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Dude Fest!Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I'm attending a complete dude fest, also known as the annual American Urological Association (AUA) meeting. It's held in the illustrious city of Chicago this year, and it's been quite fun and informative so far. Though it has "american" as part of its acronym, the AUA is actually quite an international event with tons of international urologists in attendance. I'm constantly hearing Spanish, Portuguese, Arabic, French, Korean, Japanese, German and many other languages in the meeting halls. It's quite impressive and makes for a nice multi-cultural event.However, I'm never more amazed at the paucity of women in urology than ...
Source: UroStream - April 28, 2009 Category: Urologists and Nephrologists Source Type: blogs

Show and tellEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Doctors love it (NOT) when patients come into the office carrying jars or other homemade specimen containers holding all manners of bodily fluids.I am sure that the average PCP or ENT doc has seen their share of "funny-looking" or -insert favorite color- sputum that the patient carefully brought with them to the office, after they had been saving the used Kleenex for a day or so....or perhaps the occasional stool specimen.You can see where this is going, since I am a urologist....I actually encourage patients to bring me the kidney stones they have passed. We can get those analyzed, and the information is quite useful in t...
Source: UroStream - April 16, 2009 Category: Urologists and Nephrologists Source Type: blogs

New favorite website of the dayEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This is why you're fat.It's like watching a car accident in slo-mo – I just can't take my eyes off of it. It makes my stomach churn, but I can't figure out whether it's in a good or a bad way.
Source: UroStream - April 7, 2009 Category: Urologists and Nephrologists Source Type: blogs

Picture perfectEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Imagine this scenario:Two hard-of-hearing patients both in a crowded clinic waiting room.... (sounds like the start of a good joke, doesn't it?) The nurse opens the door and calls out a name: "Mr. Will Shakespeare!!!" An elderly patient stands up and walks into the exam room. The nurse proceeds to take vital signs and obtains a urine sample and other pertinent information before informing the doctor that the patient is ready to be seen.The doctor walks into the room and says: "Hi Mr. Shakespeare, how are you doing today?" to which the patient promptly replies: "Huh??? My name's not Shakespeare, it's Andre Gide!"Yes, indeed...
Source: UroStream - April 2, 2009 Category: Urologists and Nephrologists Source Type: blogs

Happy National Doctor's Day!Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I know this was the main thought of your day today, with March 30th being national doctor's day. And there was great celebration and rejoicing!!! ...huh, not really. Despite the fact that this has been an annual event for the past several years, I'm only really aware of it when I start getting letters from my hospitals telling me how much they appreciate me.So I did a little internet research regarding this so-called holiday. Apparently this got started on March 30, 1933, a date which marks the anniversary of the first use of general anesthesia in surgery. However, the first national doctor's day was not officially cel...
Source: UroStream - March 31, 2009 Category: Urologists and Nephrologists Source Type: blogs

RedemptionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Despite the nature of my job, and despite what some of my readers may think, I don't actually enjoy causing pain and suffering. In fact, I'm barely able to watch a gory horror movie though I know intellectually that special effects and acting (some of it bad) are creating the images.I'm acutely aware that some surgeries/procedures hurt more than others, whether the pain be purely physical, or with a significant psychological aspect. I think orchiectomies (removal of testes) definitely fall into this category.Even though an orchiectomy is technically a very simple procedure, most patients (especially the male patients) tend...
Source: UroStream - March 28, 2009 Category: Urologists and Nephrologists Source Type: blogs

Out of Jail!!!Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I would like to say that I was pitifully huddled on a pallet in a Singapore jail, awaiting my sentencing for smuggling illegal chewing gum, but the truth is much more simple: I have just been busy and preoccupied. Thanks for all the caring and concerned messages you have left on my last post. It's really nice to feel loved...I am very much alive and doing quite well.The last time I wrote was before my trip to Southeast Asia, which now seems such a long time ago. How did we get to be in March already? AND it's the year 2009???? Yikes... Time really seems to fly by when you are busy. And please, don't think that I am complai...
Source: UroStream - March 12, 2009 Category: Urologists and Nephrologists Source Type: blogs

