Thursday, June 16, 2011

Everybody Quits--Someday!

When discussing smoking cessation with patients, I often have a simple argument. For my business, smoking is good. Smokers are major percentage of my patients. To stay busy, I ought to promote smoking.

However, my oath is to do the best for the patient. Therefore, it is imperative that I get my point across how important smoking cessation becomes in reducing future morbidity for the individual.
Most improtantly, I impress on the patient that EVERYBODY QUITS.....SOMEDAY.
Some quit after they die--THIS IS TOO LATE.
Some quit after cancer affliction--THIS IS ALSO LATE.
Some quit after a heart attack or heart surgery--Better late than never.
Some quit when the doctor tells them to--Good choice.
Some never start--BEST CHOICE.

This approach has helped me achieve significant success in getting patients to stop smoking.


Saturday, August 21, 2010

Coronary Disease and Myopia

I often explain to patients with severe coronary disease who are immediately status post bypass surgery. In high school, my teachers noted that I was squinting when reading the black board. One suggested that I get an eye exam. I found out that I had very poor vision which was not notable to me as the visual loss had been a slow progressive disease. I assumed every one was "seeing" like me. Then after taking home my glasses, I noticed "wow." It was unbelievable how well I was seeing. It was then that it became clear that I had been suffering for a long time from a "disease" which I did not know.

In the same manner, cardiac disease involving the coronary blood vessels, leads to slow "plugging" of the involved vessel(s) over time. The patient may not appreciate the degree of fatigue, weakness, low energy and may atribute symptoms to deconditioning rather than admit there may be a heart problem, until debilitating angina keeps him or her from completing daily activities.

Then the diagnosis is sudden. The treatment is oftent immediate. After a short recovery period, he or she may feel exactly as I did after my glasses. "Wow!"


Sunday, December 13, 2009

Thin Man

Access
Ever Access
Dual Access
Ever-Lean
Leanstent
Purdue
PopEye


Names

Abb-Stent
Abstent
Abs-Stent
Abbsent
Absent
Abs(two stents making T) ent
Ever-and any of above

Friday, December 11, 2009

Stent

I toured the abbott factory in Temecula today. It was fun.
I offered them the name Abbs-stent, Abbstent, Abs(two stents making T)ent, Abbs(two stents making T)ent or event Ever-preceding any of the above names--as potential names for the new bio- absorbable stent

I also offered them Access as name for the thin-man stent or Ever-Access.....

Thursday, November 26, 2009

The Flight

As an interventional cardiologist, I routinely perform risk-laden procedures on patients. Coronary angiograms, angiolplasty and stenting are to name some. Theses procedures have inherent risk including bleeding, infection, perforation, heart attack (ironically), stroke, kidney failure, limb loss and even death. These risks are rare with risks ranging from 1% to 1:10,000.

Akin to taking a flight which has inherent risks of being late, engine failure, landing in water, crashing into a mountain and even death, there is always an alternative which is not flying in the first place. However, sometime one needs to fly regardless of the plane's mechanical condition, regardless of the weather and regardless of risks beyond one's control. What risks an individual takes to proceed are really up to the individual.

I liken the patient to the plane and myself to the pilot and my team to the crew. No one wants a failed or complicated flight as no one wants a procedural complication. No one wants a plane crash as no one wants for the patient to suffer. However, there are inherent risks. Even the best pilot and plane can hit birds and end up in the Hudson.

We try to optimize risk by taking extreme measures but despite this we can not negate risk to zero. One thing that remains certain, when risk benefit is calculated appropriately and the indications and alternatives are explained, flying remains the safest mode of transportation.

Wednesday, November 25, 2009

Youth is wasted on the young

Assume life was $100 bill. So crisp, so hard earned. Realize how carelessly, we move through and spend the first twenty dollars. The next thirty is spent cautiously, but quickly in preparation for spending the last $30. However, too often we discover that the last 30 can quickly be robbed from us...poof.

Youth is indeed wasted on the young.