Previous Thread
Next Thread
Print Thread
Page 5 of 10 1 2 3 4 5 6 7 9 10
kml #2915265 02/18/21 03:26 AM
Joined: Dec 2013
Posts: 1,922
G
Member
Offline
Member
G
Joined: Dec 2013
Posts: 1,922
Wow, KML. Interesting. Glad you are doing well and that your bf is having some good days.



3 kids
BD 12/15/13 (IDKIILY. )
Rope dropped Cirque du Soleil style
D final 9-9-14
"Some people are born on 3rd base and go through life thinking they hit a triple." Barry Switzer
kml #2915266 02/18/21 03:28 AM
Joined: Dec 2013
Posts: 1,922
G
Member
Offline
Member
G
Joined: Dec 2013
Posts: 1,922
Oh and sorry for the double post. My exh used to say Valentine’s Day was the most important day of the year. Apparently he feels different now. He told his wife this past weekend that it was a “$h!t, fake holiday” and that no one was getting anything. :-)



3 kids
BD 12/15/13 (IDKIILY. )
Rope dropped Cirque du Soleil style
D final 9-9-14
"Some people are born on 3rd base and go through life thinking they hit a triple." Barry Switzer
kml #2915267 02/18/21 03:34 AM
Joined: Jun 2019
Posts: 4,627
Likes: 71
T
Member
Offline
Member
T
Joined: Jun 2019
Posts: 4,627
Likes: 71
Wow, kml, you are an awesome individual--taking in CMM, warning about COVID here, and helping this fellow! The people I've known in the medical field deal with the emotional weight by compartmentalizing (the patience ceases to exist when they leave work) or keeping an emotional distance (the patient is a funny story). These patients and outcomes sound very important to you, and yet you don't seem overwhelmed.

kml #2915313 02/18/21 05:21 PM
Joined: Jan 2003
Posts: 18,913
Likes: 316
K
kml Offline OP
Member
OP Offline
Member
K
Joined: Jan 2003
Posts: 18,913
Likes: 316
There's a lot of burnout in medicine today unfortunately. I'm an old timer who has been practicing for more than 35 years so I remember the days when it wasn't like it is now. I've managed to avoid burnout in my later years by structuring my own practice the way I want. The downside is I don't make nearly the amount of money I would make working for a big organization (I make about half). The upside is I don't deal with insurance, I treat the diseases I am interested in (not doing general primary care anymore - they can see other people for their colds and vaccinations etc) and I spend one hour appointments with my patients, so I have the luxury of actually thinking about their diseases and listening closely to the clues in their histories.

Most people who go into medicine do so out of compassionate interests, but the grind and stress of medical practice today can beat that out of them. Some of course are just in it for the money, they're more likely to be in lucrative specialties. I could have gone into almost any specialty I wanted but I found in my training that I liked the variety of family medicine. I worked in a busy urgent care center early in my career and liked the variety and making new diagnoses.

I think, unfortunately, there's another factor happening in the US today besides just burnout. When I went to medical school, it was one of the best occupations you could aspire to, and it was very competitive to get accepted. It's still competitive, don't get me wrong, but the rise of Silicon Valley drained off a lot of good minds who could make their fortunes quickly in computers. I have heard of more stupid doctoring (i.e. stupid things said or done to my patients or their family members by other doctors) in the last ten years than I ever did in the whole rest of my career prior. It does worry me about the quality of medicine being practiced today. (My business partner and I have made a promise to each other to keep our medical licenses active in retirement just so we can treat each other if need be!).

Still - there are many caring family doctors out there and the best thing you can do is find a doctor you can stay with, who can get to know you, and who you can communicate reasonably well with. Good family doctors will recognize that they can't know everything but will be willing to read up on something if needed.

kml #2915314 02/18/21 05:39 PM
Joined: Jan 2003
Posts: 18,913
Likes: 316
K
kml Offline OP
Member
OP Offline
Member
K
Joined: Jan 2003
Posts: 18,913
Likes: 316
Quote
My exh used to say Valentine’s Day was the most important day of the year. Apparently he feels different now. He told his wife this past weekend that it was a “$h!t, fake holiday” and that no one was getting anything. :-)


Haha GB - just in case you thought his new wife was getting something better than you had - NOPE! Wherever they go, there they are.

kml #2915348 02/18/21 10:19 PM
Joined: Jun 2005
Posts: 2,265
Likes: 58
D
Member
Offline
Member
D
Joined: Jun 2005
Posts: 2,265
Likes: 58
Originally Posted by kml
. Still - there are many caring family doctors out there and the best thing you can do is find a doctor you can stay with, who can get to know you, and who you can communicate reasonably well with. Good family doctors will recognize that they can't know everything but will be willing to read up on something if needed.