Happy Holidays!Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I will be taking a short break over the holiday season. We are traveling to Southeast Asia for the very first time, and I am really looking forward to all the new culture, colors and culinary delights awaiting us. Moreover, we will be traveling with my parents, which should make it an even more interesting trip.I will be back the first week of January to give a mini trip report. Hope everyone has a safe and happy Christmas/Hanukkah/New Year!!!
Source: UroStream - December 20, 2008 Category: Urologists and Nephrologists Source Type: blogs

Radiation scareEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Recently, I have begun to see more and more patients who are sent to my office from the ER with presumed renal/ureteral stones without a CT scan.They present with typical symptoms such as blood in the urine, sudden flank pain and mild nausea, and if they've had a stone in the past, some ER physicians will not order a CT scan for fear of radiation exposure, and subsequently will send these patients to see me as an outpatient. With mounting evidence on the risks of radiation, especially after multiple studies, I can understand the reluctance. However, what am I supposed to do with the patient? How can I offer them any medic...
Source: UroStream - December 11, 2008 Category: Urologists and Nephrologists Source Type: blogs

PantomimeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Though one of my nice older patient does not speak a word of English, this has never been a problem since he is always accompanied by a bevy of daughters who provide excellent translational services. However, communication issues arose after his admission to the hospital, when his relatives were not always present as I made rounds. Though I speak four languages pretty fluently (including English!) and know a smattering of words in a dozen other languages, Vietnamese is not one of them... In order to ask a few basic questions, I resorted to pantomiming at his bedside.As I was trying to ascertain whether he had ambulated tha...
Source: UroStream - December 2, 2008 Category: Urologists and Nephrologists Source Type: blogs

Giving thanksEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I am on call this year for Thanksgiving, and it's already been mildly painful and busy (an exploratory laparotomy AND a kidney transplant last night!). The even more painful part is that this call lasts from wednesday until monday morning!!! Yikes....But as I was rounding at the hospital today and encountering sick patients and their families, I became profoundly thankful that my loved ones are in good health. Perhaps I am getting more emotional in my dotage, but I was feeling almost teary as I was walking through the wards, as there are few places sadder and lonelier than a hospital during the holiday season.
Source: UroStream - November 27, 2008 Category: Urologists and Nephrologists Source Type: blogs

Harley riders: beware!Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I have to admit that I've never liked motorcycles, especially Harleys since their riders seem to derive great enjoyment at making their machines be as loud as possible. I find it rather obnoxious. However, as this new information is coming to light, it might be possible they are trying to compensate for something????This information is straight from the AUA (American Urological Association) Daily Scope: "Australia's The Age (11/23, Benson) reported that a survey found that men who ride motorcycles "risk impotence and urinary problems because the engine vibration damages nerves in their penises." For the survey, researchers...
Source: UroStream - November 24, 2008 Category: Urologists and Nephrologists Source Type: blogs

Not looking foward to it yet....Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
As the appointment with a follow-up patient was nearing its end, he suddenly quipped: "I gotta tell you doc, I don't know what you did to yourself but you look about 20 years younger than when I last saw you. I hardly recognized you...."Considering that I just saw him only a month ago, that comment took me somewhat aback. I could take it as a very nice compliment, or it meant I simply looked like hell a month ago...After trying to convince him there had been absolutely no recent plastic surgery involved, I informed him it was actually my birthday today, but that I was really not too excited about this event ever since I tu...
Source: UroStream - November 22, 2008 Category: Urologists and Nephrologists Source Type: blogs

