32 - Shortness of Breath

Dr. Payam Abrishami joins the show to discuss all things dermatological. Dr. Abrishami is a Dermatologist in Agoura Hills, CA and has over 21 years of experience in the medical field. Today we learn: How bad is the sun for our skin? Do most OTC skin products even work? Is that new mole something we should go get checked out? How do we properly care best for our skin? All these questions and more are answered on this episode of Medicine, We’re Still Practicing. Episode Timestamps: 2:25 What happens to our skins as we age? 3:45 Reversing the affects of damage to the skin 5:05 How important is sunscreen, and what kind should we use? 6:04 What is SPF and what amount should we be using? 7:00 What is UPF clothing, and does it work? 8:00 What is collagen? 9:00 How bad are tanning beds? 10:45 Is moisturizing our skin that important? 11:25 Do you get what you pay for with OTC skin care? 12:45 Why do some young people suffer from worse acne than others? 14:00 What should a parent look out for in the Childs acne profile? 18:22 What is CO2 laser skin resurfacing? 20:00 How to tell the difference between cancerous and non-cancerous moles? 26:00 How does skin cancer develop? 27:00 How do you treat skin cancer? 28:20 How does the biopsy process work, and what is the followup process? 31:15 Recent technological breakthroughs for skin cancer detection at home ----------------- Learn More: Medicine, We’re Still Practicing Follow Us: Twitter | Facebook | Instagram Hosted by: Dr. Steven Taback & Bill Curtis Produced and Edited by: AJ Moseley Theme Music by: Celleste and Eric Dick A CurtCo Media ProductionSee omnystudio.com/listener for privacy information.

In this episode, we revisit our conversation with Dr Suzanne Donovan and her harrowing work on the Ebola outbreak. As Dr. Donovan breaks down her first time fighting overseas against this truly terrible disease, one can't help but draw the similarities and foreshadowing between her work in a nation in desperation, and the COVID pandemic that was just around the corner.  Episode Timestamps: 1:40 How is Ebola spread? Why is the outbreak so bad in West Africa? 4:20 Why were so many doctors dying from Ebola? 6:20 Evacuating doctors back to the US? 7:30 What is the treatment for Ebola in Africa? 10:00 Transmission timeline for Ebola 14:30 What was the scene like on Dr. Donovan's first day in the African hospital? 17:48 Contact tracing and testing for Ebola 19:50 Healthcare worker safety in West Africa 22:23 Dealing with dead bodies? 23:36 Dr Donovan compares how governments in third world countries handle health crisis differently than the US 25:36 The progress in HIV/AIDS treatment over the years ----------------- Learn More: Medicine, We’re Still Practicing Follow Us: Twitter | Facebook | Instagram Hosted by: Dr. Steven Taback & Bill Curtis Produced and Edited by: AJ Moseley Theme Music by: Celleste and Eric Dick A CurtCo Media ProductionSee omnystudio.com/listener for privacy information.