So many good comments in this post and I agree with most. Funny I just dealt with this AGAIN today. For much of my life I had a GREAT family doc - internal medicine. He was VERY sharp. Took care of my mom and dad, took care of my grandparents and worked with and allowed me to be their daily providers into home hospice as the official nurse was granted an hour a day with them. He even took care of my exW for many years. It was an old fashioned practice with him and his partner. A few years ago he sold the practice to a huge provider here. I can’t blame him as I’m sure it was a very smart financial decision. They moved him into a brand new shiny clinic. His long time staff quickly got fed up with the new bureaucracy of the big conglomerate and quit. Clearly his plan was to retire which he did 3 or 4 years ago - less than 2 years after selling his practice. Luckily my health picture has not changed much but I’m already on my third new doctor. They come and go within a year. The staff sux. I did my last physical in April, for whatever reason my refills ran out yet they refuse to refill them because my doc is no longer there ven though I’m 20 months into my every 12 monty visit plan. Just crazy. And we are not talking oxy and Xanax or something - it’s flipping potassium! Rather than argue I just called one of my doc friends who called it in. I am pretty sure if I could speak to the doctor he’d just refill it. I just can’t get to him, never met him before so took this path. New guy started practicing in 1983 so wanna bet he retires in a few years and I’ll be onto doc #4. So yes, finding a long time doctor is great advice. Sadly it’s easier said than done. Sort of like finding a long time loyal partner in life.

And when you do get sick.... OMG. My dad is nearly 85. He’s not at all the typical 85. His quality of life is near mine. Other than he can’t Fng hear and refuses to get a hearing aid, he’s in great health, until out of nowhere he developed a plural effusion. I won’t go into it all but it’s turned into a fascinating case. After ruling out some of the common causes including PE and CHF, the somewhat young pulmonary specialist tells him “m pretty sure you have cancer.” They do a pluroscooy and install a Plurex catheter (very cool invention BTW) after which in recovery doubles down on he thinks it’s cancer - not only cancer but mesothelioma! That had came up already so I had researched it. About 3,000 people are diagnosed with mesothelioma in the USA annually. That’s TINY!!! 1.5 million get a plural effusion. Near100% is directly related to asbestos contact. Im like where did he encounter asbestos? Nothing in his history to indicate this. Other than the fluid buildup he has Zero symptoms- none. No cough, no weight loss, no bumps, no symptoms actually. He Triples down and says everyone gets something at the end of life and you just got this. He walks me through using the Plurex catheter and quadruples down saying, “this is exactly what malignant plural effusion looks like.” My dad took it better than I thought but I could tell he thought it was all over. By now I’m guessing readers know where this is going. NO CANCER. 27 slides were all negative and a second opinion from a renowned doc confirmed he was 100% certain it’s not mesothelioma or another cancer.

Why did this doc open his yap? I could immediately see the profound difference in my dad after he was told he didn’t have cancer the doc was humble about it and I’m confident or at least hopeful he won’t make this same mistake again but I’m sure it’s the same thing you are talking about. BTW the effusion has resolved on its own, catheter will likely come out. They will scan him every six months for two years to be certain and his lung has fully re-inflated and he’s back to 100% normal. I have to wonder how his original PMD would have handled all of this. Heck, his new doc said his lungs were clear - when he had a pneumothorax and was Absent base to midway up and clearly diminished on top. How could he miss that? He’s been useless in this entire case. Yes, it’s not common and it doesn’t even have an official name though there are several studies that have identified it and followed hundreds of patients with it. “Your lungs are clear but I’ll send you for a chest X-ray”. Oh look at that, your lung has collapsed due to nearly a half gallon of fluid compressing it. And they call him doctor.

The other best advice I can give everyone is you have to involve a knowledgeable family member or friend in your healthcare if you are sick. It’s a must. You cannot rely on today’s medical system with 10 minute rushed visits to figure out and follow the whole picture. This doc made a quick gut guess that likely would have been correct more often than not. He treated the machine and lab results - not the patient. He assumed my dad was the average near death 85 year old. He didn’t know my dads grandfather lived to his 90s, his father lived to 97 and mother to 95. You must be actively involved in your healthcare or find a friend who can assist you in that.


