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...
by Caroline Fife, M.D. | Apr 14, 2021 | Do the Right Thing: Thoughts on Quality, Fight the Good Fight, Nutrition & Wound Healing, US Wound Registry
This is a young man in his 20’s who is a quadraplegic and suffered a bowel obstruction about 6 months before this photograph was taken. The midline abdominal wound is granulated, but still hasn’t epithelialized. Why? There’s no pressure over this area and it doesn’t...
by Caroline Fife, M.D. | Mar 30, 2021 | Fight the Good Fight, Health Information Technology and Wound Care, Nutrition & Wound Healing
There’s increasing interest in Vitamin D. I became focused on this after a series of patients who failed to heal operative wounds. I found their Vitamin D-OH levels were in the teens (in some cases, single digits) when 30 is the lowest value we want for wound healing....
by Caroline Fife, M.D. | Dec 11, 2020 | COVID-19, Nutrition & Wound Healing
I’ve talked a lot about the importance of having a Vitamin-D-OH level of at least 30 ng/ml for wound healing. The majority of my patients with non-healing wounds have Vitamin D-OH levels less than 30 ng/ml, even though most of them are taking supplemental vitamin D....
by Caroline Fife, M.D. | May 27, 2020 | COVID-19, Do the Right Thing: Thoughts on Quality, Fight the Good Fight, Nutrition & Wound Healing
If you are a wound management practitioner, then like me, you’ve continued to care for patients during the pandemic. It wasn’t easy before COVID-19 and it’s even harder now. My clinic is only able to see half the volume (due to the time required for COVID-19...
by Caroline Fife, M.D. | Aug 2, 2019 | Don't Miss This, Nutrition & Wound Healing
Fifty years ago I stayed up late with my grandfather to watch the Apollo 11 astronauts land on the moon. We sat riveted, watching grainy images on a tiny black and white television set, marveling at how far technology had advanced. In the 1960s, my father was an...
by Caroline Fife, M.D. | Jul 25, 2019 | Cassandra Chronicles: Regulatory and Coverage Policy, Fight the Good Fight, Nutrition & Wound Healing
This month in TWC, learn about the history of total parenteral nutrition and how the Space Race of the 1960’s helped patients with malabsorption. I explain why QCDR quality measures have been a disappointment for all specialties, why Practice Improvement Activities...
