Kevin Pho, M.D. (@kevinmd) header
Kevin Pho, M.D. (@kevinmd) profile picture

Physician | https://nitter.cf/t.co/ymdHK4O5hQ | The Podcast by KevinMD

Nashua, NH, north of Boston
Joined December 2007
Photo by Kevin Pho, M.D. (@kevinmd)Photo by Kevin Pho, M.D. (@kevinmd)Photo by Kevin Pho, M.D. (@kevinmd)Photo by Kevin Pho, M.D. (@kevinmd)Photo by Kevin Pho, M.D. (@kevinmd)Photo by Kevin Pho, M.D. (@kevinmd)Photo by Kevin Pho, M.D. (@kevinmd)Photo by Kevin Pho, M.D. (@kevinmd)Photo by Kevin Pho, M.D. (@kevinmd)Photo by Kevin Pho, M.D. (@kevinmd)
A physician mom was pumping on the bathroom floor of a skilled nursing facility, just crying. Internal medicine physician and geriatrician Poonam Merai: “I wanted to do this thing for my children, but there was just no time and no place.” Listen to the full conversation on The Podcast by KevinMD. Link in the replies. Search “The Podcast by KevinMD” wherever you listen to podcasts. #ThePodcastbyKevinMD
1
2
432
An ER doctor told an elderly woman her cancer had spread to her bones and was generally not survivable. She was shocked, like she’d never heard it before. Family physician Pamela Buchanan says the woman had a primary care physician, an oncologist, and some radiation. The woman’s husband told Buchanan: “I thought this was really bad, but nobody really just explained it like you do.” Listen to the full conversation on The Podcast by KevinMD. Link in the replies. Search “The Podcast by KevinMD” wherever you listen to podcasts. #ThePodcastbyKevinMD
2
3
2
1,841
Her practice asked her to start doing Botox, and the training turned out to use fresh cadaver heads. She says there was no mention of that in the course listing. Ophthalmologist Jade Wong says she told the speaker her concern the night before. He said: “Don’t worry, they’re fresh.” She says that was not reassuring. In the room, she says, there were probably 15 to 20 heads, under blue cloths, in pans that looked like turkey roasting pans. “It was five days before Halloween.” Listen to the full conversation on The Podcast by KevinMD. Link in the replies. Search “The Podcast by KevinMD” wherever you listen to podcasts. #ThePodcastbyKevinMD
3
1
1
1,102
A woman who thought her leg pain was a pulled muscle was about to be sent away from urgent care with an ACE bandage, until the nurse practitioner stopped. Then she said: “You know, I just have this feeling that maybe we need to schedule an MRI just to get it checked out.” Randy McNeely says his wife had treated the pain as a muscle pull for about two weeks. The MRI came the next week. Three or four hours after it, the call: a mass on her leg and a biopsy the next day. Listen to the full conversation on The Podcast by KevinMD. Link in the replies. Search "The Podcast by KevinMD" wherever you listen to podcasts. #ThePodcastbyKevinMD
2
2
6
5,537
A grandmother with diabetes was hospitalized for days with dangerously low blood sugar. No one could explain it. Her doctor finally asked her: “Look, you’re the expert here. What do you think happened here?” Internal medicine physician Dean Schillinger (@drdeancommxn) says the hospital team ran the usual workup for sepsis, liver failure, and an insulinoma and never figured out the cause. At the follow-up visit, every question he asked, “she just answered perfectly, and I was getting nowhere.” Then she started tearing up. He says she told him about her husband, who “has been using her insulin as a weapon against her, either withholding it or administering it against her will as a form of power and control.” The intervention, he says, was a restraining order and ultimately the prosecution of the husband. Listen to the full conversation on The Podcast by KevinMD. Link in the replies. Search "The Podcast by KevinMD" wherever you listen to podcasts. #ThePodcastbyKevinMD
2
1
2
1,700
A woman was flown to the hospital with a suspected ruptured ectopic pregnancy. The obstetrician-gynecologist on call walked in ready to go. Her husband said to the doctor: “You’re the doctor? You’re the doctor? Oh no, we’re not having some Black doctor operate on my wife.” Obstetrician-gynecologist Melody McCloud (@DrMelodyMcCloud) was the GYN on call for the ER that night. She says the patient was in and out of consciousness, and her hemoglobin and hematocrit were terribly low. “I walk in the room, I’m ready to go, because this patient’s critical.” McCloud was the first Black female obstetrician-gynecologist to set up a practice in DeKalb County, Georgia. She says she has experienced racial attitudes as a physician and will never forget a few cases, “but one in particular.” Why she tells it: “It happens, and I just want people to be aware of that. It still happens in many instances.” Listen to the full conversation on The Podcast by KevinMD. Link in the replies. Search "The Podcast by KevinMD" wherever you listen to podcasts. #ThePodcastbyKevinMD
