Inspired by Other Threads

Discussion in 'Homesteading Questions' started by whodunit, Nov 5, 2005.

  1. whodunit

    whodunit Well-Known Member Supporter

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    Kind of long...hopefully it won't bore you to tears!

    I didn't want to highjack the other threads regarding tooth aches and bird flu, so I started my own.

    I guess this is kind of a medical rant; nothing serious, but things that I hopefully remember the next time I need a doctor.

    DW and I (especially my wife) are pretty much anti-medical establishment. While we don't completely shun doctors, we see them very, very infrequently.

    DW probably hasn't seen a doctor for almost six years.

    My oldest DD had the second doctor visit of her lifetime (6 YOA in January), for what we thought could have been appendicitus or a twisted bowel, but what turned out to be severe constipation.

    Our younger two DDs (3 and 1) have never seen a doctor.

    I just had my first doctor visit in almost five years, I think. I thought I had a partially torn rotator cuff in my left shoulder, which due to the nature of my job, I thought I could easily injure more seriously.

    In my daughter's case, we felt the doctor did a good job, but I definitely sensed that he was CYA'ing and feeling us out.

    He ordered an x-ray and a blood test. He could clearly see from the x-ray that she was severely constipated, but wanted to hear back about the blood test.

    The test showed elevated white blood cell count, which he said could indicate appendicitus.

    The options ranged from keeping her overnight (not a chance) or trying an enema.

    We chose the enema, which worked like a charm, and he made us promise to return if DD showed any signs of getting worse or developing a fever.

    While I am overall satisifed, it seems that he could have gone with the x-ray first, then if it did not shed any light on things, ordered the blood test. This would have saved some money, although not for me since I have insurance, but it's the principal of the thing.

    In my case, I saw a nurse practitioner, since I walked in and wanted to be seen right away and she had an opening.

    I am not kidding when I say that the examination was about five minutes in length, during which time she diagnosed me with a possibly partially torn rotator cuff, ordered an x-ray and physical therapy.

    She told me that another possibility might be arthritis and that either way, the x-ray would show this and physical therapy would still be warranted, so I should get an appointment to have a Physical Therapist (PT) "evaluate and treat".

    To her credit, she did take time to answer my questions.

    She told me that she would call with the x-ray results later that afternoon or first thing the next morning.

    I made an appointment with physical therapy (PT) for the next afternoon, and they told me that the PT would want to know what the x-ray results were.

    I met with the PT and without the benfit of the x-ray, he told me that he believed that I had an impingement and bicep tendonitis. He told me that he was going to do some medicated ultrasound and show me some exercises to strengthen the muscles in my shoulder.

    At one point, he asked if I had ever been injected with hydrocortisone. I told him that I was concerned about using it, since I've read that it can contribute to diabetes and I have a family history of adult diabetes.

    He told me he just wanted to know if I was allergic to it and what he was using was not hydrocortisone.

    I started the ultrasound treatments, which helped the pain, but later found out that the medicated part was dexamethasone, which is a hydrocortisoid(sp?).

    Now, I did not insist he stop using it, which I should have done if I felt that strongly about it, but so much for my concerns. I was also conflicted since I felt better.

    Additionally, he told me that an x-ray technically won't show a torn rotator cuff, but will show some abnormalities in the joint, which might indicate a torn rotator cuff. The x-ray results, which I got hours later, showed everything was normal. What exatly was the point of the x-ray?

    The PT wants to see me for 4-6 weeks, 2-3 times a week, but I think I am going to nip that one in the bud.

    It's basically $40, a visit and the only purpose (other than the exercises, which many I can do at home) is pain control.

    I cancelled my last appointment due to work conflicts and told the PT's receptionist that I was going to wait a week and see what happens.

    Several days now and my shoulder feels much better. I haven't taken anything for it and if it never feels any better than it does now, I could live with that.

    I have also ordered an anti-inflammatory herbal mix and will give that a try when needed.

    I guess my complaints are small compared to some, but they are indicators of the problem with our medical system.

    Why did I need to see a doctor when a PT figured out what was wrong on his own?

    Why did I need an x-ray, if the doctor was going to have the PT "evaluate" me anyway?

    Are the risks of using a hydrocortisoid warranted if I can handle the pain without it? It's not helping me to heal and coulkd be causing other worse problems.

    Anyway...time to wake up, I'm done!
     
  2. mpillow

    mpillow Well-Known Member Supporter

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    Doctoring is an inexact science that has been manipulated by the insurance industry....
     

