Advertise on Bikeforums.net



User Tag List

Page 5 of 18 FirstFirst ... 3456715 ... LastLast
Results 101 to 125 of 450
  1. #101
    Wheelsuck Fat Boy's Avatar
    Join Date
    Jun 2007
    Posts
    6,159
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    Great Stuff, GeorgeB.

    People that have done their homework will probably tell the Doc to stuff their statins, but the vast, vast majority will just pop the pills without a question. It's really ugly stuff.
    Austin doesn't have hippies. They have slightly rebellious Methodists. - Racer Ex

  2. #102
    Long Distance Cyclist Machka's Avatar
    Join Date
    Jan 2003
    Location
    I ride where the thylacine roamed!
    My Bikes
    Lots
    Posts
    39,535
    Mentioned
    38 Post(s)
    Tagged
    0 Thread(s)
    Quote Originally Posted by HawkOwl View Post
    So, since patients have the legal right to refuse treatment why not just refuse? The downside to that is the patient is now marked as acting against medical advice. In short, being a non-cooperative patient. That can have some pretty serious consequences in the availability and quality of future treatment.
    Really??

    You're paying for a service ... you're the customer ... you're the one in control. You can give the Dr a bad review ... the Dr cannot give you a bad review. If you don't feel you're getting good service for your money ... go elsewhere. That's why they recommend getting second opinions.

  3. #103
    Senior Member GeorgeBMac's Avatar
    Join Date
    Jul 2012
    Location
    Pittsburgh, PA
    My Bikes
    2012 Trek DS 8.5 all weather hybrid, 2008 LeMond Poprad cyclocross, 1992 Cannondale R500 roadbike
    Posts
    1,809
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    Quote Originally Posted by HawkOwl View Post
    Probably the best supported review I've seen.

    Interestingly, my blood chemistry is excellent. But, today because of the new recommendations I fall into the group where statins are to be presecribed, ignoring all else. So, since patients have the legal right to refuse treatment why not just refuse? The downside to that is the patient is now marked as acting against medical advice. In short, being a non-cooperative patient. That can have some pretty serious consequences in the availability and quality of future treatment.

    The best hope is that, so far, these are only recommendations and may not be adopted by all providers.
    ... and to make matters even worse: The new standards dictate that the physician should start you on the highest dose available -- unless you are intolerant of statins, then he should drop down to a medium level dose...

    That is, the new standards have eliminated low dosages and only use medium level dosages when the patient can't take the highest dose.

    While they offer no evidence to support that (except vague blurbs about "studies have shown..."), most serious side affects occur at the higher dosages. YET THE NEW STANDARDS MAKE NO MENTION OF THE INCREASED RISK OF TAKING THE HIGHEST DOSES OF THESE MEDICATIONS!

    For instance, the FDA effectively removed Simvastatin 80mg from the market because:
    "The U.S. Food and Drug Administration today warned patients and healthcare providers about the potential for increased risk of muscle injury from the cholesterol-lowering medication Zocor (simvastatin) 80 mg. Although muscle injury (called myopathy) is a known side effect with all statins, today’s warning highlights the greater risk of developing muscle injury, including rhabdomyolysis, for patients when they are prescribed and use higher doses of this drug. Rhabdomyolysis is the most serious form of myopathy and can lead to severe kidney damage, kidney failure, and sometimes death"

    For some reason, the people writing the new standards simply forgot all about that warning from the FDA...
    --------------------------------------
    bikes: 1992 Cannondale R500, 2012 Trek DS 8.5, 2008 LeMond Poprad

  4. #104
    Senior Member GeorgeBMac's Avatar
    Join Date
    Jul 2012
    Location
    Pittsburgh, PA
    My Bikes
    2012 Trek DS 8.5 all weather hybrid, 2008 LeMond Poprad cyclocross, 1992 Cannondale R500 roadbike
    Posts
    1,809
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    Quote Originally Posted by Machka View Post
    Really??

