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#11: Transitioning to Congregate Living

RS: Hello and welcome to another episode of Medical Narratives with Dr. Michael Gordon. I'm Regina Starr. And today we're discussing a topic that many seniors and their families face at some point in their lives. The challenge of deciding when to leave one's home for congregate living, such as a retirement home, an assisted living facility, or a nursing home. To help us with this complex issue, joining us today is Dr. Michael Gordon, an expert in the care of the elderly.

Hello Dr. Gordon. Welcome to the show.

MG: Hello and good morning.

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Dr. Michael Gordon recently retired after a fulfilling career as a geriatrician that spanned 56 years, 44 of which he spent working at the Baycrest Center in Toronto. He is Emeritus Professor of Medicine at the University of Toronto. Dr. Gordon is a recognized ethicist and a thought leader on all topics of care of the elderly and end-of-life decisions. Currently, Dr. Gordon provides part-time professional medical consulting mainly in the domain of cognition and memory loss.

Medicine and the Humanities

Teaser: 

Michael Gordon, MD, MSc, FRCPC,

Emeritus Professor of Medicine, Member, Joint Centre for Bioethics, University of Toronto, Toronto, ON.

CLINICAL TOOLS

Abstract: In the earliest writing of stories, physicians and illnesses often played an important role. Some of the renowned scholars in the Jewish tradition, like Moses Maimonides was a philosopher, a prolific writer, and a physician. A few of the world-famous authors include: François Rabelais (1483-1553), Anton Chekhov (1860-1904), Arthur Conan Doyle (1859-1930), Oliver Sacks (1933-2015) and the contemporary Abraham Verghese (1955-), to name just a few. The connection between medicine and the humanities appears to have diminished in some domains due partially to the focus on the scientific advances in medicine and the diminished focus on the humanities, especially in higher education. This I suggest, is a problem for medicine.
Key Words: medical humanities, education, medical students.
The exposure to the humanities in the education of physicians provides an expanded framework of understanding the person beneath the patient.
Education in the humanities should be a prerequisite or even a component of a more humanistic medical education.
As part of connecting to new patients it is important to find out who they are before asking why they are in your office or hospital bed.
Explore as many ways to connect to the patient on their life’s experiences, cultures or backgrounds in order to promote a therapeutic relationship of trust.
To have access to full article that these tools were developed for, please subscribe. The cost to subscribe is $80 USD per year and you will gain full access to all the premium content on www.healthplexus.net, an educational portal, that hosts 1000s of clinical reviews, case studies, educational visual aids and more as well as within the mobile app.
Related Terms: Law and Ethics, medical humanities, education, medical students

#31: Insights into Mastering Hypertension: Part 2

Welcome to 3P: Pills, Pearls, and Patients where we will discuss current events in medicine, stories from real patient-physician encounters, and gain insight into what it's like being a physician in today's society.

Please note that while the first episode is available to listen to without registration, accessing additional episodes will require you to subscribe and log in.

  Back to Pills, Pearls & Patients (3P)

Hello and welcome to the next episode of Pills, Pearls and Patients. I'm your host, Dr. Marina Malak. And today is the second episode in our blood pressure series, Battling Blood Pressure. So I hope you've had an opportunity to listen to the first episode of battling BP. In that episode, we talked a little bit about the diagnosis of hypertension, how it's kind of a murky line and not a one time diagnosis for the high blood pressure in clinic. We talked about the various ways to diagnose blood pressure.

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Dr. Marina Malak is a family physician in Mississauga, Ontario and a lecturer and faculty member at the University of Toronto. She is actively involved in medical advocacy, and is a board member of the Mississauga Primary Care Network. She is also a member of the National Committee of Continuing Professional Development at the College of Family Physicians of Ontario, and a member of the Research Ethics Board at Trillium Health Partners.

She is passionate about patient care; medical education; and promoting mental, physical, and emotional wellness. She enjoys reading, writing, public speaking, puzzles, doodling in her bullet journal, and creating drawings on Procreate.

#30: Insights into Mastering Hypertension: Part 1

Welcome to 3P: Pills, Pearls, and Patients where we will discuss current events in medicine, stories from real patient-physician encounters, and gain insight into what it's like being a physician in today's society.

Please note that while the first episode is available to listen to without registration, accessing additional episodes will require you to subscribe and log in.

  Back to Pills, Pearls & Patients (3P)

Hello and welcome to the next episode of 3P: Pills, Pearls and Patients. I'm your host, Dr. Marina Malak. And today's episode is called Battling Blood Pressure.

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Dr. Marina Malak is a family physician in Mississauga, Ontario and a lecturer and faculty member at the University of Toronto. She is actively involved in medical advocacy, and is a board member of the Mississauga Primary Care Network. She is also a member of the National Committee of Continuing Professional Development at the College of Family Physicians of Ontario, and a member of the Research Ethics Board at Trillium Health Partners.

She is passionate about patient care; medical education; and promoting mental, physical, and emotional wellness. She enjoys reading, writing, public speaking, puzzles, doodling in her bullet journal, and creating drawings on Procreate.

