It is sobering to witness how marketers of medicine try to convert the well into the potentially ill. I am just amazed to watch Morgan Freeman, during a break from national news coverage, earnestly pitch a new treatment for cardiac amyloidosis. I have been practicing medicine for a long time and know barely anything about this diagnosis. Overmedicalization is a big problem in this country.
Personally... I avoid them like the plague... I know if they will go looking... they will find something and I am happier and healthier ... so far... without them... at least until my daughters force me to do the bloodwork...
I like doctors as people, and I'm interested in seeing my bloodwork come back normal, but otherwise I tend to strongly resist medical care that I don't need.
I very time I do an ID consult (PA) I look at the reason for the consultation. Sepsis is over-entered. Wound infection. Urinary tract infection. Then read the ED note-- two sentences in to even find out why the patient came in. "Sent in by primary for abnl labs" happens but it isn't written... then because they have a wound- cx obtained but the abnl lab was the potassium and we are consulted with ED wound swabs that have been nuked with vanco zosyn for a week by the time we are involved for now good reason. Or fatigue, weakness as a reason but when you ASK the patient (because they tell you they have been fatigued for months)--- why today? It was a friend who died and it scared them. Or a kid who came to town and hadn't seen them for a year and they had lost weight. And then to the ED with more blood work and a week later we have a urine cx of unknown significance.
Why did you present to the ED and if a chronic complaint- why today? That data would be so much more helpful than what I read so often as I dig in trying to figure out the "why". To see if whatever positive cx or treating abx are relevant. So often they are not. Love having you back! Thanks.
I debated this question but opted for treatment for SMM because I wanted to continue to work and figured a 50% chance or so that I would end up on aggressive treatment within 2-3 years which would likely end my career warranted 3 years of a low morbidity treatment (Dara) now. Hope I chose well but will never know with certainty.
There's a saying in Korea. Not knowing is the medicine. As someone who was hit with NSVT, pulmonary embolism, and a brain aneurysm (out of nowhere...funny how that happened). What I learned was that
A) Doctors are too busy to care - with few exceptions - my cardiologists cares, luckily.
B) Eating what you can recognize matters the most
C) Getting off life-long prescription is hard when doctors lobby so hard.
D) Pharma and old FDA/CDC didn't care about you nor health. (hopeful that it can get better)
E) Pharma cares about money and not health
And finally, get your fat asses to the gym and lose the tonnage. Or if you don't have access to a gym, go find out what your miles and miles of sidewalk looks like. After getting all three of those diagnoses, I finally got the wake up call and lost 20 lbs. Not with some exotic diet. I just walked 3-7 miles every or every other day *AND* ate only things that we can recognize. Turns out, carrying around extra 20lbs wasn't healthy. Imagine that.
Every time I do an ID consult (PA) I look at the reason for the consultation. Sepsis is over-entered. Wound infection. Urinary tract infection. Then read the ED note-- two sentences in to even find out why the patient came in. "Sent in by primary for abnl labs" happens but it isn't written... then because they have a wound- cx obtained but the abnl lab was the potassium and we are consulted with ED wound swabs that have been nuked with vanco zosyn for a week by the time we are involved for now good reason. Or fatigue, weakness as a reason but when you ASK the patient (because they tell you they have been fatigued for months)--- why today? It was a friend who died and it scared them. Or a kid who came to town and hadn't seen them for a year and they had lost weight. And then to the ED with more blood work and a week later we have a urine cx of unknown significance.
Why did you present to the ED and if a chronic complaint- why today? That data would be so much more helpful than what I read so often as I dig in trying to figure out the "why". To see if whatever positive cx or treating abx are relevant. So often they are not. Love having you back! Thanks.
Wow, I think a lack of healthy people was large part of Pfizer's excuse to get out of there Covid vaccine PMC (randomized placebo trial in 50 to 64-year-olds. I think the inclusion criteria Clinical trials.gov just stated "healthy" without defining it, and they still couldn't enroll I guess. But then there is the issue with the straight only showing 9% of sites activated and FDA's PMC tracker is still showing the studies pending which means no subjects enrolled. How much of that is due to lag is a question, but I still would like to see details on how much they actually recruited but anyway, I digress.
