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Does Venous Reflux a Venous Ulcer Make?

Does Venous Reflux a Venous Ulcer Make?

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...
The Saga of an Autoamputated Breast, Local Radiation and Transdermal Oxygen with OxyBand

The Saga of an Autoamputated Breast, Local Radiation and Transdermal Oxygen with OxyBand

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...
Cancer, Biofilm and the Keto Diet

Cancer, Biofilm and the Keto Diet

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...
Don't Miss This: Annoyed by Livedoid

Don't Miss This: Annoyed by Livedoid

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...
The Ironman Competition

The Ironman Competition

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...
Don't Miss This: This One is Neither a Pressure Ulcer Nor a Pressure Injury

Don't Miss This: This One is Neither a Pressure Ulcer Nor a Pressure Injury

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...
Watch Epithelium "Think"

Watch Epithelium "Think"

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...
The Wound Whisperer – Lymphedema of the Plantar Foot

The Wound Whisperer – Lymphedema of the Plantar Foot

by Caroline Fife, M.D. | Apr 1, 2019 | Fight the Good Fight, Health Information Technology and Wound Care, Lymphatic Imaging & Lymphedema

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...
The Unwilling Doing the Impossible for the Ungrateful: Wound Care Quality Measure Development

The Unwilling Doing the Impossible for the Ungrateful: Wound Care Quality Measure Development

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...
The Wound Care Practitioner Reduction Program (HRRP)

The Wound Care Practitioner Reduction Program (HRRP)

by Caroline Fife, M.D. | Mar 27, 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 frustrating issue of the quality measure development process (as well as its funding model). If any wound care practitioner has looked at their Quality and Resource Use Report (QRUR), you might...
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