Articles written by Richard P. Holm


Sorted by date  Results 1 - 16 of 16

  • A permanent answer to temporary problem

    Richard P. Holm MD, The Prairie Doc|Dec 11, 2019

    Years ago, a family brought a 25-year-old farmer into the emergency room with a gunshot hole over his heart and with no pulse or breathing for more than ten minutes. It was a self-inflicted wound and this young farmer would farm no more. The family was besides themselves with loud and sorrowful wailing that wrenched my soul. They told me that the impending harvest looked poor, the loan was coming due, and he had been isolating himself, drinking more and getting angry at every little thing. They had no clue he was at risk of suicide. Sure, he...

  • Noise induced hearing loss: What's that?

    Richard P. Holm MD, The Prairie Doc|Nov 27, 2019

    Of the 40 million people with hearing loss in the U.S., 25 percent of those, or 10 million, have lost their hearing as a result of exposure to excessive noise. But how much noise is too much? Measured as decibels (dB), the acceptable manufacturing noise standard is to allow a daily exposure up to but not over 85 dB in an eight-hour period. More than that can cause permanent injury to our hearing. This is likely due to wear and tear on the tiny hairs that vibrate when sound is introduced. It’s like a line of kids walking across one path on the g...

  • Language, literature, ethics, music and spirit

    Richard P. Holm MD, The Prairie Doc|Nov 20, 2019

    A muddle and mixture of family and friends surrounded the dying elderly woman like she was a campfire. They came to honor and pay their respects; many generations, from all over the country. This group seemed well educated, well-read, and the intellectual discussions were tossed around in that room like a basketball. She had said, to all, that it was time. “Please stop the dialysis,” she insisted, and, it was stopped. At first, she was almost holding court, but over the days, as she was slipping across to the other side, the hymns started fil...

  • Quality rural health care with less burnout a possibility

    Richard P. Holm MD, The Prairie Doc|Nov 7, 2019

    The elderly patient came back to our rural hospital from a hospital in a nearby larger city after having had major surgery and feeding-tube placement. The care from the bigger hospital was superb except that the patient was getting too much nutrient and fluids and was a bit “overloaded.” Also, the family was concerned that perhaps they had been too aggressive in getting stressful surgery for their elderly mom, whose memory had begun to slip. As her physician, I cut back on the feeding-tube supplements, stopped the intravenous fluids, provided a...

  • The value in having a loving family is great

    Richard P. Holm, The Prairie Doc|Aug 22, 2019

    I appreciate how the old prayer goes, “Bless the food before us, the family beside us, and the love between us...” A few years back, our youngest son, had a break-in at his home and they took his computer with all his pictures as well as his original created songs. They also got away with my old film-dependent camera with a bunch of undeveloped pictures my son had taken. He decried that it wasn’t the loss of the computer or the camera, it was the loss of memories and ideas contained within. He was dismayed that he dreamt he caught the thiev...

  • Heart can make a popping-corn rhythm

    Richard P. Holm MD, The Prairie Doc|Aug 15, 2019

    “Every once in a while, my heart seems to be jumping out of my chest, I get a weak feeling and short of breath,” the patient explained. When I listened with my stethoscope, his rhythm was different than the usual lub-dub, foot-tapping, sounds, which are regular as a band marching through town on a summertime parade. Instead his heart had the irregular rhythm of popping corn, chaotic and unpredictable, and I couldn’t tap my foot to it. As predicted, the EKG showed the rhythm of atrial fibrillation, with the atrial rate running at three to 400 b...

  • It's time to stand up against bullies

    Richard P. Holm MD, The Prairie Doc|Jul 25, 2019

    We have all had to deal with bullies throughout our lives, and I have had my share. One fall day, coming home from school, I saw two guys from my third-grade class beating up on a smaller kid and was moved to step in to help. I was chagrined, but not surprised when the victim ran home, and I became the new target. The beating I took that day was minimal, however, the sense that I did the right thing by standing up against bullies has propped up my self-worth my whole lifetime. Bullies and abuse are everywhere. While in medical school, I was in...

  • Is the information one reads fake news?

    Richard P. Holm MD, The Prairie Doc|Jul 18, 2019

    It is miraculous to consider how much access and exposure we have to information through our computers, televisions, radios and newspapers. Unfortunately, we need to be on guard because too much of this buzz can be false information. In an October 2017 article, the Pew Research Center found 43 percent of people in 2016 received their news from Facebook listening for information that aligned with their world view (not necessarily with facts). Pew also found 23 percent had shared, by intention or accident, untrue political messages on social...