    You're paying for a service ... you're the customer ... you're the one in control. You can give the Dr a bad review ... the Dr cannot give you a bad review. If you don't feel you're getting good service for your money ... go elsewhere. That's why they recommend getting second opinions.
    All very true ...

    But for the average Joe, working long hours, raising a family, and more interested in watching the football game than playing in one, (or researching cholesterol standards), they simply have to rely on the knowledge and expertise of their physician...

    Even for myself, I will often go along with a questionable opinion from one of my physicians if I think that, overall, his advice is good.

    Plus, the history and trust one builds with a physician who knows you is a valuable asset and one not easily abandoned...

    The best, I think, is to find a physician who values your opinion along with his own and will help you to find the best answer(s) for YOU.

    Actually, for myself, I am thinking that these new standards (as bad as they are) may be good medicine for the "Typical American, drinking beer, eating pizza and watching the football game", and trusting in his physician and the medicine he prescribes to fix his clogged arteries...
    ... (But the new standards do differentiate that kind of American from the type that frequent this forum).
    Last edited by GeorgeBMac; 11-18-13 at 08:10 AM.
    --------------------------------------
    bikes: 1992 Cannondale R500, 2012 Trek DS 8.5, 2008 LeMond Poprad

  5. #105
    Senior Member GeorgeBMac's Avatar
    Join Date
    Jul 2012
    Location
    Pittsburgh, PA
    My Bikes
    2012 Trek DS 8.5 all weather hybrid, 2008 LeMond Poprad cyclocross, 1992 Cannondale R500 roadbike
    Posts
    1,809
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    And, from today's (Nov 18th) New York Times:
    "Risk Calculator for Cholesterol Appears Flawed"



    http://www.nytimes.com/2013/11/18/he...flawed.html?hp

    ... And, what they point out is exactly my experience with it: It calculated my risk at about 50% greater than any other risk calculator I had ever used...

    But what the article does NOT address are the questions:
    -- Why would you prescribe a cholesterol lowering medication for somebody with high blood pressure?
    -- Why would you prescribe a cholesterol lowering medication for somebody who's only problem is old age?

    Even if the calculator was excellent at predicting risk, that doesn't mean that every risk factor can be cured with a statin!

    From the article:
    "Some doctors who tested the calculator with hypothetical patients wondered if they should trust the results.Dr. Nissen entered the figures for a 60-year-old African-American man with no risk factors — total cholesterol of 150, HDL (the good cholesterol) of 45, systolic blood pressure of 125 — who was not a diabetic or a smoker. He ended up with a 10-year risk of 7.5 percent, meaning he should be taking cholesterol-lowering statins despite being in a seemingly low-risk group.
    Dr. Nissen also calculated the figures for a healthy white man, age 60, and also got a risk factor of 7.5 percent.
    “Something is terribly wrong,” Dr. Nissen said. Using the calculator’s results, he said, “your average healthy Joe gets treated, virtually every African-American man over 65 gets treated.”
    Last edited by GeorgeBMac; 11-18-13 at 09:41 AM. Reason: Add Dr Nissen quote
    --------------------------------------
    bikes: 1992 Cannondale R500, 2012 Trek DS 8.5, 2008 LeMond Poprad

  6. #106
    New Orleans
    Join Date
    Jan 2006
    Posts
    2,527
    Mentioned
    6 Post(s)
    Tagged
    0 Thread(s)
    The guidelines identify four high-risk groups who could benefit from statins: people with pre-existing heart disease, such as those who have had a heart attack; people ages 40 to 75 who have diabetes; patients ages 40 to 75 with at least a 7.5% risk of developing cardiovascular disease over the next decade, according to a formula described in the guidelines; and patients with the sort of super-high cholesterol that sometimes runs in families, as evidenced by an LDL of 190 milligrams per deciliter or higher.


