General Health Plea

Triathlon Forum
1

I just got done answering a question about a possible heart attack which brought me to a pleas to all people out there.

Please find a primary care physician. It is very important to have a doctor who you can call and say I am having this this and this symptoms what should I do… This is far superior to what can be done over email or a web board.

If you have enough money to buy a set of wheels, you have enough money to go to the doctor.

Second I woudl highly reccomend that everyone get a major check up before planning on doing something like an iron man. An iron man is incredibly stressful on your body and can do some serious damage to your body if you have some type of underlying problem.

Third take all of the medical advice (mine included) you get on the internet with a healthy grain of salt. It is impossible to give an accurate diagnosis with what can be written in a couple of lines on a message board. I try to tell every one… it may be this this or this but the only way you can really know is if you go to your doctor. This is not becuase I don’t want to get sued but because it is the truth. The terms which a patient may use to describe their pain are easily misinterperted by a reader.

Point being
Your health is the most important thing. I enjoy speaking to all of you and would like to have you around as long as possible.

a final word
Just becuase you are in the best shape of your life, don’t fall into the trap of thinking that there can be no way that something is wrong with your health…

sorry to bring you down.

2

Very good points. I am a physcian and am sometimes shocked that people turn to a forum such as this for medical advise. SEE A PROFESSIONAL. There are a lot of wivestales, hearsay and plain bad advise floating around in this forum. And another thing, “alternative medicine” is just a bunch of crap to make money from homespun remedies which have not been proven to work by randomized double blinded studies. “Drugs” are just “herbs” which have been proven by the scientific method to actually work. Rant over.

3

alternative medicine simply means there is no reason to believe that it works. Once there is reason to believe it works it is no longer alternative. It’s always good to hear some common sense of this subject - thanks slick.

Taku and slick, my only problem is that it seems that dr.'s with any common sense are few and far between. How do you find a dr. that is any good?

My own limited experience, general practioner says he doesn’t know what is wrong with me and suggests checking with an allergist, ent (for sinus), and if all those come back negative, check with a neurologist. The allergist reports I’m allergic to proctically everything (BS!!). The ENT says I need my head drilled out to relieve pressure on my sinus - granted I live in Houston, everyone has bad sinus problems periodically. The neurologist comes up with his diagnosis as well. All 3 doctors say they are confident they have found the problem. The allergist and neurologist gaurantee 100% that they have found the problem and there can not be another reason!!! The ENT says he is only positive that I need my head drilled out but can’t gaurantee that it will stop the pain.

The only dr. worth a damm was the GP and he couldn’t help.

4

I am under no illusions that every doctor is fantastic… having said that having a doctor is better than nothing. It is unfortunate that people feel that they have to turn to a message board to get emergency medical advice…

If you are unhappy with your doctor act like the consumer that you are and shop around for another one… Like bikes fit is the most important thing

Perhaps one day I will open a doctor fitting buisiness and give Tom Demerly a run for his money

5

Is there any set of criteria for choosing a good dr? What questions should I ask him to determine if he is a good dr?

So far the only way I know is to try dumb luck until I find a good one. There are a lot of dr’s in the Houston area - random chance just isn’t going to work.

I don’t mean to be antagonistic, I’m just ignorant on this subject and hoping to learn from someone who may have some good answers.

6

I think it’s difficult to come with some question up in order to choose a good dr. I believe what taku wrote reflects a more realistic situation. I think you should ask your doctor to explain to you, in an understandable language, which conditions can cause the symptoms you present, which exams can lead to a final diagnosis, which treatments are available according to the evidence-based medicine, the pros and cons of all the alternatives, their possible side effects and expected results, and so on. If your dr is not able to answer you these questions in a consistent way, then you may want to look for a second opinion. Ask your friends or neighbors, do they have good drs.? Do they trust’em? Or ask one of the drs you trust: does he have any colleague of a given specialty that he could refer you to?

The situation you’ve been trough is pretty common nowadays, since drs. are becoming more and more specialized… Maybe if they talked to each other, they could exchange thoughts, reach a consensus, and give you a better treatment and a greater level of confidence…

7

My top 10 list of health…even though you didn’t ask for it:

  1. Doctors are people.

2.Some are better than others at getting a diagnosis right…that means that some are worse, and don’t get it right often enough.

  1. EVERY doctor makes mistakes…see #1 above.

  2. YOU, the patient, are responsible for making the choices which affect your health. If you don’t understand the doctor’s advice, either get the doctor to explain it until you do understand it, or get another doctor, or trust that the explanation is beyond your comprehension. Still, it is up to the individual to make sure their health is being cared for in the way that is satisfactory.

  3. Quit thinking there is a majic pill for every ailment.

  4. When there is a majic pill that miraculously can cure your ailment, quitcherbitchin about the cost. You can choose not to take it. It’s not a right to have the best healthcare in the world (at least, not yet, not in the USA), it is a priviledge, and unless that is changed, that is just the way it is.

