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I’m going to the doctor today

I remember going to the doctor a lot as a kid. If it wasn’t strep throat almost every summer, it was a cold or the flu or something like that. I remember the smell of doctor’s offices, a kind of antiseptic smell to them. I also remember the doctor wearing a white labcoat and having this look of being very smart and caring. I never had a “bad” doctor.

Mom used to be the personal secretary to the director of the medical school in Juarez. Through her work there, I got to meet a lot of young, aspiring medical students who became physicians. The director of the medical school had his own lab, and he took me as an apprentice when I was 14 years old. That kicked off my interest in medicine, science, and then public health.

The plan all along was for me to get my bachelor’s in something science-related, then a master’s in some other thing, and then go to medical school or get a doctoral degree. I got my bachelor’s in medical technology and worked at a lab for seven years. During those seven years, I worked on my master’s in public health in epidemiology and went on to work at a state health department. Now, I’m working on the doctor of public health degree.

So why not med school?

Well, the more I saw what the physicians at the hospital where I worked went through to get there, the less I wanted to put myself through that. Don’t get me wrong. I admire them a lot — a whole lot —  for doing what they do. I’ve come to appreciate healthcare providers even more after meeting my wife, a physician assistant. But dealing with people on a one-on-one basis is not for me. I have too much of a big mouth and I would be in trouble all the time for telling it how it is to patients. I know plenty of providers who are like that (not my wife, though) and are always frustrated with their practice of medicine.

I chose the public health route because I get to take scientific knowledge and apply it to entire populations. In my job at the state health department, my reports on influenza activity influenced how providers acted when presented with an upper respiratory infection and how policy makers approached influenza vaccination. That’s some rewarding work right there. And I hope to do even more as a DrPH student and once I get that degree.

So why am I going to the doctor today? No big deal. It’s just a yearly check-up where I we get to discuss my overall health, and I get to hear him tell me about my weight. (Although my lungs have been a little irritated with the cold air after a bout of pneumonia a few years ago.) That really is my only problem, my weight. It’s not a small problem, but it’s not a huge problem. My blood chemistries are good. Cholesterol is good. Fasting blood sugar is good. Blood pressure is lower than the population average for men my age. I don’t smoke. I seldom drink. I don’t do hard drugs, or soft drugs for that matter. I try and work out, go play soccer.

It should be a good visit to the doctor… Though I do need to talk a better strategy on my weight. Being overweight is not a good way to be, especially as I get older. My chance of getting everything from diabetes to cancer is too high to be acceptable. So I’ll have that honest discussion with the doc, and try hard not to be one of those patients that think they know more than their physicians… Because I don’t. I never went to medical school, I wasn’t tested time and time again on the proper delivery of medical care, and I didn’t spend countless sleepless nights earning that medical degree.

When was the last time you had a chat with your doctor?

[do action=”credit”]Featured image credit: Alex E. Proimos / Foter / CC BY-NC[/do]

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René F. Najera, DrPH

I'm a Doctor of Public Health, having studied at the Johns Hopkins University Bloomberg School of Public Health.
All opinions are my own and in no way represent anyone else or any of the organizations for which I work.
About History of Vaccines: I am the editor of the History of Vaccines site, a project of the College of Physicians of Philadelphia. Please read the About page on the site for more information.
About Epidemiological: I am the sole contributor to Epidemiological, my personal blog to discuss all sorts of issues. It also has an About page you should check out.

1 reply

  1. Haven’t seen my doctor in quite some time.
    I’m hypertensive, controlled with an ACE inhibitor and calcium channel blocker combination. My cholesterol is frighteningly high, triglicerides as well. Can’t take a statin to save my life, I go into rhabdo quite quickly.
    Dietary control was a laugh, my cholesterol remained stable under the most draconian diet. :/
    I have protein in my urine, courtesy of my forgetting water one time when driving to the base in the desert with a broken car A/C. Ended up with a heat stroke that caused mild kidney damage and caused conduction changes in my cardiac rhythm.
    Indeed, I had noticed the protein when I came home, literally a week after the heat stroke. I was home on medical leave to have cataract surgery in one eye, replacing a trauma damaged lens. During the pre-admission testing, I looked at my ECG strip and *really* didn’t like the pattern that I saw.
    So, I had the tech run a second strip for my to give to my primary physician.
    My primary took one look and asked, “Can you see this cardiologist tomorrow?”
    As I only had a month medical leave scheduled, that was a big yes.

    The cardiologist took a look, then did his own ECG, proclaiming after that I had had a heart attack. My Q-T interval was a bit stretched, which sends the automatic readers into fits of “digitalis effect”.
    I chuckled at the good physician and explained that I had not had a heart attack.
    He said, “Yes you did.”
    Around $50k in tests later (thank heavens for good medical insurance!), he read the results and said, “You did not have a heart attack. You have a maximum of 10% blockage in only one artery. I’m at a loss to know why your cardiac rhythm looks that way or why you run so many PVC’s in a row.
    I related that his medical history missed one key fact: A week prior to that first ECG test, I had had a heat stroke and have extremely mild kidney damage.
    His response was, “Yes, that would do it!”

    I’m lucky. First, at the time, I was in excellent shape. I had just retired from the Army and had just started working as a DoD contractor.
    I’m also luckier than any human deserves. A heat stroke can destroy brain, heart, liver, kidneys and more. *If* it doesn’t kill you! It’s nothing to fool around with and I still kick myself for not bringing water, for the first time in years, with me when moving around outside in the desert!
    Meanwhile, my family history is a bit dire. Cancer, stroke, coronary artery disease, high cholesterol, easy weight gain, diabetes, vascular dementia, two turtle doves and a partridge in a pear tree.
    Someone didn’t urinate in my gene pool, they left something that most certainly was *not* a hershey bar laying at the bottom of my gene pool!
    So, I watch my weight, keep in decent shape, if not the peak shape I was in when I was in the Army. My joints don’t appreciate that much stress, these days. I test my blood glucose. I check my blood pressure.
    I’ll need to get with doctor and see what she thinks of high dose niacin. And also discuss my relatively recent increase in glare or bright scene induced scintillating scotoma. What was once or twice per year is now happening far more often.
    In a way, it’s sort of like a painless migraine. Increase of migraine activity without the “usual” triggers after age 50 can be a sign of vascular issues.
    Especially with someone whose total cholesterol hovers around 318.

    So, I haven’t been to my doctor recently. I did talk to her, as she’s my father’s doctor as well and he was just released from the hospital after making a comment suggestive of suicide and was grabbing his central line.
    Suicidal talk should always be taken seriously.
    His dementia and behavioral medications have now been a bit better tuned to him and his current condition.
    But, I’ll have to see her soon. Time for more labs to see how my chemistry is doing.
    It was *so* much easier when I was military, I’d simply order up my own labs and tests, have doctor or PA sign off at the end of the day.


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