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Death By Design

Kimberly Paul

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Kimberly C. Paul wants to radically change the way people face end of life, and she’s using her extensive experience as a storyteller to do just that. From the set of Saturday Night Live in New York City, to casting for CBS daytime, Kimberly has spent the last 17 years telling a very different kind of story. As Vice President of Outreach and Communications for Lower Cape Fear Hospice, she used a myriad of award-winning marketing strategies to share real stories about death and dying and the ...
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Last Week in Medicine

Stephen Jenkins, MD, Austin Rupp, MD

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Wouldn't it be nice if someone reviewed all the latest internal medicine literature and distilled it into a brief podcast you could listen to on your way to work? Get updates from the New England Journal of Medicine, JAMA Network, Annals of Internal Medicine, Journal of Hospital Medicine, Journal of General Internal Medicine, Lancet and more.
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Guest Darrin Tangeman joins Red Nun Talks host Teresa Martin to explore how Truro's challenges over voting and town meeting reflect issues across the Cape and Islands. Available in video and as a podcast at your favorite podcast location. For Lower Cape News reporting about Truro's much-rescheduled special town meeting https://www.lowercapenews.org…
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As Barnstable County Sheriff Donna Buckley's term reaches its first anniversary, Red Nun Talks host Teresa Martin checks in with her to see what has changed under the oversight of the office's first new leadership in more than two decades — and how treatment and rehabilitation of mental health and substance abuse plays an ever-growing role.…
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In this episode of Red Nun Talks, host Teresa Martin talks with architect Peter Haig and musician and clerk of the works Paul Tingley share the design thinking behind Arts Empowering Life's Newest performing arts center. This unique space, opened in August and is nestled in the woods, on the Brewster-Orleans line. More Here: https://www.lowercapene…
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Today we are joined by Dr. Brian Locke, recently graduated pulmonary-critical care fellow, who takes us on a journey of avoiding statistical fallacies. Does metformin reduce the likelihood of long COVID? Should we give platelet transfusions to thrombocytopenic patients before central line placement? Did the CANVAS trial change practice in cancer as…
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Today we have a special guest, Dr. Joel Topf, board-certified nephrologist and medical educator extraordinaire. Our listeners will likely recognize Dr. Topf from his prolific tweeting @Kidney_boy, as well as his numerous appearances on the Curbsiders podcast. He is a co-founder of the NephJC on Twitter, and host and founder of the NephJC podcast Fr…
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This week we have special guest, Dr. Adam Spivak, to talk about the new study on doxycycline post-exposure prophylaxis for STIs. Dr. Spivak is an infectious disease expert and works in both an HIV clinic and a free PrEP clinic. I also review the latest COVID-19 anticoagulation trial and a paper looking at rates of fracture non-union in people who r…
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Today we have special guest, Dr. Sarah Gilligan, a nephrologist, to talk about the new study of thiazides for kidney stones. We all learn in medical school that thiazides reduce urinary excretion of calcium, but does that really translate to fewer kidney stones? We also have Dr. Brian Locke on to talk about the CAPE COD trial, a big new critical ca…
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Today we welcome special guest and fellow EBM lover Dr. Mita Hoppenfeld to talk about a new randomized controlled trial evaluating the best duration of antibiotics for febrile UTI in men. Is 7 days as good as 14 days? We also review the latest guidelines for lower GI bleeding and a new retrospective study on renal outcomes in patients with AKI who …
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We're back with Season 4! Sorry for the unplanned hiatus. Today we talk about the CLOVERS trial, which tested the hypothesis that early vasopressors and restrictive fluid would be superior to liberal fluids plus rescue vasopressors. We also looked at the TRANSFORM-HF study, which compared torsemide and furosemide in congestive heart failure, the PR…
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Today we have a couple special guests under the age of 2. Birdie and Gus! Do SGLT2 inhibitors improve diuresis in acute heart failure? Are they better than metformin for reducing cardiovascular mortality? Is high dose dexamethasone better than standard dose in ICU patients with COVID? We also talk about outcomes in patients with isolated distal DVT…
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Today we are joined by Dr. Brian Locke to talk about multiple new critical care trials, including the CLASSIC trial of a restrictive vs standard fluid strategy, the LOVIT trial of vitamin C in septic shock, and the PREPARE-II trial of fluid bolus at the time of intubation to prevent cardiovascular collapse. We also look at whether 72 hours of antib…
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Today we had Dr. Patricia Liu to talk about a new study from Journal of Hospital Medicine on the management of opioid use disorder in the hospital. And then we got a little carried away covering way too many articles! Inpatient Management of Opioid Use Disorder Hepatitis C Care for People Who Inject Drugs Final SOLIDARITY trial results for Remdesiv…
