Feeds:
Posts
Comments

Posts Tagged ‘physician evaluation’

From the Physician’s Desk … Weekly Blog!

Don’t forget to visit … http://www.LegacyEducators.org and click on “Cancer Information”

——————————-

October is Breast Cancer Awareness Month. Although breast cancer is only one of many cancers, I am pleased of the exposure that the many “pink” ribbon brings. It gives me hope that other cancers can have a similar banner of awareness…in the near future. Despite our many progress and technological advances in medicine, cancer remains the second leading cause of death in the United States. For example, Breast Cancer has over 220,000 new diagnosis annually, and over 400,000 deaths each year. Many are surviving a longer time thank in the past.

  • Overall, cancer has taken on a more “chronic” long term debilitating effect, for those who survive initial treatment and are then diagnosed with recurrence/metastatic disease.
  • One the most feared symptom in this category of patients is pain. Overall, 50% to 70% of people with cancer experience some degree of pain, which usually intensifies as the disease progresses.
  • Less than 50% of these patients receive adequate relief of their pain, either because they are afraid to ask because they fear “addiction”, or physicians are unlikely to prescribe adequate medication to attain relief that will allow the patient continued good quality of life.
  • Suboptimal pain control can be debilitating and caregivers are often times unsure how to address this issue.

pm_general_cp_pain_approachThe World Health Organization program for cancer pain control recognizes that 1 in 5 patients with cancer has uncontrolled pain and has a ‘three-step ladder’ for the rational use of analgesics including morphine (recommended adaption to 4-step-ladder – see HERE).

Analgesic pain 4Morphine has long been the ‘gold standard’ for the treatment of severe cancer pain. However, its side-effects, particularly sedation/drowsiness, and cognitive impairment have led to ‘opioid rotation’ to alternatives such as methadone and hydromorphone. The one I like to use most in uncontrolled pain situation is the 72-h transdermal patch for Fentanyl, which offers advantages of reduced side-effects and increased convenience over oral morphine. Another novel pain medication is Intravenous (IV) strontium-89 and bisphosphonate therapy which are effective for both short- and long-term control of metastatic bone pain.

Pain Management Physician Review

Patient Discusses Pain

——————————————–

Remember …

Ipsa Scientia Potestas est    ———  Knowledge itself is power!

Don’t forget to visit my website … www.LegacyEducators.org 

Your Family Friendly Doc … Dr McGann!  

See you next week…

 

Read Full Post »

From the Physician’s Desk … Weekly Blog!

Don’t forget to visit … http://www.LegacyEducators.org and click on “Cancer Information”

——————————

We have become a very busy society.  Everything moves fast and the demand for “faster” is on the rise. Attention spans are limited to a few minutes and “waiting” and “patience” will soon be removed from our vocabulary, garnering looks of disbelief, and ultimately tagged as “bad” words.

While I am in great favor of advancement, prompt customer service, and completing the task at hand quickly, there is something to be said for a doctor’s visit that is slower and specific to one’s needs or ailments. Physicians have great demands on their time as well, and their services are in danger of becoming similar to assembly lines: patients must be seen quickly and passed along to the next section to meet Relative Value Units (RVU’s) for reimbursement.

PAUSE.

touch1Things must be slow enough in a clinic, such that a patient is touched – a Physical Exam (PE) focused or otherwise should be performed. I am bewildered by reports of folks being seen by healthcare providers and not even being touched/examined. Gathering vital signs (blood pressure, respiratory rate, temperature, etc.,) and the history are only portion of a doctor’s visit.

Digital health is the new wave, as patient call in with their questions and symptoms and a likely diagnosis is given over different media platform. However, take note of the disclaimers…

So, what type of physical exam should be expected at a Physician’s office? Well, it truly depends on the complaint or reason why you visited in the first place. Some are more direct than others.

Complaints of:

  • touch2Abdominal pain or discomfort – look, palpate, press the abdominal region
  • Cough – listen to lungs, heart, look in the mouth, feel neck nodes, etc.,
  • Back pain – look at skin, palpate area (bone, muscles, etc.,)
  • Earache – look in the ear, look in the mouth, palpate the neck nodes, etc.,
  • Breast pain – breast exam including visual, palpating, eval under arms, above clavicle and neck nodes…

The bottom line is: When someone sees their healthcare provider any reason, at the very least, a focused physical examination should be performed. No excuses. AND, if they do not, speak up and ask why!

Annual Physical Examination

Focused History & Exam for Headache

Complete Physical Exam

——————————————–

Remember …

Ipsa Scientia Potestas est    ———  Knowledge itself is power!

Don’t forget to visit my website … www.LegacyEducators.org 

Your Family Friendly Doc … Dr McGann!  

See you next week…

 

Read Full Post »