently correct irregular rhythms using techniques that would seem natural on Star Trek. Other specialists gift infertile couples with children.

For a lot of the rest, supporting evidence that it works is lacking."

Robert Yoho is a cosmetic surgeon and author of Butchered by "Healthcare": What to Do About Doctors, Big Pharma, and Corrupt Government Ruining Your Health and Medical Care. (https://amzn.to/36U4sdj)

He shares his story and discusses his KevinMD article, "How I was wrong about health care." (https://www.kevinmd.com/blog/2020/09/how-i-was-wrong-about-health-care.html)

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