by Caroline Fife, M.D. | Oct 4, 2018 | Do the Right Thing: Thoughts on Quality, Don't Miss This
A recent National Academy of Medicine discussion paper reviews the concept of “team-based healthcare” and the way in which it is associated with both improved patient outcomes and clinician well-being. According to the authors, teamwork must,...
by Caroline Fife, M.D. | Aug 16, 2018 | Don't Miss This, Fight the Good Fight, Health Information Technology and Wound Care
Wounds are a symptom. Our job is to find the disease. Here’s a patient with a non-healing abdominal wound after a ruptured aneurysm. He’s lost the outer third of his eyebrows. Today one of his labs came back very high. What lab was it? If you guessed his...
by Caroline Fife, M.D. | Jun 18, 2018 | Don't Miss This, Fight the Good Fight, Health Information Technology and Wound Care
This is a man in his 80’s whose dementia can’t conceal his sweet personality. He has diabetes and relapsing Polychondritis. After he suffered a spiral fracture of the femur due to Myelodysplastic Syndrome, both his surgical incisions broke down a week after surgery. I...
by Caroline Fife, M.D. | Jun 6, 2018 | Don't Miss This, Fight the Good Fight, Health Information Technology and Wound Care
These excruciatingly painful, necrotic leg lesions began about the same time on both legs when the patient began oral prednisone as part of chemotherapy for a myeloproliferative disorder. They have increased in size rapidly over two weeks. She had been on peritoneal...
by Caroline Fife, M.D. | May 30, 2018 | Don't Miss This, Fight the Good Fight, Health Information Technology and Wound Care
It’s good to be reminded that wounds are a symptom of a disease or diseases. The things we see from day to day are amazing. Here’s a quiz about fingernails. This little lady weighs less than 100 lbs. and is nearly as many years old. She worked as a welder...
by Caroline Fife, M.D. | Jan 23, 2018 | Don't Miss This, Fight the Good Fight, Health Information Technology and Wound Care, Nutrition & Wound Healing
Forget about the flu epidemic. At least it’s pretty easy to figure out when a patient has the flu. I feel sure I have missed some patients with wounds due to low Vitamin D. The Vitamin-D deficiency epidemic is ridiculous. What scares me is not that 80% of the tests I...
by Caroline Fife, M.D. | Dec 8, 2017 | Don't Miss This, Fight the Good Fight, Health Information Technology and Wound Care
The photo above is a pretty classic case of vasculitis, with palpable purpura, and these lesions HURT. The patient is a young healthy school teacher and we never found the cause. This is a leukocytoclastic vasculitis, too. This patient, who has a lot of medical...
by Caroline Fife, M.D. | Nov 29, 2017 | Don't Miss This, Fight the Good Fight, Health Information Technology and Wound Care
This is atrophie blanche. Note the smooth ivory white plaque of skin with telangiectasias. It has other names, including lividoid vasculopathy. These areas often ulcerate. It is NOT vasculitis. It is usually excruciatingly painful. The majority of these lesions are...
by Caroline Fife, M.D. | Oct 31, 2017 | Don't Miss This, Fight the Good Fight, Health Information Technology and Wound Care
After 30 years I have made enough mistakes for several people, so maybe I can spare you some of them. Don’t miss Necrobiosis lipoidica diabeticorum. Necrobiosis lipoidica diabeticorum (NLD) is a skin eruption that usually occurs on the shin in diabetic patients...
by Caroline Fife, M.D. | May 20, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Don't Miss This, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
This is the photo of a 30-year-old white male with a one-year history of a small non-healing ulcer on the dorsal aspect of his right great toe. He was followed for a year at another wound center in my city, using a variety of topical products. I follow the “wounds...
