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...
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...
by Caroline Fife, M.D. | Mar 25, 2019 | Fight the Good Fight, Health Information Technology and Wound Care
Mysterious Sepsis in a Dialysis Patient I have been taking care of a young woman with Type 1 diabetes who lost her kidney transplant about a year ago. She suffers from all the complications of diabetes, and is on home peritoneal dialysis. When I first saw her, she had...
by Caroline Fife, M.D. | Mar 14, 2019 | Fight the Good Fight, Health Information Technology and Wound Care
I have the nurses leave the dressing they just removed on a chuck or on top of the trash so that I can look at it. It is amazing what you can learn from a discarded wound dressing. I’ve blogged previously about the fact that frankly bloody drainage is increasingly...
by Caroline Fife, M.D. | Mar 11, 2019 | Fight the Good Fight, Health Information Technology and Wound Care
84 year old man with a history of lymphoma but is purportedly disease free. Severe peripheral edema began 2 years ago. He says he developed this very large ulcer after minor trauma. His skin perfusion pressure is normal (68 mmHg), he has a biphasic PVR and strong DP...