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Today, Dr. James Fang, Chief of Cardiovascular Medicine at the University of Utah, and AHA/ACC/HFSA Heart Failure Guideline Committee Member, joins us to talk about the new heart failure guidelines, published in April 2022. We talk about the new classifications, including HF with improved EF and HF with mildly reduced EF, and new recommendations fo…
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Dr. Brian Locke is back to talk about that "nonrandomized" proning trial. We also talk about the new oral carbapenem for UTI trial, whether 1-2 months of DAPT is non-inferior to 12 months of DAPT, whether less than 1500 mg of sodium reduces heart failure hospitalizations, the risk of anaphylaxis from IV iron, and whether pickle juice is effective f…
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Today we have Dr. Brian Locke back on to talk about asthma management and a new trial of reliever-triggered inhaled glucocorticoids for Black and Latinx patients with asthma. Other questions we try to answer: Does methenamine prevent recurrent UTIs in women? Should CT coronary scan be done before invasive coronary angiography? Does melatonin preven…
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We finally have the published trial results for Paxlovid! We also look at the latest trial showing the ivermectin is ineffective in treating COVID-19 and one year outcomes in ICU COVID-19 patients. We also look at a meta-analysis of trials looking at different diagnostic strategies for ruling out PE, a retrospective study of thiamine use in ICU pat…
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Today we are joined by Dr. Brian Locke to talk about the newest big trial on IV fluids in critically ill patients and a meta-analysis that looks at all the similar trials. Is this question finally settled? We also look at PICC lines vs midlines, IV L-ornithine L-aspartate in acute treatment of hepatic encephalopathy, a new ward-based program for de…
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It's our last episode in 2021! This episode we have Dr. Libo Wang and Dr. Jon Harrison on to talk about their new paper in the Annals of Internal Medicine about ultrasound JVP for estimating CVP, validated with right heart catheterization. We also ask them their thoughts on a new meta-analysis looking at metoprolol vs diltiazem for atrial fibrillat…
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Somehow we got through 7 articles today, and none of them are about COVID-19! Happy Thanksgiving! Chlorthalidone in CKD Milvexian for VTE Prevention Risk of Recurrent VTE in Subsegmental PE Rivaroxaban associated with higher rates of GI bleeding Depression and Residency Mental-Stress Induced Myocardial Ischemia Patient Outcomes for Part Time Hospit…
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Mike Ferris is a nationally recognized expert in home care and hospice sales, marketing, and customer service. He has consulted with many of the most successful home care and hospice organizations in the country. Mike and his team deliver consulting and training programs based on their combined experience and expertise. Their services focus on refe…
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Jonathan is obsessed with helping others improve positive and decrease negative habits to live more fulfilling lives. As the co-founder of Evolve United, he’s fueled by spreading that positive impact. How? By presenting the multifamily industry with a tool that provides added value to residents, while simultaneously building the #1 place for wellne…
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A practicing physician for over 30 years, Dr. Martha Calihan blends her knowledge of Functional and Integrative medicine with the mystical and spiritual, creating the space to help people heal on all levels. She practices and teaches Mindfulness, offers workshops in the US and in Ireland, and has done extensive work in death and dying. She lives an…
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Andrea is an LCSW with a unique skill set after years working in the field of palliative care and community education. She graduated from Indiana University and received her Master of Social Work from the University of Southern Indiana. She quickly learned grief is beyond death, but rather any form of loss. Her business, Tree of Life Counseling, LL…
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Today we talk about the effect of eliminating the race coefficient from the estimated GFR calculators, the risk of bleeding from anticoagulation after first unprovoked VTE, another trial looking at therapeutic anticoagulation in COVID-19, and whether 12 mg of dexamethasone is better than 6 mg for severe COVID-19 infections. New GFR Equations withou…
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The Macy Catheter was invented by Brad Macy, a veteran hospice nurse and recipient of 2013’s National Hospice and Palliative Care Nurse of the Year Award. The inspiration for its invention came directly from a memorable patient interaction. Over the years, Brad has seen thousands of difficult symptom management cases while assisting patients and th…
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Hospice physician. End-of-life researcher. Acclaimed author of Death Is But a Dream. Death Is But a Dream, based on Dr. Kerr’s extensive research with hospice patients and their families in Buffalo, NY, highlights and validates the powerful dreams and visions often experienced at end of life that bring comfort and meaning to the dying process. Dr. …
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​Just Call Bill specializes in providing technology services to senior adults and their families. We are the company that loves working with seniors! Our team of technology professionals has the experience to take care of your phone, tablet, laptop and computer and more. This is an ideal service for you, your mom, dad, aunt, uncle and grandparents …
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We're back after a nice relaxing summer taking care of a surge of COVID-19 patients. To start off season 3 we decided to do a rapid review of some of the best articles over the last three months. Dr. Brian Locke returns to help us break down some critical care papers, we talk about the miracle of SGLT-2 inhibitors, the treatment of UTIs in men, and…
