Lucky but Skeptical

Because I was married to an M.D. and most of our acquaintances were also doctors, I learned that the good doctor image is iffy. They are not gods, but a whole variety of people. In more recent years, as I grow older and have a few age-related medical problems, I have been lucky in my dealings with the medical world but retain an edge of skepticism.

These thoughts arise today because I am recovering from bilateral eyelid surgery yesterday. All is well as long as I don't look in the mirror at my red-rimmed swollen eyes. [I was warned this would be the case and am icing on schedule and it will go away.] Where does the skepticism come in? My doctor is part of a very large ophthalmological practice which I became acquainted with two years ago when I had cataract surgery that was thoroughly successful. Almost upon the first appointment the retina specialist mentioned that one eyelid was especially droopy while the other seemed fairly normal. This was mentioned on follow up visits so last summer I had a peripheral vision test that showed that indeed the eyelid -- in fact both lids -- interfere with my peripheral vision. So the surgery was eventually scheduled.
My skepticism arises from large medical practices that seem to gently push people toward procedures that are probably helpful but that they may not need in a serious sense. My hope is that I will see better and I have my own peripheral hope, which is that once the trauma to the area is healed I will look a bit more bright eyed and bushy tailed, that is to say a little bit younger.

This is not my first instance of wondering if I have had a procedure that was not strictly necessary. About 9 years ago my internist said my EKG was abnormal and sent me to a cardiologist who did a stress test and echo cardiogram in his office. He said there was some blockage and we should find out how much with an angiogram at a major hospital. It was scheduled, I was told very little but to bring overnight necessities in case ... The catheter was threaded up to my heart, the docs called my cardiologist and told him I had about a 60% blockage in the left ventricle, what about placing a stent? Do it, said the cardiologist who had not discussed this possibility with me, nor, as far as I remember did the hospital personnel although I think there was small print in a consent form I signed. The stent -- the latest version, of course -- was placed. It was a painless, short procedure, I was awake the whole time. I remained in the hospital, went home the next day with the need now to take the latest greatest blood thinner for three years.

It is my belief that in a smaller city I would probably have had angiography -- removal of the blockage--and no stent. And if a stent possibly not this super newest one. However, I did have a problem and it was treated and I've had no recurrence although I hated that blood thinner, especially as first the recommendation was one year and suddenly "new tests" showed that I should take it for three years. That seemed to me out and out manipulation by the pharmaceutical company. I feel much the same about the standard prescription for statins which every cardiologist now says I must take for the rest of my life. However, I happened to transcribe in the work I did a speech by one of two MDs who won a Nobel for discovering statins who said that he is still working on understanding them because all his data shows that only 17% of people using them actually from taking them. They have side effects, especially, for me, muscular fatigue when doing something like stair climbing. I believe I could keep my cholseterol at good levels through diet - indeed, I strongly suspect my diet and not the statin I take is responsible for my good statistics.

One other example of big city hospitals' possible over zealousness. [Procedures and devices are reimbursed by Medicare and are money makers for large institutions and doctors] When I broke my hip, the doctor explained afterward that he had implanted the latest and greatest artificial hip because, besides the actual break in the bone, there was some age related degradation of the hip joint. It is my belief that I probably didn't need an artificial hip and might have lived my entire life without problems once the broken bone healed. But I have my titanium joint and, happily, although there is widespread replacement of faulty artificial hips. this doesn't seem to be one of them.

I consider myself in good shape and have been treated by highly skilled physicians -- it is not they who make me skeptical, it is the medical establishment, big pharma and the device people who seem to overtreat when money is to be made.

Meanwhile my luck is holding out because this new operation was originally schedule for later in the month when I would have missed various activities because I don't care to be seen looking like I do at this moment. However I have over a week ahead with no appointments. I can say home and let nature take its curing course.