  3. dlangland

    dlangland dlangland

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    It took me this last just over a year of no longer having health/dental insurance to realize that. Strange. I never need to go to the doctor anymore...I know I shouldn't even dare speak of it. I on rare occasions, give myself permission to act like I am sick...sit at home and drink my juice or hot herbal teas...I pull out 4 times faster then when I used to run in to the doctor for antibiotics, most of which I ended up being allergic to. Not having insurance any longer seems to have been enough of a punch to prompt myself to not just take better care of myself and listen to my own body, but to do what I can to heal thyself in my own way...things most humans already do like get the proper amount of sleep, eat right, take vitamins...I am still here. I just sometimes lack common sense.

    Most of what I used my insurance benefits for were things like prescription allergy meds...over $100 a month for a bottle, then after so long I would grow immune to them and have to change brands anyway. Now I don't take them unless I know I am in for an especially heavy-duty outdoor, windy allergy day, and it seems they don't help anyway, so I quit worrying about it. A hot shower or bath and a change of clothes to remove the allergens as soon as I am back to the indoors does just as well for me. The things I still need on a yearly basis, I just budget appropriately for the anticipated costs. Deb
     
  4. fordy

    fordy Well-Known Member

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    ................I haven't had health ins. in about 5 years . I had BC\Blue cheese and after I turned 53 my monthly premium doubled so Statistically I guess I was becoming a potential liability . This is how they get "rid" of us older folks who will start having problems due to age . The cheapest and BEST health ins. a person can "have" is to become a member of their health club and start working out on a 3 aweek visit schedule . But , some folks will just never become involved for whatever reason . I've figured out that at some point say between 70 and 75 I'm going to get sick and die and it doesn't really bother me because that we were never meant to be here forever . fordy... :eek:
     
  5. mightybooboo

    mightybooboo Well-Known Member

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  6. MrPG

    MrPG Well-Known Member

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    If you talk to doctors out of their office, they will admit that if they want to keep their malpractice insurance, they have to order many more tests than are actually needed.

    Another gotcha: if a doctor sees even ONE Medicare/Medicaid patient, he has to keep the same detailed records and do all the paperwork for ALL his clients. Thanks Hillary!

    In no other field that I can think of, do you take someone, spend 10 years training them, then load them down with ridiculous paperwork requirements that take up 25% to 33% of their working day.
     
  7. Explorer

    Explorer Well-Known Member Supporter

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    You ever wonder why, no matter the TYPE of Doctor or nurse, they all work at a Medical PRACTICE place. Makes you wonder when they will stop getting ready to cure people and actually do it.
     
  8. mkoonrn

    mkoonrn Member

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    The main reason that all those tests are ordered is the docs CYA because of our lawsuit happy society. Medicine is not an exact science, some guesswork goes on, and yes, it is the "practice "of medicine.
     
  9. Country Doc

    Country Doc Well-Known Member

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    90% of my time is now spent with paper and various other forms of logitics. I hate it, the patients hate it, the government requires it , and to discourage lawyers we do it. I trained to be a doctor, not a clerical worker.
     
  10. comfortablynumb

    comfortablynumb Well-Known Member

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    I'll assme, your kids aint vaccinated either...

    Ive had more than my share of doctors, x rays surgery PT drugs and allllll the stuff that comes wih repeatedly injuring yourself.

    after all these yrs I do see some method to the madness. got a shore sholder? get the x ray and the blood test.... stop whining. :D

    a sore bone can be anything from arthritis to bone cancer. my uncle died from bone cancer he put off as self diagnosed "lumbego"... he had bone cancer, it started in his hip joint as a "slight ache".

    I look at it this way... if a blood test can pick up some unseen variable to maybe detect some killer early on,,, tap me once a yr like a tree.

    I had a colonoscopy, for no other reason than lots of family die from cancer and it is that time in life when it pops up....
    good to know, I have spotless pipes...but I will go get another in 10 yrs. or so.
    I think.... for a possible riped up sholder you want the doc to lay on hands and know instantly whats wrong.
    I could fill 3 pages with possibilites what a painfull sholder could be... wouldnt you like to narrow it down as muchas possible?
    yes you have to almost hold some doctor hand and be a doctor too... sometimes not.
    but I dont see where you had any extra ordinary tests or procedures...
    if the doc sees nothing on an x ray, and you got pain... a specialist may see what they dont.