    The 3rd group- 7.5% risk etc-that is the "RUB"
    1)Had an MI- ok
    2)Diabetic-OK
    4)Freakishly high LDL-ok
    3) 7.5% risk over 10 years- of developing cardiovascular disease-this is responsible for the HUGE- doubled-increase in folks who could be put on statins

    Oh-I take Lipitor-it makes me "feel foggy logy" which is very hard to quantify-and I'm medically jargon adept-so an older person-on lots of meds-how in the world are they going to even "Know" something isn't right.
    How do you quantify "I feel foggy"?
    Now I'm just going to take it once a week-Friday- so I can recover on the weekend when i don't have to be sharp.

    There are other meds in the works-testing etc-that "might" be a bit more specific
    But since some/most of the statin good effect-might be do to decreasing inflammation -at the blood vessel wall-by as yet undefined mechanism- if these new meds concentrate on cholesterol-they will miss the boat.

    Sucks to get old

    PS On the bright side My Saints beat the MUCH HATED 49's-so all is well.I don't know why I care-but i do.

  7. #107
    Wheelsuck Fat Boy's Avatar
    Join Date
    Jun 2007
    Posts
    6,159
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    Quote Originally Posted by GeorgeBMac View Post
    Dr. Nissen also calculated the figures for a healthy white man, age 60, and also got a risk factor of 7.5 percent.
    “Something is terribly wrong,” Dr. Nissen said. Using the calculator’s results, he said, “your average healthy Joe gets treated, virtually every African-American man over 65 gets treated.”
    You're being naive if you think this is the practice of medicine. The calculator assumes practically everyone 'needs' this medicine at just about the same age that the government starts paying for it. This is nothing more than marketing.
    Austin doesn't have hippies. They have slightly rebellious Methodists. - Racer Ex

  8. #108
    Senior Member GeorgeBMac's Avatar
    Join Date
    Jul 2012
    Location
    Pittsburgh, PA
    My Bikes
    2012 Trek DS 8.5 all weather hybrid, 2008 LeMond Poprad cyclocross, 1992 Cannondale R500 roadbike
    Posts
    1,809
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    Quote Originally Posted by phoebeisis View Post
    ...

    I'm medically jargon adept-so an older person-on lots of meds-how in the world are they going to even "Know" something isn't right.
    How do you quantify "I feel foggy"?
    ...
    .
    In heart medicine, the medical community has been well conditioned to dismiss any and all 'something isn't right' conditions...

    In my own experience:
    -- When I developed a full blown myopathy from a statin my physician blamed it on too many trips to the gym.

    then, later, when I developed muscle weakness from a different statin:
    -- my cardiologist had no comment on it and basically ignored it.
    -- my wellness physician blamed it on an unrelated medication I was taking...

    In all three cases, the message from the physicians was clear: they were taking the 3 monkey's position with regard to statins:
    See no evil, Hear no evil, Do no evil...

    The same is true for cardiac stents and bypasses: the physicians doing the are great at expounding their benefits, but few will they tell you about their "side affects" not will they tell you that they will NOT prevent future cardiac issues ... (Ask Bill Clinton)
    --------------------------------------
    bikes: 1992 Cannondale R500, 2012 Trek DS 8.5, 2008 LeMond Poprad

  9. #109
    Senior Member GeorgeBMac's Avatar
    Join Date
    Jul 2012
    Location
    Pittsburgh, PA
    My Bikes
    2012 Trek DS 8.5 all weather hybrid, 2008 LeMond Poprad cyclocross, 1992 Cannondale R500 roadbike
    Posts
    1,809
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    Quote Originally Posted by Fat Boy View Post
    You're being naive if you think this is the practice of medicine. The calculator assumes practically everyone 'needs' this medicine at just about the same age that the government starts paying for it. This is nothing more than marketing.
    ... Was that slam either necessary or warranted?

    These are the supposed recommendations of our leading physicians, researchers and organizations...
    ... I have only pointed out their deficiencies, but I have not speculated on the reasons for those deficiencies...

    But, you are probably right. Big pharma had a major role in these guidelines.

    That is: while the committee rightly states that none of those voting on the new guidelines had connections to big pharma, they are less vocal about the fact that over 50% of those RESEARCHING and RECOMMENDING those guidelines came from those most likely to profit from these guidelines...

