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, Skin Perfusion Pressure (SPP)
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...
by Caroline Fife, M.D. | Mar 11, 2019 | Fight the Good Fight, Health Information Technology and Wound Care, Nutrition & Wound Healing
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...
by Caroline Fife, M.D. | Oct 3, 2018 | Fight the Good Fight, Health Information Technology and Wound Care, Nutrition & Wound Healing, Quality Payment Program
What scares me is the fact that I didn’t really pay attention to this until I started developing quality measures for wound care. But now that I’m paying attention, the extent of it is terrifying. In one day I saw three patients who were starving, two of whom had on...
by Caroline Fife, M.D. | May 23, 2018 | Fight the Good Fight, Health Information Technology and Wound Care, Nutrition & Wound Healing
On Saturday May 19th I joined Drs. Jay Shah, Noel Oliveira and Rafael Rafols at the Texas Medical Association (TMA) meeting in San Antonio, Texas for the first ever wound care CME event at a TMA meeting. We focused on wound care for the primary care physician, and it...
by Caroline Fife, M.D. | Jan 23, 2018 | Don't Miss This, Fight the Good Fight, Health Information Technology and Wound Care, Nutrition & Wound Healing
Forget about the flu epidemic. At least it’s pretty easy to figure out when a patient has the flu. I feel sure I have missed some patients with wounds due to low Vitamin D. The Vitamin-D deficiency epidemic is ridiculous. What scares me is not that 80% of the tests I...
