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Best of 2021: Steroid Poker

It began as many cases do: an ill patient, in the ICU, with signs and symptoms across several body systems, yet no clear unifying diagnosis on admission. With things stabilizing, the internal medicine hospital team on which I was serving as hospitalist that week assumed care of the patient. As the case unfolded – pulmonary infiltrates that could be hemorrhagic, renal dysfunction with proteinuria – rheumatic diseases rose in the differential. When serologic studies and other data suggested GPA rather than glomerular basement membrane (GBM) disease or other possibilities such as infection, it seemed the right time to act. And that is when a game of what I call “steroid poker” began.
2020 dead crime scene

Best of 2021: 20,21 Whatever it Takes

Amazingly, we made it through 2020, a most forgettable year.

Life was great in the first 3 months of 2020, and then COVID hit the fan and a pandemic steamroller derailed life as we knew it.

zoom room

Best of 2021: Zoomatology – Present in Absentia

Are you a zoomatologist or a doomsatologist? Zoom has replaced the meeting, the teleconference or the board meeting. If your old meetings were bad, then your replacement zoom meetings will also be bad, if not worse. Largely because you have failed to master the medium. Here are the rules of Zoom.
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Best of 2021: My Personal Delta COVID-19 Breakthrough Infection

As many of you are aware, I have written and spoken on COVID-19 extensively over these past 20 months, and just last month wrote about the dangers of the delta variant. In July, things took an unexpected turn when I developed a breakthrough infection with the delta variant.

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Best of 2021: Consults in Cars

In this episode of Dialing for Doctors (aka, Tales of Telehell), we consider a growing subset of telehealth seekers connecting from their cars. This has happened several times and it always catches me surprise. While I've had "live" televideo visits with patients walking the dog, waking up in bed, and from the waiting room of another doctor's office, consults in cars is about the nuttiest. What is the patient's role in telehealth?
Couple walking on beach with dog

Redefining Aging

I was thrilled that the American College of Rheumatology put together the Community Aging Hub and multiple sessions to help rheumatologists identify gaps in care for older patients with rheumatic diseases. My friend and colleague, Dr. Una Makris, taught me the 5 M’s of aging that should be assessed in our patients.
poker.jpg

ICYMI: Steroid Poker

It began as many cases do: an ill patient, in the ICU, with signs and symptoms across several body systems, yet no clear unifying diagnosis on admission. With things stabilizing, the internal medicine hospital team on which I was serving as hospitalist that week assumed care of the patient. As the case unfolded – pulmonary infiltrates that could be hemorrhagic, renal dysfunction with proteinuria – rheumatic diseases rose in the differential. When serologic studies and other data suggested GPA rather than glomerular basement membrane (GBM) disease or other possibilities such as infection, it seemed the right time to act. And that is when a game of what I call “steroid poker” began.
virus,injection,COVID,vaccine

My Personal Delta COVID-19 Breakthrough Infection

As many of you are aware, I have written and spoken on COVID-19 extensively over these past 20 months, and just last month wrote about the dangers of the delta variant. In July, things took an unexpected turn when I developed a breakthrough infection with the delta variant.

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Interview Season

We are at that time of year when rheumatology fellowship programs across the nation are exploring potential candidates to train. Program directors work hard to attract the finest candidate, hoping to shape a future leader; applicants want to impress programs with their experience and desire a place where opportunities are available to explore their potential. So how does a program choose from a large pool of qualified applicants to fill just a few seats? What should applicants look for in a program to ensure a good fit? 
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Three Healthcare Hashtags You Should Follow 

I've sent more than 2,000 tweets since joining Twitter in July 2010. Even better, I've read (and sometimes shared) thousands of other educational, informative and sometimes humorous tweets from fellow rheumatologists, physicians, healthcare providers and others around the world. While following individuals and organizations relevant to you is important, so is following hashtags. Here are three I recommend.
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Rebuttals

Since the COVID vaccine rollout, more people have been eligible to receive the vaccine. However, not everyone chooses to get one. I have heard many reasons (aka excuses) from my patients who are vaccine hesitant. 

Selfie car cell telehealth

Consults in Cars

In this episode of Dialing for Doctors (aka, Tales of Telehell), we consider a growing subset of telehealth seekers connecting from their cars. This has happened several times and it always catches me surprise. While I've had "live" televideo visits with patients walking the dog, waking up in bed, and from the waiting room of another doctor's office, consults in cars is about the nuttiest. What is the patient's role in telehealth?
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