Tuesday, October 25, 2011

It is a balance

When we are sick, hurt, or in pain, we are trained to rush to the doctor and say 'heal me, cure me'.  The doctors are trained to examine, test, treat, and prescribe. And to avoid potential malpractice, they test, treat, and prescribe some more. I admit I am one of the people who is quick to run for treatment (am I a hypochondriac these days?) when I have an 'owie'. But I try to slow myself down.

I went to the doctor for my shoulder in early September because in mid-July I caught the corner of my car door in my shoulder which was extremely painful and bruised a week later but slowly got better so I ignored it. Then it started hurting again to the point that I spent the last weekend in August with ice on my shoulder for three days. At that point I was ready for a bit of medical attention. After an x-ray the diagnosis was I had done something to my shoulder and it was probably almost healed and then I overused it. I was told rest it some more and keep icing it. It is slowly getting better. I have enlisted help at the gym to tweak my work outs to help heal it and not re-injure it. There was a momentary flash of disappointment at the doctor's office that there was nothing else to be done. Did I want/need a prescription, test or procedure? No.

I am also 'discussing' my blood pressure/pulse issues with my doctor. We have currently agreed on a little more testing and if it is all normal I will get another medication. A lot of people think blood pressure medication is no big deal. But to me it is. I already am on five daily medications - two for my back, one for my well-being/sanity, one for my thyroid, and one for post breast cancer. I don't really want another one. If I could ditch them all I would. And balancing them is complicated. I take two pills when I wake up. I have to wait an hour before I can eat and take another round of pills before leaving for work. When I get home or at least four hours later I take my vitamins. Finally at dinner time I take another round of pills. If I add another one to the mix I will have to figure out a new schedule because some things need and empty stomach or a full stomach or can't be taken with other things. Its a balance I try to maintain and every new pill requires rebalancing.

If a doctor prescribes rest, lifestyle changes and a wait and see approach, I am happy to leave their office with those recommendations. I dislike the need for tests, procedures, and other medical adventures. Apparently there is a term in medicine for this called 'clinical inertia' which has some negative overtones. I don't think its negative. Tell me there are not millions of parents out there who are delighted to take their screaming, feverish child to the doctor and be told that it is a cold and will go away in a day or two and doesn't require antibiotics. Find me some patients who aren't happy to go to the doctor about a concern and are happy to be told that it will go away with rest and ice.

I would rather have clean x-rays than another medical (mis)adventure. I think Americans tend to be over treated in many areas. Too many antibiotic resistant infections are the result of over-prescription of antibiotics. Too many tests are ordered in a rush to get a diagnosis. A little more inertia or 'wait and see' might not be a bad thing for all of us.

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