by Caroline Fife, M.D. | Jun 4, 2021 | Nutrition & Wound Healing
Check out this article by Efthymios Gkotsoulias, David Kuten and me, published in the April issue of Today’s Wound Clinic entitled, “Multidisciplinary Teams, All the Time: Treat the Patient and Not the Wound.” The patient had a limb-threatening lesion, and his leg was...
by Caroline Fife, M.D. | Jun 1, 2021 | Nutrition & Wound Healing
I can’t decide if I am seeing more truly starving patients since I started focusing on nutrition, or if I’m just more sensitive to it. All 3 of these patients have a body mass index (BMI) of less than 17. The first patient completely healed a stage 4 pressure ulcer...
by Caroline Fife, M.D. | May 21, 2021 | Nutrition & Wound Healing
We see a lot of sad situations in the field of wound care, but every now and then, a case really gets to you. This patient is a 47 yo man with a sacral pressure ulcer which had developed 2 months earlier when he was hospitalized for pneumonia. He suffers from a rare,...
by Caroline Fife, M.D. | May 19, 2021 | Nutrition & Wound Healing, PAD Hall of Shame
This is a retired physician in his 90’s whose mind is as sharp as a tack. He’s got congestive heart failure (CHF) and leg edema so severe that his skin is splitting open. He’s a chair sleeper in part because he has orthopnea (shortness of breath lying down), but also...
by Caroline Fife, M.D. | May 11, 2021 | Fight the Good Fight, Nutrition & Wound Healing
This is a man in his mid-eighties with severe peripheral edema and a nasty looking leg ulcer that’s been present for about 2 months. His edema began 2 years ago, some weeks after his wife died. It turns out that he’s lost at least 20 lbs. over the past year. When I...
by Caroline Fife, M.D. | May 10, 2021 | Nutrition & Wound Healing
This is a poster I presented at a wound care conference two years ago. It’s not earth shattering, it’s just interesting. The patient is a woman in her late 80’s with advanced dementia who was being taken care of lovingly at home by her two daughters. She developed a...
by Caroline Fife, M.D. | May 7, 2021 | Nutrition & Wound Healing
This is a 61-year-old woman with Lupus who presented with huge non-healing ulcers on both knees, thought to be related to vasculitis. However, her BMI (Body Mass Index) is only 13.8 — which is lower than patients I treated in Haiti. She weighs only 83 lbs. None...
by Caroline Fife, M.D. | May 5, 2021 | Fight the Good Fight, Nutrition & Wound Healing
I’ve been talking about how I use IMPACT® in surgical patients who are nutritionally at risk. This is the second patient I tried the approach on. She’s a very beautiful, 33-year-old, previously healthy young woman who developed sepsis with cardiogenic shock and was in...
by Caroline Fife, M.D. | May 4, 2021 | Fight the Good Fight, Nutrition & Wound Healing
I have spent the last several years making nutrition a major focus of my wound care practice, and I think it has revolutionized the way I manage patients. It would be ideal if all my patients could be evaluated by a registered dietician, but unless they have diabetes,...
by Caroline Fife, M.D. | Apr 30, 2021 | Do the Right Thing: Thoughts on Quality, Fight the Good Fight, Nutrition & Wound Healing
This is a 35 y.o. woman with type 1 Diabetes, liver disease and end stage renal disease on home peritoneal dialysis after failed renal and liver transplants. She also has other wounds on her body due to pressure and ischemia. The abdominal wound had been present for 9...