    As for the Dr Nissen comment that you quoted: yesterday, before it was pointed out how bogus this calculator is, he was supporting these guidelines! STRONGLY supporting these guidelines!

    from 'the Heart':
    "Dr Steven Nissen (Cleveland Clinic, OH) said the guidelines are a "radical change" from ATP III, but he agrees with moving away from the traditional targets. "Those goals, of less than 70 or less than 100 [mg/dL], were never based on any kind of careful scientific study," said Nissen. "They were helpful to physicians and patients because they were a target. The guideline writers threw out those goals and are working very hard to identify patients in whom statins provide benefit."
    Nissen also said treating patients with a calculated risk exceeding 7.5% is a lower threshold for treatment than previous guidelines and likely expands the use of statins to millions of patients who would not have otherwise been treated under the ATP III guidelines. What will help is that the drugs are so cheap, now that all the statins, with the exception of rosuvastatin, are available as generic medications"
    Last edited by GeorgeBMac; 11-18-13 at 11:16 AM. Reason: add Dr Nisen comment
    --------------------------------------
    bikes: 1992 Cannondale R500, 2012 Trek DS 8.5, 2008 LeMond Poprad

  10. #110
    Wheelsuck Fat Boy's Avatar
    Join Date
    Jun 2007
    Posts
    6,159
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    Quote Originally Posted by GeorgeBMac View Post
    ... Was that slam either necessary or warranted?
    I'm not sure why you took this personal because it was not directed at you. It was merely a general statement/opinion.
    Austin doesn't have hippies. They have slightly rebellious Methodists. - Racer Ex

  11. #111
    New Orleans
    Join Date
    Jan 2006
    Posts
    2,527
    Mentioned
    6 Post(s)
    Tagged
    0 Thread(s)
    Quote Originally Posted by GeorgeBMac View Post
    In heart medicine, the medical community has been well conditioned to dismiss any and all 'something isn't right' conditions...

    In my own experience:
    -- When I developed a full blown myopathy from a statin my physician blamed it on too many trips to the gym.

    then, later, when I developed muscle weakness from a different statin:
    -- my cardiologist had no comment on it and basically ignored it.
    -- my wellness physician blamed it on an unrelated medication I was taking...

    In all three cases, the message from the physicians was clear: they were taking the 3 monkey's position with regard to statins:
    See no evil, Hear no evil, Do no evil...

    The same is true for cardiac stents and bypasses: the physicians doing the are great at expounding their benefits, but few will they tell you about their "side affects" not will they tell you that they will NOT prevent future cardiac issues ... (Ask Bill Clinton)
    Your myopathy-from "working out to hard" a guessing-middle aged male ? Your enzymes were elevated etc.

    1)Did your MDs actually MEASURE your pre statin strength-peak strengh or perhaps some sort of exhaustion strength"
    Easy enough to have someone do leg presses-a max or near max-or just have you see "how many reps can you do with 150 lbs" sort of thing?
    Zero chance right? No one actually measures strength of loss of strength in "how many reps with 150 lbs sense"

    My wife "discovered" her problem-she was gardening-and LITERALLY couldn't get up.When i got home-I tested her-how far down could she "squat"
    it was roughly 110 degrees(upper leg low leg angle-knee angle)- 3 days after stopping/dropping her 40mg lipitor-she could go past 90 degrees-to 80 degrees
    So yeah-MDs are at fault because they aren't measuring per statin "strength" offices aren't set up to measure it-MDs do blood tests fancy imaging studies

    But the MAIN PROBLEM with statins
    1) Hard to quantify "I feel foggy loggy sore" which i "FEEL" memory a bit "off"
    2) No one measures pre statin strengh
    3) Damn STATINS WORK!! Yeah in certain groups-folks who had an MI- they make you less likely to have a second one.
    Yeah-big problem-the WORK better than the other "pills"
    Not GREAT not curative but they work "some"