  • Skin cancer questions answered

    Richard P. Holm MD, The Prairie Doc|Jul 3, 2019

    Q: What are some types of skin cancer? A: The three major types are basal cell, squamous cell and malignant melanoma. In general, one in five, or 20 percent of people in the U.S. have had or will have some type of skin cancer. In Australia where the sun is intense, two out of three skin cancers are basal cell, one in four are squamous cell, and one in twelve are malignant melanoma. Q: Should I go to a dermatologist for screening? A: The dermatologist is the most experienced with skin cancer, but primary care providers can help, too. Realize,...

  • From misery to miracles

    Richard P. Holm, The Prairie Doc|Jun 26, 2019

    Miracles still happen. Some think that the scourge of smallpox was present around 12,000 years ago, however, we know for sure it was here 3,000 years ago as it was found on the face of an Egyptian Pharaoh mummy. We know that it caused many large and devastating epidemics killing about 35 percent of infected adults and 80 percent of infected children. Even during the 20th century, smallpox still resulted in 300-500 million deaths world-wide. Pictures of people suffering from this miserable viral illness show skin of face and body breaking out...

  • A prayer for aging discovered from the ancient medicine wheel

    Richard P. Holm MD, The Prairie Doc|Jun 19, 2019

    Nothing has touched my soul and spoken to aging with grace quite like the ancient Indian medicine wheel and the traditions that have evolved from it. From the National Library of Medicine, I learned that in the Americas, Indian tribes have multiple interpretations of the four directions, but the following prayer is my own, geriatrician’s interpretation of a version from the book “Black Elk Speaks” and Oyate (Nakota, Dakota, Lakota) tradition. First, we get down on our knees and feel the soil, the sacred Mother Earth, bringing the world aroun...

  • Thumb-sucking and other addictive behaviors

    Richard P. Holm MD, The Prairie Doc|May 15, 2019

    Addiction can be defined as the compulsive repeated use of a drug or substance (such as alcohol) or performance of a behavior (such as gambling). Dependence is different, occurring when repeated use of a drug (such as heroine) results in physical dependence which causes an unpleasant feeling of withdrawal when the drug is stopped. Addiction and dependence can occur separately, although they often run together. At five-years-old, I was a thumb-sucker. I recall not being proud of it as my folks seemed progressively upset about my “addiction.” The...

  • Men would rather face a charging lion than visiting a the doctor

    Richard P. Holm, The Prairie Doc|May 8, 2019

    Did you know that an average South Dakotan male lives to 75 years of age, and the average woman lives to 80? Why is that? Is it because we men are more prone to violent deaths early by going to war, riding motorcycles or driving cars faster? Nah! This accounts for only a small part of the difference. I think more likely it is because men, who are genetically built larger and more muscular, likely in order to be the defender or hunter for the family, no longer need to use those muscles in this modern world. Just look at most 22-year-old men,...

  • Imaging with a little help from my friends

    Richard P. Holm, The Prairie Doc|Apr 10, 2019

    The world of radiology began in 1895 when a European physicist Wilhelm Röntgen noticed fluorescence behind heavy cardboard when a cathode tube was activated nearby. Röntgen used his wife’s hand to demonstrate for the first time how these unknown rays, or X-rays, could penetrate the soft tissue of her hand and illustrate the bones that lay within. Röntgen generously refused to patent his discovery, which allowed the explosive growth and development of a new industry. Unfortunately, researchers were unaware of the dangers of too much X-ray expo...

  • Anaphylaxis and shock, reversed by epinephrine

    Richard P. Holm, The Prairie Doc|Mar 27, 2019

    Ms. A. was in the bagel shop line and told the server she was allergic to peanuts. The server reassured her there were no peanuts in the bagel but was unaware some peanut butter was left on the knife from an earlier sandwich. After a few bites of the bagel, Ms. A.’s face and lips started swelling, she itched all over, slipped off her chair, vomited and fell flat losing consciousness. When the ambulance arrived the emergency team kept her flat, gave an intramuscular injection into her thigh muscle of epinephrine (also known as adrenalin), t...

  • How we get bacterial pneumonia

    Richard P. Holm MD, The Prairie Doc|Mar 6, 2019

    (Publisher’s note: The Prairie Doc is a new health column offered to us from the Wyoming Press Association. Let us know if you enjoy it.) My good friend, a single man in his 60s, didn’t like going to the medical clinic for anything, let alone a cold. His illness started with a fever, aches all over and a sudden overabundance of mucus. After one or two days of those obvious viral symptoms, for which we have no good therapy, he got better, except he acquired a new dry hacky cough. Initially he did what he should have and stopped going to wor...

Rendered 05/22/2024 17:37