More on Health

>> Monday, April 13, 2009


I try to catch up, but it just isn't working. Ended up working until late at night for WORK so I'm just now starting my blog. Which means I doubt I'll get it all up before the night's out. Whew!

I mentioned some speculation about unforeseen consequences for our pill-poppin' tendencies in my last blog. But I kind of would like to continue that line of thinking with regards to the whole health care industry. Now, let me preface my opinions with an assurance that I know many health care professionals are dedicated and devoted. I don't intend to imply that problems I've seen are a condemnation of the whole medical profession.

However, there are some serious problems out there, whether they result from insurance issues or financial pressures or laziness - a tendency that exists in most professionals to find an "obvious" answer and then leave there without looking deeper. In certain professions, like space safety, that kind of laziness can get people killed (or at least spacecraft lost). This is also true for the medical profession.

Too often, in my opinion, an obvious answer is addressed without digging for the real cause. Treat a symptom without realizing what the real problem is.

Case in point, my mother-in-law, for instance, has been battling mini-heart attacks since she was thirty-seven (little less than a decade, by the way - yes, my husband's younger). She's gone into the emergency room multiple times. She's fought multiple bladder and other abdominal infections and pains that no one's taken seriously. So, two weeks ago, she went into the emergency room and someone suspected a gall bladder problem and gave her a simple blood test. There it was. Her gall bladder was 19 cm in diameter (instead of the normal 3) and filled to (literally!) bursting with 37 gall stones. And, yeah, the doctor thinks it's been a problem for ten years but no one ever checked.

Now, this is one person, anecdotal evidence at it's best, but can you honestly say you don't know a story like this? Someone calling in to the doctor with their four month baby's coughing but never able to get an appointment, but getting prescription medicine over the phone, only to force the issue and find out the baby now has pneumonia because she'd been given the wrong medicine? When she told me I'd made my baby sick because I'd given her the wrong medicine (that she'd prescribed), I vowed never to go back to that doctor. And I didn't.

A relative's son had surgery for an in-grown toenail. He ended up with a fever that the doctor repeated dismissed over the phone. Fortunately for mymy relative's son, my relative took her son to the emergency room when his temperature topped 103. But not, unfortunately, before he ended up with an infection in his bones that made for three very scary days in the hospital and took six months of IV antibiotics to overcome.

My poor mother-in-law has had a number of doctors that have not ever seemed to delve to her real problems. But I learned something listening to her struggles. I believe most doctors do their best, but, even under the best circumstances, they aren't going to understand your body as well as you do. They're going to know how many people react to certain medicines, but they don't know how you have responded or will respond. When it comes to your health and the health of your family, you had better be an informed consumer and know what's happening and what isn't going like it should.

People don't come with warranties and you can't just toss 'em if they break down. And, for all the uncertainties and unknowns that come with chemistry and physics, it's just a drop in the bucket to what we don't know about biology.

Just sayin'.

11 comments:

  • Boris Legradic
     

    Hear, hear!

    Everytime I piss and moan about how vast the parameter space in my experiment is - pressure, and voltage and gas composition and electrode geometry and matching, and and and) I think about my poor collegues in medicine, and coll right down. Talk about a nightmare! Not only do your compounds get digested and filtered by a system that has evolved to keep crap out over millions of years, you can't even trust your patients to take their medicine regularily, or to not do stupid things like wash it down with a couple of other pills and a shot of whiskey!

    I am astounded that we even manage to heal anything, let alone the vast progress medicine has made in the last few decades...

    On the flip side, that means that even a good doctor can be helpless just because he doesn't happen to think of the one thing out of who knows how many that may have caused your illness.

    My father for example was plagued for years by headaches and neck-pain, until finally a chiropractor (the last in a long line of different specialist) happened to see him write down something. Turns out that the way he held his pen while writing was unnatural and cramped, which in turn caused the neck muscles to be strained which caused the headaches. As soon as my father had re-trained himself to write differently, the pain vanished for good.
    Who would'a thought?

  • Stephanie Barr
     

    It's the simple stuff that gets you. But it's also why I'm an advocate for people understanding their own care. If you have an adverse reaction to psychotropic drugs, you should be wary about new ones you're prescribed, for instance. You can't just trust that the doctor knows what he's doing. He sees dozens/hundreds of patients and, even if he's dedicated, he's not going to know your body like you know it.

    Be informed and speak out if something sounds wrong!

  • Quadmama
     

    It all comes down to making sure you understand what your doctor is saying. If I don't understand I ask for clarification. Plus ask your doctor why he/she is doing certain things... why do I need this medication? what will it do? Too many times I've encountered people who say "oh my doctor prescribed x for my child but I'm not sure what the purpose is."

