Apparently, I was pretty bright at one time.  Last night, I was talking to one of my former patients when she reminded me of some of the advice I had given her over the last 36 years.  At the top of the list of advice that had served her well over the years was my offering to teach her enough about her body so that she would be comfortable knowing whether she should be seen by me or not.

It was my belief that a portion of every visit to my office should be an educational event. I believe that the more patients know about themselves, the healthier they would be.  One of my favorite lessons was teaching patients to trust their “gut” feelings.  “Gut” feelings are really based on a person’s inherent knowledge of themselves. 

You’ve lived a lifetime in your body.  Even if you are a typical male and ignore your body, subconsciously you learn how it feels and, if prompted by your doctor or wife, can recognize imbalances and abnormalities.  Over the years, I’ve made multiple brilliant, sometimes life-saving diagnoses, by believing my patients “gut” feelings.  My best was a young lady whose complaint was vague, “something is not right in my head.” She had no physical findings and no real symptoms of disease other than just not feeling normal.

Her “gut” was telling her something bad was happening to her.  I told her I could not find anything wrong but I pay attention to the “gut” so I would get a CT of her brain.  In the early years of my practice, I could actually order a test and have it done without talking to the insurance company. The aneurysm was found in time and surgically repaired.  She is still alive and kicking.

In today’s medical world, in order to get any test done, you must justify it to the insurance company.  “The patient’s gut is telling him/her that something is wrong” just doesn’t cut it. Nonetheless, follow your “gut” and tell your doc what’s going on.  Understand that your doc has limits to what he/she can do without sufficient findings but that, if necessary, you always have the choice of paying cash for non-covered tests.

I know that CTs can be expensive and money is always tight.  Insurance companies never say “no” to a test, they simply say they are not going to pay for it.  When it comes to a bad, leaky roof, most people will find the money necessary for a new roof or repairs even if they have to borrow it.  When it comes to their body, most patients will not do necessary tests or repairs on their bodies if the insurance company refuses to pay.  I’ve got to admit, I’m “most people” some of the time.  I’ll assess what the value of the intervention is, the risk of not doing it and the cost and,  on occasion, skip the intervention and save the money. 

Inbrija is an inhaled levodopa used by patients with Parkinson’s for its rapid onset of action and its ability to quickly relieve symptoms.  Levodopa is a very old medicine (fairly cheap); but because Inbrija is a modern remake of levodopa, its manufacturer charges a fortune for it.  My co-pay is $16,000 a year.  LOL! On average, for $16,000 a year, Imbrija will improve my motor function 15 minutes quicker than the pills I’m currently taking, which cost $240 a year.  I’ll just have to wait for my old medicine to kick in.

Here’s today’s joke.

A cop parks at the bottom of a bridge, waiting for a speeder. He pulls a man over for doing 40 over the speed limit, and says, “Son, I’ve been waiting for you all day.”

The man quickly responds, “Well, I got here as fast as I could!”

Here’s today’s music.


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