How do you know though? Everything you say in your post seems very much like the OP’s husband who distrusts doctors.
They aren’t just pulling this shit out of their asses- it’s evidence based and usually very well considered. Just because you didn’t want to go through surgery, and pestered them into stenting you, doesn’t mean that you got the treatment with the best outcome, or that it was the right decision for your health. It was merely the one that you were the most comfortable with in the moment, which IMO is NOT much of a reason to choose a treatment over another. It’s about as stupid as not wanting to get vaccinated for COVID, shingles, flu, etc… because the side effects make you feel bad for a day. Penny wise and pound foolish as the saying goes.
So you believe that “feeling bad for a day” is exactly comparable to major surgery that will leave you seriously disabled and in pain for at least six months – and that’s provided that you come out of it alive, that is, which is far from certain. That’s totally asinine bullshit.
And, incidentally, I did a lot of reading about this before trying to get the doctors to agree to my decision, and it turns out that PCI (percutaneous coronary intervention – fancy term for stenting) has been gaining favour over bypass surgery in recent years due to improving technology both in locating optimal stent placement and in the composition of the stents themselves.
Nope, feeling bad for a day certainly isn’t comparable to major surgery that required six months to recover from - but here’s my story.
It started with an abnormal stress test , which sends me to the cath lab where I received a stent. Ok , fine so far. Four years later, another stress test, another stent in the same artery. Two years later , after prepping for a colonoscopy ( which was scheduled because of a positive FIT test) , I started to have a rapid heartbeat and shortness of breath. Turned out I had a mild heart attack. Angioplasty with no stent this time - one of the prior stents had scar tissue blocking it. So back on Plavix for the third time. I still haven’t had the colonoscopy and the cardiologist won’t take me off Plavix until a year after the angio unless it’s urgent, which it wasn’t. I end up with a different test that isn’t as accurate the colonoscopy but doesn’t require me to go off the Plavix. Completely unrelated to all of this, a nodule is found on my thyroid . Two biopsies and a genetic test say there’s a good chance that it’s cancer and I should have it removed - but the risk in going off the Plavix is greater than the risk of waiting six months for the surgery.
So now I have been to the cath lab three times, had three procedures, will have been on Plavix a total of around three years by the time I’m done , put a colonscopy off a for a year and put the thyroid surgery off for six months. I can’t help but wonder if I would have been better off having bypass from the beginning - and I couldn’t know it was going to turn out this way when I got that first stent.
Not my spouse but my long term boyfriend is an alcoholic with gout, severe depression and anxiety and VERY bad sleep apnea. And really really bad psoriasis.
His depression is keeping him from working so he doesn’t get medical insurance. Now I’m chomping at the bit to get him on Obamacare this time around. He’d probably get it for super cheap. Then he can get some help for something. Anything. Help for any of those problems would be such a boon for his life.
We’ll see tho. He’s not my spouse and we don’t live together so technically not my circus. But I love the idiot so I want to help. He’s had medical insurance in the past and didn’t use it but we’re in a different place in our relationship now so maybe I can convince him.
He doesn’t need to live forever but he’s only 44, he could at least put some effort into living better while he’s here.
No. He can work just fine. Or if not he’d have to admit to a doctor he’s too depressed to work, but he’s not. He’s living in a situation that is very specifically triggering to his anxiety. He definitely has the psychological conditions of depression and anxiety but there are loads of things he could do to not trigger those conditions. Right now honestly he’s just being lazy.
Specific to the claim that some things may be looked for an found that were possibly better left not looked for - certainly the possibility gets raised by some expert committees. (Other experts may come to other conclusions.)
I suspect though that more are done than not for both. And there are definitely some who do other tests of questionable utility in those without specific risk factors, various labs and screening EKGS …
Not a spouse, but a friend (M 50) and relative (F 76) who wouldn’t see a doctor about persistent digestive issues. Leading eventually to discovery of Stage 4 stomach cancer (M) and complete blockage of the lower intestine and an ostomy (F), and both fatal within 18 months. This is Canada, so no cost issues, just stubbornness.