What do you do for a living?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Simple question for most people.... However, this seemingly innocuous question used to stress me out when I first began training as a urologist. I was raised by my very conservative parents that talking or even mentioning certain areas of your anatomy was taboo, or at the very least, not an appropriate subject to bring up. Yet, the very essence of my job entails a journey into a realm which produces squirming in a polite society.Inevitably, this question would be raised in public setting such as in a plane, at a bar or some sort of social gathering where escape was not a possibility.I thought about lying outright and feig...
Source: UroStream - November 9, 2008 Category: Urologists and Nephrologists Source Type: blogs

HopeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I have been criticized for talking politics on my blog (though my long-time readers will know that it's certainly not the first time). We have just voted for the new president of the most powerful nation on the earth. How could I not speak about it today unless I lived with my head buried in the ground?I know we cannot agree on everything politically. This very choice is what makes this country so great!!! We have the freedom to research and make informed decisions based on it. It is the basis of a democratic nation...I love this country, as I am sure all of you do as well, and I want the best for it. Whether you are blue ...
Source: UroStream - November 6, 2008 Category: Urologists and Nephrologists Source Type: blogs

A new day has arrived...Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
With tears in my eyes and a soaring heart, I extend a huge welcome to President Barack Obama!I feel that I have just been part of a historical and unforgettable moment in the history of the United States of America. He ran an amazing, almost flawless campaign, but the victory truly belongs to the man himself. He is smart, thoughtful, eloquent and inspirational, basically the anti-thesis of Bush. He is a breath of fresh air after eight years of a truly horrendous and corrupt administration.I even liked John McCain tonight during this concession speech, though I cannot feel the same generosity towards Sarah Palin. What an od...
Source: UroStream - November 5, 2008 Category: Urologists and Nephrologists Source Type: blogs

Hallelujah!!!Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
O Most glorious of days!!! Most anticipated time since AD 1991!!! Sweet bright light at the end of the tunnel!!! Most welcoming of happenings!!!I just officially paid the last cent off my medical student loans today!!! And I thought this day would never come...I started med school in 1991, right after graduating from college, and I didn't want to burden my parents for additional funds after they had generously paid my college tuition in full. I distinctly remember the first loan check I got for my medical tuition, and feeling scared... very scared... (but not as scared as some of my medical colleagues who went to private m...
Source: UroStream - October 28, 2008 Category: Urologists and Nephrologists Source Type: blogs

Risk managementEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I recently attended a risk management workshop with presentations from various medical professionals and attorneys (both plaintiff and defense) regarding ways to avoid being sued. It's an absolutely lovely way to start your saturday morning (7:30AM!!!)This is especially apropos after reading Shadowfax from Movin' Meat receiving his first lawsuit notice. I really feel for him, since this is one of the most dreaded event in the career of a physician.The workshop consisted of impromptu video interviews from people off the street who were invited to talk about their doctors, and what they considered good and bad medical care....
Source: UroStream - October 27, 2008 Category: Urologists and Nephrologists Source Type: blogs

Shot interruptedEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
It's flu shot season again, and I know I've covered my morbid fear of injections in prior posts ad-nauseam, but here we are once more. Doesn't it seem to come sooner every year???Yes, call me a hypocrite, a poltroon, a coward, but whereas I have no trouble wielding a scalpel or a hypodermic syringe on my patients, the thought of getting an injection on my tender deltoid puts me into a hyperventilating diaphoretic mess. Mind you, it's not the pain, because truth be told, the stupid injection does not hurt a bit. I've had more painful sessions with a pedicure... But it's just the thought of a needle... going into my flesh......
Source: UroStream - October 20, 2008 Category: Urologists and Nephrologists Source Type: blogs

No need for thanksEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I was finishing up a clinic visit with a new patient, when, as I was heading towards the door, she uttered these parting words: "Thank you for seeing me and taking my insurance."Since I don't personally check ahead of time what insurances my patients have, I was intrigued by her comment and asked her who provided her healthcare coverage. She answered Tricare, which is the healthcare insurance provided to the United States Armed Forces and their families.The reason for her gratitude was because she was finding it progressively more difficult to find physicians who would accept Tricare. Though it pays marginally better than ...
Source: UroStream - October 16, 2008 Category: Urologists and Nephrologists Source Type: blogs

