Doctors are hazardous to your health. I remain healthy by avoiding cures that are worse than the ailments.
In the end, it's not the years in your life that count. It's the life in your years. - Abraham Lincoln
That's like saying that a mechanic is bad for your car. Sometimes mechanics screw things up. Sometimes you can do a better job yourself. And sometimes you need one. I try hard not to need a doc. Sometimes I don't succeed.Originally Posted by BirdBrain
I always know where I am. I'm right here.
When I was 53 I hadn't seen a doctor in 30 yours. 15 years later I am under constant care. Nothing too serious so far but I'm just saying things change.
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30 years not yours
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Yup. Tongue in cheek with a tinge of truth. People rely too much on quick fixes. My doctor looks at my habits, lifestyle, and environment. If there is no fix to be found in those areas, then a more drastic approach is discussed. People take pills so they can eat fried food. They get liposuction and stomach staples instead of stepping away from the table and going outside. As with all things, none of these things work all the time. That is where our advances in medicine are needed. I am thankful for the advances. I am even more thankful that so far I have not needed them for anything serious.
In the end, it's not the years in your life that count. It's the life in your years. - Abraham Lincoln
30 years...not a bad run, I been seein' doctors my whole life, sometimes I pull a mutiny of sorts and just don't go for a while...strangely that's never worked to my advantage.
Some of those side effects can truly be a real killer.
I totally agree. A good doctor is much like a technician and technicians are troubleshooters and love their jobs. However, there are a some that just can't seem to troubleshoot themselves out of a wet paperbag. They'd rather rely on mindless flowcharts and such to diagnose the problem, but for those that have worked on complicated systems (and the human body is top of the list of complicated systems) you know that troubleshooting guides are only good for the simple problems like blown fuses and loose connectors....
For everything else you need a troubleshooter, not someone that just follows a flowchart -- rather someone that truly understands the system and all its intricacies. I have tons of respect for the real doctors, but there are some out there that should probably not really be working on people. But what can you do that's just part of life.
House is a real doctor, even though he's a total ass
Staying healthy:
Minimalize stress
Have good genes
Tax your cardiovascular system AT LEAST 3 times a week for AT LEAST 30 minutes.
Get some sunshine
Eat veggies
Don't smoke.
Drink moderately (or not at all)
Stay busy (but not stressful busy)
Eat pretty much what you want if you can do all of the above.
Anyway, that's what works for me.
Don't let your fears stand in the way of your dreams
The doctor will see you now...
Sometimes I just need someone who can sign a 'script for me. Often enough, the conversation goes, "Have you had this before?" "Oh, yes!" "Did you take anything for it?" "Yes, I took x mg of yyy twice a day." "Did it work?" "Well enough." "OK, let's do that again." But I don't have the union card to skip the doc's visit.
And sometimes the problem is bleeding obvious - literally - and a good technician is exactly what I want. When I went off my bicycle onto a glass-strewn shoulder in the 1980s sometime, I just needed someone who could sew up the elbow that I sliced open. There's no diagnostic puzzle there, and following the flowchart is just fine, thank you very much!
On the other hand, I had some severe trouble back in 1996 or so (and eventually wound up having three operations in the same week) - that was misdiagnosed for six months. The problem was that the issue didn't show up on a scan, and so the radiologist considered it conclusively ruled out despite the fact that it was everyone's first guess as to the diagnosis. Eventually, after I went into crisis, a sharp-eyed radiologist spotted the problem that had been conclusively ruled out, but he went and reread the original scans and said that even knowing where to look, he couldn't see it. And nowadays they don't operate until they've spotted the problem conclusively by radiology.
End result was that I had four surgeries and missed over a month of work, for something that by the standard of care only a few years earlier would have meant a night or two in hospital and back to work in a week.
When my primary was doing my discharge orders from hospital, he said to me, "One thing that we tend to say about the young doctors just out of medical school is that they are the ones who hear hoofbeats and think of zebras, while the experienced guys know it's horses. Well, I know the team who were attending on you here, and they're some of the best in the business. I'll never be in their league. And even though you had a common problem, you had all of them hearing the thundering hoofbeats of a whole herd of zebras."