    Stents-don't prevent future MIs-they increase blood flow-meaning you can do more work-now oldsters with plenty of other problems-the extra potential flow-is never needed-they aren't running the mile.Docs usually don't claim they prevent MIs-maybe at that VERY SPOT- but that is just 2cm of artery-and it CAN replug-and stents help athletic older bike riders-yes less exercise induced angina
    Member here was having exercise angina-got stent-all should be well-but he only had angina when climbing HARD-1/100,000 oldsters need that sort of heavy duty cardiac output.
    Last edited by phoebeisis; 11-18-13 at 12:57 PM.

  12. #112
    Senior Member GeorgeBMac's Avatar
    Join Date
    Jul 2012
    Location
    Pittsburgh, PA
    My Bikes
    2012 Trek DS 8.5 all weather hybrid, 2008 LeMond Poprad cyclocross, 1992 Cannondale R500 roadbike
    Posts
    1,809
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    Quote Originally Posted by phoebeisis View Post
    Your myopathy-from "working out to hard" a guessing-middle aged male ? Your enzymes were elevated etc.

    1)Did your MDs actually MEASURE your pre statin strength-peak strengh or perhaps so sort of exhaustion strength"
    .
    Clinical myopathy is not necessarily connected with strength (although it is often confused with that).

    Rather, myopathy from statins is the destruction of muscle tissue and it is the predecessor to Rhabdomyolisis -- which happens when the junk from the dead muscle cells clog the tubules of the kidneys and you die.

    To be diagnosed with full blown "myopathy", your CK (Creatinine Kinase) levels must be significantly elevated -- which is the clinical indication that the muscle cells are being physically destroyed, not just weakened. There are preceeding lesser levels to myopathy with different names that do not require the elevated CK levels.

    Oftentimes (although physicians are loath to admit this), muscle weakness from statins is caused by them blocking the production of enzyme Q10 which the mitochondria need to produce the ATP that is the fuel used by the muscle cell's...
    --------------------------------------
    bikes: 1992 Cannondale R500, 2012 Trek DS 8.5, 2008 LeMond Poprad

  13. #113
    Senior Member GeorgeBMac's Avatar
    Join Date
    Jul 2012
    Location
    Pittsburgh, PA
    My Bikes
    2012 Trek DS 8.5 all weather hybrid, 2008 LeMond Poprad cyclocross, 1992 Cannondale R500 roadbike
    Posts
    1,809
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    Quote Originally Posted by Fat Boy View Post
    I'm not sure why you took this personal because it was not directed at you. It was merely a general statement/opinion.
    Sorry, it sounded like it was directed at me rather than in general...
    --------------------------------------
    bikes: 1992 Cannondale R500, 2012 Trek DS 8.5, 2008 LeMond Poprad

  14. #114
    Senior Member
    Join Date
    May 2008
    Posts
    2,429
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    Quote Originally Posted by Machka View Post
    Really??

    You're paying for a service ... you're the customer ... you're the one in control. You can give the Dr a bad review ... the Dr cannot give you a bad review. If you don't feel you're getting good service for your money ... go elsewhere. That's why they recommend getting second opinions.
    While that the patient is the customer may appear true, in fact it is not. The customer is the insurance company, the government, or wherever payment for their services comes from. You, as the patient, are merely the carrier of the disease, problem, or whatever that allows them to get paid.

    Your medical records follow you. So, once certain labels, drug seeker, difficult patient, etc., are applied you are approached in quite different ways. If you are labled as a person who acts AMA there are providers who will not touch your case under any circumstance. If a provider has elected certain insurance and business models you won't be seen, period.

    Then there is how the insurance company handles your claims. Well, you get the idea. The medical industry is a business. Business comes first, not solving your individual problems. But, that is way off topic here.

  15. #115
    New Orleans
    Join Date
    Jan 2006
    Posts
    2,527
    Mentioned
    6 Post(s)
    Tagged
    0 Thread(s)
    Quote Originally Posted by GeorgeBMac View Post
    Clinical myopathy is not necessarily connected with strength (although it is often confused with that).