Please don't make me cry...Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Though no death is ever easy to deal with, I find it particularly emotional when it's one of my older patient who has recently lost their spouse. It's absolutely devastating to see the sorrow etched on their face, the dazed and lost look they have in their eyes and the palpable grief emanating from their body.One of my patient had recently lost her husband of 59 years. Thankfully he passed away gently in his sleep, but it had obviously taken a toll on my patient. A normally brave, independent and spry woman in her 80s, she looked incredibly vulnerable and tiny that day. She could not help the tears that slowly rolled down ...
Source: UroStream - October 7, 2008 Category: Urologists and Nephrologists Source Type: blogs

Alternative treatmentsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Few things frustrate me more than patients diagnosed with cancer that could be cured via conventional medical therapy, who end up resorting to alternative "treatment" options.I could learn to accept these decisions if these were real legitimate treatments they were exploring, as opposed to the utter quackery offered by exploitative and unscrupulous individuals.I'm already distraught enough when I have to reveal the diagnosis of cancer to a patient, and I usually spend a good amount of time in clinic discussing the problem, prognosis and various legitimate treatment options. But then my distress turns to perplexity and disb...
Source: UroStream - September 12, 2008 Category: Urologists and Nephrologists Source Type: blogs

ShiversEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
There are few things as horrific as seeing a patient with advanced penile cancer. Thankfully, it's not a common disease, and over the last 6 years, I've only seen a handful of cases, which is to say a handful more than I want to see...The horror comes not only in the diagnosis of cancer in such an unusual area (most people are probably shocked to learn that there even exists such a condition), but also in the treatment for this diagnosis which, even in the best possible scenario, can only be called mutilating.Unfortunately, the best cure lays in surgical extirpation of the cancer. In lay terms, that means we have to cut it...
Source: UroStream - September 5, 2008 Category: Urologists and Nephrologists Source Type: blogs

AtonementEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Med list for my new patient:-Omega 3 fish oil-Gingko biloba-Green tea extract-Centrum multivitamin-Saw PalmettoHe's actually quite healthy without any serious medical issues. Yet despite all these nutritional supplements that would seemingly identify him as a health-conscious individual, I also noticed that he smokes a pack a day for the last 40 years....I'm always a little amused yet perplexed when I see something like this. Do the supplements somehow "atone" for all those cigarettes? Do the antioxidants negate the carcinogenic effects of tobacco? If only it were that easy...Perhaps this line of thinking is akin to orderi...
Source: UroStream - August 15, 2008 Category: Urologists and Nephrologists Source Type: blogs

Summer fareEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I'm just writing a little warning note for my readers. Don't expect any insightful posts (have I ever written one?), or even any posts at all over the next 17 days. Didn't you hear? The summer Olympics just started tonight!!!!I absolutely ADORE the Olympics, especially the summer games. There is something almost surreal about thousands of athletes from hundreds of different countries coming together for a little over two weeks to compete. I love the individual stories of people who, against all odds, are able to make it to the games. There are people who know they are never going to win a medal, yet still compete just for ...
Source: UroStream - August 9, 2008 Category: Urologists and Nephrologists Source Type: blogs

TardinessEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
One of my biggest pet peeves is tardiness. As a rule, I am a fairly punctual person, and I like to be even a little early for my appointments. Call it my obsessive-compulsive nature, or a lifelong fear of displeasing others, but few things stress me out more than being late. I think my upbringing also plays a crucial role, since my parents are known to show up at the airport a minimum of two hours before their flights. They both have type A personalities that will not allow them to be tardy for anything.There are lots of surgeons who are known in the OR for showing up chronically late to their cases, which drives me crazy ...
Source: UroStream - August 3, 2008 Category: Urologists and Nephrologists Source Type: blogs

