Kelly’s Clinic

10/13/2026

He calls it a hobby. It takes a very disciplined person to be standing in a field at dawn, and a gifted one to know what to do when the light arrives. The Experimental Farm, in the middle of our city, in all its fall magnificence.

10/10/2026

10/08/2026

10/08/2026

10/05/2026

09/30/2026

09/05/2026

Three months after the CKM guideline, nephrology answered (ASN Kidney Health Guidance, JASN, Sept 2026).
They named it: endo aging. Puberty, pregnancy, menopause — hormonal transitions that modify heart-kidney-metabolic risk.
Menopause is now a scheduled reassessment: BP, lipids, glucose, weight, urine albumin. Hypertensive pregnancy earns structured postpartum follow-up.
GLP-1 therapy: no kidney floor for most agents, continued into dialysis, used to reach transplant eligibility. Foundation for most CKD: RAS inhibitor + SGLT2 inhibitor.
Their research agenda: trials analyzed by s*x and menopausal status. The field is naming what it doesn't know.
Practice points, not graded evidence — their words. But hormones are on nephrology's calendar.
Bansal et al., JASN, Sept 2026.

09/05/2026

until the evidence catches up! My truths of practice for depression in men and women puberty to our oldest age Hormones matter

09/05/2026

That deep ear itch no cotton bud fixes? After 45, it's often a fungus — settling into a canal that's gotten drier and thinner-skinned as hormones decline. And when fungal infections keep coming back — ears, skin folds, yeast, nails — it's worth two simple blood tests: fasting insulin and HbA1c. Blood sugar drift feeds fungus years before anything is diagnosed, and midlife is the easiest moment to turn it around.
The fix: a proper clean-out, antifungal drops, dry ears — and no more cotton buds. Be seen promptly if pain escalates or wakes you at night.
Small symptoms, read early, are how we prevent the big ones.
Education, not diagnosis. midlifehealth

09/04/2026

Patch on backorder? Here's how the switch actually works.
EstroGel is a pump — once a day, spread over one whole arm, let it dry a few minutes before you dress.
Divigel is a pre-measured sachet — once a day, on the thigh, no pump to prime.
What doesn't change: the hormone, or the goal. What does: the routine — daily instead of twice a week.
One thing to know before you switch: you can't match your patch number to a gel number yourself. A patch dose is how much reaches your bloodstream each day. A gel dose is how much you're putting on your skin — most of it doesn't make it in. Different measurements, not interchangeable math. Your provider matches you to the right band — you just follow the new instructions.
If your patch is out of stock, this isn't a downgrade. It's a different door to the same room.