Indeed, you just can’t always know for certain what the best approach is. The best we can do is make an informed decision based on the circumstances – and by “we” I specifically mean a joint decision between a medical professional and an informed patient. My decision involved two competing factors. One was that this particular cath lab had especially advanced technology and expertise and was in fact a participant in one of the field trials that was helping to establish PCI as an increasingly viable alternative to bypass surgery. The difference in intrusion and risk is staggering; PCI is done under mild sedation and can be an outpatient procedure; bypass is major open-heart surgery. The other side of the coin is that bypass remains the gold standard for treating multiple arterial stenosis.
Thanks for your story. At least, being in Canada, my difficult decision wasn’t being further complicated by the meddling of insurance company bureaucrats.
As a sober alcoholic, with psoriasis and arthritis I can only say that he might be self medicating. I’m off the booze, but the only way to get enough sleep is with pills. So I’ve traded one addiction for another, but this one doesn’t damage me in nearly the same way. My rheumatologist told me substance abuse is very common among her patients.
Also - apnea. It got a lot better when I quit drinking.
I agree with Thudlow_Boink. Average benefit far exceeds average risk of untoward outcome for an average visit to a bona fide health care practitioner.
Otherwise I’m through with trying to motivate people to make healthy/rational medical choices, after over 4 decades of dealing with that issue. I will make exceptions for personal friends and family, along with those who approach me directly to ask my opinion about specific matters.
No doubt. I used to be in charge of the IT systems for my company’s occupational health physician review service. The whole point was as a hedge against fraud AND for insurance companies to make sure that the treatments adhered to the guidelines.
There are definitely quacks out there, but they don’t represent the majority of the doctors, nor the profession as a whole.
My sympathies, I was that spouse at one point for the very same reason, though my quantities were a half-gallon of whiskey every 2 days. A mistreated UTI led to sepsis, which led to a hospital stay where I had to admit to my problem, and to rehab. Haven’t missed a doctor appointment since. Wish it would do some good for you to tell him I said “Go to the doctor, dumbass!”
Most are actually quite good! And health maintenance visits with some frequency makes sense. Even if I can’t say what the frequency ideally should be. Pretty sure though that the OP’s spouse doesn’t really believe that docs are all quacks. He’s scared and it is, in the short term, easier to ignore the big hole, look in the other direction, than to pick up a shovel and start filling it in.
The OP is not about the relative value of health maintenance visits and awareness that there is nuance to the position that screening is good (not always better on average than not screening, but what is of more benefit than potential harms evolves as screening methods and treatments do) …
It is about someone with health problems they are aware of who is actively avoiding getting care for them.
It is about the OP’s frustration with their spouse’s avoidance of dealing with their health, and the problems it imposes on them as they feel obligated to enable the destructive behaviors (and not only self-destructive as the OP is being harmed too).
Not a doctor of adults but you don’t have to be to know that to ignore a non-healing large “sore” is quite possibly ignoring a skin cancer until it has metastasized, that each gout episode allowed to happen makes future ones more likely to occur (and while the behavioral changes advised to reduce risk are great to make for many reasons, gout medicines are very effective.) Substance abuse and addiction is tough, to treat and to be around, and this time of year is very hard on those at risk of alcohol overuse.
@teelabrown, it sure sounds like he’s not ready to deal with his alcohol problem. I defer to the QtM as being extremely expert here on how you can help yourself about being stuck with the consequences of his illness as someone who loves him. But it may also be that fear of having to be confronted over his alcohol use is what is driving his avoidance of all health care.
It may be more effective to present a visit not as needed for the overwhelming intractable problems but for the easiest to fix one? Hitting bottom with an epiphany probably won’t happen until way too late. He is in physical pain now. There is medication that can prevent future gout flares and thereby prevent them occurring more and more frequently that can work even if everyone agrees to ignore the elephants in the room of alcohol overuse and obesity. For now. Get him through the door focused on that, not the big problems that overwhelm and that he wants to pretend don’t exist, and while there get a derm referral to get the possible skin cancer looked at. Maybe just maybe he will actually see a real person talking and listening to him and get beyond some fictional quack image in his head seeing a real person who he can start a health partnership with. It might not happen but it can’t happen if he doesn’t get through the door into that first meeting.