My Favourite Typewriter

Teaser: 

Of the innovative programs of those offered was a special three years in two opportunity, was a combined course in typing and homemaking.

Related Terms: Medical Narratives
Disclaimer: 
Disclaimer at the end of each page

#10: A Breakthrough in Alzheimer's Disease Treatment: The Approval of Lecanemab

Good afternoon. Welcome to another episode of Medical Narratives, the podcast where we explore best practices, groundbreaking medical research and advancements in medicine. I'm Dr. Michael Gordon, the host of the Medical Narrative Podcast. In today's episode, we review the news that Lecanemab has received approval as a treatment for early Alzheimer's disease from the U.S. Food and Drug Administration, the FDA.

A potential much needed good news in Alzheimer's treatment. Our guest today is Dr. Sharon Cohen. Dr. Cohen is a behavioural neurologist and the medical director of the Toronto Memory Program, a community based medical facility which she established in 1996 for the purpose of the advancing diagnosis and treatment for individuals with Alzheimer's disease and related disorders.

Please note, that to access this episode in full instead of the teaser available just below you would need to login.

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6 applauses

Dr. Michael Gordon recently retired after a fulfilling career as a geriatrician that spanned 56 years, 44 of which he spent working at the Baycrest Center in Toronto. He is Emeritus Professor of Medicine at the University of Toronto. Dr. Gordon is a recognized ethicist and a thought leader on all topics of care of the elderly and end-of-life decisions. Currently, Dr. Gordon provides part-time professional medical consulting mainly in the domain of cognition and memory loss.

Cauda Equina Syndrome: a review of all you need to know

Teaser: 

Vega-Arroyo Miguel, MD,1 Perry Dhaliwal, MD, MPH, FRCSC,2

1 Section of Neurosurgery, Department of Surgery, University of Manitoba.
2 Assistant Professor of Neurosurgery, Section of Neurosurgery, Department of Surgery, Rady Faculty of Health Sciences, University of Manitoba.

CLINICAL TOOLS

Abstract: Cauda equina syndrome (CES) is the collection of signs and symptoms produced by severe compression of the lumbar spinal nerves that form the cauda equina. The compression can be caused by lumbar degenerative changes, intraspinal tumors, epidural hematoma, and infections. Rapid diagnosis and treatment are paramount as CES requires emergent surgical decompression. With delay, the patient could develop permanent neurological deficits including loss of lower limb sensorimotor function, bladder, bowel, and/or sexual dysfunction. Unfortunately, even with expeditious surgery, neurological improvements remain unpredictable. Failure to fully explain the possible prognoses can involve all the healthcare providers in medicolegal consequences.
Key Words:Cauda Equina Syndrome, Spine Emergency, Urinary retention, MRI scanning, Saddle Anesthesia.

Members of the College of Family Physicians of Canada may claim MAINPRO-M2 Credits for this unaccredited educational program.

www.cfpc.ca/Mainpro_M2

You can take quizzes without subscribing; however, your results will not be stored. Subscribers will have access to their quiz results for future reference.

Pre-test CME Quiz Post-test CME Quiz
1. Cauda Equina Syndrome results from pathologies that compress the nerves in the lumbosacral spinal canal, most commonly due to an acute lumbar disc herniation.
2. Early diagnosis is crucial and is made clinically by distinctive symptoms of saddle anesthesia, acute urinary incontinence combined with acute back and leg pain.
3. The most consistent early clinical sign of CES is urinary retention, and the prognosis is worse when present.
4. Urgent MRI is the study of choice and should be performed to confirm or rule out CES.
5. Surgery is highly recommended within 24 hours after CES is identified.
1. Cauda Equina Syndrome is caused by a large space-occupying lesion within the central canal of the lumbosacral spine, most commonly a large disc herniation. However, compression can also be caused by lumbar degenerative changes, intraspinal tumors, epidural hematoma, and infections.
2. Cauda equina syndrome generally presents with varying degrees of sensory loss and motor weakness in the lower extremities, saddle anesthesia, and bowel/bladder dysfunction (these last 2 are required to establish the diagnosis of CES).
3. The main clinical feature between differentiating Cauda Equina Syndrome vs Conus Medullaris Syndrome, is the absence of UPPER MOTOR NEURONS findings in CES).
4. About 70% of patients with cauda equina syndrome have a previous history of lower back pain and/or sciatica.
5. Although the prognosis is largely determined by the preoperative severity of neurological deficits, early surgery improves the chance of significant recovery so patients with CES require urgent surgical intervention.
To have access to full article that these tools were developed for, please subscribe. The cost to subscribe is $80 USD per year and you will gain full access to all the premium content on www.healthplexus.net, an educational portal, that hosts 1000s of clinical reviews, case studies, educational visual aids and more as well as within the mobile app.
Related Terms: Back Health, cauda equina syndrome, spine emergency, urinary retention, MRI scanning, Saddle Anesthesia