Friday, December 30, 2022

When should you listen to doctors?

Created on Dall-E AI.

     Anti-vaxxers have a point.
     Not in their blanket rejection of vaccines. Those save millions of lives, maybe mine. I’ve taken five, count ‘em, five, COVID shots and wish you would too, even though you probably haven’t — 90% of Americans didn’t bother with the latest booster.
     But they have a point about questioning medicine. Doctors are not always right; their advice is sometimes clouded by self interest. Some are highly skilled; others, less so. How to tell the difference?
     In 2019, when something was obviously wrong with my spine, I fled the first surgeon I spoke with, but let a second, at Northwestern Medicine, cut open my neck — decisions based on differences of bedside manner and because Illinois Bone and Joint Institute’s name sounded to me like something plucked from a Lemony Snicket novel.
     It’s a gut call. Earlier this year my father contracted COVID at his senior lifestyle community in Buffalo Grove. They sent him to a hospital. After a few days he was discharged into a rehab facility in Arlington Heights, and the facility told me he’d need two weeks of physical therapy to learn to walk again.
     Interesting if true, as they say in my business. As soon as he was out of isolation, I hurried over to the chaotic facility. Eventually I found him in a wheelchair in a dim room. We exchanged pleasantries. His roommate watched a blaring television.
     “Let me wheel you into the hall, Dad, where we can talk,” I said. I looked closely at him. He smiled back. A youthful 90, heavier than in the past, due to not remembering that he’s just eaten.
     “Dad, can you stand up?” I said. He did. “Dad, could you walk over there and back?” He walked over there and back. I went to the nurse’s station.

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  1. I vividly remember the first time I refused to take the treatment proffered by my physician: my knee hurt from playing basketball a little too vigorously (not a problem today) and my doc gave me a prescription for butazolidin. Not 5 minutes later, I noticed an article in the Sun-Times by Dave Feldman mentioning that a horse taking the drug had a stroke and died, as it supposedly was well known that butazolidin can raise a horse's blood pressure dangerously. Not for me, I told myself; plenty of high blood pressure in my family. Not worth the risk just to show off my dwindling basketball skills. Not that I mentioned that to the doctor.


    1. That would be unusual for Feldman to write something bad about drugs given to race horses. He was furious when people wanted to ban the use of Bute & lasix in horses. He loved the stuff! He was always going on about horses that were "bleeders". Lasix is a diuretic & makes the horses piss like crazy, so they lose weight & can run faster. The Bute is for arthritis. It was the #1 reason I stopped reading him!

  2. If this is an annoyance problem like what you had I always follow the rule of try the least invasive first and see if it cures the problem. If it doesn't, "go up the ladder" of suggested procedures. If it's a life altering or threatening condition--you normally can't take a slow and steady procedure. Our son one morning woke up with "dropped foot" and a surgeon from IBJI suggested surgery ASAP. With nerve damage time is not your friend. He got the surgery and the issue was immediately gone. My husband also has had three surgeries because of spinal stenosis and he wishes he had had his first hemilaminectomy surgery much sooner than he did--but the prevailing attitude at the time was he would need spinal fusion and not a hemilaminectomy to cure his problems. He did wait and then saw another surgeon who suggested a hemilaminectomy. Since then he has had two further surgeries to work on other vertebrate and to touch-up the others. His issues have never gone away completely, but he wishes he had not waited and gotten a hemilaminectomy when his issues first appeared as it might have cured the problem.

    I would have done the same as you if it was my dad. And you did the least invasive procedure with your shoulder.

    1. Dropped Foot?? I have that now and getting PT for it. As I recall, no one has mentioned surgery as yet. This is an after effect of a major medical year.

    2. Surgery was done after xrays and MRI. He had had back issues, and the dropped foot was the "last straw". His issues are similar to what my husband had so the sooner the better was the right call as the dropped foot and pain were gone the night after he had his surgery.

    3. I don't have pain, just a gimpy walk. The PT seems to be helping.

      I can see where back issues would enhance the problem.

    4. I had drop foot as well. No one mentioned surgey. I did some pt and was given something like a brace to put in my shoe. I wore it for a bit and then finally took it off. It was making my big toe sore. So I stopped using it. Eventually the problem went away, but my toe felt sore for quite while.

    5. That was good you only needed a brace sanford and PT ! In our son's case the xrays and MRI showed he had a severe herniated disk and spinal stenosis--the same issues my husband has/had (these issues can be hereditary). PT wouldn't have helped him and with nerve damage/impingement the sooner you correct the issue the better the chance of nerve regeneration.

