Part 4: Google Recommended Treatment/Medications

  • hiermedia
  • March 22, 2019

This is Part 4 in a 5-part series of articles on 5 Tips to Be a Better Participant in Your Healthcare. In Part 4, I ask you to do your homework about the medications you take and about possible treatments or surgeries.

5 Tips to Be a Better Participant in Your Healthcare: Introduction

Part 1: Find the Right Doctor

Part 2: Speak Up During the Visit

Part 3: Find the Right Hospital

Part 4: Google Recommended Treatment/Medications

Tip 4: Google recommended treatment/medications

There is wide variability in responses to treatment and medication. This means when taking the same medication, some patients get better while others do not. One patient may experience a side effect that other patients do not experience.  

Do you know the possible side effects of the medications you take? Start by asking your doctor “what are the most common side effects of this medication.” You can search the website of the producing drug company for a list of common side effects. You can also speak with your pharmacist for more information about your medication.   

Even in surgery, one size does not fit all. For example, robotics and laparoscopy may not be a great option in some patients with large amounts of adhesions or scar tissue. As a doctor, I have to individualize surgery for each patient. To help you better understand future surgeries, you can find pictures and illustrations online. Bring those with you when you come to the doctor. As I said in an earlier post, while some doctors get frustrated with patients consulting “Dr. Google,” there are few physicians who can argue with patients striving to better understand their disease.  

Your doctor will be ready to discuss potential medical and surgical treatment options with you. Unfortunately, your doctor will not know everything about you and specifically how you may respond to some medical and surgical treatments.   

But, do your homework!   

You may learn the recommended medication and treatment may not be right for you. Likewise, you could learn about treatment options that would not have been offered if you did not ask.   

Knowing more about your medications may improve how you treat chronic diseases such as diabetes and high blood pressure. You are more likely to stay on track and use medications as they were intended to be used. For example, are you using a prescribed respiratory inhaler properly? Are you using it as often as you should to maximize its effectiveness?   

Most importantly, by doing homework about your medications and future treatments, you may save your own life. You will more likely recognize dangerous side effects or reactions to a given medication or treatment and call for help when you need it the most.   

Black Health Disparities are Real: Here’s How We Can Reduce Their Impact

  • hiermedia
  • January 8, 2019

Sitting in class in medical school and learning about various diseases often felt like a roll call of many of the people in my life. When reading about lupus, I thought of a childhood friend from my church who was diagnosed with lupus in her late teenage years and died in her mid-20’s. Having discussions about kidney disease reminded me of a family friend who spent 3-4 days a week in dialysis, requiring the remaining days of the week to rebound from the fatigue it often brought her. Discussion of the anticoagulant warfarin (Coumadin), brought back conversations with my grandmother about altering doses of the same medication for her ever prevalent heart disease. The pathology I learned in medical school reminded me too much of my familial circle.

The data is alarming: younger African Americans live with or die from many conditions usually found in white Americans when they are older. Data from the Center for the Control and Prevention of Diseases further show African Americans are more likely to die at earlier ages from all causes. African American women are more likely to have an aggressive form of uterine cancer and are more likely to die from it. Other studies have shown both women and men who are African Americans have more advanced stages of colorectal cancer at diagnosis and have lower survival rates. Prostate cancer, hypertension, Alzheimer’s disease, COPD, and diabetes are other disease processes with disparity in African Americans. Another study demonstrated that African American women have higher rates of maternal death during childbirth.

There are several explanations of these findings. Discussions often center on genetic links that connect diseases in African Americans from one generation to another. Dietary factors such as diets high in salt, sugar, fats, processed foods, and cured meats often found on the table during traditional African American “soul food” meals help explain higher incidences of high blood pressure and kidney disease. High cost and limited access to healthcare has been shown to delay diagnosis and treatment (such as with a colonoscopy to find precancerous polyps before they become cancerous). If there is no available doctor in the neighborhood, city, or town it may be extremely difficult to find one or arrange transportation. Biases (conscious and unconscious) on the part of both physicians and patients can limit care the patient receives. Even more, deeper cultural influences such as mistrust of doctors (an unfortunate result of decades of unchecked medical experimentation on Blacks and other minorities) and reliance solely on faith may additionally negatively influence seeking out medical help.

These factors can seem insurmountable. How can one effectively change the cultural thread from which they are made? Beliefs are deeply embedded and habits are hard to break, especially when some of the behavior, which leads to diseases, is so pervasive and accepted around you. At times, for both patient and the healthcare provider, sometimes it seems easier to not even try.

But we should. We must. We can all play a role in overcoming these challenges. For members of the healthcare profession, we have a responsibility to create awareness of the diseases we know disproportionately affect the patients we treat. We must advocate for early screening, and continue collaborations with government, churches, and community groups to create programs to increase access to care. In my own practice, I have learned to take extra time even at the expense of running a few minutes behind in the office to explain in plain language information about a disease and the treatment plan. I often request additional members of the family to come into the office to help ensure understanding of the plan. Patients must seek health professionals they trust and seek their advice when they first experience symptoms. While you cannot change your genetics, you can move more. Another solution is to make changes in the diet by including vegetables and whole grains as the main course in the meal with a choice of a lean cut meat as a side. Let fruit be your desert. Become an active member of your healthcare team and seek solutions as a team. Ask questions. And if your reliance is solely on faith, recognize all good gifts come from God, even your doctors and the knowledge and advice they share with you.