It is sobering to witness how marketers of medicine try to convert the well into the potentially ill. I am just amazed to watch Morgan Freeman, during a break from national news coverage, earnestly pitch a new treatment for cardiac amyloidosis. I have been practicing medicine for a long time and know barely anything about this diagnosis. Overmedicalization is a big problem in this country.
THIS is why I am (still) a paid subscriber!! Articles like this!
Same. 🥂
If “low testosterone” is a pathology then let’s just call “high age” the same.
Personally... I avoid them like the plague... I know if they will go looking... they will find something and I am happier and healthier ... so far... without them... at least until my daughters force me to do the bloodwork...
I like doctors as people, and I'm interested in seeing my bloodwork come back normal, but otherwise I tend to strongly resist medical care that I don't need.
I very time I do an ID consult (PA) I look at the reason for the consultation. Sepsis is over-entered. Wound infection. Urinary tract infection. Then read the ED note-- two sentences in to even find out why the patient came in. "Sent in by primary for abnl labs" happens but it isn't written... then because they have a wound- cx obtained but the abnl lab was the potassium and we are consulted with ED wound swabs that have been nuked with vanco zosyn for a week by the time we are involved for now good reason. Or fatigue, weakness as a reason but when you ASK the patient (because they tell you they have been fatigued for months)--- why today? It was a friend who died and it scared them. Or a kid who came to town and hadn't seen them for a year and they had lost weight. And then to the ED with more blood work and a week later we have a urine cx of unknown significance.
Why did you present to the ED and if a chronic complaint- why today? That data would be so much more helpful than what I read so often as I dig in trying to figure out the "why". To see if whatever positive cx or treating abx are relevant. So often they are not. Love having you back! Thanks.
I debated this question but opted for treatment for SMM because I wanted to continue to work and figured a 50% chance or so that I would end up on aggressive treatment within 2-3 years which would likely end my career warranted 3 years of a low morbidity treatment (Dara) now. Hope I chose well but will never know with certainty.
Did you mean more good than harm?
There's a saying in Korea. Not knowing is the medicine. As someone who was hit with NSVT, pulmonary embolism, and a brain aneurysm (out of nowhere...funny how that happened). What I learned was that
A) Doctors are too busy to care - with few exceptions - my cardiologists cares, luckily.
B) Eating what you can recognize matters the most
C) Getting off life-long prescription is hard when doctors lobby so hard.
D) Pharma and old FDA/CDC didn't care about you nor health. (hopeful that it can get better)
E) Pharma cares about money and not health
And finally, get your fat asses to the gym and lose the tonnage. Or if you don't have access to a gym, go find out what your miles and miles of sidewalk looks like. After getting all three of those diagnoses, I finally got the wake up call and lost 20 lbs. Not with some exotic diet. I just walked 3-7 miles every or every other day *AND* ate only things that we can recognize. Turns out, carrying around extra 20lbs wasn't healthy. Imagine that.
GREAT ARTICLE!!!!
Every time I do an ID consult (PA) I look at the reason for the consultation. Sepsis is over-entered. Wound infection. Urinary tract infection. Then read the ED note-- two sentences in to even find out why the patient came in. "Sent in by primary for abnl labs" happens but it isn't written... then because they have a wound- cx obtained but the abnl lab was the potassium and we are consulted with ED wound swabs that have been nuked with vanco zosyn for a week by the time we are involved for now good reason. Or fatigue, weakness as a reason but when you ASK the patient (because they tell you they have been fatigued for months)--- why today? It was a friend who died and it scared them. Or a kid who came to town and hadn't seen them for a year and they had lost weight. And then to the ED with more blood work and a week later we have a urine cx of unknown significance.
Why did you present to the ED and if a chronic complaint- why today? That data would be so much more helpful than what I read so often as I dig in trying to figure out the "why". To see if whatever positive cx or treating abx are relevant. So often they are not. Love having you back! Thanks.
Wow, I think a lack of healthy people was large part of Pfizer's excuse to get out of there Covid vaccine PMC (randomized placebo trial in 50 to 64-year-olds. I think the inclusion criteria Clinical trials.gov just stated "healthy" without defining it, and they still couldn't enroll I guess. But then there is the issue with the straight only showing 9% of sites activated and FDA's PMC tracker is still showing the studies pending which means no subjects enrolled. How much of that is due to lag is a question, but I still would like to see details on how much they actually recruited but anyway, I digress.
Brilliant!