by James Hubbard, M.D., M.P.H.

Once, I told a perfectly sane, intelligent and otherwise coherent patient to wait in the exam room to have blood work drawn. He smiled, said thanks and followed me out the door. I told him again he needed to come back into the room and wait to have blood drawn. He smiled, said thanks again and walked down the hall to leave. When he opened the door to go to the reception area, I had to gently restrain him so he would actually listen to what I was telling him. He had no fear of the lab work itself. He was just nervous about being in an unfamiliar setting and didn’t comprehend what I was saying.

If you’re like a lot of patients, you forget much of the advice your doctor gives by the time you walk out the door. You’re nervous, traumatized or more concerned about getting out of the building in one piece. Either that or the doctor was too rushed to give you the information in the first place.

We have a new article that provides general instructions on what to do after treatment for some common ailments. (The advice is generic. Always get specifics for your case.) I also wrote a follow-up on common misconceptions I see in my office.

Have you ever made any mistakes treating yourself at home?

James Hubbard, M.D., M.P.H., is the publisher of www.MyFamilyDoctorMag.com, a Web site written by health-care providers for the general public.

Sign up for our FREE e-newsletter here!

James Hubbard, M.D., M.P.H.

I always dread seeing chainsaw injuries.  It is never a clean cut.  Even if the blade barely nicks the skin, it causes a nasty, dirty, macerated laceration leaving an ugly scar.  Of course the less you use the saws the more likely you are to get cut when you do, but experience is not immunity.  I have seen bad cuts in old pros.  Most of the time the the saw kicks back so fast and with such force you can’t stop it, and it cuts really well through flesh.

The CDC has good tips for preventing injuries.  Mostly take your time and stay focused on what you are doing.  Remove excess debris and wear goggles.  Keep your body out of the way of a kickback as best you can.  Have a partner within hollering distance and know where the limb will fall.  If you are helping, stay clear of danger.  You may think “duh”, but once I saw a patient (more…)

James Hubbard, M.D., M.P.H.

Lawn mower accidents can be pretty devastating.  They can mangle a hand or foot, or injure an eye.  The American Academy of Orthopedic Surgeons released these tips to avoid lawn mower injuries this summer.  Even though they are simple and obvious, they are worth a read.  Every year I see someone who has something in their eye thrown from a lawn mower and occasionally I see more serious injuries due to rocks.

Often I see someone with a mangled finger or hand who tried to remove debris from the blades before they had completely stopped, or gets a bare foot or toe caught underneath.  I know of children being killed when they fall off the larger tractor type mowers.

Invariably the victims say they feel so dumb, but really they just had a lapse of judgement. 

Read these tips and keep them in the back of your mind.

(more…)

by James Hubbard, M.D., M.P.H.

I still remember when a sweet, smiling little girl came into my office a few years back. She had injured her wrist. I did my usual exam which includes palpating areas of tenderness. Well I hit a sore spot; she let out a yelp and sobbed “why did you hurt me?” I felt so bad, but was tempted to tell her that’s what doctors do (not really). Instead I explained I needed to know what specific area was injured so I would know where to look on an x-ray. I don’t think she bought it.

At any rate, I thought of this when I read an Academy of Emergency Medicine study concluded the Ottawa Ankle Rules could be applied to as young as 6 years old and up. What are these rules? (more…)

by James Hubbard, M.D., M.P.H.

Like a lot of doctors, I have mixed feelings about narcotics.  They are great for severe, short-term pain and a must for some terminal cancer pain.   Some people abuse them for nothing more than the high they get.  And then there are all of the in-betweens.  We doctors are kind of caught in the middle, also.  We can lose our license if we prescribe too much or inappropriately.  We are told, by some groups, we prescribe too little to the patients that really need it.  But how do we know who really needs them?  If we are too gullible, we will be prescribing to a bunch of abusers, too strict and we are doing a disservice to those in need.

It is the long-term, chronic use that concerns us the most.  Narcotics are habit forming. They alter your mental state. If you take them long enough, you will have a physical withdrawal trying to get off of them.  Most people will become tolerant needing more and more to get the same effect.

So what to do?

(more…)

by James Hubbard, M.D., M.P.H.

I must admit I slip on the ice frequently.  Sometimes I fall.  Luckily, I have always gotten back up with only my pride bruised.  However, I do see serious injuries after every significant snowfall.  You really don’t want a cast for Christmas, do you?

Dr. Ronald Grelsamer, a knee and hip orthopedic doctor from Mt. Sinai hospital in New York, gives his winter walking tips to avoid serious injuries.

(more…)

by James Hubbard, M.D., M.P.H.

Everyone’s heard you should get a little loose and do some slow exercises before you start the real stuff.  But investigators in Norway went way beyond stretching and showed a significant decrease in injuries in teenage, female soccer players (pdf file)  by doing so.  They were concerned there were too many injuries in these young athletes and decided to try a rigid, 20-minute exercise program prior to practices and games, called the 11 Injury Prevention Program.

(more…)

by James Hubbard, M.D., M.P.H.

While practicing for the TV series Dancing with the Stars, Misty May-Treanor ruptured her Achilles tendon.  “It felt like I was hit in the back with a baseball bat,” she said.  I’ve heard that before. Sometimes people hear a pop also.

If you play competitive weekend warrior sports you will know someone with this injury sooner or later.  But Misty May?  An elite athlete in prime condition, who tests her Achilles daily with jumps and sudden starts?  She tears it dancing?  Why?

(more…)