    Rather, myopathy from statins is the destruction of muscle tissue and it is the predecessor to Rhabdomyolisis -- which happens when the junk from the dead muscle cells clog the tubules of the kidneys and you die.

    To be diagnosed with full blown "myopathy", your CK (Creatinine Kinase) levels must be significantly elevated -- which is the clinical indication that the muscle cells are being physically destroyed, not just weakened. There are preceeding lesser levels to myopathy with different names that do not require the elevated CK levels.

    Oftentimes (although physicians are loath to admit this), muscle weakness from statins is caused by them blocking the production of enzyme Q10 which the mitochondria need to produce the ATP that is the fuel used by the muscle cell's...

    Sorry I was unclear. My "your enzymes were elevated etc" comment was supposed to have made that clear-myopathy=muscle damage.

    I was referring to the MUCH more common-complaint of "muscle weakness" and muscle soreness.These are COMMON statin complaints-but how in the heck can you measure muscle weakness-if you didn't measure it before the statins were given?? Simple-you can't detect small amounts of weakness if you don't have a baseline. Sure if someone can't get up-yeah muscles weaker-but it would be simple(well simple if they were equipped to do it) to pretest.
    The weakness could be from actual myopathy-damage- or from the drop in enzymes involved in "using" your muscles.The enzymes blocked by the statins.

    But make no mistake-if you have clinically diagnosed myopathy-your muscles will be weaker-and it would be easy to measure-but you have to measure it BEFORE you take the statins.

  16. #116
    Senior Member GeorgeBMac's Avatar
    Join Date
    Jul 2012
    Location
    Pittsburgh, PA
    My Bikes
    2012 Trek DS 8.5 all weather hybrid, 2008 LeMond Poprad cyclocross, 1992 Cannondale R500 roadbike
    Posts
    1,809
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    Quote Originally Posted by HawkOwl View Post
    While that the patient is the customer may appear true, in fact it is not. The customer is the insurance company, the government, or wherever payment for their services comes from. You, as the patient, are merely the carrier of the disease, problem, or whatever that allows them to get paid.

    Your medical records follow you. So, once certain labels, drug seeker, difficult patient, etc., are applied you are approached in quite different ways. If you are labled as a person who acts AMA there are providers who will not touch your case under any circumstance. If a provider has elected certain insurance and business models you won't be seen, period.

    Then there is how the insurance company handles your claims. Well, you get the idea. The medical industry is a business. Business comes first, not solving your individual problems. But, that is way off topic here.
    +1
    ... But there are some physicians who try to actually treat the patient (within limits of course!)
    --------------------------------------
    bikes: 1992 Cannondale R500, 2012 Trek DS 8.5, 2008 LeMond Poprad

  17. #117
    Senior Member
    Join Date
    Apr 2010
    Location
    SoCal
    My Bikes
    Roubaix SL4 Expert , Cervelo S2
    Posts
    2,398
    Mentioned
    3 Post(s)
    Tagged
    0 Thread(s)
    Quote Originally Posted by GeorgeBMac View Post
    In my own case, the spreadsheet gives me a 6.8% -- so I should not be taking a statin. But, next June when I turn 64, my number will automatically change to 7.5% and they will try to put me on the highest dosage of statin the FDA will permit -- only because I turned 64!
    Actually the risk factor spreadsheet says a 63 y/o white male with optimal risk factors has a 7.5% risk of developing ASCVD in the following 10 years. That's right, every single white dude who turns 63 y/o should be going on a statin according to these guidelines even if they have optimal risk factors. You would actually need to be significantly under the optimal values to have a risk <7.5% starting at 63. And of course, the research has shown there's no benefit to longevity to being to being on a statin after the age of 70.
    Last edited by Dunbar; 11-18-13 at 01:34 PM.