Journey to #BlackMenInMedicine

  • hiermedia
  • November 27, 2017

There were fewer Black men enrolling in medical school in 2014 than in 1978.

In a world where the first Black president of the United States was elected nearly a decade ago with many declaring it to be a new day of progress for Blacks in America, statistics such as this one come as a surprise. Fifteen years ago only 677,000 Blacks held an advanced degree. Today that number is 1.6 million. For unclear reasons, these successes have not translated into increased representation of Black men in medicine.

The 2015 AAMC report Altering the Course: Black Males in Medicine provided interviews of premedical students, physicians, and researchers that highlighted reasons for the decline in Black men enrolled in medical school, emphasized research and data to help explain trends, and sought ways to encourage more black men to consider medicine as a career. They identified recurring themes such as unequal educational opportunities from kindergarten-12th grade, absent role models or mentors in medicine, negative societal bias and perceptions of black men, and the increasing financial burden from the cost of a medical education.

We are familiar with the AAMC report, and many of us have been working to address the issues presented.While at Duke University, Dale Okorodudu, MD created the video series “Black Men in White Coats” with the goal of inspiring and encouraging black men to pursue careers in medicine. He wrote blogs, such as Where The Brothers At?-Mentoring and Black Men Doctors, which called for strong mentorship to young men who could and would pursue medicine if they were exposed to “men of seniority…similar to our black men…who could capture their attention and gain their respect.” In September 2015 Damon Tweedy, MD released his book, Black Man In A White Coat, to document the challenges he faced and to inspire other black men to follow in his footsteps. In his New York Times Op-Ed article “The Case For Black Doctors,” he recognized that further under-representation of this group in medical school could lead to “even worse health outcomes for a population that is already the least healthy.”

So, when medical student, Vince Morgan, tweeted the statistic from the AAMC report November 16, 2017 many of the black male physicians on Twitter felt a sense of camaraderie and solidarity with Vince’s tweet. While our experiences in medical school spanned decades, we were united by our common experience of representing less than 2% of our individual graduating medical school classes. Unfortunately, for the majority of medical schools, these numbers remain unchanged today.

A robust conversation ensued on Twitter among those of us who recognized the problem and wished to do something to rectify the disparity and to find ways to lead by example and support those coming behind us. Perhaps inspired by the strength and resiliency we have seen demonstrated by women physicians and hashtag movements such as #ILookLikeASurgeon and #ThisIsWhatADoctorLooksLike and an immediate recommendation by Quinn Capers, IV, MD, we decided a social media movement and community of our own was in order. In fact, the surgeons among us had previously brainstormed with Heather Logghe, MD, founder of #ILookLikeASurgeon as to how to leverage social media and create a similar, simple to read, but influential hashtag. The goal of the hashtag would be to promote and encourage more young black men to pursue careers in medicine, especially to those who may not recognize medicine as a viable career option perhaps because they have never actually seen or met a black male physician.

Similar to #WomenInMedicine, Darrell Gray, II, MD, MPH suggested #BlackMenInMedicine. Dr. Dale Okorodudu mentioned the Facebook group with a membership of nearly 500 strong with the same name started by Dr. Henry Lewis, III. While we shared the same goal of advising, mentoring, and motivating black men to enter the medical profession with that Facebook group, our goal of re-purposing #BlackMenInMedicine is to encourage universal use of the hashtag across Twitterverse and other social media. Our hope is that the hashtag will be used not only by Black physicians and the allies similarly passionate about increasing diversity in medicine, but by anyone wanting to recognize the many accomplishments of Black men in medicine.

With use of #BlackMenInMedicine, we aim to:

  • Provide visible role models of black men in medicine, both as they practice medicine, and perhaps more importantly, how they spend their time outside of the clinic or hospital
  • Highlight achievements of black male physicians, as well as black men in medical school, and those aspiring to the premed track
  • Inspire black men to pursue careers in medicine and become motivated to care for communities of color
  • Highlight outstanding achievements of black doctors in both community and academic medicine and practice
  • Provide support, mentoring and sponsorship of black women in medicine who face additional challenges at the intersection of gender and race
  • We pledge to speak up when we witness gender-biased microaggressions, blatant sexual harassment, or harmful bias and discrimination toward other minority groups
  • Together, we aim to ensure a safe and inclusive educational, training, and working environment for all of us

Blog post written by Cedrek McFadden, MD and Heather Logghe, MD

Supported and developed by:

Cedric Bright, MD (@CedricMBrightMD)

Quinn Capers, IV, MD (@DrQuinnCapers4)

Dale Okorodudu, MD (@DoctorDaleMD)

Darrell Gray, II, MD, MPH (@DMGrayMD)

Joshua J. Joseph, MD (@joshuajosephmd)

Alden Landry MD MPH (@AMLandryMD)

Heather Logghe, MD (@LoggheMD)

Cedrek McFadden, MD (@cedrekmd)

James Moore, III, M.A.Ed, Ph.D (@DrJLMooreIII)

Brian H. Williams, MD (@BHWilliamsMD)


Also Supported By: Tour for Diversity in Medicine (@tour4diversity)

The Hemorrhoid Talk

  • hiermedia
  • February 16, 2017

Hemorrhoids are not the only cause of anal pain. Find out why searching Google for solutions for this common complaint could be detrimental to your health.