E-mail funniesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Two e-mails put a smile on my face today:The first came from my AUA Daily Scope (daily news bites and articles of interest from the American Urological Associations) with a bold title that announced:"Global warming may increase kidney stone rate!"Mind you, not that global warming is funny at all, but the headline just sounded so unnecessarily alarmist, and so unlike the usual "less sensational" articles the AUA presents. And as a side note, I do believe that global warming will make us urologists busier.The second came from one of my bestest of friends, whose mother actually reads my blog! Mom came to visit her, and said:"...
Source: UroStream - July 20, 2008 Category: Urologists and Nephrologists Source Type: blogs

Not so insignificantEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Even though I'm just a dumb surgeon-type, and not a clever endocrinologist or nephrologist, I still need to know all my patients' medical history in detail. (I've always thought the specialities mentioned above attracted the super intellectual types...Urologists are more akin to the humble plumbers whereas the nephrologists are considered the engineers...) Yes, I like to be in the operating room and I like to use a scalpel to help people, but that doesn't mean I don't do some thinking of my own.I am always astounded at the details that patients omit on their medical history form. I'm clued in when I look at their medicatio...
Source: UroStream - July 13, 2008 Category: Urologists and Nephrologists Source Type: blogs

ApprehensionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
You know my previous post about the rule of three? Well, I just took care of two penile fractures in a 24 hour period of time.OK, technically the human penis does not have a bone (though other animals like dogs do), hence a "fracture" is somewhat of a misnomer. However, this is the correct medical term for a rupture or tear in the tunica albuginea, which is the tough yet elastic sheath that surrounds the erectile tissues in the penis called the corpora cavernosum. (I admit that there is a tremendous amount of incomprehensive medical mumbo jumbo, but don't blame me for the nomenclature since I wasn't the one who thought up...
Source: UroStream - June 28, 2008 Category: Urologists and Nephrologists Source Type: blogs

Retained stentEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Seaspray's unfortunate close encounters with ureteral stents reminded me of the nightmare that is a retained stent. (not that you have that Seaspray, and I really hope you feel better soon!!!) If anything is guaranteed to shave years off the life of a urologist, it would be a retained stent.Ureteral stents, unlike vascular stents, are not meant to stay inside permanently. They need to be removed, or at least changed every few months (depending on the patient and the type of stent), otherwise the stent becomes calcified and it becomes virtually impossible to remove the stent. Anytime there is a foreign object in the urinary...
Source: UroStream - June 16, 2008 Category: Urologists and Nephrologists Source Type: blogs

The rule of threeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
There must be some cosmic rule that urological conditions come in groups of three. I have mentioned this on a previous post, but I have noticed that when I see a patient with a somewhat unusual medical condition, I am guaranteed to see two more patients within a short period of time with the same problem. I'm not talking about UTIs, stones or incontinence, but more like ureteral tumors, penile cancer and peri-urethral cysts. Nothing that is outrageously unusual, but not conditions we see daily.Recently, within a span of one single week, I have see three patients with acute urinary retention (over 3L) being admitted for ele...
Source: UroStream - June 7, 2008 Category: Urologists and Nephrologists Source Type: blogs

In a slumpEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Sorry about the long break. It seems that within just a few days of returning from vacation, I felt like I never went away at all. Isn't that always so?In any case, I have been trying to keep afloat of my very hectic schedule. Besides my clinical duties, I've also had an unusual amount of administrative type meetings that are always scheduled at the convenient time of 7AM. Things have been so crazy busy at work that I have even cancelled one of the few treasured activities that I strive to attend bi-weekly: my Pilates class. Not only is it badly needed exercise, it is also a huge stress reliever and one of my therapeutic ...
Source: UroStream - June 6, 2008 Category: Urologists and Nephrologists Source Type: blogs