  3. I once had serious back trouble. Went to three specialists, whose recommendations matched their speciality. To a man with a hammer every problem looks like a nail. I rejected their recommendations, including surgery, and bought a shiatsu massaging chair. I still have the chair 30 years later and haven't had serious back pain since.

    Your article fascinated me because you note the problems with the medical industry without rejecting the medical industry. This sort of common sense nuance has become rare in the twisted MAGA world we now inhabit.

  4. This article was helpful and informative and I sent it to some relatives with similar problems.

  5. I’ve had my own share of experiences with practitioners who almost seem to be shooting in the dark when diagnosing and treating various ailments, but nothing compared to a guy I know that had developed some lumps on his upper thigh which proved to be malignant, and was told by the first specialist he consulted that the only option was to amputate. He got a second opinion and was told no, there are other treatment options, and today, eleven years later, he’s still with us, and still has both legs, and is still mobile, although he hobbles a bit.
    In Woody Allen’s autobiography he says that, with rare exceptions, most doctors are hacks who are just plying a trade that, for them, involves a lot of hunch following and educating guessing. The high level of training and education that is required of them is not for nothing, but it doesn’t endow them with the kind of scientific genius that we’d all like to think that they have.

  6. I spent the last few years in a perpetual disagreement with my sister over my mother's care. She felt we should always do whatever the doctor said and I felt like we should do the least invasive treatment of available.
    My mom ended up on about 30 medications and had five surgeries before she died and I honestly don't think it improved her quality of life. It just probably extended her suffering.
    Facilities and practitioners can consult chart and find out what an insurance company is willing to pay for and I think more times than not that's what they recommend.
    It's a crap shoot what's best for the patient and doctors have to make money.
    Unfortunately, once you're elderly, parent can't take decisions for themselves and they're at the mercy of whoever they've selected to make those decisions for them. If you did it right, they kind of laid out a path that they'd like to travel during their last year's.
    Me personally I avoid the medical industry like the plague. I intend to be sick when I die

  7. For knee pain the orthopedic doc gave me a cortisone shot but was willing to schedule surgery ASAP. I gave it some thought, made a plan, and 40 pounds later/lighter my pain was banished. When my shoulder pained me regularly, a different orthodoc gave me a shot that worked for approximately 18 months. By then both shoulders were causing me great pain. A third doctor said I had extreme osteoarthritis and had pictures to prove it. Nasty little bone spurs were cutting up my muscles and shoulder replacement was definitely in my future. He gave me more cortisone and said he could do the surgery in a couple months. I consulted a friend who had both knees replaced and was also having shoulder problems. He gave me a tube of diclofenac sodium gel, which was working for his pain. When the cortisone ceased its' effectiveness the gel, a prescription version of Voltaren, worked like magic. I now use it only occasionally and my friend and me have both steered clear of the knife.

  8. I guess I am one of the lucky ones. 2022 has been the year of medical issues. I started with a routine endoscopy, treatment for Barrett's syndrome, discovery of Esophageal cancer and procedures leading up to an Esophagectomy.

    All the way along I was impressed with the doctors and other staff that I dealt with. Turns out that the two surgeons who worked on me (one high, one low) have been rated among the top 5 in the country for this procedure. Bedside manner played a big part of trusting the various practitioners. There was only one who was slightly questionable, but was one of the experts in his field.

    I am now in a (at least) year long recovery period, gaining back weight and strength. One must be patient to be a patient sometimes.

  9. A few years back, I commented at EGD about the death of a longtime friend in 2017. His doctors told him that being a vegetarian for decades made him so healthy that he could forego routine colonoscopies. He believed it. At his son's graduation, he got very sick, was hospitalized, and the diagnosis was Stage 4 colon cancer. A family doctor had either missed the original symptoms or downplayed them.

    He made the long shlep from Ohio to a Texas cancer treatment center in a medical van. The trip merely bought him a little more time. From diagnosis to memorial service (on what would have been his 63rd birthday) took only nine months. At the end, he looked like he was about 112.

    My wife and I not only lost a friend, but the hair stylist who cut my wife's locks for 38 years, and my own for 24. His son was devasted by the loss, and on his blog, he wrote a long, long post about his father and the family's ordeal and he had this advice: If you're over fifty (or even 25), and your doctor doesn't suggest a routine's time to find another doctor.


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