In the third installment for our Cedars-Sinai series, hosts Dr. Steven Taback and Bill Curtis are joined by Geriatrician Dr. Sonja Rosen, where they discuss the in’s and out’s Geriatric Medicine and at home care for the elderly. The group also discusses the organization (or lack there of) of the countries medical records in regard to polypharmacy, how to handle the difficult conversations that revolve around elderly care, and some tips for both you and your loved ones to live a long and quality life.In this dedicated series, we're showcasing the medical breakthroughs & innovations from one of the world's most preeminent hospitals: Cedars-Sinai. Cedars-Sinai is dedicated to improving the health of the community and the world by setting the standard of excellence in medical education, research, and clinical care.Episode Timestamps:2:09 What is unique about treating geriatrics vs normal internal medicine?3:10 Is diagnosis harder for older people?3:47 Should you give up your normal internist for a geriatrician? Can you?5:49 Do geriatricians usually get brought in as specialists?7:00 What can the average person do to improve their lifespan and quality of life?8:38 Do memory supplements work? Does Dr. Rosen recommend any specific ones?10:00 How much and what kind of exercise do we really need?11:04 Tips on convincing patients to exercise?14:00 How to approach your elderly ones in moving towards finding a geriatrician?15:40 Are electronic records well organized for the case of poly pharmacy?20:00 Fixing the chaos of poly pharmacy?23:00 Managing insurance companies and getting the best medications in your patients hands24:22 How to handle the difficult situation of ‘independence’ with your elderly loved ones.27:30 How important is teeth care?28:25 How important is ‘hearing’ as an elderly person?29:13 Swallowing issues as an elderly person29:50 Does our sleep decline the older we get? Why?31:08 High blood pressure treatment as an elderly person31:54 What are the ‘4 Ms’ of optimally caring for older patients? ----------------- Learn More: Medicine, We’re Still Practicing Follow Us: Twitter | Facebook | Instagram Hosted by: Dr. Steven Taback & Bill Curtis Produced and Edited by: AJ Moseley Sound Engineering by: Steve Reickeberg Theme Music by: Celleste and Eric Dick A CurtCo Media ProductionSee omnystudio.com/listener for privacy information.

In the second installment for our Cedars-Sinai series, hosts Dr. Steven Taback and Bill Curtis are joined by pulmonary and Critical Care Director Dr. Victor Tapson, where they discuss all things pulmonary embolism and hypertension related. Pulmonary hypertension is known as the silent killer because more often than not, you’re only diagnosed after it’s too late. The panel discuses some of the causes for pulmonary embolism, how COVID has played a role in the disease, as well as signs and symptoms for both patients and physicians to look out for when treating the pulmonary embolism and hypertension.In this dedicated series, we're showcasing the medical breakthroughs & innovations from one of the world's most preeminent hospitals: Cedars-Sinai. Cedars-Sinai is dedicated to improving the health of the community and the world by setting the standard of excellence in medical education, research, and clinical care. Episode Timestamps: 2:30 How has COVID played a role in blood clots?  3:53 Dealing with the social devastation of COVID as a physician. 5:36 Are blood clots in COVID patients different than those who get clots without COVID? 8:30 Does anti-inflammatory agents or immunotherapy have any effect on blood clots? 9:49 What got Dr. Tapson originally interested in studying Pulmonary Embolism?  10:58 Why do DBT and PE consistently get missed on diagnosis? 12:00 What are the best tests to diagnosis PE? 13:53 Young physicians and the conundrum of minimizing the amount of testing with a disease that’s diagnosis relies mostly on “suspicion.”  16:00 Minimizing CT scans because of the dye/contrast’s effects on kidneys. 17:53 How do blood thinners work? 22:07 Pulmonary hypertension vs. high blood pressure. 23:15 What are the 5 classes of pulmonary hypertension? 25:45 How do you test for PH? 26:57 What predisposes one to pulmonary hypertension? 28:18 Has PH risen with COVID “long-haulers?” 29:20 The balancing act of 'best-treatment’ for a disease and kidney/liver function. 30:47 Dr. Tapson shares the biggest breakthroughs and exceptions in his field. ----------------- Learn More: Medicine, We’re Still Practicing Follow Us: Twitter | Facebook | Instagram Hosted by: Dr. Steven Taback & Bill Curtis Produced and Edited by: AJ Moseley Sound Engineering by: Steve Reickeberg Theme Music by: Celleste and Eric Dick A CurtCo Media ProductionSee omnystudio.com/listener for privacy information.