    so when I have a twinge... I thnk of my uncle wasted away on a bed, because he decided doctors didnt know jack... they said if he had had a blood test, and some xray work, they may have been able to extend his life by many yrs.

    so... I fill my head with all I can resonably understand about medicine.... and let them run their tests.
    and I insist on having the details explained to me.
    what did you test for? whats that reading mean? whats "normal" what else would cause that if it looked bad and wasnt yak yak yak doctors hate me. :D

    go vaccinate your kids... :D
     
  11. Selena

    Selena proud to be pro-choice

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    MrPG maybe your profession should start dealing with inept, dangerous, and/or criminal doctors. I personally dislike my tax dollars being nothing but quick income for doc seeing medicaid patients. I suspect the majority of doctors give the same quality care to a patient regardless of where payment is generated. But those who do not order a test for a medicaid patient but orders one for a person with group/individual insurance, he/she should have his/her license revoked in ALL states as well as charged with a crime. Brings to mind the "study" where by they gave placebos to poor folks with syphillis without informing the patients.
     
  12. whodunit

    whodunit Well-Known Member Supporter

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    Doing some more thinking, I guess what bothers me about my situation is that the medical professionals don't listen to their patients' concerns and include them in the decision making process when they prescribe treatment.

    My main concern during this visit was finding whether or not my injury was serious, such as the torn rotator cuff.

    If it had been and I injured it to the point of requiring surgery, since it was not work-related, I would have completely exhausted my sick leave during my recovery.

    Once the sick leave was gone, I would probably keep my position, but without any pay. This would likely mean bankruptcy.

    Knowing what I know now, that all they could really do was pain management, but nothing really to solve the problem or help me heal, I would not have bothered with the medicated ultrasound and PT.

    I guess my other gripe is that doctors seem to have become a toll-booth that you have to go through to get what you need.

    An example would be, I want to have my cholesterol and blood sugar levels checked, which most hospital labs could do, but I would have to go to a doctor first.

    During that visit, I would be in the waiting room longer than I would be in the examination room.

    Most of the visit would involve a nurse recording my weight, temperature and blood pressure.

    The remainder of the visit would be with the doctor asking a couple questions and poking and prodding some, before ordering the blood tests. This time with the doctor would be about five minutes.

    That seems like much unnecessary procedures when I feel healthy but just want to gather some information on myself that I can use to make better decisions.
     
  13. RedneckPete

    RedneckPete Well-Known Member

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    I live in Canada where we have “free” health care.

    I NEVER go to the doctor except for a physical every three years as required for my truck-driving license. At this physical I make clear to the doctor that his job is to ensure I can safely drive a truck, not to poke and prod every orifice in my body.

    The medical system in North America is great at treating trauma injuries, but anything less obvious then open wounds usually produces an uncertain and possibly incorrect diagnosis.

    The dental industry is just as bad. Chiropractors are the worst. Bottom line in my book is this. The medical “experts” have only scratched the surface in understanding the human body. Add to this the fact that we live in a fallen world where life hurts, and you have a recipe for doctors trying desperately to stamp out aches and pains with little understanding as to how their actions and medications are affecting the rest of the body.

    The vast majority of pain is a simple fact of life. People have lived with it for thousands of years. A positive attitude will overcome almost all of it.

    Pete
     
  14. RedneckPete

    RedneckPete Well-Known Member

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    No self-respecting doctor in this world can say that. I’ve seen cancer patients who refused treatment live another 15 years (and still going strong) after the doctor told them they would be dead in 4 months.

    I’ve also seen people drop dead two months after starting treatment with a bullet proof promise for a long and healthy life.

    No one knows. I bet your uncle didn’t have to spend the last 5 years of his life pumped full of crap clinging on desperately to another week of “life.”

    Pete
     
  15. Jeff54321

    Jeff54321 Well-Known Member

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    I have not seen a doctor in at least 10 years and my opinion of the medical industry could not be much lower than it is. While I realize that somewhere out there is the doctor who TRULY cares for his/her patients.........that person is very rare. The degree and number of tests/procedures perscribed seems to correlate directly to whether the practioner is making payments on a BMW or a Lexus and just how big that payment might be.

    Try herbalists and/or acupuncturists, I think your chances or true "care" are much greater there.
     
  16. Jenn

    Jenn Well-Known Member Supporter

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    Comments from an FP, not currently In the real world of US private practice and I only have your side so maybe I’d agree with the medic if I heard their side etc.

