Spring 2011
PMH STORY by Robert Kelly MD FACP
“My direct access to you and your attention to the details of my care is worth a million.” A gentleman’s pain had begun unexpectedly. There were questions whether or not the pain was caused by a disease which would require surgical intervention. He had undergone cervical spine surgery in the past for a painful condition and had done well, so the possibility of another surgery was considered.
After seeing the patient in the office he was admitted directly to the hospital. Over two days, he was seen by subspecialty caregivers to assess why this pain in the lower back was occurring. Unfortunately, an emergency at home prompted him to have to leave the hospital unexpectedly before definitive care.
At home, after addressing his emergency, pain, nausea and vomiting persisted. He called his PMH doctor and reported that the pain was not improving and he was having recalcitrant nausea and vomiting. He was again directly admitted to Harris Hospital for further care.
In the hospital, a team from neurosurgery, urology, and palliative medicine, including an anesthesiologist, saw the patient. After five days in the hospital with attention to pain relief he showed no need for surgical intervention, and the pain began to abate. He was able to eat, and the nausea and vomiting resolved.
The patient was pleased by the way, at each step, he had been able to reach his doctor and describe his complaints. This led to prompt effective intervention. His quote appears above.
Subscribing to Premium Medical Home and being a patient in a Premium Medical Home benefits subscribers and patients. It allows direct access. It provides attention to interdisciplinary care and the attention, when appropriate, of a subspecialty team coordinated by a trained expert physician who knows the patient well. This is a great value to patients and family.
DO STERIOIDS HELP JOINT PROBLEMS by Allan Kelly MD FACP
Common joint and tendon problems can improve with exercise and weight loss. Pain relief can be achieved with drugs like Tylenol, and elastic supports can be helpful at the wrist and the ankle and the elbow. Other interventions are less certain……
THE RISK OF BLOOD CLOTS FROM LONG FLIGHTS by Robert Kelly MD FACP
The risk of blood clots goes up after a long airplane ride, The absolute risk is low, less than 1%. In an average group of 400 passengers on a flight lasting for 12 hours, it is probable that one person may have an episode of blood clot from the flight…..
FATIGUE by Allan Kelly, MD FACP
Fatigue is a common symptom for patients making a doctor appointment. Fatigue is something that we all experience: It can be a part of our daily life, even in people who are healthy and strong. Fatigue is also a common manifestation of illness. Infection, malignancy, metabolic diseases, diabetes, and others will, in the natural history of the illness, cause fatigue……..
NEW CANCER STATISTICS by Robert Kelly MD FACP
The March issue of CA, a cancer journal for physicians, included a review of cancer incidence. Worldwide, approximately one third of cancer deaths were potentially avoidable through reducing major risk factor, including tobacco use, unhealthy diet, physical inactivity, infection, unsafe sex and alchol use………
Medical Quotes:
“Medicine, at its fundamental, is still about suffering, healing, and comforting; it is about individuals; it is about relationships and trust; it is about stories…… Concern of coding, billing, documenting, administration, computers, surveys, rules, regulations, and politics have increasingly occupied my mind and space like an intracranial tumor.”
– Michael Monroe, JAMA, Volume 305, No. 12, Page 1176 to 1177