Tuesday, June 3, 2014

Modern Medicine

After a rough year at Yellowstone, physically and emotionally, I was ready for a long period of relaxation and the chance to see some doctors. The health insurance I had in the park came in handy when I took a sixty mile ambulance ride in the middle of the night due to a kidney stone, but generally wasn't of any use since I didn't have access to anything more than basic medical care. 

While I waited for new insurance coverage here, I started doing some research and self-diagnosis. Considering age and weight and an almost complete lack of exercise last summer due to balance problems (maybe caused by the terrible diet I was living on then), and various symptoms, I leaned toward some stage of diabetes. I don't have a great record of diagnosing my illnesses--I think the only one I've really gotten right was plantar fasciitis a few years ago. Oh, and the childhood broken finger that was at a 45 degree angle. 

So when I finally got to a doctor here, the main thing I was concerned about was to see what my blood numbers were, and considering all those factors mentioned above, I thought I'd see if I could get my heart checked out. The doctor asked if I had insurance (not that we want to milk it, he said) and scheduled an echo cardiogram stress test which was fine with me, and a CT scan which was justified as a followup to a kidney stone I'd had six or seven years ago. I thought that was pretty ridiculous but went along with it.

I'd been eating better and exercising more for about a month before I had my first appointment, but was still amazed that blood pressure and glucose and cholesterol numbers were all better than the last time I'd had them checked a couple years earlier in the park. So another wrong diagnosis on my part. 

In the month between making the appointment and having it, I'd started having some strange arm pain so I wondered what the heart results would be. Being half naked and surrounded by four women working on me was pretty stressful, and I did some treadmill also. Other than feeling like the wand was going to get pushed through my ribs, there weren't any problems and the results turned out great--heart works, arteries clear. 

I started wondering about all the health warnings we get--I was overweight, getting old, ate lots of junk food, didn't belong to a gym or get enough sleep, spent a lot of years smoking and drinking--and still seemed relatively healthy. In the course of appointments, I several times encountered amazement that I wasn't on any medications. My theory is that for all the bad I did to myself, I was also a vegetarian for most of my life who cared about eating quality food when not eating junk, and never owning a car meant that I had always done a lot more walking than most people. I think I offset the negative.

I had a followup appointment a month after the first to go over results. CT scan results didn't find anything terrible either. There's a very tiny speck on a lung which would be ignored in anyone who had never smoked; in a former smoker's case, the protocol would be to look again in a year and then ignore if there was no change. Since I doubt I'll have insurance a year from now, it's good that I'm not the least bit concerned about this one--I rarely inhaled.

And I've got a big prostate which I've been told repeatedly all my life, and as with all men, it's presumably getting bigger as I get older. The doctor was more concerned about this and suggested a very invasive procedure, even as he said not to be discouraged because with modern medicine, normal was always changing. But my related symptoms haven't changed much in decades, and my PSA results were fine so I'm not too concerned about this either. In any case, I've decided against any further experimentation on myself, and realized that even with insurance and access to doctors, I'm still not going to get the type of medical care I want. I need a doctor who is more interested in listening than playing with the latest technology.

I thought back to a friend in Yellowstone and talks we'd had. Over the years, I've generally become a very reserved person, not given to having wide-open personal conversations with people, but in the past few years I had met a couple people in the park who seemed to have no walls and I was amazed how good it felt to have that type of conversation again. One was a woman who made a great hiking and dinner companion (I usually tried to get out of the employee cafeteria as quickly as possible, but shortly after we met, we had a two hour lunch conversation there.) and the second was a man who I didn't really talk to often but could always count on it being real when I did. 

At some point I'd said to him that I'd just as soon not know if I was dying or had cancer. (In fact, I even told the doctor here that I probably wouldn't want to have any major surgery due to my circumstances.) Months later, he reminded me I'd said that and wished that he didn't either as he described treatments and changes in his life following a cancer diagnosis. Although he's much more social than I am, and had known previous physical suffering, in terms of really close relationships we're each essentially on our own in life and we both acknowledged that a point comes when your best days are past and death wouldn't be the worst thing that could happen. I know my personality as well, and that for me on the subject of health, ignorance and denial is bliss, and knowledge would be hell. 

There's nothing suicidal about this (believe me, I've been there, almost done that) and knowing that my best days are past doesn't mean it's over. If I live as long as my grandfather, who didn't have the dubious pleasure of modern medicine for most of his century plus life, I've got almost fifty years left although I certainly don't expect or probably want that. But I do want some more on my terms, as long as I'm fully functional and independent.

I hope to get some more Yellowstone in six months, and should know before the end of the summer if that is going to happen.