2
5
2,957
A hospital sent a mother home with her 6-year-old son’s seizure records and medication. A month later, a neurologist told her, “I’m sorry to say it, but we’re reversing the results.” Poet Ana María Caballero (@caballeroanama) describes the 3 days her son spent in the hospital after seizures started out of the blue. A CT scan found nothing, then came an EEG and an MRI. At the end, she says, the team told her they thought they might have found something and gave her the records and the medication. A month later, at the follow-up with the pediatric neurologist, the MRI was the opposite of what the record said when she left. The EEG too. When she asked why, he told her: “Sometimes MRI technicians want to give us something to tell the parents, because it feels like an answer.” Her read: “I just felt like it was patronizing. They didn’t trust the parents to be able to intellectually understand what was going on.” She also says nobody in the hospital asked what her son ate, whether he was sleeping, or whether anything traumatic was going on. “There were no questions at all.” Parents: what question did no one ask you in the hospital? Listen to the full conversation on The Podcast by KevinMD. Link in the replies. Search "The Podcast by KevinMD" wherever you listen to podcasts. #ThePodcastbyKevinMD
1
1
2
695
A woman newly diagnosed with diabetes handed her prescription to a pharmacy student and said to keep it back there. She felt OK, she said, and would start the medicine when she started feeling bad. Bruce Berger, a health care consultant, says he was precepting pharmacy students when it happened. What he says they did: Reflected back how she was making sense of it, instead of correcting her. Asked if they could share a few thoughts. Drew an analogy of syrup on a stack of pancakes that look fine right now. How he says it ended: “Wow, nobody ever explained it to me that way. I’ll take the medicine.” When a patient says they will start the medicine once they feel bad, what do you say first? Listen to the full conversation on The Podcast by KevinMD. Link in the replies. Search "The Podcast by KevinMD" wherever you listen to podcasts. #Diabetes #ThePodcastbyKevinMD
3
4
1,482
A pediatrician started her residency four months pregnant. One attending asked what she was thinking. Another told her, “I didn’t breastfeed my children, I formula fed them, they turned out OK.” Amaka Nnamani, a pediatrician, says her husband was thousands of miles away in Nigeria. She points out that it was a pediatrics residency program. What she describes: No FMLA, because she hadn’t worked a year yet. About 5 weeks off, largely unpaid, arranged with the help of a residency coordinator. Her daughter was born 2 days before Thanksgiving. Being scared to ask about pumping. “I would need to pump and I just couldn’t find a room. And I would find one, sit, and then my pager goes off.” Years later, a lactation pod for nursing residents. “That definitely made me cry.” She says she wouldn’t call it toxic: “But there was not extra effort made, or I would say barely any effort made, to support me.” What did you need at work that you were scared to ask for? Listen to the full conversation on The Podcast by KevinMD. Link in the replies. Search "The Podcast by KevinMD" wherever you listen to podcasts. #Residency #ThePodcastbyKevinMD
3
3
8
4,680
In the first year of COVID, visitors were not allowed in the ICU. On the video chats set up for one family, the nurse sometimes left the room, and a daughter was left watching her mother gasp for breath during a breathing trial. Sara Merwin (@Saramerwin1), an epidemiologist and patient advocate, says she helped that family from the outside. What she says they ran into: The only contact from the ICU was a request for authorization for procedures. Calls that were often put on hold for 20 minutes. Staff pulled in a million different directions, with many out sick. Video chats where the nurse would sometimes leave the room and leave the patient on the feed with the daughter. Her ask to the hospital: you cannot leave the feed on and not be bedside. If a family is watching a loved one on a video feed, who should be at the bedside? Listen to the full conversation on The Podcast by KevinMD. Link in the replies. Search "The Podcast by KevinMD" wherever you listen to podcasts. #CriticalCare #ThePodcastbyKevinMD
3
2
1,034