My doctor retired, I might have mentioned. I had, for probably twenty-seven years, gone to this one doctor. He is a gynecologist. I might have seen a few GPs here and there to get something for a cold or something. I know when we first married FFP and I went to an Eye, Ear, Nose and Throat. Yes...eyes, too. That guys been dead a long time.

But I digress. Anyway...I was reasonably dutiful about getting a minimal checkup from this gyn who retired. At first his deal with me was 'no birth control pills after 40' because they aren't safe. (This was later more or less disproved except for smokers. He wouldn't prescribe them to smokers in any case.) So I got him to tie my tubes when I was 40. Which was the first time I'd been in the hospital since 1970. It was that micro surgery which, I must say, is really no big deal except for being blown up with air (which is uncomfortable when it dissipates) and having to fast which meant I got a headache from no caffeine.

But I digress, Sort of. My old gyn then was happy until I asserted that I had menopausal symptoms. At first he thought I imagined it because I was too young, I think. Then he started pimping HRT. That was then. I might say that he also: (1) always ran a blood test to look for anemia; (2) after menopause was clearly coming and done started pimping calcium supplements; (3) thought I should have a mammogram every year, not every eighteen months or two years like I usually did and was especially insistent when he had a financial interest in the screening center; (4) didn't pimp colonoscopy, the popular (and I believe expensive and painful) screen for colon cancer for those over 50 but did do a manual rectal exam; (5) always forgot that I had no right ovary during the exam and then recalled it.

The guy got me through menopause and a few years past the change while I resisted HRT and he changed his mind about pimping it. I was always pleased with just what he did each year, too. Listen to my heart and lungs, look in my ears and eyes, the pap smear, breast exam, organ exam, rectal exam, note that I wasn't the least anemic, talk about calcium supplements I never took (see food diary...are you kidding? with all that cheese?), talk about the mammogram if it had been over a year. The nurse would have run a urine sample through the lab and weighed me and taken my blood pressure.

So today I had a new doctor. First, the guy's name is the same as a 1960's underground cartoonist. Harumph. First thing I had to do was get beyond that. (He isn't related, he saw the documentary, he was nice about it.) In fact, the guy was nice and kind and did the talking before when I had my clothes on since it was my first time. He explained why he didn't do a rectal exam (the colonoscopy is so much better). He didn't push HRT, he didn't push calcium, he didn't order any blood work but wanted me to come back fasting and do cholesterol and all that. I declined. Actually he didn't say that, the nurse did. He did the pap smear and he listened to heart and lungs. (No eyes and ears.) The nurse ask if I'd gotten a 'primary care physican' since last year. This is so overkill.

So...why do I have this dad attitude toward doctors? Why is it that I don't think each one's procedure and particular drug and test pimping is a pronoucement from on high? Because...most of the time in my life when I've encountered doctors they haven't had a diagnosis when needed. I've been subjected to tests that didn't show anything, yada yada, while the few times I've had anything medical science was helpless with real help. Same for most of my relatives. I would say FFP's experience has been different. But this is about me.

As a kid I had colds, mumps, measles, sprained ankles and a bunch of good doses of pencillin until I developed an allergy to it. When I was ten, the psoraisis started. Remember the commercials? The Heartbreak of Psoraisis. My case is relatively mild but persisent. In that there is always a lesion trying to come around. Medical science hasn't ever done much good. The ultraviolet treatments helped but then will I get skin cancer one day? The creams and potions and baths didn't. Not really. Medicated shampoo, used daily, solves the scalp problem or it solved itself. Today I hear about cures but they are worse than the disease. It's no big deal, really. [Ed. note: The gynecologist always notes the random psoraisis lesion, both of them, with interest.]

So...really I only ever had one disease or condition requiring medical treatment. [Ed. note: If colonoscopy and menopause and pap smear were already making you queasy, read no further.]