I'm glad they figured it out, since I got better. The zebras were all death sentences. (In fact, the first operation was intended "to make me more comfortable for what life remained." The surgeon was pleasantly surprised when it turned out to be something curable.)
I always know where I am. I'm right here.
All you hikers with toothpick armsneed to read this http://www.cheatsheet.com/health-fit...s.html/?ref=YF
Or you could strap a litre of water to each hiking pole like a well know PCT thru hiker did a few years back.All you hikers with toothpick arms
Colorless green ideas sleep furiously.
Yeah, I guess you have to start somewhere, for hikers with toothpick arms, it's curling about 2lbs....ha, ha, ha....Or you could strap a litre of water to each hiking pole like a well know PCT thru hiker did a few years back.
But I can't really laugh, because when I started cycling I had to tape two wheels on either side of my rear wheel
My Doctor who sadly retired years back said that walking is the perfect exercise. A fast pace on uneven path's or a local trail is a great workout. Not enough, wear a pack with weight to your liking.
I prefer hills, which fortunately are right outside of my house.
There are also many body weight exercises that we can all do with no gear. Squats, lunges (done right they are tough), push ups, sits ups, planks (see how long you can do them, time yourself to gauge improvement), etc.
Another Kevin,
Hey, this is a good article on what I see as why doctors are overworked and why I have nothing but tons of respect for the profession. It really does it an injustice to compare doctors to other technicians (which wasn't my intent above), because there is no set standard (such is the case working on machinery).
Furthermore, you gotta see one person after the other, not really affording any one the correct attention potentially needed. I see that not as the fault of the doctor, nor the medical system as a whole, rather us the patients as a whole. Too many people go to the doctors with too high an expectation, thinking it's the medical community's responsibility for keeping them healthy.
That's just crazy. I have nothing but respect for the medical community, I know I couldn't do that job -- I just can't deal with people with a victim mentality.
Excellent Article!
http://well.blogs.nytimes.com/2015/0...ef=health&_r=0
Getting the Diagnosis Right
By DANIELLE OFRI
Recently I had one of those bursting-at-the-seams types of days in the clinic. Every scheduled patient showed up, plus a few extras. Everybody seemed to have burning concerns that needed immediate attention. One patient had newly diagnosed thyroid disease, but the medication was making her feel worse not better. Another was having strange twinges in his lower abdomen. One woman had been having muscle aches in her arms for the past month, and now had the same aches in her legs. Another patient was experiencing a drilling-like pain in his lower back that spread up to his neck and scalp. One man had a cough that just wouldn’t clear up. A woman was concerned because the soles of her feet felt like they were on fire. Another patient said she simply had no energy and could hardly get through her day.
For each of these presenting symptoms there can be a gamut of possible causes — what doctors call the “differential diagnosis” — that run from the prosaically benign to the concernedly urgent to the immediately life-threatening. The goal is to come up with a broad differential for each symptom, then prioritize them by likelihood and by severity. Testing for every possible diagnosis is not feasible, so the doctor needs to ask the right questions, listen carefully to the answers, do the right kind of physical exam and pay attention to the clinical cues.
If I had the luxury of an hour with each patient, I would have the time to carefully sort through every possibility. But the reality is that I, like most doctors, have five to 10 minutes to push the majority of diagnoses to the bottom of the list, come up with the most likely few at the top — being careful, of course, to keep in the rare but life-threatening possibilities — and then explain to the patient what I think. I can order lab tests, X-rays and the like, but those results won’t come until later. I need to offer to the patient the most likely diagnoses and a plan for how to start treatment or investigate more.
It’s a tall order, and an incredibly stressful one. As I raced through my day trying to avoid falling too woefully behind schedule, I was also struggling to be as thorough as possible. The ulcer gnawing at the pit of every doctor’s stomach is, “What if I miss something serious?”
