Saturday, October 31, 2015

Medical Nihilism

 The Worried Well



5 min video Like a Bridge Over Diagnosis



I think it was Hank Williams who sang "No one gets out alive".

Who said in Mad Magazine, "What me Worry".

My dad like to quote the British Navy saying: "You are taking youself too seriously.

"A hundred year old man said, "If I knew I was going to live this long I would have taken better care of myself."


I think the video above is great.  It has much good information. Much of it has to do with personal philosophy. 

 I have been a physician since 1973.
The most gratifying work I have done is the preventive work with medicine and cancer screening.

As an internists the plan is to prevent disease.
Vaccines are the best.
Medications during my career have become inexpensive, safe and extended life in people who are asymptomatic.

It's all about risk vs. reward.

Hypertension.
Diabetes.
High Cholesterol Particle Number
High Triglycerides.
Osteoporosis.

All have safe generic brand medicine available now.
Of course of medicine has potential side effects.
We have learned that using lower doses in combination can avoid many of the side effects.

Cancer screening.
To wait for symptoms before getting a colonoscopy is not a good plan.

Heart screening.
CIMT, CAC are inexpensive ways to find subclinical plaque early.  Rx early with low doses to eradicate the disease and avoid stents, strokes and bypasses.  100,000 sudden cardiac deaths a year with half of them having death as the first symptom.


 








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