How to tell you are married...Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Our nightly bedtime ritual involves my husband lovingly putting a Breathe-right strip on my nose. (allegedly, I snore, though I'm not convinced) .Before my LASIK surgery, I used to fall asleep next to my husband with my glasses on. Really sexy...When I reach over to cuddle with my husband, I also try to sneak in his monthly testicular exam.Hubby now feels perfectly comfortable to inform me that I look like a "car accident victim with a head injury" when I wake up in the morning. Granted I'm not a morning person and my AM conversation usually involves unintelligible monosyllabic grunts (hence the head injury part), and I gu...
Source: UroStream - May 1, 2008 Category: Urologists and Nephrologists Source Type: blogs

GratisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I encountered a somewhat difficult patient the other day to whom I recommended a standard of care cystocopy as part of a hematuria (blood in the urine) workup. He proceeded to question everything I was doing and my decisions for doing so. I usually encourage these questions, but I had the sense that this patient was extremely anxious and was just talking himself into an even higher state of anxiety.Finally, after all the relevant medical questions were exhausted, he asked me how much the procedure was going to cost, and I told him that "it depended but I could give him a ballpark figure". He then flew off the handle and ra...
Source: UroStream - April 24, 2008 Category: Urologists and Nephrologists Source Type: blogs

Six word memoir memeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I'm very late in the game as this meme came out a few weeks ago, but I got tagged by Seaspray, and since I've let her down so many times before, I thought I would give this one a try.The Rules are:1. Write your own six word memoir.2. Post it on your blog and include a visual illustration if you want.3. Link to the person that tagged you in your post and to the original post if possible so we can track it as it travels across the blogosphere.4. Tag at least five more blogs with links.5. Leave a comment on the tagged blogs with an invitation to play.I've been very busy these past few weeks, to the extent that I've even had t...
Source: UroStream - April 19, 2008 Category: Urologists and Nephrologists Source Type: blogs

Vocabulary lessonEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Presenting some new medical verbiage in the field of urology, as introduced to me by numerous patients:Prostrate:Male gland that likes to worship face down on the ground. Frankly it makes me feel uncomfortable when I encounter it because my god complex is not that highly developed.Sphinxter:Enigmatic yet strong lion-like little muscle in control of certain nether functions. May have egyptian etymology.Urether:In-betwixt a urethra and a ureter! It transports urine directly from the kidney straight out into the toilet!Blatter:Can be used to store and hold urine, as well as carry food on special occasions.Penes:A multi-purpos...
Source: UroStream - April 10, 2008 Category: Urologists and Nephrologists Source Type: blogs

Information overloadEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We are required by law to give an informed consent on any medical procedure/surgery we perform. This involves explaining in detail what the procedure is, what the risks and benefits are, and what other alternatives are available for treating the ailment. It's something we are taught to do very early on in our career, not only because it's a requirement, but it's also the correct course of action in order for the patient to make an informed decision about his/her medical care. Should you fail to do so, not only would you be deemed a bad doctor, but there are many unpleasant legal ramifications that can await you...I take c...
Source: UroStream - April 4, 2008 Category: Urologists and Nephrologists Source Type: blogs

I've changed my middle nameEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I've come to realize that I have become increasingly obsessive-compulsive in my old age. I don't know exactly when this change occured, but I can assure you that I wasn't born this way. Procrastination was my middle name. Growing up, I always did my homework at the last minute, waited until the very end to send in college applications and always pulled all-nighters to finish up papers and other assignments due to poor time management. Medical school wasn't much of an improvement, and the lack of sleep and constant fatigue during residency ensured that I rarely did anything ahead of time. Utility bills were often paid late ...
Source: UroStream - March 27, 2008 Category: Urologists and Nephrologists Source Type: blogs