  • Patricia Rockwell
     

    Over the years I have learned that I have an extremely low tolerance for pain and other narcotic type meds. Even though I tell each new doctor my lengthy experiences, some choose to believe me and some don't. My experience with my most recent colonoscopy is typical. They said I "probably" wouldn't even fall asleep, but I was out for three hours and was taking so long to wake up in the recovery room that they didn't have enough room for the next patients. They had to carry me to my car and by the time my husband finally got me home, I was starting to wake up. I know my body and I know what drugs and amount of drugs I can tolerate.

  • Bob Johnson
     

    I never understand what my doctor is saying or writing for that matter,lol, I'm lucky I don't see one that often, maybe once a year for a check up.

    My Mom got addicted to barbs years ago because of a certain doctor who thought pills were the answer to everything, unfortunately my mother has passed but we did manage to get her away from the drugs a few years ago.

    I can only imagine what it must be like for cost in the States, everything is free up here, even a lot of drugs if you have extra coverage through work, which I do.

  • Stephanie Barr
     

    Quadmama, the only thing worse than those parents who don't understand what's going on with their child are those parents who trot them to the doctor for every sniffle and insist on getting antibiotics for viruses and medicines to treat every symptom.

    Patricia, that's exactly what I'm talking about. As much as we need doctors that care about our health, we need doctors that listen to us.

    Bob, there you go predicting my next post.

  • Phyl
     

    This does relate: Last summer I read Michael Pollan's book In Defense of Food, where he talked about how scientists had managed to isolate certain nutrients in a food like a carrot, but there were still thousands left that they hadn't figured out. And that meant that the way all a carrot's nutrients interact to give us something healthy is really not that well known.

    So rather than pull the few nutrients they do know out of the carrot, and put them into supplements for us to take -- why not just eat the carrot?

    I'm sure the same issues happen in medicine too. One very good treatment or drug might be just part of the health equation, and could throw off other things, because the complete interactions are either not known or not taken into account. I don't dismiss the wonderful advances that have been made, medically, but I still have a feeling that a lot of things aren't very well understood.

  • Relax Max
     

    I think we do have to take responsibility for knowing about our diseases instead of trusting doctors to know and cure us. We are the ones who are going to die if not treated correctly, not them. But having said that, and having a spouse in the medical profession, I can't help but wonder how many of you would be so caring and thorough if you were presented with 50 to 60 unique health problems in a 12 hour shift, and knew that each of them wanted a quick fix and wouldn't do what you told them to do anyway? Such is the life of an emergency room physician in a large city, and such is the life of a clinical physician who wants to make a difference on, say, an Indian reservation in the public heath sector.

    I myself have finally found a doctor who treats me as an individual and who takes the necessary time to work with me and follow up with me and call me at home to give me test results. She dropped out of the assembly line rat race in the world of hospitals and opened her own little clinic. The downside? She barely makes enough money to pay the rent for her little office and were her husband not also a successful physician still in the rat race, could not survive.

    There is neglect and fatigue and hopelessness in every occupation. But there are a heck of a lot more caring and studious doctors out there than perhaps you realize. But Stephanie, you have the right answer: know your own self and take responsibility for your own treatment. Amen to that.

  • Stephanie Barr
     

    Phyl, sometimes the whole is more than the sum of the parts. That's another thing it's easy to lose sight of.

    Relax Max, I don't disagree. Note that I mentioned economics as a factor, but I did neglect to mention the patients who felt that anything should be curable with just a prescription. I get frustrated, particularly, with the tendency to have children with ADD or ADHD or autism or something else wrong to doctors and ask for something that makes them controllable until the kids are so drugged up, they live in a fog. My son is sort of autistic and sometimes he's a challenge to deal with, but we can deal with him without necessarily controlling him until he just does as he's told. Really, if we make an effort, we can both come out happy but it takes care and patience on both sides.

    I prefaced my comments with the fact I know there are caring doctors out there (I've had two through my adulthood) just like I know you can't expect a doctor who sees 50+ patients a day to be able to know you like you know yourself. That's why we all have to take some responsibility. Thanks for commenting, RM.

  • Stephanie Barr
     

    I wanted to add, in case it wasn't clear, that medicine, unlike many of the physical sciences, is not cut and dried. A medicine that works on 95% of the populace may do bupkus on a patient and the only way to find out is the hard way. It's not an exact science and many doctors know that. Some, I fear, do not and, worse, many patients are clueless as to the many uncertainties.

  • Phyl
     

    I think some of the attitude of "we'll just cure it with a prescription" is still a leftover of the major revolution when they discovered penicillin and things like that, and suddenly these monstrous diseases that nobody could overcome really could be gotten rid of, for the first time in history.

    That was almost miraculous, when you think of it. And a source of magnificent optimism. I think maybe society has carried that to its farthest extreme, and now just assumes that everything can be accurately diagnosed and cured, now.

    Perhaps we're in the middle of some pendulum swings, and the final settling-down of abilities and expectations will finally put the pendulum somewhere in the middle, down the road a few years.

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