Patients, of course, have a parallel thought process going on. Before they even get to the doctors’ office, they’ve thought about the symptoms that ail them, considered the cause, maybe asked a family member’s opinion, and probably searched the web for answers. There are now dozens of so-called symptom checkers on the Internet that allow you to enter your symptoms and come up with your own differential diagnosis. But are they accurate?
A group of researchers in Boston set out to find out. Using 45 case vignettes in a medical school curriculum, they entered the presenting symptoms into 23 different online checkers. One-third of the programs got the correct diagnosis on the nose. When looking at the differential diagnosis, 58 percent of the programs had the right ones listed in their top 20 possibilities.
Much of the media coverage of this study focused on how lousy these symptom checkers are. But Ateev Mehrotra, the lead author on the study, made a different observation. “It made me realize just how hard this task is. What we are asking symptom checkers to do is an extremely difficult task,” he said.
His words make me reflect on my overwhelming day in clinic. Each and every patient presented a wide chasm of possibilities that could be nothing, or something, or something horrible. Was the patient with no energy just not getting enough sleep? Or was she anemic, hypothyroid, depressed, suffering from pancreatic cancer or experiencing domestic violence? Was the patient with muscle aches having a medication side effect or exhibiting the onset of a systemic inflammatory disease? Did the gentleman with abdominal twinges have vascular compromise to his intestines, or was he a hypochondriac or taking a weight loss concoction he had purchased on the Internet?
General practitioners, like internists, family doctors, pediatricians and emergency doctors, face the biggest challenges because the diagnostic field is so wide open. We all want to get it right, but don’t want to over-order tests that can be harmful (and expensive). We may want to allow some observation time to see if the symptoms self-resolve or progress, but we are worried about missing a serious illness, harming a patient or getting sued. Some days it feels shocking that we get any of it right at all.
And we do, on average, get it mostly right. Doctors’ diagnostic accuracy is estimated to be in the range of 80 to 90 percent. That, of course, implies a 10 to 20 percent error rate, but on days when it feels like you are being pelted with diagnostic possibilities from every cell of the body and that imminent death is lurking everywhere you turn and that you have only minutes to make those decisions, 80 to 90 percent is a comforting percentage.
On cooler-headed days, though, that 10 to 20 percent error rate is disturbing. It’s a definite cut above the online symptom checkers, but is it really good enough? Luckily, the Institute of Medicine has taken on the topic of diagnostic error, exploring how they occur, how they can be measured and how they can be minimized. Look for the report, coming soon.
Danielle Ofri, M.D., Ph.D., an internist at Bellevue Hospital and Associate Professor of Medicine at N.Y.U. School of Medicine, is the author of What Doctors Feel: How Emotions Affect the Practice of Medicine. She spoke on Deconstructing Our Perception of Perfection at TEDMED.
I didn't mean to say that doctors are just technicians. I simply meant to point out that sometimes a technician is exactly what I need. (And nowadays, I often seem to wind up seeing a PA or NP for those needs.)
And that the way my luck has run, when I have had need of more than a technician, the diagnostic technology - good as it is - led them astray. (And it's unquestionably good. Even in my lifetime there was a time where about a fifth of the appendices and gall bladders that a typical surgeon removed were healthy. We've definitely improved on that.)
I always know where I am. I'm right here.
LOL! Pithy
I know you didn't say that docs are just technician, I said that. I didn't mean it quite that literally, that was my only point on that.
And my last link wasn't a comment on your personal experience, it was just an example of how difficult I see their job, much of which is created (IMO) by patients. Here's another angle on that perspective, but it strays a little, but the beginning of the article is pretty good. http://www.newyorker.com/magazine/20...l-atul-gawande
Most people blame the doctors and/or the medical community, or they blame the insurance firms, or big pharma or the USDA, or (and the list goes on...).
However, I think it's us the patients that bare much of the responsibility in creating the demand. But people don't like hearing about personal responsibility.
Not saying that there's no room for improvement in the other aforementioned areas, but I've been to a few hospitals and there's always one common denominator. People who don't keep themselves healthy. We are overburdening the system. That's not THE fix, there is no one fix. However, it's a significant factor that I believe is too easily overlooked.
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