The Weekly Check-Up Podcast

Heart failure has a long history in medicine. It began with the Greek physician Galen in 200 AD. In 1300, Ibn Nafis established the foundation upon which William Harvey made his revolutionary conclusion some 400 years later. Harvey noted that blood circulates continuously left to right through the lungs by the pumping or propelling action of the cardiac muscle, thus making the heart the center of the cardiovascular system.  Today, heart failure remains a major public health problem and a leading cause of death affecting 26 million people worldwide. On this episode, Dr. Feinberg explores heart failure management with two specialists: Dr. Ugo Egalum, a cardiologist, and Dr. Kyle Thompson, a cardiothoracic surgeon.

The all-too-familiar topic of school shootings remains the focus of endless debate. While we all wring our hands at the perceived inability to stop this horror, there are folks focused on what can be done to limit the death and injury while the problem itself remains intractable, with more than 43,000 children exposed in 2022 alone. One such shooting occurred less than 60 miles from Dr. Feinberg’s home in Atlanta on September 4, 2024 at Apalachee High School in the city of Winder, Georgia. On this episode, Dr. Feinberg talks to first responders Kevin Locke, who was on site at Apalachee High School, and Crystal Shelnutt, of the Georgia Trauma Commission, to understand what can be done to limit the carnage of school shootings and other types of traumatic injury. The interview also includes perspectives from Cheryle Ward, executive director of Georgia Trauma Foundation, which invests in trauma care in Georgia, including the Stop The Bleed campaign, which works to get Stop The Bleed kits in schools throughout the state. Donations to the Georgia Trauma Foundation can be made here.

Vision is the dominant of the five senses the body uses to interpret its surroundings. The organ of vision is the eye which is composed of a series of lenses and spaces that give focus to images, just as a camera does. It is composed of the cornea, lens, and the aqueous and vitreous humor, each of which contribute to perfecting the focus of the light received by the retina, analogous to the film of the camera.  Given how critical the eye is to the understanding of our surroundings, it is heavily protected by a bony orbit and allowed near omni-directional movement made possible by six eye muscles and three of the 12 cranial nerves.  Vision can be disturbed if the light can’t be focused, if the retina can’t receive the light, if the optical nerve is impaired, or if the eye muscles cannot move synchronously. All of which require an intact blood supply and orbit.  On this episode , we'll be joined by Dr. Joseph Hyatt, an ophthalmologist and eye specialist, as we talk to callers about varied issues impairing their vision.

For centuries, family doctors delivered babies, cared for them as children, and managed them later as adults. Today, the human medical journey is most often managed by specialists, with children cared for by pediatricians.  From post-pandemic developmental delays, obesity, and declining rates of vaccination in younger children to mental health crises, and opioid and substance use in older children to screen addictions across all ages, the role of the pediatrician has never been more critical.

On this episode, we continue our exploration of the body’s circuitry moving from the heart and its circuitry disruptions causing arrhythmias to the brain where circuitry disruptions cause seizures. Maybe you’ve witnessed a seizure in a family member or friend, or you’ve seen them portrayed on TV or in a movie like the Paul Muni classic, “The Last Angry Man.” Whatever your exposure, your understanding is likely more informed by fiction than by fact. Thought for millennia to represent demonic possession causing its victims to be shunned and feared, seizures today are well understood, successfully treated and in some cases cured.

The complexity of the human body makes it perfect fodder for analogies and metaphors to explain its workings. The urinary tract removes liquid waste, gaining its analogy to plumbing and urologists as plumbers. The muscles and bones of the skeletal system are not unlike the beams and girders of a building, resulting in orthopedists being called carpenters.  All of which begs the question: Who are the electricians, and what body system do they manage? It turns out that our body’s electrochemical circuitry is quite complex and only recently understood well enough that it could be manipulated. The next two episodes will address two distinct circuitry problems managed by different specialists. This episode will address diseases of the heart circuitry, which result in abnormal heart rhythms like atrial fibrillation.

The external human ear is a shell-shaped structure composed of cartilage covered by skin that lies on the lateral aspect of the head. Inside the head lie the middle and inner ear. All together they are the organ of hearing or audition and equilibrium or balance. When it comes to common disease associations, the outer ear is skin cancer, the middle ear is otitis media or earaches, and the inner ear is hearing loss, tinnitus (hearing sound when no source is present often referred to as ringing in the ears), as well as vertigo or dizziness.  Patient complaints about their ears are more expansive. They’re too big, they stick out, they itch inside, they’re full of wax, they hurt, they don’t pop, they feel clogged, etc. We’ll hear all of that and more on this episode.

The skin is the largest organ in the body, covering its entire external surface. The skin’s structure is an intricate layered network that serves as the body’s suit of armor protecting against everything from bacteria and fungus to ultraviolet (UV) light, to chemicals and mechanical injury, while also regulating temperature and hydration. In aggregate cancers of the skin are the most common cancers. Fortunately, they can be prevented, screened for, and when found early, as most are, cured. On this episode, we’ll hear from callers with questions touching on each of these issues.

