- Medical Weight LossA medication that increases the rate at which the kidneys allow water to leave the body. Normally, the kidneys filter blood so that virtually everything in the blood except the cells is on track to leave the body in the urine. Then, in a very efficient manner, the kidney plucks out everything that is useful to the body. This arrangement has the desirable effect of allowing dangerous substances to leave the body (since the kidney does not retrieve them). In some disease states, however, the kidney retains too much water. Diuretic medications help the kidney retain less water than it otherwise would. The effect on the is to increase the amount of urine passed per day, weight loss, and (hopefully) relief of symptoms.
- Family PracticeAtrial fibrillation is the most common abnormal heart rhythm in older people. It is characterized by an irregularly irregular pulse. It can cause problems when the heart goes too fast (high pulse rate) or too slow (low pulse rate), or when blood clots (thrombi) form in the atria. If you think you have this rhythm, you can consult with an Internist or a Family Medicine specialist. For complex cases, you can consult with a Cardiologist or a Clinical Cardiac Electrophysiologist.
- Emergency CareThus, only a qualified physician should make the diagnosis of myocardial infarction. The diagnosis is hard to make accurately in some cases. The proof for this statement comes to two observations about contemporary practice in the United States. The first observation is that the leading cause of malpractice suits in the U.S. is when patients with acute MI are sent home by a doctor with a different diagnosis (for example, indigestion). The second observation is that the leading complaint of hospital administrators about emergency room doctors is that they are admitting too many people with the diagnosis of "possible myocardial infarction." The administrators find that most of these patients have some other diagnosis (for example, indigestion) when the case is investigated in the hospital. So, MI is a very hard diagnosis to make accurately even for well-trained physicians. The safest action is to treat all symptoms that
- ElectrocardiogramWe can do electrocardiograms and check implanted devices such as pacemakers and defibrillators, in the office. Stress tests and echocardiograms are done in a nearby hospital, which has much better equipment than we can afford.
- Internal MedicineA specialist who has extensive training in the diagnosis and treatment of abnormal heart rhythms. Clinical cardiac electrophysiologists graduate medical school, complete full training in Internal Medicine and in Cardiology and Cardiovascular Diseases, then complete an additional one to two years of further training, and then pass a national examination administered by the American Board of Internal Medicine.