New Concussion Guidelines Stir Up Controversy

Posted on June 9th, 2009 by Doc Shazam

In this latest NYT article about Concussions in Youth Sports critics of the new policy state that more kids will be injured as a result of it.  Fear that a student will hide or mask symptoms in order to stay in the same-day game has sideline docs and coaches recommending against the new guideline!

My thoughts are that peer pressure should not influence medical decision making.  Plenty of times in the ED patients, parents and adult children alike try to manipulate my recommendations to mold to their current circumstances. I always remind them that my job is to make a medical evaluation and appropriate reccomendation. What they choose to do with my recommendation is entirely up to them.

I try to leave them as fully informed as possible.

If scientific research shows that it is safer to pull kids from a same day game for any evidence of a concussion, who are the sideline docs and coaches to say that this policy is unsafe?  All we can do is educate.  The arguments against this policy are one reason why I do not envy sideline docs, because my decision would be to bench every kid that got hit in the head until further evaluation cuold take place. It’s just not worth the risk.

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My Policy on User Comments

Posted on March 11th, 2009 by Doc Shazam

I have noticed a large increase in the number of comments left in an effort to get backlinks to affiliate website and blogs.  While many of these are somewhat healthcare related, If you leave a comment that says something like:

“Interesting thoughts, I’d like to hear more”

and then provide a link back to “My Healthy Skin Site”, I will immediately flag it as spam

Please provide relevant comments or risk having your URL flagged as spam by the askimet plugin preventing you from posting on any wordpress blog.

For those of you commenting appropriately, please continue to do so.  I believe my Sumatriptan post has nearly 50 comments so far, and I publish every one of them whether it is pro or con because I feel it’s important to have people see all sides.

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Generic Imitrex (Sumatriptan) - Is it as Effective as Brand Name Imitrex?

Posted on December 8th, 2008 by Doc Shazam

Some of you may know that Doc Shazam suffers from an occasional migraine, worse at a certain time of the month, and exacerbated by lack of sleep and irregular work schedules…something not uncommon to ER docs.

I have used Imitrex with great success since my 2nd year of medical school.  Typically a 50 mg tablet relieves my headache with nearly 100% effectiveness within about 45 minutes to an hour with no significant side effects.  The first few times I took it, my muscles felt a little bit “wierd”, but otherwise no real problems.

Yesterday I obtained a refill for my Imitrex and was told that it was available in generic form, with a co-pay that was $15 instead of $35.  I was pretty excited as the outrageous cost of imitrex (over $200 for 9 tablets!) is prohibitive for a lot of people, myself included.

Since then I have taken 2 of “Dr. Reddy’s” generic sumatriptan tablets with almost no relief of headache symptoms, but a plethora of side effects, including aching muscles, nausea, “light headed” feeling and general dis-ease.

My conclusion is that they don’t work as well as brand name Imitrex for me.  Does anybody know if I can return the unused pills? I hate to have my insurance charged for medicine that isn’t going to get used.

Guess I’ll have to make some phone calls tomorrow.

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Transcript of Obama’s Election Night Speech

Posted on November 5th, 2008 by Doc Shazam

Already, someone has transcribed this speech.  I’m not the most politically savvy person in the world, probably among the least.  But I’ve never been so enthralled as to listen to a politician speak.  Now I want to go backwards and listen to all the speeches I didn’t hear, even back into his days as a state politician and law student.  He’s always seeming to overcome, but I guess that’s what happens when you are a smart, successful, eloquent, passionate, mixed minority, charismatic leader in the right places at the right times with the right world, political and local circumstances compelling the people to make their opinions count.

Here is the transcript of Obama’s Election Night Speech

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Daylight Savings Time Causes More Heart Attacks

Posted on October 31st, 2008 by Doc Shazam

Yes, I thought that the study headline seemed odd as well…after all how would a man-made construct…the clock…lead to more heart attack deaths?

In a widely report on study from the New England Journal of Medicine, heart attack deaths and hospitalizations dropped 5 % the day after clocks “fell back”, ending daylight savings time.

Could the causative factor be, oh, I don’t know…an extra hour of sleep?

Americans are chronically sleep deprived, including Doc Shazam.  THe problem is that we think that this is normal…it’s a badge of honor to be able to “function” on 4,5,6 hours of sleep per night. In reality, we only learn to tolerate the chronic fatigue associated with the lack of sleep.

