by Caroline Fife, M.D. | May 15, 2019 | Fight the Good Fight, Health Information Technology and Wound Care
The following patients with leg ulcers were referred to me (sometimes by the vein center) after undergoing venous ablation for documented venous reflux. The first is a 92 year old, alert little lady referred from a local vein center. A circumferential leg ulcer had...
by Caroline Fife, M.D. | Apr 17, 2019 | Fight the Good Fight, Health Information Technology and Wound Care
If you have been in wound care for any length of time, you have seen a patient like this. The local cancer is eradicated, and then we handle the aftermath. I tried to get a video of the day I could see her lung moving but it was a TINY little hole under the rib after...
by Caroline Fife, M.D. | Apr 15, 2019 | Fight the Good Fight, Health Information Technology and Wound Care
This is a 70 year old man who underwent surgery for a ganglion cyst two months before he was referred to the wound center. Ten days later when the sutures were removed, the wound just fell open. He underwent debridement and closure, and the same thing happened. These...
by Caroline Fife, M.D. | Apr 11, 2019 | Fight the Good Fight, Health Information Technology and Wound Care
The video above depicts a 68 year old woman who had first noticed a lump in her breast 8 years earlier, but she did not seek treatment because she was overwhelmed with the death of her father and suffered a stroke due to a blood clot. She was placed on Coumadin for...
by Caroline Fife, M.D. | Apr 10, 2019 | Fight the Good Fight, Health Information Technology and Wound Care
Here are two patients with “livedoid” skin changes. Are they the same thing? Case #1: A 66 year old woman with a narcotic addition who fell asleep on her heating pad and suffered a burn on her buttock (see above). She has livedoid changes to the skin – a reticulated...
by Caroline Fife, M.D. | Apr 8, 2019 | Fight the Good Fight, Health Information Technology and Wound Care
One of the things that makes wound care fascinating is that you can work your way through the Merck manual of rare diseases in a few months. I walked into see a new patient who had some of the worst leg ulcers I have ever seen (see above). He was a diabetic on...
by Caroline Fife, M.D. | Apr 5, 2019 | Fight the Good Fight, Health Information Technology and Wound Care
This patient was referred for a persistent buttock lesion that developed during a severe illness. I like to listen to the patient’s story before I look at their wound, since the history will usually tell you the diagnosis. His story was unusual, because he described...
by Caroline Fife, M.D. | Apr 3, 2019 | Fight the Good Fight, Health Information Technology and Wound Care
I never tire of watching epithelium “think.” This lady had an open fracture of the ankle. The dorsal foot wound (where hardware was placed) separated and as the sough was debrided, enlarged. Then granulation begins to fill the defect. Then an amazing thing...
by Caroline Fife, M.D. | Apr 1, 2019 | Fight the Good Fight, Health Information Technology and Wound Care
I read Malcolm Gladwell’s book, Blink: The Power of Thinking Without Thinking, and since then I have been paying more attention to my instinctive reaction to certain wounds. I saw a patient getting a compression bandage change (who was not my patient), and the first...
by Caroline Fife, M.D. | Mar 29, 2019 | Fight the Good Fight, Health Information Technology and Wound Care, Quality Payment Program
A recent column in Med Page Today by David Nash draws attention to the quality measure development process as well as its funding model by CMS. My comment in response was not published in Med Page (shocking!), so I thought I’d post it here: “Thank you for...