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In 2014, Margo Fowke’s 21-year-old son, Jimmy, died after an eight-year battle with brain cancer. A year later, her mother died. In 2017, the Loomis resident started the website Salt Water (findyourharbor.com). The website is chock-full of blogs with topics ranging from loss to caring for yourself after loss. It also offers resources for the bereav…
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Jennifer O’Brien helps people talk about caregiving and end of life. She encourages compassionate, real conversation through her book, The Hospice Doctor’s Widow: A Journal, where she shares her story of caregiving through collages and writings. After years of caring for people with serious illness as a physician, Jennifer’s husband, Bob Lehmberg, …
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Ken Ross, son of Dr. Elisabeth Kübler-Ross, is the founder of the EKR Foundation (2006) and President (2006-2013 & 2018-Present). He also served on the board of the Elisabeth Kübler-Ross Center from 1989-2005. Ken was the principal care provider for his mother in the last 9 years of her life until her passing in 2004. His responsibilities include h…
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Emma is a seasoned technology entrepreneur, MIT graduate, and award-winning change-agent, who started building online communities before Netscape was born. Her 25 year career leading online and mobile projects has included building tools to register young people to vote, creating online networks of support for families facing health challenges, and…
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Today is our season 2 finale, and we have a master class on prosthetic joint infections from Dr. Laura Certain. Is 6 weeks as good as 12 weeks for prevent recurrent infections? How does the surgeon decide what kind of surgery to do? Should we use oral or IV antibiotics? When should you use rifampin?? Dr. Certain answers all these questions and more…
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Sarah Bamford Seidelmann was a fourth-generation physician living a nature-starved, hectic lifestyle until a walrus entered her life and changed everything. She is a shamanic healer and has trained at Michael Harner’s Foundation for Shamanic Studies and is a Master Coach trained at the Martha Beck Institute. She is the author of Swimming with Eleph…
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“Nobody likes to sit down and listen to a talk about life’s challenges. But somehow, Rachel makes it all Okay. Her warmth and sensitivity, and especially her story, enables us to hear brutal honesty and embrace it, rather than fear it. Bravo, Rachel Kodanaz.” —Ora DeMorrow, Senior Financial Advisor, Vice President Merrill Lynch No one knows better …
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How long can you delay antibiotics in patients with suspected sepsis before the risk of hospital mortality increases? What proportion of patients with suspected sepsis end up having actual sepsis? Dr. Devin Horton joins us to review a paper in Critical Care Medicine that tries to answer these questions. Antibiotic Delay Intervals and Hospital Morta…
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Today we have special guest Dr. Natalie Como to talk about Hospital at Home and what it's like to practice hospital medicine at a rural critical access hospital. We also look at a retrospective paper on ACE/ARBs in veterans with pulmonary hypertension and talk about vaccine-induced immune thrombotic thrombocytopenia (VITT). Check it out! Hospital a…
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Absolutely Delicious: A Chronicle of Extraordinary Dying After a life marbled with exploration, academia, and domesticity, the writer Valerie Lester retired to a residential hospice and set about enjoying the final act of her life. She died nine weeks later, having engaged in dying with equanimity, curiosity, and even amusement. In Absolutely Delic…
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Vicky Roncero is a certified Usui Reiki Master Practitioner/ Instructor with a private practice, in Upper Montclair, New Jersey. She is grateful to be working with Reiki and empowering clients to use this beautiful energy in whatever way is helpful to them. Some clients are healing from illness and injury, or managing stress and anxiety. Others are…
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Phyllis Shacter courageously shares the first personal story ever written about Voluntarily Stopping Eating and Drinking (VSED). This memoir and guidebook follows the journey she took with her husband, Alan. Alan decided to VSED – so he didn’t have to live into the late stages of Alzheimer’s disease. This is their love story, their partnership, the…
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An End of Life Doula is a non-medical person trained to care for someone holistically (physically, emotionally, and spiritually) at the end of life. End of Life Doulas are also known around the world as: end of life coaches, soul midwives, transition guides, death coaches, death doulas, doula to the dying, end of life doulas, death midwives, than a…
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Today we are joined by heavy hitter Dr. Brian Locke to talk about the new paper on 3 vs 8 days of antibiotics for pneumonia, a clever new paper looking at whether there is any association between IV contrast and kidney function, and a new retrospective study on DOAC use for valvular atrial fibrillation. Check it out! Three Days of Antibiotics for P…
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Claire B. Willis is a clinical social worker who has worked in the fields of oncology and bereavement for more than 20 years. A cofounder of the Boston nonprofit Facing Cancer Together, Willis has led bereavement, end-of-life, support, and therapeutic writing groups. She has co-taught Spiritual Resources for Healing the Mind, Body, and Soul at Ando…
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