What we don’t see is the toll this takes on our bodies on the inside…inflammation, arthritis, allergies, asthma, immune system problems, frequent colds, etc…

The very first thing I notice when I’m sleep deprived? My knees hurt.  They ache all day and all night.  Funny that they were fine all summer while I was working in Colorado, a regular schedule albiet 7am-7pm…my body was used to the schedule and I got 8 hours of sleep per night.

But now?  I work till 1AM or 3AM, come home, wind down for several hours, get to bead at 4, 5, 6 AM, try to sleep while it’s light out, and get up aching everywhere.  It’s not right, it’s not a natural schedule.

Just like those people in the study, my schedle is an artifiicial construct of modern society and modern medicine.  Convenience care in the ER at 10pm..what?  I’m losing sleep over some punk who wants a z pack for his cold?

The increase in heart attacks is not due to daylight savings time at all…it’s due to the artifically contrived workday requiring one to be in an office for a set duration of hours and at a certain time.   I’m all for going back to a society where we go to bed when the sun goes down and get up when it rises, living in harmony with the circadian natural rhythms.

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Uninsureds Don’t Tell the Whole Story - and a little rant…

Posted on October 30th, 2008 by Doc Shazam

In this New York Times report of  a recent study, the uninsured did not take up a disproportional amount of volume in the ER for minor complaints.  Uninsured people DO tend to be more informed users of hospital resources because they know that they will get a bill in the mail and have to pay it.  So this is a great study to bring light to a number of issues.

What’s truly disturbing is the study’s documentation of how many people come to the ER for minor complaints

 As it turns out, people who have public insurance, such as Medicaid, were more likely to crowd into the emergency room for minor complaints, especially in low-income areas.

This makes total sense to me…in my experience, the patients that  tend to be most demanding and least appreciative of the services offered in the ER, feeling that it is their right to receive treatment, regardless of acuity and regardless of cotemporaneous demands of the ER are medicaid patients.  Remember me telling you about the 2AM delivery of the premature infant where I was the only doc working, and the nurse could not leave the room?  The group in the next room over was furious at the inadequate care received because no one would bring them a glass of water!  Can you guess what insurance they had?  Yep, medicaid.  GOMER.  Get Out of My ER.  If you are well enough to complain about no one bringing you a glass of water when you have two visitors with functional feet and legs, then you don’t need to be in my ER. Go away.

Whoops…sorry for that little rant there, lost control of myself.

I’m not saying that I don’t like the fact that medicaid exists, I’d imagine many children are happier and healthier because their parents were able to bring them to the ER at night for asthma and pneumonia (although why their parents continued to by cigarettes is beyond me…).

What I am saying is that the government needs to direct healthcare dolllars to places that are going to have the biggest impact on healthcare….I don’t know where that area is right now, but there are certainly a number of places to look.

Capitalistic healthcare is not working in this country.  How about taking $700 billion dollars of your money and putting towards a few fixes?

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Another #1 Google Ranking for “How to Fake Wheeze”

Posted on October 30th, 2008 by Doc Shazam

I love it!  My post on How to Fake Wheezing and Stay out of Jail is ranked #1 for the google search phrase ‘how to fake wheeze’!

Satisfaction indeed.

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The Hallway is the New Place to Be

Posted on October 28th, 2008 by Doc Shazam

When I saw this headline on CNN I was afraid they were going to get the story all wrong.  But this reporter did a good job of explaining at least part of the situation:

Hospitals put Patients in Hallways

My favorite quote from the article, with which I agree 100%

“I wish the $700 billion went for hospitals, roads and bridges and not to bail out those folks on Wall Street,” he said.

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Can I base my voting off of this poll?

Posted on October 25th, 2008 by Doc Shazam

77% Bill Richardson
74% Chris Dodd
72% Hillary Clinton
71% Barack Obama
68% John Edwards
59% Joe Biden
54% John McCain
53% Dennis Kucinich
53% Mike Gravel
49% Mitt Romney
44% Rudy Giuliani
42% Mike Huckabee
42% Tom Tancredo
38% Fred Thompson
37% Ron Paul

2008 Presidential Candidate Matching Quiz

Apparently, I’m STILL a democrat.

Take the Presidential Candidate Matching Quiz Here.

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Guess we know which way I’ll vote…

Posted on October 23rd, 2008 by Doc Shazam

I’m ranked number 8 on Google for a search on “don’t vote for McCain reason“.

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