DonH
Midwest
Me 56
WAW-EXW 55
Met 11/95 / Married 5/00
Bomb 6/20/05 / She Filed on 6/2/06 / Divorced on 10/9/06
4 who'd qualify as GF since D & dated about 25 women since D
kml #2915360 02/19/21 10:51 AM
Joined: Jun 2015
Posts: 6,119
Likes: 408
B
Member
Offline
Member
B
Joined: Jun 2015
Posts: 6,119
Likes: 408
you are AWESOME

Originally Posted by kml
Well! I think I posted before about a patient I had, whose rare (but definitely taught in medical school!) neurological condition had been missed by three neurologists at his HMO even though I was telling them what his diagnosis was and the diagnostic bedside test I had done which was positive for this condition. So I've been treating him (cautiously as the medication used for this isn't used for anything else and I had no real experience with it) and referred him to an outside neurologist recommended by the organization for people with this disorder (this neurologist agreed with my suspicions and my treatment plan when we discussed the patient initially).

He saw her, and she recommended a repetitive nerve stimulation test to try to clinch the diagnosis (since his antibody tests were negative, as they can be in 10% of cases). Well he FINALLY had the test today and it definitely confirms the diagnosis!!!! He and I are thrilled! I mean, it's not great to have this disease, but to finally be vindicated with a diagnostic test that confirms the diagnosis! This means he can go back to his HMO and they will have to treat him for what he actually has, instead of telling him it's psychosomatic and sending him back to his psychiatrist!!!

This has been the single most frustrating experience of my entire medical career, being blown off by those a$$hats at his HMO when the diagnosis was textbook! I'm so thankful that the patient happened to know my son and my son asked me to help him. And he's elated, after so much medical gaslighting, to have his diagnosis confirmed with a test they can't argue with. I'm smiling pretty wide right now.


M 20+ T25+
S ~15.5 (BD)
BD 4/6/15
D 12/23/16

"Someone I loved once gave me
A box full of darkness.
It took me years to understand,
That this too, was a gift."
~ Mary Oliver
kml #2915379 02/20/21 05:28 PM
Joined: Jan 2003
Posts: 18,913
Likes: 316
K
kml Offline OP
Member
OP Offline
Member
K
Joined: Jan 2003
Posts: 18,913
Likes: 316
Well, after a slow start in January , yesterday I finally reached the 100 mile mark in my 1,000 mile challenge! I think I’ve figured out how to squeeze it into my schedule - the worst case scenario days I just pace while CMM makes dinner or during TV after. (He cannot handle me walking the neighborhood in the dark, even though it’s a super safe neighborhood; in his mind I think it just fills him with fear that something could happen to me and then where would he be?). I’m on pace to hit my February goal, and if I can keep this pace up, I’ll be able to finish the year with with a little leeway. Hoping to step the pace up slightly so as to give myself a month of leeway.

kml #2915381 02/20/21 05:54 PM
Joined: Jun 2019
Posts: 4,627
Likes: 71
T
Member
Offline
Member
T
Joined: Jun 2019
Posts: 4,627
Likes: 71
Originally Posted by kml
Well, after a slow start in January , yesterday I finally reached the 100 mile mark in my 1,000 mile challenge!

Great job! We're 50 days (1/7th) into the year, so you're close to the "ideal" 140 miles. Seems like a SMART goal--challenging enough to push you, but not overwhelming. Do you plan to enter any races this year?

kml #2915383 02/20/21 06:32 PM
Joined: Jan 2003
Posts: 18,913
Likes: 316
K
kml Offline OP
Member
OP Offline
Member
K
Joined: Jan 2003
Posts: 18,913
Likes: 316
I’m walking, not running - never been able to become a runner. If it weren’t for the pandemic I might sign up for a 5k that includes walkers - maybe later in the year it will be safer. I’d like to get back into my race walking gait once I get a little fitter - the last time I did a 5k a few years ago I think my time was 43 or 44 minutes, but I know I can do better if I get back into shape and train for it. Right now I’m still just working through muscle soreness and building back some strength, as I’ve done next to no exercise for the last year and a half. But that’s a good idea, to set a goal for a race later in the year and set a goal to improve my time. Obviously, I’ll have to get back out of the house to work on that race walking stride though lol.

Page 5 of 10 1 2 3 4 5 6 7 9 10

Moderated by  Cadet, DnJ, job, Michele Weiner-Davis 

Link Copied to Clipboard