Is Crohn's passed on from family members? Does diet have anything to do with it? In the first installment of our Cedars-Sinai series, hosts Dr. Steven Taback and Bill Curtis are joined by Gastroenterologist Dr. Stephan Targan, where they discuss the ins and outs of IBD and Crohn's disease. Dr. Targan shares some key insight on symptoms and techniques used in the fight against this widespread disease that is thought to affect almost 3 million Americans. Dr. Targan also enlightens us on the efficacy of probiotics and whether gluten plays much of a roll in IBD. In this dedicated series, we're showcasing the medical breakthroughs and innovations from one of the world's most preeminent hospitals: Cedars-Sinai. Cedars-Sinai is dedicated to improving the health of the community and the world by setting the standard of excellence in medical education, research, and clinical care.Episode Timestamps:2:20 What is Crohn's Disease?3:23 Is there a definitive cause for IBD (inflammatory bowel disease)?4:29 What are the techniques used to test for Crohn's Disease?5:01 How do we treat Crohn's Disease?5:50 How important is diet’s impact on IBD?7:06 What is the efficacy of probiotics in general and in regards to IBD?8:35 Does eating vegetarian ease symptoms of Crohn's Disease?10:34 Targeted Therapeutic Selection? What is it and how is it used with IBD?14:22 What is a TNF inhibitor?16:23 Does family history play into getting IBD?17:11 At what age can you develop IBD?18:14 Is each case of IBD trial and error, or are there some already established practices?19:55 Immunotherapy and IBD?20:36 What is fibrosis?21:35 Has COVID had any impact of IBD?22:59 Whats the distribution of Crohn's Disease geographically?24:23 What is the population of those infected with IBD?25:50 Genetic mapping and Crohn's Disease?26:23 Does the consumption of gluten have any relation to Crohn's Disease?27:55 Dr. Targan shares his main focus moving forward in his research29:24 What are the symptoms the general public should be aware of when it’s time to go see a doctor because of IBD? ----------------- Learn More: Medicine, We’re Still Practicing Follow Us: Twitter | Facebook | Instagram Hosted by: Dr. Steven Taback & Bill Curtis Produced and Edited by: AJ Moseley Sound Engineering by: Steve Reickeberg Theme Music by: Celleste and Eric Dick A CurtCo Media ProductionSee omnystudio.com/listener for privacy information.

On this episode, Bill and Dr. Steve are joined by three members of the Certis Oncology team: CEO Peter Ellman, Dr. Arun Singh M.D., and Surgical Oncologist Dr. Fritz Eilber M.D. Certis is an early stage biotech company with a focus on advancing translational oncology through the O-PDX technique. O-PDX standing for “patient derived xenografts” are models of cancer where the tissue or cells from a patient's tumor are implanted into an immunodeficient or humanized mouse. Certis acquires intimate knowledge about the biology, chemistry and evolution of individual cancers to empower patients, inform treatment strategies and advance the next generation of oncology therapeutics. We think you’ll be just as inspired by this episode as we are.Episode Timestamps:3:40 Why is treating cancer still such a mystery?4:30 What is cancer?5:24 What is the Certis Oncology all about?6:54 Petri Dish vs Mouse Model7:39 The novelty of using immunosuppressive mice9:35 How does Certis scale this model to the whole world10:57 Can you start your oncology treatment with the mouse method via Certis?12:08 Do insurance companies play ball with mouse model research?13:15 What should general surgeons outside of Certis be doing with biopsy specimens?14:32 What is the turnaround time on the mouse model research?16:27 What is the dynamic with Certis and an individuals specific oncologist?21:33 Peter Ellman shares how Certis got started26:00 Does a tumor that is implanted in a mouse have the same likelihood of traveling to other organs as it would in a human?28:22 Can patients request having work done with Certis?30:13 Where is Certis getting it’s funding from, and what is the future dynamic with insurance companies?33:00 Can the model work for other diseases outside cancer? ----------------- Learn More: Medicine, We’re Still Practicing Follow Us: Twitter | Facebook | Instagram Hosted by: Dr. Steven Taback & Bill Curtis Produced and Edited by: AJ Moseley Sound Engineering by: Steve Reickeberg Theme Music by: Celleste and Eric Dick A CurtCo Media ProductionSee omnystudio.com/listener for privacy information.

