by Caroline Fife, M.D. | Mar 22, 2017 | Fight the Good Fight, Health Information Technology and Wound Care
A new advanced wound care treatment? This patient’s neighbor had a salve made from her placenta for him to use on his non healing wounds. His wounds are pretty bad and he is nearly out now. It will take her awhile to make another placenta. I am not sure what...
by Caroline Fife, M.D. | Dec 2, 2015 | Fight the Good Fight, Health Information Technology and Wound Care
This 51 year old man has horribly painful ulcerations on the plantar surface of both feet. He was cured of Hepatitis C with Sofosbuvir a year ago. The ulcer did not improve with prednisone, cyclosporine, or topical Aczone gel. After multiple biopsies the lesion was...
by Caroline Fife, M.D. | Nov 25, 2015 | Fight the Good Fight, Health Information Technology and Wound Care
Here’s one more strange disorder that causes staining of the tissues. Ochronosis is a syndrome caused by the accumulation of homogentisic acid in connective tissues. The phenomenon was first described by Rudolf Virchow in 1865. The condition was named after the...
by Caroline Fife, M.D. | Nov 12, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
If you are getting ready for Thanksgiving you might consider putting lobster on the menu. When colonists arrived in the New World, lobsters were almost certainly part of their diet. English settlers reported catching lobsters in nets as early as 1605 and Captain John...
by Caroline Fife, M.D. | Nov 11, 2015 | Fight the Good Fight, Health Information Technology and Wound Care
Prolonged venous hypertension results in venous dilatation and passage of red blood cells through the endothelium into the interstitium with subsequent breakdown and conversion of hemoglobin to hemosiderin. Iron oxide remains as a brown pigment stain on the skin...
by Caroline Fife, M.D. | Oct 29, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
Earlier this month, I showed you some photos of a malnourished patient who I think has improved because of Argenaid. While there may be some things in the past that I miss, I confess that in the past I did not pay sufficient attention to nutritional issues. I’m...
by Caroline Fife, M.D. | Oct 28, 2015 | Fight the Good Fight, Health Information Technology and Wound Care
This is a photo of the patient I mentioned previously this month. It may be hard to get your bearings, but the gauze is over his tracheostomy at the anterior neck. The wound is on the lateral neck and you can see his major neck vessels exposed. This is metastatic...
by Caroline Fife, M.D. | Oct 26, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
On September 28, 2015, CMS made available the 2014 Supplemental Quality and Resource Use Reports (QRURs) to every medical group practice and solo practitioner nationwide. Providers are identified in the Supplemental QRURs by their Taxpayer Identification Number (TIN)....
by Caroline Fife, M.D. | Oct 21, 2015 | Fight the Good Fight, Health Information Technology and Wound Care
This is not “what is it” but “who is it?” Wednesday. This is Mario Martinez, cped. I am showing this slide as a reminder about how HARD off-loading can be. I can’t take any credit for this serendipitous situation, but it turns out that a terrific Orthotics group is in...
by Caroline Fife, M.D. | Oct 20, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
How can we get out of this silly problem of trials that don’t enroll our patients to get coverage for patients who really don’t need the product anyway? We need a way to risk stratify wounds that includes patient factors. Thanks to partial funding from a grant by KCI...