Please don't press that buttonEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PCA (Patient Controlled Analgesia) is a godsend for most patients and nurses. It's a pump attached to your IV that contains your narcotic of choice (usually morphine or dilaudid), and by pressing a button whenever you need it, you are able to get a preset amount of pain med into your system.You can order the settings in a variety of ways, from the dose of each pain med, to how often it can be administered, to a four hour maximum dose limit. This way, no matter how many times a patient pushes on the button, you only get a certain set amount, and very rarely do you see overdoses. And if you don't need any pain meds, you just...
Source: UroStream - March 24, 2008 Category: Urologists and Nephrologists Source Type: blogs

Just call me BozoEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
For those of you who don't give a hoot about women's hair issues, you can stop reading now. This post is for the 51% of the population who can commiserate with me. I had a somewhat eventful trip to my hair stylist yesterday whom I love and who usually does a top-notch job. She just returned from an 8 month hiatus and had been sorely missed. Since I was overjoyed at seeing her again, I decided to entrust fully in her artistic flair and became putty in her capable hands. She cut my hair to perfection, but when I mentioned I wanted "vibrant highlights" in my hair, she interpreted this to mean "fiery orange-red".To my dismay, ...
Source: UroStream - March 17, 2008 Category: Urologists and Nephrologists Source Type: blogs

Bizarre interruptionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I've already discussed this topic on one of my previous posts, but I always shudder when I get a consult from the locked psychiatric ward. No matter which hospital you happen to be in, the locked ward is always the same. First of all, it's a veritable hassle to enter, as you have to call from the phone outside of the impressive-looking set of steel doors, and wait for someone from the central desk/tower to let you in. It's the same process (though perhaps more frantic) when you are trying to exit the ward as well.Inside are rather depressing bare rooms with unmade beds, while heavily-medicated lost souls slowly wander arou...
Source: UroStream - March 1, 2008 Category: Urologists and Nephrologists Source Type: blogs

Smug and proud of it.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
At the risk of sounding extremely smug and self-satisfied, I have to tell you that I had a very productive Saturday morning this past weekend. Alas, I happened to be on-call, and there were several patients at different hospitals that needed to be seen, in addition to new consults and procedures to be done.Nevertheless, before 11:00 AM, I was able to:-Wake up at 6:45 AM. (Come on! Remember that this was a SATURDAY... this should be considered a major achievement already!!!!)-See a trauma consult for a bladder rupture and meatal stenosis (tightness at the opening of the urethra, making insertion of a foley catheter impossib...
Source: UroStream - February 25, 2008 Category: Urologists and Nephrologists Source Type: blogs

Lunar EclipseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Was anyone else able to catch a view of the lunar eclipse last night? It was quite amazing! I was worried that clouds would obscure our view, but it was an unusually clear night, and the event was wonderous.We have a telescope that I bought as one of my better christmas present for hubby several moons ago, that is now mainly used as a decorative accent to our living space. I always feel like Jimmy Stewart from "Rear Window" when I look through it, but this was the perfect opportunity to use it as it was originally intented. The shadow of the earth eclipsing the moon is a sight to behold!
Source: UroStream - February 21, 2008 Category: Urologists and Nephrologists Source Type: blogs

Girll's best friendsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
No, not diamonds, but high heels!!!I just read this little article on high heels from BBC online which suggests that "high heels may improve sex life".An Italian urologist and self-professed lover of the sexy shoe set out to prove that high heels are not as bad for women's health as some suggest. Although high heels can cause a host of problems, Dr Maria Cerruto asserts in her letter to European Urology (an academic journal) that they improve pelvic muscles (Kegels anyone?), which can assist in sexual performance and satisfaction, and provide support to the pelvic organs, including the bladder.I'm inferring from the articl...
Source: UroStream - February 20, 2008 Category: Urologists and Nephrologists Source Type: blogs

