Diabetes Part 1 with Dr. Laura LaFave
Endocrinologist Dr. Laura LaFave
This week we did a Healthy Matters show about diabetes and I wanted to write a post about that topic while it is fresh in my head. So I sat down to write but quickly realized that diabetes is probably the most wide-ranging medical condition of them all. It has complex causes, different types, multiple risk factors, numerous complications, and lots of treatments. It is a chronic illness that requires a team of health care professionals and dedicated patients to manage. So I really can’t cover diabetes in a blog post.
At least one that isn’t of Tolstoy-like length.
Then I remembered a comment from a caller to last Sunday’s show. Betty had called in with a question about diabetes, and she noted on the air that she had learned more in the previous 15 minutes of our broadcast than in all the years she had been living with diabetes. (I love our listeners!)
So I thought, hey, I don’t have to cover all of diabetes, I’ll just summarize what we talked about in those 15 minutes, putting it in progressive levels of detail. Sort of like college. Except without the tuition.
Of course, those first 15 minutes of diabetes discussion didn’t come from me. It was my guest, Dr. Laura LaFave, who skillfully broke it down for us. That’s Laura in the photo above, taken just before we went on the air from the WCCO studios in downtown Minneapolis. Dr. LaFave is an friend and colleague with whom I did my training at Hennepin County Medical Center many years ago. Recently, she re-joined our clinical and teaching faculty at Hennepin. (Hint: you, too, can see Dr. LaFave as a patient if you need an Endocrinologist by clicking this link).
For the aurally-inclined among you, I really encourage you to listen to the podcast of the broadcast by clicking the banner here. For those drawn to the written word, I’ll summarize the key learning points in the the following paragraphs. Your choice!
MRI: a (hi-def) glimpse inside the human body
Five MRI images of the brain, all obtained in under 13 minutes. Photo courtesy Dr. Chip Truwit
CT, PET, MRI, IR, X-ray . . . the world of radiology! Perhaps you’ve encountered some of these tests, maybe had some of them yourself, maybe you even know what these letters mean. For those of us in medicine, imaging studies are a critical and daily part of our work. I order these tests all the time, and when the images show up on my computer screen, I take a look at them and marvel at them. But then I call my radiology colleagues to tell me what I’m really looking at.
At Hennepin Healthcare in downtown Minneapolis the department of Radiology just installed the most advanced MRI machine in the country. Before we launched the new magnet into public use – and “launch” seems the right word since the thing looks like something from NASA – the staff needed to warm the thing up. So I volunteered to have an MRI done.
I had an MRI once before. It was a couple decades ago for a running knee injury. I remember it being cold, loud, lengthy, and rather claustrophobia-inducing.
Not anymore.
By Tobias from Wikimedia Commons
The new 3-Tesla MRI scanner at Hennepin’s Clinic and Specialty Center is awesome. First of all, I was welcomed by the staff, then I changed into nice cloth gowns. I got to pick the environment I wanted to be in from a touch screen on the wall. Let’s see, do I want to be on a tropical island, in a forest with pandas, or maybe in an undersea fish scene? I touched “Seychelle Islands” then entered the scanner. The technicians put a visor-like thingie on my face, covered me with a blanket, then the woman with the British accent talked me through the scan while I watched the sea gently roll on the sand of the Seychelles on the screen in front of me.
I never even realized that my body was inside a huge magnet tube. If fact, I fell asleep during my scan.
Three sections in this post if you read on:
- Building the best radiology department right here in downtown Minneapolis. What being patient-centered really means.
- Like wheat in a field. A short physics lesson.
- The role of imaging in a public safety net hospital. Something to get you thinking about healthcare for all people.
The intersection of physical and mental health
“Despair” (public domain art)
A good part of my medical practice at Hennepin Healthcare is in mental health. Although I’m a general internist, meaning I specialize in chronic diseases of adults, I have a special interest in the intersection of medical and mental illness. Consequently, I spend a hefty portion of my days on the inpatient psychiatry units. So when a piece came out in the New York Times this week, I was immediately drawn to it. Written by Dr. Dhruv Khullar from New York-Presbyterian Hospital, it is entitled The Largest Health Care Disparity We Don’t Talk About. I strongly encourage you to read it.
This is particularly of interest to me since I have also been part of a group of five medical systems across the country who have recently published our own experience in caring for people with mental illness. You can read our very brief paper at the Annals of Internal Medicine.
In this post I’ll talk a bit about my own experience in caring for patients with mental health conditions. I’ll end with a few suggestions. read more…