  18. #118
    Senior Member GeorgeBMac's Avatar
    Join Date
    Jul 2012
    Location
    Pittsburgh, PA
    My Bikes
    2012 Trek DS 8.5 all weather hybrid, 2008 LeMond Poprad cyclocross, 1992 Cannondale R500 roadbike
    Posts
    1,809
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    Quote Originally Posted by Dunbar View Post
    Actually the risk factor spreadsheet says a 63 y/o white male with optimal risk factors has a 7.5% risk of developing ASCVD in the following 10 years. That's right, every single white dude who turns 63 y/o should be going on a statin according to these guidelines even if they have optimal risk factors. You would actually need to be significantly under the optimal values to have a risk <7.5% starting at 63. And of course, the research has shown there's no benefit to longevity to being to being on a statin after the age of 70.
    I agree

    but, just to clarify; I don't hit the magic number of 7.5% until 64 because my numbers are actually a little better than what they consider "optimal".
    --------------------------------------
    bikes: 1992 Cannondale R500, 2012 Trek DS 8.5, 2008 LeMond Poprad

  19. #119
    Long Distance Cyclist Machka's Avatar
    Join Date
    Jan 2003
    Location
    I ride where the thylacine roamed!
    My Bikes
    Lots
    Posts
    39,535
    Mentioned
    38 Post(s)
    Tagged
    0 Thread(s)
    Quote Originally Posted by HawkOwl View Post
    Your medical records follow you.
    No ... they don't. I wish they did. But they don't. It takes a huge amount of effort to have your medical records follow you and even if you put in that effort, chances are your medical records are going to get lost anyway.

    Maybe they do for some people, but unfortunately, I've got hardly any medical history following me around.


    The thing to remember is that doctors, and the medical profession in general, are not gods. They are people just like you and me. You, the patient, are free to take their advice ... or not.

    If you don't like one doctor, you are free to go to another until you find one who is on the same page as you. And if all the doctors in your neighbourhood want to push drugs and you think you can accomplish the same thing through diet and exercise, you have the choice of not going to any doctors at all ... or maybe trying something in the alternative medicine line.

  20. #120
    Has opinion, will express
    Join Date
    Jun 2003
    Posts
    13,007
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    I just said less than a week ago "No" to a cardiologist who was suggesting that statins may be something I should take. I pointed out that my cholesterol levels have been about the same for more than 10 years and that "no thanks, I'll modify my lifestyle" was my answer to his intimation. He sees no need to pursue my course (and that is in writing).

    However, there was an interesting development in my "heart attack" diagnosis from 16 or so years ago after the tests I had done. I won't go into details, but "broken heart syndrome" is something that has been diagnosed as a heart attack when it's not, and providing the patient survives the incident, a return to normal heart function happens in most cases.

    Fortunately, my medical record doesn't follow me around like a bad smell unless I allow it to for one reason or another. Doctor-atient confidentiality means a lot in Australia.

    By the way, if you are paying health insurance premiums or tax, you are the customer one way or the other.
    Dream. Dare. Do.

  21. #121
    Senior Member GeorgeBMac's Avatar
    Join Date
    Jul 2012
    Location
    Pittsburgh, PA
    My Bikes
    2012 Trek DS 8.5 all weather hybrid, 2008 LeMond Poprad cyclocross, 1992 Cannondale R500 roadbike
    Posts
    1,809
    Mentioned
    0 Post(s)
    Tagged
    0 Thread(s)
    Quote Originally Posted by Rowan View Post
    I just said less than a week ago "No" to a cardiologist who was suggesting that statins may be something I should take. I pointed out that my cholesterol levels have been about the same for more than 10 years and that "no thanks, I'll modify my lifestyle" was my answer to his intimation. He sees no need to pursue my course (and that is in writing).

    However, there was an interesting development in my "heart attack" diagnosis from 16 or so years ago after the tests I had done. I won't go into details, but "broken heart syndrome" is something that has been diagnosed as a heart attack when it's not, and providing the patient survives the incident, a return to normal heart function happens in most cases.

