Grand Rounds - Volume 4 number 8

Greetings from Tuscon, Arizona which is only 2,000 miles from the comfy confines of home. Why did I come all the way out here just to host Grand Rounds. Well, not really, but I hope you like the pics (yes, that's really me).

These are the 43 best posts that the medical blogosphere has to offer this week. In my editors picks, I wanted to highlight well-written stories. There is also a short excerpt from each of my picks of the week.

Also, I invite you to check out my interview with the grand poobah himself - Nicholas Genes - on my internet radio show last week. Thanks Nick for being a guest on Doctor Anonymous Live and thanks for the opportunity to host Grand Rounds again.

You can also check out the Grand Rounds 4.08 Premiere Party on my show as well. Finally, don't forget to check out my Pre-Rounds interview on Medscape. Here we go!

Dr. A's Picks of the Week!

In Sickness And In Health tells a touching story about Paul and Mary and how their lives were touched by Alzheimer's Disease.
Paul and Mary were soul mates. They were best friends, lovers, and enjoyed each other’s company above all else. Even after fifty years of marriage, Paul always greeted his wife with a kiss when he returned home from the office. These days, however, his eyes watered a bit as they lingered on her mismatched outfit and the cracker crumbs clinging to her shirtfront. He watched her float from room to room in the house now vacated by their grown children as if seeking sanctuary from the enemies that were slowly stealing her memory.

Other Things Amanzi shares a surgical story that is uniquely South African.
she was massive. her bmi must have been hovering around the 50 mark. then she developed severe abdominal pain, complete obstipation and vomiting. as is common, she went to her local neighbourhood sangoma. he did what sangomas do. he made cuts over the area the patient reported to be the problem (her abdomen) and smeared his muthi (in this case, apparently cow dung) into the cuts. the idea, i think, is that the medicine can get to work directly where the problem is.

Borneo Breezes tells the tale of a medical student cholera workshop in Uganda. (Great pictures!)
As a result of their visit they learned that people in the fishing village were collecting drinking water from the Kazinga Channel frequented by hippos, water buffalo, elephants and a multitude of birds. Boiling was not regularly done because wood and money for fuel was in short supply. Oral rehydration packets in the health unit had all been used up. Juices were being made from unboiled water. Handwashing was not doing regularly and latrines were available in only one-third of the homes. So there were many possible sources for spread of cholera and much need of health education.

Vitum Medicinus, a med student in Canada, tells a story about being corrected by a patient during a physical exam.
Now that I'm in second year, that's something that I've been able to do, and be confident doing: if a patient presents to me in clinic with an ear/nose/throat issue, a heart or lung problem, a musculoskeletal problem, or an abdominal problem, I'm able to do a focused physical exam before the doctor comes in. "The doctor will come in and do an exam as well in a few minutes, but for now could you lay on your back and lift up your shirt so I can examine your abdomen please?"

A Float Floor RN describes a surprise that she really did not want to see.
He is very angry, pacing around his bed. I try to keep my eyes on his eyes. He is yelling about this and that and I am not quite following what exactly it is he is angry about. I am hearing about his dissatisfaction with the hospital food, he's run out of cigarettes, he can't get in touch with his baby momma, there aren't enough stations on the TV, get the idea. I don't talk, I just listen thinking maybe he just needs to vent.

The rest of the medical blogsosphere's best posts this week!

Running A Hospital speaks for statistical transparency to improve patient care and enhance academic medical centers.

The Fitness Fixer shares a story from Afghanistan showing options for pain other than medication.

About A Nurse describes her encounter with the alcoholic patient.

In a poetic style, The D-Log Cabin writes what it means when diabetes and dreams mix.

Who knew suturing was cool? Who says? Well, the Surgeonsblog, of course.

Finally, a technology solution to the healthcare crisis, says Musings of a Distractible Mind.

Kolahun posts for the first time to Grand Rounds and talks about the frustration of health care workers in New Orleans.

Continuing with the New Orleans theme, Daily Interview shares a conversation with the supervisor of Katrina physician Dr. Pou.

Does excess body fat cause cancer? Junkfood Science analyzes the evidence.

Nurse Ratched's Place does a meta-analysis on 20 medical romance novels in the tongue-in-cheek study.

How To Cope With Pain discusses a proposal that the USA buy Afghanistan’s poppy crop and making morphine for the world's poor.

Experts are selling molehills as mountains, Med Journal Watch proclaims, when looking at the obesity/cancer connection.

Is a spinal tap required when evaluating dementia patients? The Clinical Cases Blog analyzes this question.

Dr. Wes explains Why Medical Errors Are Good For You.

Diabetes Mine tells the story of how a girlfriend has learned more about her boyfriend and his diabetes.

Counting Sheep describes a day in the life of taking care of a trauma patient.

Dinah from Shrink Rap tells us the basics of how to select a sleep medication.

Everything Health ask why the revenue of office based physicians is falling while insurance company profits are rising.

Dr. Val tells the story of a friend, a cancer survivor and patient advocate, who received poor treatment in the ER.

A Chronic Dose shares a colleague's dilemma when dealing with the rising cost of health care.

InsureBlog writes how unprofessional medical office managers can be sometimes.

Did you know Chicago is the most caffeinated city in the US? Disease Proof states why this is a bad thing.

Teen Health 411 explains why it's important for teens to receive a flu shot.

Healthline Connects has a solution to EMRs.

Highlight Health gives a good definition of influenza, who should get vaccinated, and why the flu vaccine works.

Marc Andreesen, a venture capitalist, recently gave $27 million to Stanford Hospital. PixelRN theorizes that it could be because he reads medical blogs.

The Diet Dish gives us tips on how to reduce our diabetes risk.

Eye on DNA makes a connection between breastfeeding, genetics, and IQ.

Birth control pills slightly increase risk of cervical cancer. TBTAM, a gynecologist, puts things in perspective.

Episcopal Hospital Chaplain analyzes ethical concerns of basing human studies on animal studies.

Health Business Blog describes a networking site.

Medicine For The Outdoors asks if wildfire conflagrations can be stopped.

Tech Medicine shares his thoughts on handwashing, MRSA, and C. Diff Colitis.

Science Roll lists applications relevant to medicine that can be placed on your Facebook page.

Fruit Of The Womb talks about endometriosis.

Six Until Me shares a personal story on how blood sugar numbers have such a way of planting that little, tiny seed of guilt.

During an ER visit, Rickety Contrivances of Doing Good reflects on the differences between violent movies and real life.

Freedom From Smoking asks why docs do not treat tobacco dependence.

That's It! Sheesh! Thanks to Nick Genes for giving me the opportunity to host Grand Rounds. It was a lot of fun to put together. I hope you have fun reading all these great posts. Next week, Grand Rounds travels south of the border to Mexico Medical Student.