A while ago I was asked to write a column about why patients lie to their doctors. That got me to thinking about what I have learned in the past thirty-seven years since I started my career as a primary care physician, or PCP. Since I write my columns well in advance of the date they will run, this was the first chance I had to answer that question.

It is said that the best way to learn something is to actually do it, and I have learned much over the years. The keystone to good medical care is communication. Consider, if you will, a bicycle wheel. Medical communication is akin to that wheel. At the hub is the PCP. Specialists are located along the rim and tire. The spokes of the wheel represent the two-way communication between the

Gout is a common and complex form of arthritis. It has been around since the days of ancient Egypt and has been called the “disease of kings” or “rich man’s disease.” It affects 1-2% of the population, mostly men aged 30 to 50, but can be seen in post-menopausal women. An attack causes sudden, severe joint pain, swelling, redness, and tenderness in the affected joint. Classically, it attacks the base joint of a big toe, but it can be seen in any joint in the body. Symptoms come and go. When an

Milk products from cows and other non-human mammals are major components of traditional Western diets, especially in colder climates. The recommended intake of milk or equivalent portions of cheese, yogurt, or other dairy products here in the U.S. is three 8-oz (237 ml) servings per day for adults and children nine years of age and older, an amount that is substantially higher than the current average intake among adults of 1.6 servings per day. The recommended intake amount has been justified

Dementia is a word that strikes terror into the hearts of people and families. Not all dementia is Alzheimer’s dementia, however. There are multiple medical diseases and conditions that may cause dementia, and although in most cases once dementia appears, it is irreversible and incurable, there are some exceptions. While most cases of dementia are incurable, the progression of the disease may be slowed down by medications and other forms of treatment. There are a number of standardized tests to

Neurological conditions are the leading cause of non-traumatic disability worldwide, and the prevalence of Parkinson’s disease (PD) is increasing more rapidly than other neurological disorders. PD is the most common form of parkinsonism, a term reflecting a group of neurological disorders with Parkinson’s disease-like movement problems such as rigidity, slowness, and tremor. Less common parkinsonisms include other neurodegenerative diseases (multisystem atrophy, progressive supranuclear palsy)

Last week, I discussed the seven stages of dementia. Dementia is a term used to describe a decline in mental abilities including memory, language, and logical thinking that is severe enough to affect daily living. When these symptoms appear in older people, concern about Alzheimer’s disease is common. Alzheimer’s disease is a neurodegenerative dementia, meaning that there is a loss of brain tissue that is not reversible. Another irreversible cause of dementia is vascular dementia, in which poor

Today’s topic is a ketogenic, or “keto” diet. Before getting into the diet, however, I would like to lay a little groundwork. Glucose, a simple sugar, is the fuel that powers our bodies. Usually, glucose is produced by the breakdown of starches, or carbohydrates. Once produced, glucose is transported into cells by insulin. The human body needs a constant supply of glucose in order to function. When there are no carbohydrates available to breakdown, the body will revert to breaking down fat, or

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