Change of Clinic Schedule in Citimedic (Tuguegarao) Clinic

We changed one of our scheduled days. There will be NO clinic on 8-Oct. We will hold a NEW clinic day on 1-Oct. The schedule will  also be kept for the 3-Dec date.

Our apologies for the change. Hope that you can plan ahead to accommodate it.

Change of Clinic Schedule in Santiago Clinic

We changed a few of our published clinic days. There will be no clinic on 1-Sep and 6-Oct at the Callang General Hospital clinic. A NEW clinic day will be scheduled for 29-Sep. We will keep the scheduled days on 3-Sep and 20-Oct. Please make a note of it.

Our apologies for any inconvenience on your part.

Rayuma-tologist, part two

I found this link page on "What is a Rheumatologist?" in the ACR website. Let me know if this is helpful in choosing your doctor for your medical problem.What is a Rheumatologist?

Dr. Katz' Super 6 for adding years to your life

Dr. Katz writes about six habits to add years to your life, as follows: feet, forks, fingers, sleep, stress and love. His review of the topic was inspired by one of his patients who is in his first year after surgery for cancer and wants to find out what he can do to stay healthy.

Dr. Katz' Super 6

Drugs to Avoid or use with Caution in Older Adults: Updated list of Potentially Inappropriate Medications for Older Adults

Updated 2012 AGS Beers criteria for potentially inappropriate medications for older adults now includes 53 medications or medication classes divided into three groups: (1) avoid for ALL, (2) avoid for those with certain diseases/conditions, and use with caution. The usual suspect anticholinergics are still there, but with new or stronger wording against NSAIDs, antihistamines, benzodiazepines and antipsychotics. VERY useful for the primary care clinician who would like to reduce adverse events due to medications.


Updated 2012 AGS Beers Criteria

Managing Gout in patients with chronic kidney disease

Three common scenarios when I treat these patients with a nephrologist:
1. Colchicine is given every two days. Use of low-dose acute gout colchicine regimen is disapproved (2 tabs NOW, then 1 tab in 6h).
2. Allopurinol is started at a low dose AND kept there whatever the serum uric acid results.
3. Routine use of febuxostat, instead of allopurinol.

This article confirms my practice that does NOT follow the above three.
http://www.ccjm.org/content/77/12/919.full

Getting back to exercise?

Exercise is ALWAYS good whatever your age. Most people complain they do not have time to exercise. It is NOT easy to get started exercising or getting back to it. Like most important things, it is better to have clear goals. Here are tips from the MedlinePlus library.

http://www.nlm.nih.gov/medlineplus/news/fullstory_122149.html

Trying to lose weight? Don't diet. Eat intuitively.

That would summarize for me this general internist's advice on weight loss. Sensible stuff.

http://www.drdialogue.com/2012/01/intuitive-eating-and-more.html

When you think of SLE (lupus), consult a rheumatologist

Robelle's experience draws attention to SLE, rheumatologists and a database for SLE patients.

http://www.mb.com.ph/articles/352059/project-builds-database-on-lupus

Ask your doc before changing your meds

I would like to share this guest post from KevinMD.com. It is a good reminder to communicate your plan to change your meds with your primary care physician.

http://www.kevinmd.com/blog/2012/02/saving-patients-internet-health-information.html

Triple-board again!

Good news! I am triple-board recertified in Internal Medicine, Rheumatology and Geriatric Medicine. It was a lot of work but well worth the effort. 

Next project (on-going) is incorporating more geriatric content in the UST Faculty of Medicine and Surgery curriculum with the eventual goal of training fellows in Geriatric Medicine. I will need all the help I could get on these.