In our final installment for our Johns Hopkins series, hosts Dr. Steven Taback and Bill Curtis are joined by founder of the field and Johns Hopkins Director of Neuroplastic Facial Reconstruction, Dr. Chad Gordon. In this episode, Dr. Gordon illuminates the groundbreaking developments in Smart Cranial Implants, and shares his passion for the importance of a dedicated Neuroplastic Facial Reconstructive Surgeon. Dr. Gordon shares how his team is leading the charge in building the next evolution of skull and neurological care via Customized Cranial Implants. You won’t want to miss this enlightening conversation! We want to deeply thank Johns Hopkins Medicine for helping us showcase the outstanding medical breakthroughs and innovations from their preeminent hospital. We wish your whole institution nothing but the best moving forward. Johns Hopkins Medicine is dedicated to improving the health of the community and the world by setting the standard of excellence in medical education, research, and clinical care. Timestamps: 2:08 What is the field of neuroplastic reconstructive surgery? 3:05 Is neuroplastic reconstructive surgery classified as cosmetic? 4:22 What is the original need for a neuroplastic reconstructive surgeon? 6:39 Whats the difference to what a neuroplastic reconstructive surgeons and a brain surgeon? 8:08 Does insurance generally cover skull reconstruction? 8:33 What is the cause for the rise in neuroplastic reconstructive cases? 10:13 What are smart cranial implants? 12:01 What should local surgeons do to preempt the necessity for neuroplastic reconstruction? 13:53 Why did Dr. Gordon decide to bypass the lucrative field of cosmetic surgery? 15:31 The evolution of neuroplastic reconstruction and how robotics plays into the field 19:42 Dr. Steve shares what a craniotomy is and why it would be used 23:07 Use cases of skull implants of the future 26:00 Modifying the brain over the next 100 years 27:17 Side effects of replacing the skull with plastic 29:01 Dr. Gordon’s take on the future of neuroplastic reconstructive care 31:00 How can local neurosurgeons reach out to Dr. Gordon for help/info? ----------------- Learn More: Medicine, We’re Still Practicing Follow Us: Twitter | Facebook | Instagram Hosted by: Dr. Steven Taback & Bill Curtis Produced and Edited by: AJ Moseley Sound Engineering by: Steve Reickeberg Theme Music by: Celleste and Eric Dick A CurtCo Media ProductionSee omnystudio.com/listener for privacy information.

In our seventh installment for our Johns Hopkins series, hosts Dr. Steven Taback and Bill Curtis are joined by Assistant Director of Special Operations at Johns Hokpins Medicine, Dr. Matthew Levy, where they discuss the harrowing yet heroic care that the nations frontline EMT’s delivered during the pandemic. You’ll discover how the complexity of top notch EMS care is coordinated, as well as ground-breaking innovations like the Israeli AED drone delivery protocol, and the inner-workings behind how the emergency medical care system is funded. You won’t want to miss this enlightening conversation!In this dedicated series, we're showcasing the medical breakthroughs & innovations from one of the world's most preeminent hospitals: Johns Hopkins Medicine. Johns Hopkins Medicine is dedicated to improving the health of the community and the world by setting the standard of excellence in medical education, research, and clinical care.Episode Timestamps:2:28 What is the ‘Division of Special Operations’ at Johns Hopkins?3:54 How do EMS systems coordinate with other departments on a regional and national level?5:47 Fire Department EMS systems vs private EMS systems.8:11 How has EMS care progressed through and after COVID?11:46 EMT’s and their direct contact with COVID.13:00 Were people avoiding hospital care during the pandemic?16:40 What is the difference between EMS and EMT?19:31 Are EMS and EMT fields properly funded? How can they be optimized to the patient?21:42 The dynamic of insurance in its relation to EMS care.24:38 How do EMT’s handle the difficult decisions they’re put into every day?27:29 Dr. Levy elaborates on the Israeli EMS drone delivery AED system.31:58 Dr. Levy shares about his experience of working in emergency care in the difficult city like Baltimore. ----------------- Learn More: Medicine, We’re Still Practicing Follow Us: Twitter | Facebook | Instagram Hosted by: Dr. Steven Taback & Bill Curtis Produced and Edited by: AJ Moseley Sound Engineering by: Steve Reickeberg Theme Music by: Celleste and Eric Dick A CurtCo Media ProductionSee omnystudio.com/listener for privacy information.