"Street" diagnosisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I was walking around my little part of town this Saturday with Hubby, doing a little shopping--embracing the clinical benefits of retail therapy, not to mention fulfilling my patriotic duty to help out ailing retailers in these dog-days of looming recession.I was feeling just a tad sorry for myself since the last three pairs of jeans I tried on were far from flattering, emphasizing the less desirable aspects of my physique. Try as I might to shift the blame on the jeans themselves, still, I could not help being just a little sulky. Hubby attempted to convince me that my thighs were not hideously obese and lard laden, but I...
Source: UroStream - February 17, 2008 Category: Urologists and Nephrologists Source Type: blogs

Project RunwayEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Why hasn't anyone told me about this show before??????I just discovered it last night because hubby was working late, and I was listessly flipping through channels, looking for anything of interest. I suddenly happened upon Heidi Klum looking annoyingly perky and blonde amidst a group of anguished would-be designers, and the remote control locked itself in place.There is so much drama, cruelty, back-stabbing and tears!!! I was immediatly hooked.I admit that I don't usually watch the "popular" TV shows. I've never seen "Grey's Anatomy", don't know that the big deal is about "Lost" and couldn't tell you what "Desperate House...
Source: UroStream - February 15, 2008 Category: Urologists and Nephrologists Source Type: blogs

Mr. GrumpyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I've known Mr Grumpy for a little while now, and he didn't come by this nickname because I love Snow White. (well, I actually do love classic Disney animated movies, but that's beside the point). Mr Grumpy always comes to my office full of piss and vinegar, generally annoyed at the whole world. The 30 minutes office visits consist of a litany of grumbles about everything, even when I try to direct the conversation to pleasant topics like kittens and pink cotton candy. Perhaps he is allergic to cats, but then again, he would have to be allergic to the whole world to excuse his mindset.Mr. Grumpy has cancer, and I have to op...
Source: UroStream - February 6, 2008 Category: Urologists and Nephrologists Source Type: blogs

AbbreviationsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abbrevations are incredibly common in the medical world. They are practically a way of life in medicine, and I use them on a daily basis in my notes, dictations and orders. It was a mark of great pride when I managed to write the following clinic note as a 3rd year medical student:67 yo H M c/HTN & DM, dx c/PCa (init PSA 5, Gleason 3+3) s/p RRP 3 yrs ago. PSA:0, DRE: neg. No c/o. No LUTS, mild ED. RTC 6mo with PSA.*This two-liner managed to convey all the critical pertinent information while being terse enough as a surgical note, and even my senior resident at the time was thoroughly impressed by this feat.However, rec...
Source: UroStream - January 30, 2008 Category: Urologists and Nephrologists Source Type: blogs

Heavy stonesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Again, I must apologize for my lack of blogging of late. My insidiuous cough has persisted, keeping me up at nights, and it's been rather trying. Moreover, being the ever dutiful wife, I have given this lovely virus to my husband who is seriously attempting to cough out one of his lungs.Needless to say, neither one of us has gotten much sleep recently, and I'm feeling tired and perhaps the tiniest bit guilty. I have been concocting some homemade naturopathic remedies from the "old country" consisting of lemons, pears, ginger, dates and honey (slice and dice, mix it all up and pour hot water to make a wonderful aromatic and...
Source: UroStream - January 29, 2008 Category: Urologists and Nephrologists Source Type: blogs

Diplomacy neededEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Sorry about the recent lack of blogging. The recent combination of the start of the new year, the return from a week off and a heavy on-call schedule has conspired to keep away from writing.On top of it all, I am now harboring an odious virus whose intent is to have me cough out a bronchus or two. I'm at the tail end of this infection, and I no longer have chills and muscle aches, but the persistant coughing is keeping me up at night. I really do not understand how smokers can tolerate this slight perpetual shortness of breath and imminent phlegm. Yuck...Though I don't think I'm still in the infectious stage, I'm also in t...
Source: UroStream - January 17, 2008 Category: Urologists and Nephrologists Source Type: blogs