  5. A good doctor is a treasure beyond measure.

  6. Exercise. Daily. Even if it is only mental exercise.

  7. Eat right.

  8. Don’t listen to good advice at your own peril…see #4.

8

if i might add to some of this stuff - i am an RN, and know a thing or two about doc’s. might as well say it, some of them, many, are somewhat arrogant a-holes. B-U-T as ktalon sez, they are people. they are trained to be able to reach into people’s chest cavities, and heads, and make decisions on the very thin line juggling a million different factors in a split second with life and death in the balance. and then do it again and again. frankly, it is the very very rare person who would do this routinely and NOT be arrogant to some degree. in fact, i think a certain degree of arrogance (confidence) might be just what i want in a dr !! same as in my military officer or general.

and, i do not mind calling dr’s "Dr., or “sir” one bit. frankly, they know than you or me and they deserve it. to equate their knowledge with some guy selling oriental pig’s bile is off the scale of silly, iff’n you ask me. same with the internet as our original poster suggested - apart from some random anecdotal “what does this mean for me” type question or the like.

9

“alternative medicine” is just a bunch of crap to make money from homespun remedies which have not been proven to work by randomized double blinded studies"

All right-I can’t let a dig at my industry go without a response. I don’t know what you mean by “alternative medicine”, but I assume you mean supplements. Maybe you don’t, and if that’s the case, please just disregard this “rant”.

One of the many problems I see with “medicine” is people don’t bother to read the actual studies done on supplements. They just read what the newspaper says, or what their pharmaceutical sales rep says, or what one of thier patients/coworkers/friends say. There are plenty of people who have an interest in perpetuating negative attitudes about supplements, and there are plenty of people that don’t know how to read a clinical trail. So it’s easy to get “misinformation”.

When it comes to supplements, there are tons of double blind, placebo controlled studies. There was a study quoted in the JAMA a couple of years ago stating that Ginkgo helped with the beginning stages of alzheimers’ disease. This doesn’t make this herb any less effective, it just means that no drug company can patent it since it’s a natural plant. And didn’t the JAMA just recently recommed that every adult take a multi-vitamin?

Having said that, I realize that there are tons of products out there that are just a big rip off. They are usually put out by companies that don’t have the history of testing their products. These companies are just in it for the money.

But to say that “alternative medicine is a bunch of crap” just doesn’t make sense anymore.

To turn it around, I could just as easily say things like “traditional medicine is a bunch of crap.” It’s a documented fact that “you” kill over 100,000 people every year. I don’t say generalizations like that because I think there is a time and place for traditional medicine, and a place for “complementary” medicine. I think there are some awesome doctors out there, and some terrible ones. Just like I think there are some companies/people in “complementary” medicine that are very reputable, and there are plenty of “quacks”.

I certainly don’t have all of the answers. Call me nuts, but I see a day when there are “clinics” that patients can go to that will have staff members that are “specialist” in not only traditional medicine, but also complementary medicine. These clinics would actually consult with the patients to see what type of protocals they are comfortable with. A place that would explain all of the benefits and risks of different types of healing options. I know that day won’t be here anytime soon, but I guess I can dream…

Jeff

10

Finding a good doctor is like finding a good plumber, lawyer, carpenter…etc. Word of mouth is probably the best way, and not from lay folk, from other docs. They know who is good and who isn’t. Also a certain doc may be excellent and still not be able to completely fix every problem. Some diseases/illnesses are very hard to treat without one clearcut “right” treatment. Sometimes it comes down to trial and error. Also a doc may be good but may not understand the specific problems facing triathletes.

11

“alternative medicine” is just a bunch of crap to make money"

Sure there is an awful lot of crap out there but that is quite a broad base statement. IMO it depends what you consider to be “alternative”. In twenty years of being a chiropractor I’ve noted that therapies such as spinal manipulation, accupuncture, herbal medicine, nutritional therapies, etc. that were considered “alternative” or even quackery twenty years ago by conventional medicine, have gained near mainstream acceptance. In some cases, conventional medicine is now even trying to claim these as their own. It’s been my observation that the doctors that poo-poo these therapies the most are usually the ones who know the least about it.

12

Show me well constructed unbiased double blinded randomized trials proving statistically significant results and I will believe ANY therapy as effective no matter how unusual. It’s called the scientific method. Most “alternative” therapies do not have a good track record in this regard. But hey, people will believe in all kinds of therapies without a shred of proof.