Originally published by Eat This, Not That.

Should You Eat Pork?

  • hiermedia
  • February 16, 2017

Should you eat pork? Many ask this question everyday! Read this article where Dr. Cedrek McFadden explores the benefits of the other white meat.

Originally published by

Silent Lessons of My Grandmother

  • hiermedia
  • February 2, 2017

“I come as one. I stand as ten thousand.” – Maya Angelou

I am a surgeon. I am proud of this fact partly because I am the first in my family to go to medical school. I am also proud of this fact because I recognize that me becoming a surgeon has been less about me and more of a collective and cumulative effort of my parents, grandparents, great-grandparents, and countless other hard-working ancestors, many of whom remain nameless. More than any other, perhaps the one person that would influence my initial decision to become a physician was my grandmother. She would also later influence my decision to become a surgeon. Seeing her sprawled out on her kitchen floor after having a massive heart attack when I was 5 years old would, furthermore, influence my resolution to become that surgeon committed to wellness.

My grandmother was the center of our family. Growing up in a very traditional and conservative African-American home, I was surrounded by a large, loving, and supportive family. Family gatherings at my grandmother’s home were frequent and sometimes without any specific cause. She was generally in charge of deciding the menu items during these gatherings, many of which she prepared herself. At the time, the food was delicious and filling. In hindsight, it was oftentimes, greasy, fried, and nutritionally sparse. The paradox presented in this is that at the same time, my grandmother had many chronic illnesses. I always knew her to be diabetic and was unfazed watching by her self-administering her insulin injections. I became well-versed in hearing about her “Coumadin levels” or her “heart pills.” I knew she was not well as she had difficulty walking short distances and went to the emergency room on a frequent basis, but at the end of the day, medication was the only lifestyle modification for her problems.

Growing up in this setting, I wanted to know the “why” of her health problems. I was not satisfied with knowing generic glossed-over answers, but I constantly asked questions, which eventually led to me choosing medicine as a way to learn more and answer those questions. As most of her health problems were chronic, she was on many medications with oftentimes no immediate change. As a surgeon, I would have the ability to make almost a direct change in the patient’s health, which in addition to a love of anatomy and being in the OR, subsequently became a strong incentive to become a surgeon.

I was fortunate to train at an institution where the hospital embraced the concept of wellness with “eat right” programs and even offered discounted gym memberships. So it was never odd to have a mind towards personal wellness in this setting. I had many attendings that were great examples to me because of their own commitments to eating well and physical fitness. They themselves took time to exercise, spend time with their own families, go to church, and encouraged me to do the same. One attending was known for making climbing the stairs mandatory during rounds! Regrettably, during the early years of my residency, I struggled to find the time and energy to squeeze in exercise and make good food choices. I was at the hospital at 5 and leaving later in the evening. I made poor dietary choices and skipped out of going to the gym. This compromise resulted in weight gain and continued fatigue. Ultimately, towards the end of my training, I had to make my workouts a top priority. By doing so, I was able to foster the required discipline to train and to successfully complete my first marathon during my chief year.

Now as an attending surgeon, my commitment to maintain a sense of personal wellness continues to be a longstanding, purposeful, and intentional journey. By this, I remain in a much better position to prevent burnout and not become detached and frustrated with my patients and the care they require. I am able to handle the increasing physical and mental stressors of being a surgeon much better as I continue to recognize the value of exercise and have kept it a part of my routine. I make time to go to church and spend time with my family. Dietary changes have been the most difficult to make and maintain partly because it has required creating a complete turnaround of what I understand about food. The culture in which I grew up was not particularly health conscious, but after seeing the health problems of those I loved, I recognize that pattern was not one to observe and continue. I have gone through periods of being a vegetarian and even maintained a strict Paleo diet. Ultimately, while not 100 percent protective, my goal has been to make better dietary choices so that I reduce my risk of having health problems I observed as a child in my family.

The night that I saw my grandmother in cardiac arrest on the floor of her kitchen was fortunately not the last time I saw her alive. She was able to recover and lived another 20 years. In the end, she was unable to recover after a surgical procedure. At the point of her death, I was no longer a confused 5-year-old boy but now surgical resident with a better perspective and understanding on the various factors that contributed to her declining health. I now recognize my life as a surgeon is a composite of the invaluable and mainly unspoken lessons my grandmother taught me about health and wellness of my mind and body, and the personal responsibility to ensure I am continually taking care of them both.