Susan Bennett

We report the case of a 70-year-old female with a history of hypothyroidism who presented following an unwitnessed fall with bradycardia and hypothermia. She was found to have myxedema coma complicated by signs of early cardiac tamponade, requiring urgent pericardiocentesis.Myxedema coma is a rare but life-threatening manifestation of severe decompensated hypothyroidism, carrying a high mortality rate despite treatment. It commonly presents with hypothermia and altered mental status and may be precipitated by infection, trauma, medication nonadherence, or cold exposure.Early recognition and prompt treatment with intravenous stress-dose steroids and thyroid hormone replacement are essential to improve outcomes.This case highlights the potentially severe complications of inadequately treated hypothyroidism. It emphasizes the importance of considering cardiac tamponade as a rare but life-threatening consequence of this disease, requiring a high index of suspicion, timely diagnosis, and urgent intervention.

As I write this today I’m rounding out one of those weeks that felt like a week and a half.

With over a hundred small islands in a lagoon on the Adriatic Sea and having once been the epicentre of the world’s trade, Venice has an undeniable problem with tourism, and there’s a lot of graffiti that implores us all to go away.

Early in the morning of December 13, 2023, I dragged myself to the computer at my kitchen island after a terrible night of interrupted sleep. While I had experienced neck pain and stiffness for four months, it was much worse on that particular morning. I tried to prepare notes for my clinic scheduled later that day. Although I knew my patients well, there was much preparation that needed to be done prior to seeing them in the 30-minute appointment slots allotted. The pain was so severe that I almost fainted. However, after a few cups of coffee and some food, I was able to finish my preparation and headed to the hospital-based practice in Boston where I had worked for most of the prior thirty years. When I arrived, I looked so uncomfortable that my nurse insisted on taking me to the emergency department where I spent the following nine hours lying on a stretcher in a hallway. I had a thorough evaluation of my condition and spent a great deal of that time contemplating my situation. At seventy-seven years of age, I had started preparing for a retirement that was to take place at the end of 2024. It occurred to me that my body was starting to break down due to the confluence of stress and age. My neck pain continued unabated and without explanation for another nine months.

By the time this publishes I will have two full weeks of the 2026-27 school year under my belt.

Early in the morning of December 13, 2023, I dragged myself to the computer at my kitchen island after a terrible night of interrupted sleep. While I had e

Most Popular God provides each person a road of promise to travel while living on earth.

Think about when you first started working. Most Popular Dan and I don't have any grandchildren yet.

We all raise our kids with morals and values and beliefs and if we've done our job, we think they are pretty good kids. And they probably are.

Sometimes when I start this article, I know exactly what I'm going to write about. Sometimes I have multiple ideas and have to narrow it down.