13

Sometimes it is really hard to find a good doctor (or any doctor at all if you live in Ontario, Canada). We moved about a year and a half ago and were fortunate enough to get in with my inlaws family doctor. The problem with many family practioners is that they don’t have a clue about training and obsessive-compulsive athletes! When I met my new doctor, he asked if I exercised at all. I told him that I usually did somewhere between 12 and 25 hours a week, depending on the time of year. His response was “aren’t you afraid of damaging your knees when you get older?”. AAAAAAARRRRRRGH!!! What kind of rehab advice/running injury recommendations would I get from him? Probably something like … “if you stop training you won’t have to worry about it”. Medical advice for athletes would be so much easier to get if all doctors did triathlons or ran marathons :slight_smile:

14

I can show you a summery of over 400 clinical studies showing the effectiveness of spinal manipulation with low back pain done in a government sponsored study called the Manga Report here in Canada. There are also lots of good studies dealing with accupuncture, as well as various herbal and nutritional therapies.

Doesn’t this pose an ethical dilema. These therapies obviously worked for very long time before anyone bothered doing a double blind study. More likely the only reason why the study was done in the first place was because of considerable emperical and testimonial evidence which prompted some researchers interest. Had practitionors sat around waiting for for a green light from some studies without first just going ahead with the therapies think of all the people that would not have benefited.

Most of these therapies do not have the collective might and bias of the highly profitable drug industry ad it’s historically collaborative partner the AMA behind them. Just because a double blinded study doesn’t exist, it doesn’t necessarily mean that a given therapy doesn’t work. It could also mean simply that a double blinded study hasn’t been done yet.

Let’s not forget that it was only fifty years ago when the official AMA position was that infants should be fed cows milk and not human milk. This was based on their study paid for by the dairy industry.

15

Spoken like a true chiropracter.

16

“Spoken like a true chiropracter.”
Well at least perhaps that means we’re predictable which is something I haven’t found with MD’s. Of the two around the corner from my office, one comes to me for the occasional treatment while the other barely even says hello. Interesting when you consider that we all share some of the same patients. http://www.slowtwitch.com/gforum/images/clear_shim.gif

17

There has been a long history of medical people being influenced by money. The details are fuzzy but there was a huge controversy with the american heart association and their dietary guidelines being influenced by industry…

Anyways since we got to the topic of “alternative medicine” Things work both ways also. 7 years ago there was a huge policy change where the vitamin industry lobbied the US government. Now vitamins don’t have to be tested for safety or otherwise. That’s why there is not standardization and very little testing with vitamins.

Hey you know what medicine have made some grevious errors in the past (liberal use of x rays) but things have changed. Hey but chiropractics is the same story too. The die hard traditionalist chiroprachter will tell you that ANY condition (cancer, TB, etc. ) can be treated with spinal maniuplation… Uh I would bet my life that you cannot cure cancer with spinal manipulation.

the point being no one has the right answers, that is whay research is done in all of these areas. The danger is when practices aren’t looked at and researched. You run the risk of cuasing harm, even doing nothing can be bad if there are other better treatments available.

Just so people know there is a large movement towards testing “alternative” therapies. If anyone is interested there is more information at

http://nccam.nih.gov/

18

“(liberal use of x rays)…but chiropractics is the same story too. The die hard traditionalist chiroprachter will tell you that ANY condition can be treated with spinal maniuplation…”

Taku, I can’t disagree with you. Those philosophically based “strait” chiros are an embarrassment and have impeded our progress into mainstream acceptence. Also the routine use of full spine x-rays is totally unnecessary.

As or myself, I have a musculo-skeletal orientated practice with based upon knowledge of biomechanics, orthopeadics and neuroolgy. If something comes into the office outside of my scope ofpractice it gets referred out to the appropriate specialist or to the family physician. I do see some sports injuries but probably 80% is either neck or low back problems. As for x-rays, I got rid of my x-ray machine years ago and use the local hospital and radiologists.

19

Before this gets out of hand I want to say that I don’t have a problem with all chiropracters, just those that can’t or won’t face the limitations of their treatment modality. For temporary symptomatic relief of chronic non-surgical back pain there may be some benefit although not all studies have shown this. At any rate if patients believe it helps I can’t see the harm. The problem lies in those chiro’s (and there are several in my town) who treat everything under the sun with “spinal adjustments” including ear infections, asthma, headaches, even cancer. One particularly dangerous chiro insists that children receive routine “adjustments” and NEWBORN BABIES be “adjusted” immediately after birth. If your profession wants any credibility it needs to conform to the scientific method and purge the teaching and practice of these unproven and potentially dangerous practices by some of your colleages.

20

Chiro’s no matter how much I think that 80% of them are idiots who take on the name “Doctor” via the internet (I know of one who is a PhD in “Color Symptomatic Illness” - no shit, $35.00 on the internet you can be a doctor too).

No matter the fact that Chiro docs are in the medical fields (mostly Ortho) considered “Quacks”

The fact is MANY people swear by them. Some are good, some are bad. You will get that with anything from bike mechanics to surgeons. It is not fair to put all Chiros in the same melting pot…unless you know that everyone in the field that you work in is pure as the driven snow, and 100% qualified.