MD Education Insights

Diastasis Recti Abdominus I'm partially writing this blog post for my wife who, after carrying and delivering our two wonderful children, has experienced a persistent, narrow gap along the linea alba of her rectus abdominis muscles. Definition :  Diastasis Recti Abdominis (DRA) is a separation along the linea alba of the rectus abdominis muscles. The image below shows a transverse section of the abdominal wall. In the center, the connective tissue band called the linea alba can be seen. In DRA, the rectus abdominis splits along this line.  Etiology :  DRA is most prevalent in postpartum women, occurring in 33-89% in the early postpartum period and persisting in approximately 30% of women at twelve months postpartum. (1) DRA can also occur in men. Typically, it is associated with factors like advanced age, abdominal obesity, smoking, and physical inactivity.  Pathophysiology :  In pregnancy, hormones such as relaxin, progesterone, and estrogen relax connective ti...

Lessons on Learning - First Two Years of Medical School The best analogy I have heard to what learning is like during medical school is that it is like drinking from a fire hose. The first two years are traditionally when most of the classroom learning takes place, and students must learn the entire anatomy of the human body including the musculoskeletal, nervous, circulatory, and lymphatic systems; the pathology of hundreds of major diseases of each body system; the workings of hundreds of different infectious agents; embryology, biochemistry, genetics, and how to interview a patient, glean the important information, perform a physical exam, generate a list of possible diagnosis, and begin to make a treatment plan. And this is only scratching the surface! Although it is rigorous, the learning strategies I developed in undergrad and have refined over the past two years have helped me to excel, passing all of my exams and maintaining a 4.0 GPA in both undergrad and medical school. The l...

For this blog post, I am breaking from my pattern of discussing medicine to talk about something that I feel is equally important - and that is personal finance. Medical school is extremely expensive, so I knew long before going to medical school that gaining financial literacy and developing rock-solid habits with money would be crucial to my reaching my long-term goals. In this post, I will share some of the lessons I have learned regarding wealth. It’s really not about getting rich. It’s about developing character traits that lead to freedom; attributes such as discipline to delay gratification, patience to prepare for the future, and humility to live within your means.  As with most things, success hinges on “starting with the end in mind”. My goal regarding finances is to reach complete financial freedom by age 50 (or earlier). To me, that means having assets sufficient to bring in enough passive income to sustain my family indefinitely. At that point, work will no longer be a...

Why the Kidneys Matter The kidneys are two bean-shaped organs located at the back of the upper part of the abdomen whose main function is to filter blood and remove waste. While that sounds simple enough, I would argue that their physiology is some of the most complex in the body. Calculating the filtration of various substances, the effect of hormones, and the impact of conditions like acid-base disturbances in the body becomes remarkably complex, so I will not spend much time detailing that. There are whole textbooks on that topic if you are interested. Instead, I will specifically address chronic kidney disease (CKD), a rapidly growing condition worldwide. By the end of this article, you should have a better understanding of how CKD changes normal kidney function, what normal kidney function looks like, what causes CKD, and the treatments/therapies that address CKD.  CKD = chronic kidney disease Normal Kidney Function: To understand why CKD has a high morbidity and mortality (i....

Heart Failure - Disease Process and Prevention Heart failure has been the leading cause of death in the United States since 1950. Right now, more than 6.5 million people have heart failure and it is only becoming more prevalent [ 1 ]. Furthermore, national spending on heart failure-related expenses is astronomical and only expected to increase. In this post, I want to address what heart failure is, how it develops, and lifestyle factors geared toward prevention. Why is heart failure becoming more common, despite advances in medication and treatment? The other day, I was speaking with a cardiology resident and he told me that his opinion from observation, and I agree, is that heart failure has become more prevalent because medicine has gotten a lot better at treating acute, life-threatening issues like heart attacks. More people are surviving these events which exposes underlying diseases. The typical American diet and lifestyle are less than optimal, so chronic diseases like diabetes a...

Insulin Resistance      When it comes to weight loss and health in general, the most common advice I’ve heard has to be “eat less” and “exercise more”. If I have learned anything during the endocrine unit of medical school, it is that the biochemistry that governs our metabolism is far more nuanced, and its complexity makes the age-old advice of caloric restriction and hitting the weights lacking at best. Eat less of what? What kind of exercise? What if I’m hungry? What if that advice doesn’t work? Understanding the basics of metabolism, especially as it relates to insulin resistance, is one of the most important health-related topics because good metabolic health is one of the main drivers of maintaining quality of life and staving off diseases like diabetes, heart disease, cancer, Alzheimer's, and so on. By understanding the biochemistry of your metabolism, you will be able to make better, more informed choices regarding your health.       In this po...