Musings of a Dinosaur

A Family Doctor in solo private practice; I may be going the way of the dinosaur, but I'm not dead yet.

Monday, September 10, 2007

Just Being Healthy

Saw a patient last week, who kept insisting he just wanted to be healthy. His health was very important to him. Here's what he was doing to get and stay as healthy as he could:
  • He was exercising three times a week. He'd even gotten a personal trainer.
  • He was taking all kinds of vitamins and supplements, including a multivitamin, calcium, vitamin E and fish oil capsules.
  • He was taking colon flushes, to rid his body of toxins.
Here's what he wasn't willing to do just yet:
  • Get a colonoscopy (despite his age of 56 and a family history of colon cancer.)
  • Take meds for his LDL cholesterol of 195.
  • Stop smoking.
Believe it or not, I actually managed to keep a straight face. Where on earth to even begin?*

Did you know that self-inflicted tongue lacerations heal beautifully all by themselves? No sutures or prophylactic antibiotics necessary, either. Thank goodness for small favors.

*What I actually did, of course, was congratulate him for exercising; let him know that he'd probably be better off without the fish oil and vitamin E; and tell him that the colon flushes were woo. Mentioned that colonoscopy wasn't really that bad; neither were statins, though he wouldn't take a script; and talk him into trying Chantix.

14 Comments:

At Mon Sep 10, 08:27:00 PM, Anonymous RJS said...

Did you know that self-inflicted tongue lacerations heal beautifully all by themselves? No sutures or prophylactic antibiotics necessary, either. Thank goodness for small favors.

The mind boggles, right? I sometimes tell them to rinse with salt water a couple of times a day if they want. Keeps them happy because doing something is always better than doing nothing. :rolleyes:

Ditto the "My kid scraped his knee, what should I do?" questions.

Guh, keep it clean and dry. Neosporin on it if you want, but it's probably not necessary.

It's amazing how panicy people are in this day and age. Would any of these questions have been asked 100 years ago?

 
At Mon Sep 10, 09:32:00 PM, Anonymous Anonymous said...

Good job.
The guy is doing some things right, and could become more receptive.
Was his weight OK or coming down?

 
At Mon Sep 10, 09:48:00 PM, Blogger Hygeian said...

Oooh, thanks for the link.

 
At Mon Sep 10, 09:55:00 PM, Blogger Sid Schwab said...

Can't believe you don't believe in colon flushes! Why, I get emails nearly every day extolling them, and the internets are never wrong. As I've gotten older, I have had to switch to decaf, though. Those coffee enemas were keeping me awake.

 
At Tue Sep 11, 12:00:00 AM, Anonymous Anonymous said...

What's the issue with fish oil capsules? My ob/gyn has started eating fish several times a week and so I did some research and found that fish oil can be better than eating the actual fish because major manufacturers test each batch of oil for contaminants, and lots of fish have contaminants in their flesh.

 
At Tue Sep 11, 06:26:00 AM, Blogger #1 Dinosaur said...

(RJS: The tongue lacerations were mine. You know: trying not to burst out with my actual thoughts.)

 
At Tue Sep 11, 07:06:00 AM, Blogger The MSILF said...

At least he's exercising. It's not scientific, but my impression is that it's usually much easier to convince someone on colonoscopy than really getting them to exercise. You might change someone's mind on that, but very few couch potatoes actually will start moving, no matter what you do.

 
At Tue Sep 11, 05:11:00 PM, Anonymous RJS said...

"At least he's exercising. It's not scientific, but my impression is that it's usually much easier to convince someone on colonoscopy than really getting them to exercise. You might change someone's mind on that, but very few couch potatoes actually will start moving, no matter what you do."

Well some people *are* anal-retentive.

(Thank you, I'll be here all night.)

 
At Tue Sep 11, 08:24:00 PM, Blogger Midwife with a Knife said...

I will say that my colonscopy (I still can't believe that I'm writing about my colonoscopy on the internet!) really wasn't that bad at all. They gave me good drugs, and I remember waking up during the scope (although I wasn't uncomfortable at all), trying to ask what they were finding, all I ended up doing was grunting, and they gave me more drugs. They must have thought I was uncomfortable.

Actually, I was sick enough when I had it, a few months ago, even the prep didn't seem that bad. And then there's the bonus that the findings allowed me to get my ulcerative colitis treated, which made a huge difference in how I felt. Especially once my 'crit got above 30.

Having said that, I think it would have been much harder to talk me into a colonoscopy while I'm feeling fine.

 
At Tue Sep 11, 09:33:00 PM, Anonymous Kensington MD said...

Re colonoscopies: as the veteran of dozens of colonoscopies (diagnosed w/ ulcerative colitis when I was 12, then annual colonoscopies for thirty years, semi-annual for the past few years), I gotta tell you that if you're sane enough to get those wonderful IV drugs (some crazies, like my DH, decline), the colonoscopy itself is a piece of cake. I rarely recall any negative physical sensation at all, and I frankly love the sensation of the drugs. (Hey, I don't do illegal drugs, but I'm happy to enjoy legal ones!)

The worst part is the prep. Once that's over, it's all good.

 
At Wed Sep 12, 09:11:00 AM, Anonymous RJS said...

"The worst part is the prep. Once that's over, it's all good."

Unless it's an ileocolonoscopy, in which case DEATH TO THE GASTROENTEROLOGIST!!! >:(

(Unless you're completely under, of course.)

 
At Sat Sep 15, 08:15:00 PM, Anonymous Anonymous said...

Well, I met a guy once (it was a very short acquintance) who also told that his health was important to him, took vitamins and avoided sugar (no colon flushes, though). He also smoke (a lot), drank (a few beers and a glass of vodka every day), and at the time I met him was taking some performance-enhancing drugs to enable him to train harder for some adult swimming competition that had a money prize (I am not even getting into moral issues here). Now, I have no idea if steroids interact with alcohol, but this behavior didn't seem very healthy to me. But then, I am not a doctor...

Oh well, at least he exercised...

 
At Sun Sep 16, 09:07:00 AM, Blogger TBTAM said...

Just curious why you nix the fish oil...

 
At Mon Sep 17, 08:55:00 PM, Anonymous Anonymous said...

I turned down the colonoscopy, too. No history of any kind of cancer in my family for three generations back (a LOT of people). The scope itself, well, what if they nick my colon? But really it's the stuff you have to drink before going in that worries me. A friend got that far, ended up very, very ill from it, her electrolytes much out of whack for a while. What about that?

I do NOT understand people's aversion to exercise. I love it!

 

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