    Fortunately, my medical record doesn't follow me around like a bad smell unless I allow it to for one reason or another. Doctor-atient confidentiality means a lot in Australia.

    By the way, if you are paying health insurance premiums or tax, you are the customer one way or the other.
    I cannot speak for the tax -- but with insurance: Yes, in the doctor's office you are the customer. But when you become a patient in a hospital, things change. Your treatment is MOSTLY based on hospital protocols and what the insurance company will or will not pay for. Much of medical treatment is determined through negotiations between the hospital and the insurance company. But the patient is never, ever part of those negotiations. Instead, they are informed of the result -- and usually it is attributed to being a medical decision rather than a financial one (even though it is not).
    ... In short, I have seen far too many patients being told they were OK to go home, not because they were OK, but because insurance had stopped paying for them.
    --------------------------------------
    bikes: 1992 Cannondale R500, 2012 Trek DS 8.5, 2008 LeMond Poprad

  22. #122
    Long Distance Cyclist Machka's Avatar
    Join Date
    Jan 2003
    Location
    I ride where the thylacine roamed!
    My Bikes
    Lots
    Posts
    39,535
    Mentioned
    38 Post(s)
    Tagged
    0 Thread(s)
    Quote Originally Posted by GeorgeBMac View Post
    ... In short, I have seen far too many patients being told they were OK to go home, not because they were OK, but because insurance had stopped paying for them.
    Different countries ... different situations ...

  23. #123
    New Orleans
    Join Date
    Jan 2006
    Posts
    2,527
    Mentioned
    6 Post(s)
    Tagged
    0 Thread(s)
    GeorgeBmac-
    Exactly
    My wife has a terrible autoimmune vasculitis-Polyarteritis Nodosa or Churg Strauss depending
    Her Rheumatologist decided he wanted to give her Rituximab-expansive monoclonal antibody-depletes kills off B lymphocytes cells(immune cells)
    He had to get approval from insurance company-an involved sort of back and forth negotiation -because she didn't have an antibody-ANCA-
    They approve it for ANCA positive "easily" but not so easily when ANCA negative
    For Many expensive medications or procedures-there is a negotiation-back and forth- between doctor's "insurance person" and the insurance companies
    "gotta approve" person.
    Now some of this is to improve patient outcomes-but much of it is cost driven
    Even now medicine isn't completely evidence driven because the evidence just isn't clear-or not there.

    Rowan"He sees no need to pursue my course (and that is in writing)."
    So the doctor said "he passed on the only therapy I can offer-no point in my seeing him anymore"
    Is that about it?

  24. #124
    Long Distance Cyclist Machka's Avatar
    Join Date
    Jan 2003
    Location
    I ride where the thylacine roamed!
    My Bikes
    Lots
    Posts
    39,535
    Mentioned
    38 Post(s)
    Tagged
    0 Thread(s)
    Quote Originally Posted by phoebeisis View Post
    Rowan"He sees no need to pursue my course (and that is in writing)."
    So the doctor said "he passed on the only therapy I can offer-no point in my seeing him anymore"
    Is that about it?
    Nope not at all.

  25. #125
    New Orleans
    Join Date
    Jan 2006
    Posts
    2,527
    Mentioned
    6 Post(s)
    Tagged
    0 Thread(s)
    Quote Originally Posted by Machka View Post
    Nope not at all.
    Machka
    Rowan wrote-"Fortunately, my medical record doesn't follow me around like a bad smell unless I allow it to for one reason or another. Doctor-atient confidentiality means a lot in Australia."
    My guess is he -rowan-feels fortunate the record DOESN'T follow him- because this cardiologist more or less wrote "I don't want to see him because he wasn't interested in my suggested treatment" a negative sort of comment-I think- perhaps "code" to other MDs "this patient is difficult"
    which is why rowan feels fortunate it doesn't follow him.

    It is hard to say just what "he sees no need to pursue my course" actually means??
    Polite way of saying- "please don't come back" ??

Page 5 of 18 FirstFirst ... 3456715 ... LastLast

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •