Vaping has been in the news a lot lately, with reports of at least one death from respiratory complications and a number of cases of patients who develop acute respiratory problems, requiring hospitalization. In some cases, these were thought to be due to persons who were vaping THC, rather than a nicotine source. Studies have […]
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Chronic pain often goes hand in hand with opiate use. Most physicians nowadays are being encouraged, with good reason, to try to limit use of opioids and encourage patients to find alternative approaches. Studies have shown that, often, using tylenol and ibuprofen in combination will provide as much pain relief as hydrocodone or similar opiates. […]
The US Preventive Services Task Force updated their recommendations for prostate screening in May, 2018. For men between the ages of 55 and 69, they recommend that a decision should be made by the patient on the basis of a discussion with their doctor, considering the benefits and harms of PSA screening. So, you might […]
An update of a previous Cochrane review was published in January, 2019 to ask the question whether general health checks reduce illness and deaths. They examined 15 reported trials of annual examinations which included 251,298 participants. Their conclusion is that general health checks are unlikely to be beneficial. This is a somewhat disturbing conclusion from […]
The US Preventive Services task force recommends mammograms every two years for women, beginning at age 50. They suggest that a decision to obtain a mammogram before 50 years of age should be based on individual factors, including a woman’s individual level of concern about detecting breast cancer. They further recommend that women may stop […]
Whether or not you have a diagnosis of hypertension, or are taking medication for it, measurement of the blood pressure in the physician’s office often poses problems. For patients who don’t have known hypertension, but whose office pressures are high, their pressures are often normal when measured by them at home, using their own blood […]
This post is the first of a series of articles on prevention. I prefer to follow the US Preventive Services guidelines, which are authoritative and evidence based. Adults should be screened for colorectal cancer beginning at age 50 and continuing until age 75 years. This should be done using either fecal occult blood testing, sigmoidoscopy, […]
Patients often ask whether or not they need a coronary artery scan. This is a CT can of the heart to determine the presence of athersclerotic plaques in the coronary arteries and, presumably, whether or not you are at risk for cardiovascular disease. There are other tools to determine your risk, such as your cholesterol […]
Most experts recommend at least 150 minutes of aerobic exercise per week. It is easy to neglect this. In fact, studies show that the majority of Americans don’t get this minimum recommended amount of exercise weekly. We live busy lives, it is hard to get up early enough to exercise before work, we get home […]
The Direct Primary Care model at Dr Smith Direct Care uses technology to make most office visits unnecessary and obsolete. Every day, I communicate with patients about how new medications are working, whether adjustments need to be made, or whether new problems or symptoms are occurring that need attention. Other patients are more comfortable texting […]
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