In the sixth installment of our Johns Hopkins series, host Bill Curtis relives some favorite moments. Hear from Dr. Dale Needham, Dr. Martin Brodsky, and Dr. Megan Hosey on their innovative and groundbreaking techniques in the ICU. We also touch on Dr. Christopher Earley’s revolutionary care and treatment of Restless Leg Syndrome. And finally, we learn from Dr. Ken Pienta about the in’s-and-outs of the silent killer that is prostate cancer, and how best we can treat it pre- and post-diagnosis. In this dedicated series, we're showcasing the medical breakthroughs & innovations from one of the world's most preeminent hospitals: Johns Hopkins Medicine. Johns Hopkins Medicine is dedicated to improving the health of the community and the world by setting the standard of excellence in medical education, research, and clinical care. Episode Timestamps: 1:40 Why is sedating the wrong way to go for ICU care? 3:25 How did Dr. Dale Needham break the traditional adage of sedation in the ICU first? 6:09 Techniques on orienting patients during a time of delusion in the ICU. 8:15 Dr. Hosey shares some advice for physicians dealing with psychological care in the ICU. 10:30 How does Speech Language Pathologist Dr. Martin Brodsky communicate with ICU patients? 13:15 What is RLS - Restless Leg Syndrome? 15:47 What is the innovative technique Dr. Christopher Earley uses to treat RLS? 17:47 Why do so many men die from prostate cancer? 19:02 What are the signs men should look for in identifying prostate cancer? 20:02 The use of proton therapy in urological issues such as prostate cancer. 23:05 Dr. Hosey shares her emotional experience with how COVID has changed her life. ----------------- Learn More: Medicine, We’re Still Practicing Follow Us: Twitter | Facebook | Instagram Hosted by: Dr. Steven Taback & Bill Curtis Produced and Edited by: AJ Moseley Sound Engineering by: Steve Reickeberg Theme Music by: Celleste and Eric Dick A CurtCo Media ProductionSee omnystudio.com/listener for privacy information.

In the fifth installment of our Johns Hopkins series, hosts Dr. Steven Taback and Bill Curtis are joined by Dr. Megan Hosey to discuss her work in providing frontline psychological care to patients in the ICU. In an extremely unique field, Dr. Megan Hosey is gifted with the powerful skillset of providing warmth and psychological support to ICU patients in very troubled times. There needs to be more Dr. Hosey’s in the world! In this dedicated series, we're showcasing the medical breakthroughs & innovations from one of the world's most preeminent hospitals: Johns Hopkins Medicine. Johns Hopkins Medicine is dedicated to improving the health of the community and the world by setting the standard of excellence in medical education, research, and clinical care. Episode Timestamps: 2:13 What are some of the new challenges that COVID has brought to Dr. Hosey’s work in the ICU 4:32 Techniques that can help physicians ease the mind of a delirious patient 5:50 How can physicians provide the right kind of psychological support without an ICU psychologist on staff? 9:20 How should patients handle anxiety in the ICU vs outside the ICU 11:42 Where does a lot of the anxiety stem from in the ICU? 14:22 How does Dr. Hosey manage the family in relation to COVID patients? 16:05 What can family members do to better help out their loved ones in the ICU? 19:06 How important is a positive attitude for the patient? 21:24 The psychological affect of treating COVID patients in the ICU during the strongest COVID surge last year 23:50 How has COVID changed Dr. Hosey’s life? 27:45 Who’s gonna take care of the healthcare workers dealing with PTSD after COVID-19? ----------------- Learn More: Medicine, We’re Still Practicing Follow Us: Twitter | Facebook | Instagram Hosted by: Dr. Steven Taback & Bill Curtis Produced and Edited by: AJ Moseley Sound Engineering by: Steve Reickeberg Theme Music by: Celleste and Eric Dick A CurtCo Media ProductionSee omnystudio.com/listener for privacy information.