Endometriosis. I hadn't researched this in a long time but it is a fairly common disease of women. Only in the sixties when my menses started it could only be diagnosed by invasive surgery. So, they pretty much waited until serious complications made surgery necessary and then said, "Look at that!" In 1970, my appendix became infected. That useless organ probably saved my life. My right ovary and appendix were enlarged with basically menstrual sluffing in the abdomen. The ovary apparently had bad tissue or there was back flow. There were adhesions to the intestine and stomach that had to be trimmed away. By a doctor I'd met five minutes before in the emergency room.

Now...big deal right? You are twenty-two, you have an appendectomy (albeit one that took an hour and involved removing the ovary and this other stuff and a major incision for an abdominal exploratory) and that's that. It was goodness, there is no doubt. Because I had suffered extreme pain since the first moment of my menses, month after month. My mother and I had sat in front of more than one doctor who (1) said it was 'normal'; (2) never suggested an actual condition that might cause it. I abused OTC pain meds. I took enough that my hands and feet became numb and then I could maybe not scream and take to the bed with a heating pad. Sometimes I even functioned through the pain. After the surgery, no pain. Occasionally I got cramps in my gut at random times...I blamed scarring from the surgery. If I could avoid stress or just relax a little (drink half a beer), it would stop.

So, yeah, that was my brush with anything serious for my health. Overlooked, undiagnosed, handled pretty expertly apparently by a strange doctor in an emergency room once the appendix acted as the ultimate diagnosis tool. Today, diagnosis is easier but still difficult (laproscopy is the only sure way).

Nothing in this made the everyday visit to a doctor one where I thought any problem I might have would have a solution.

Then there was my mother. In her fifties she started having blackouts and falling. Then couldn't find anything and finally put her on anti-convulsants which worked but had side effects, too, occasionally. If she didn't medicate correctly, bad things happened. Then she developed multiple myeloma. While she cycled through virtually all the symtpoms short of kidney failure (that almost came after diagnosis), various GPs and specialists shook there heads and didn't appreciate her pain. Finally, a crisis in the hospital made a doctor look for the disease. Which, in turns out, ain't so hard to diagnose if you only look. I think it's ironic that during this period, they were all over her to look at 'lung shadows' and mammograms. We do what we do as specialists. We look where we look. They couldn't get my mother a remission for this fatal disease. Doctor Cartoon (won't use his real name, obviously) said when I gave him this bit of family history that Multiple Myeloma was the disaease that they knew went back the furtherest in history because the characteristic bone drop outs could be seen in mummys.

Then there was my sister. She could have exercised more, watched her blood pressure, I guess. But. One day her head exploded. (cranial aneurysm). She stroked multiple times after the repair. She is lucky to be alive and able to walk. It could be genetic. My niece by blood and I were advised to get MRAs to look for these. Except. They can't always safely operate, very controversial. Sounds like an expensive test to insure you can't be insured to me. I think it quite funny that I couldn't get in to see a neurologist to discuss it even though I'd seen one years before after fainting during a mammogram. (No...I'm not a wimp. It was concluded that the compression of the chest by the plate and the holding of breath, which you are told to do, caused a classic syncope due to a chest compression with a valsalva manuever.) So, yeah, I couldn't see a neurologist to discuss this test suggested by one miles away because I didn't have a referral. I guess I need that 'family physician' after all. Still, my own research ruled out the test.

So. Nope. Doctors haven't made a deep impression on me especially for diagnosis. Maybe it's just me. I was lucky that one scraped the endometrium out of my gut successfully. It's extra hard to get a mammogram knowing that if they get that thing on your chest just right they can make you faint when they ask you to hold your breath. Meanwhile, the cancer my mother had...is it hereditary? Well..at least I'll know the symptoms, won't I?

Medicine is a wondrous thing. But tests and treatments can be painful and wasteful and useless. And one day you will die of something. We should be more circumspect about the usefulness and the results. With my few experiences, I can't help but be so.

As I walked out of the doctor's office, I was shaking my head because with my new medical insurance I have huge deductibles. So I'll pay for the whole visit. But I had to have them do an insurance claim so that the price could be adjudicated to something reasonable. Off the street, with a wad of bills, I'd have to pay twice as much.

 

 

 

 

 

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Somehow I felt separated from myself today. Drifting away from my physical self. But I didn't feel bad.