The expression “the cure is worse than the disease” is often associated with cancer treatment and rightly so as the first decades of cancer care were as likely to shorten a patient's life as lengthen it.  Most of us have some past or recent experience that justifies the statement. Due to these experiences, we conclude that anything bad that happens to someone once their cancer treatment begins is the result of the treatment, as the callers on this episode make abundantly clear.

Cancer is among the most complex of diseases. For 5,000 years, cancer was thought to be just one disease. Over time, thinking changed, and cancer was viewed as different diseases distinguished by the organ in which it arose. The advent of the microscope revealed cancer to be a cellular disease, different in each of the 200 cell types in the body. The unraveling of the human genome revealed that mutations in genes that governed cell behavior transform the cell to cancer. This episode reveals that the increasing complexity of the nature of cancer has resulted in the increasing complexity of its treatment.

The foundations of trauma care in America began with caring for injured military personnel during war. During the Civil War, President Lincoln drove creation of the first trauma manual. During World War II, researchers started going into the battlefield to study care processes and clinical outcomes. The Korean and Vietnam Wars brought advances in medical transportation, including use of helicopters. On today’s episode, experts in the field of trauma care join Dr. Feinberg as we hear from callers who share their personal stories and concerns about trauma care.  

At the biological level, aging results from the impact of the accumulation of molecular and cellular damage over time. This leads to a gradual decrease in physical and mental capacity, a growing risk of disease and ultimately death. These changes are neither linear nor consistent, and they are only loosely associated with a person’s age in years. The diversity seen in older age is not random, it’s about your genetics, how you are able to live and how you choose to live.

Effective communication is essential in any business, but even more so in healthcare. The effects of poor communication in healthcare can have extremely serious consequences. Poor communication results in misdiagnoses and other medical mistakes that can easily lead to avoidable health complications and the death of patients. Health literacy refers to the ability of individuals to obtain, understand, and use health information and services to make informed decisions about their health and well-being.

Few body parts have been as useful to our function and the representation of our world as has the foot. In literature, a person’s manner or speed of walking or running is known as the fleet of foot. The historical military definition of an infantryman is a foot soldier. In measurement, a unit of linear measure equal to 12 inches is referred to as a foot. However, for this edition of the podcast, we will focus on the following definition: the lower extremity of the leg below the ankle on which a person stands or walks.

Possibly the most intricate and elegant of the body’s functions is the immune system. It's designed to recognize and protect your body or “the self” from all that is not the self, such as bacteria, viruses, even splinters. It can also run amok reacting to non threatening invaders like peanuts or even "the self" in what is called auto-immune disease like rheumatoid arthritis. Among the ways in which the immune system isolates foreign invaders is a process called inflammation.  On this episode, we hear from callers whose concerns introduce us to the complexity of the immune response. 

The differential diagnosis is a systematic method used by physicians to specifically identify or explain a patient's clinical complaint where multiple explanations are possible. Akin to a police who-done-it procedural, the differential diagnosis uses the evidence of symptoms, clinical signs, patient history, family history, and medical knowledge to find the culprit. On this episode, we’ll explore the use of the differential diagnosis.

Research shows that self-advocacy in healthcare can lead to significantly improved health outcomes, including better quality of care, increased patient satisfaction, reduced symptom burden, and a greater sense of control when patients actively participate in decision making about their goals, treatment, and needs.  However, self-advocacy is often misinterpreted to include self-diagnosis, self-prescribing, and reliance on Dr. Google.  On this episode, we’ll examine the many facets of self-advocacy.

Atop the textbook list of medical emergencies are the following: bleeding uncontrollably (including coughing or vomiting blood); breathing problems (difficulty breathing, shortness of breath); change in mental status (unusual behavior, confusion); fainting or loss of consciousness; chest pain for two minutes or more; feeling of committing suicide or murder; and accidents and injury (including poisoning, burns, smoke inhalation, and near drowning). On this episode, we talk with three callers whose situations challenge the textbook list of medical emergencies.

The first joint replacement surgeries were performed 135 years ago in Germany, shortly followed by efforts in France and England using rubber and steel joints. Refinements in materials and methods progressed slowly, but by 1969 the FDA finally approved the first hip prosthesis, the technical name for the artificial joint. In 2025, it is projected that 2.5 million Americans will undergo hip and knee replacement surgeries with countless more undergoing replacement surgeries of other joints.

Body fat is not a four letter word, it’s a critical part of human design. When the body consumes more calories than it needs, those calories are stored as body fat and too much storage fat results in obesity. The obesity epidemic, the causes of that epidemic, and the modern miracle of new classes of obesity drug therapy are the topics of our callers.