Tuesday, November 2, 2021

D-I-Y Medicine!

Increasingly, it seems we are going to be doing our own medical care at home!

We had our annual "physical" the other day.  Times have changed.  Our previous doctor, who passed away, did a full physical, including the old prostate exam.  Today, well, they rely on a PSA test - in fact, the annual physical amounts to little more than blood tests and maybe measuring your weight and blood pressure.  And the latter is often only to avoid malpractice, much as ophthalmologists do those glaucoma tests, after one was sued for not detecting glaucoma in a patient.

And yea, they listen to your hear to see it is still working, your lungs to make sure they are not full of fluid, you carotid artery (that goes to your brain) to make sure it is not clogged (as happened to my brother recently - which explains a lot!) and feel your glands to make sure you don't have a thyroid problem or some sort of infection.  Again, a lot of these "hands-on" physical examinations are C.Y.A. sort of things.  Most patients report symptoms of problems, but if a doctor failed to check - Oy!

Lately, I have been barraged with requests from my health insurance provider to sign up for "teledoc" so I can "see" a doctor if I have a question or need a prescription refilled.   Indeed, even our own doctor wants Mark to do a follow-up "telephone office visit" rather than come into the office.  To some extent, this is due to the pandemic - the fewer patients a doctor sees and touches, the less chance she will get CoVid or spread it to others.  It sort of makes sense.

For routine medical issues, it makes a lot of sense.  After my previous doctor died, I had to go to a "doc in a box" out by the Interstate.  They were competent enough, but the big deal was I needed to get my prescription refilled, which meant having a blood test and a signature.  So the doctor (or maybe it was a nurse practitioner, I dunno) basically read the results of the blood test along with me - and what each number meant.  It was kind of funny, because he basically read all that, word-for-word from the test results, which I also had in my hand.  So yea, a teledoc visit could have worked there.

In fact, it may work for a number of situations, and I am sure that like so many other things over the Internet, it will become even more popular as time goes on.

And part of this is the spread of what were once professional pieces of equipment to the average consumer.   We already have things like Epi-Pens for people with severe allergies, because they really are of no use to someone who is having an allergic reaction unless they are right there.  An Epi-Pen in a doctor's office is no use to the person choking to death in a seafood restaurant due to a shellfish or peanut allergy.

Similarly, home defibrillators have become a thing - and are appearing in more and more places, such as pools and restaurants and hotels.  Many people are having them implanted.  Again, a defibrillator may be less useful to someone having a heart attack, if it is 20 minutes away.  It also is a reflection of the increasing obesity and corresponding heart disease epidemic in this country.

So what's next? Well, home blood pressure monitoring is now a thing as well, and our doctor recommended getting one of these devices, which run from $25 to $50 or so.  It is not that we have high blood pressure (Mark's is slightly elevated) but that by taking blood pressure at home, we can skip an in-office visit the next time around.  It also helps to measure something if you want to control it.

Pretty soon, well, one wonders whether the home office and the home gym will be supplemented by the home medical center - with a plethora of devices to allow patients to examine and monitor their own condition.  I mean, what's next?  Home X-ray machines? (bad idea) or home CAT scanners?  (too expensive!).   One thing seems clear to me:  as technology improves, a lot of what was once limited to a hospital might become an over-the-counter home use thing.  Home heart cath, anyone?

Of course, the future never seems to arrive on-time, and maybe people are projecting too much into this trend.  Right now, a young woman is on trial for defrauding people by telling them that, at the ripe old age of 18, she invented some new kind of blood-test microchip that would revolutionize the medical field.  Maybe it is just me, but at age 18, I could barely wipe my ass, much less invent revolutionary things.  People who invested in that crap deserve what they got!

But it illustrates how folks want to believe that this sort of medical tech is right around the corner.  And maybe it is - or isn't.  Blood tests are still time-consuming and expensive, and are not the answer to everything.  Your PSA numbers go up too high, and many a doctor will say your prostate needs to be removed.  Some are wondering whether the complications from such surgery are worth it - particularly for a cancer that takes decades to kill - if ever.

Patient, heal thyself - is the old saying.  And a trip to the hospital makes me realize where it comes from.  While a number of patients are there for things they have no control over, such as hereditary defects and diseases, others, well, are there for self-inflicted illnesses, particularly obesity, type-II diabetes brought on by poor diet and lack of exercise.

A doctor can't make you live forever, and today's medical technology, while it seems all gee-whiz, will look incredibly primitive in 100 years - or even 20.  There is so much we don't understand about the human body, particularly the human mind and its motivations.

We are fortunate to be in relatively good health.  And our "numbers" are improving somewhat, as we have improved our diet and tried to exercise more - doing 10,000 steps a day and eating less junk food.  But of course, even with such measures, we can't hope to live but another 20-30 years, at most.  Anything beyond that runs into Guinness Record Book territory.  One has to be realistic about such things.

It is funny, in the last part of your life, when you are retired and have less responsibilities, you have more time to obsess about your health - which is a popular sport on retirement island.  And as your health inevitably declines, it seems to be a more important part of your life - indeed, it is your life.  You wonder why you wasted so much of life taking care of "things" and not yourself.  A fat man waxing his car and eating junk food has his priorities backwards.  The car will go to the junkyard before he will - or it should, anyway.

All that being said, I have no complaints.  Live a good life, be comfortable, be content. Trying to be rich or famous is nice and all, but not likely to ever happen.  And even the rich and famous shuffle off the mortal coil, often after their health fails - often prematurely.  But I digress.

It just seems somewhat odd to me, this trend of sending people home to take care of themselves.  What were once serious operations, requiring a week in the hospital, now are outpatient procedures, where you are sent home with a band-aid, often quite literally.  I guess this is progress, but it is funny how we end up doing more and more "D-I-Y" projects and at the same time paying more than in the past!

But then again, I guess health has always been something of a do-it-yourself project - if you want to stay healthy!

UPDATE:  A reader reminds me about home blood oxygen sensors, and of course, the plethora of diabetes-related equipment, such as blood sugar monitoring.  We have home pregnancy tests, and even home HIV testing as well - no doubt that sort of stuff will expand over time, depending on the technological hurdles.  A lot of this stuff runs off your phone (as our blood pressure monitor does) including - get this! - home EKG testing machines.

I am sure there are many, many more I am unaware of.  Back when I was a kid, our "medicine cabinet" consisted of a thermometer and a bottle of aspirin, and two band-aids.  How times have changed!

The fellows from EMERGENCY! are obsolete.  Now, it is only a matter of time before this is all built in to your body.  Blink twice and see your health stats projected onto your eyeball!

The home health center will surely be a feature of the next generation of mini-mansions!