    Daughter’s constipation- ordering one test then another takes longer- if Dr is just in ER to see her not there all night/day anyway he wants to go home quicker, if he sees something awful on x-ray he’d wish he already had blood test ordered, if the ER is full (or is likely to be so that same day) they want her cubicle freed up ASAP. Not all in your daughter’s best interest but legitimate things for Dr to work to achieve (YVMV but yes IMO even him going home quicker).

    Your shoulder: 1-I know (or think I know) a few quick tests for rotator cuff. My shoulder exam is way under 4 minutes long. However I know and admit the PT knows all joints a lot better than I. Also I don’t worry enough about the shoulder to get an xray early but I know many people who are mad as fire at their Drs for not xraying quicker (mostly because when finally done it showed soemthing- arthritis, etc). Anyway that term ‘possibly’ in her dx keeps her from being wrong. I’d probably say the same thing and treat the same way but skip the xray and tell the PT ‘you’re the expert what else should we do?’

    2-You voiced concerns re steroid and the PT told you this isn’t hydrocortisone. He knew you’d have same concerns about dexamethasone as about hydrocortisone if you knew what it was. Why not take the time to convince you (as you came to feel) it was ok for you not sort of deceive you? A bit paternalistic, what he doesn’t know won’t hurt him if you ask me. It’s a tiny bit as if a Dr’d said ‘Oh this doesn’t cause abortions’ to a woman asking if the pill would violate her antiabortion religious beliefs. I always carefully explained to such ladies that it prevents implantation and does not always prevent union of egg and sperm so some zygotes are lost unable to implant so maybe you don’t want this method. (But abortion medically = loss of IMPLANTED embryo)

    CN as always I like your mindset. Blood tests (and usually x-rays) do very little harm and make at least your dr (and his insur co) sleep better at night.

    WDI- “I guess my other gripe is that doctors seem to have become a toll-booth that you have to go through to get what you need….An example would be, I want to have my cholesterol and blood sugar levels checked, which most hospital labs could do, but I would have to go to a doctor first. “ You have insurance. Your co wants to be sure what it pays for is justified. So they want your Dr to order it, not you directly. Same for seeing PT. Saves them a lot of money not to let some more hypochondr pts get any test they think they need. A lot safer as well.

    The rest of you medical naysayers: always figure out where the money is, where it goes when you see anyone whose pronouncements you’ll have to take on faith. Drs supposedly have professionalism (approx = won’t cheat people for money) and I have to say we’re ahead (IMHO) of dentists mechanics and accountants/ actuaries. Way ahead of lawyers and politicians of course. Behind preachers, teachers, and nurses. Then consider a second opinion if the risk is high or if you’re suspicious and you have time/money to safely get a second opinion.

    I recall the professor of dentistry asked “Do you have insurance?” then when I said yes said “You need your wisdom teeth out!” I refused to get them out until an Army dentist, who made no extra money and in fact worked longer because he advised me to get the surgery, said the same thing. And I always quip to mil pts- if an Army surgeon says you need an op you definitely do, and if a civilian surgeon says you don’t need it you definitely don’t. Vice versa though maybe (hopefully not but we’ll never know for sure in all cases….) the Army surgeon just wants to quit early today, or the civilian surgeon has kids needing braces or college tuition.

    Stay healthy everyone.
     
  17. whodunit

    whodunit Well-Known Member Supporter

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    I understand the part about the insurance company not wanting to let me choose what tests I have, but honestly, when I tell the doctor I want them because my father has heart disease, diabetes and a high PSA, is he going to tell me, "No, you can't have the tests?" If he knows I feel strongly, why can't he just write an order over the phone?

    If I feel they are needed say because the results may cause me to eat and sleep better and get more exercise, isn't that better than waiting until I show definite signs of problems?

    I have the same gripe about prescriptions for something that you get the same time every year (I don't have this problem, but know people who do). Many times they will not order a re-fill until they see you.

    I also understand ordering a battery of tests all at once, but if that is being done to make more money or save them some time, maybe that is part of why our health care system is broken, that is if insurance is paying for it, why not?

    Some of it is CYA, so I guess that is what we as the consumers of health care get. "We" all started suing when good, honest doctors misdiagnosed something, instead of seeing them as human and prone to mistakes.

    If I was on a jury and a dcotor was on trial for something he could have never known, I would never find him guilty. If it was because he made a completely bone-head mistake, then yes.

    My shoulder feels better and better every day. So now my big question is was all that necessary? Did any of it actually help me or did it just heal on its own?