“Currently 17 people die every day in the US waiting for a transplant, with more than 100,000 reportedly on the waiting list.”
David Bennett was only 57. Heart disease, and related issues are a big problem.
While I’m hopeful for this technology, I wish there was a way for people to see heart issues coming much earlier in life so they can attempt to treat, or delay, the problem.
If you've not had a checkup in the last year go and get one! It'll be included on your health insurance and the blood draw will include things like if you have high cholesterol.
Meh. Might be an American thing, if you watch TV or news the images of persons will be constantly telling you to ask your doctor about this, consult a medical professional before this other activity they advertise, and oh you gotta see a dentist every six months. Just demand creation, better just to get a blood-pressure test when you do see a doctor and a cholesterol test based on the result.
To be fair, all the ad revenue for pharma products on American television networks whose parents happen to own a news network also do a great job of building leverage against the pharma companies ever being investigated too deeply.
You can go to quest diagnostics or labscorb and order yourself a test for under 200$ (no insurance needed) that would do an entire panel on you. I did this and then called a teledoc for like 40$ (copay) and had them go over hte results with me. It's pretty sweet.
If you make 100K a year in Canada you pay $29,986 in taxes of which about a third goes to healthcare, so $10000 annually and you still won't get tested preventatively.
The difference is that the US cost is true whether you're wealthy or poor (above a certain margin). In Canada, if you make the median household income of $35k, you presumably pay proportionally less (or even less than that; I can't be bothered to look up the progressive taxation margins) in taxes, so $3500 max.
You got a cholesterol test and only a cholesterol test? That was what the parent comment is about. Tests vary a lot by test. LabCorp states their prices very clearly.
Hundreds of different ones. Granted you still need some level of medical expertise to be able to accurately interpret results on a lot of them but a smart enough layman could probably self diagnose some illnesses with enough homework.
We even need a prescription for repeat labs. So if my doctor is away for personal reasons for a month and I need to have my [thing that I get tested every month] checked, I can't without having to navigate the entire healthcare system to find a workaround.
I would be easy for me to interpret the results as my doctor is clear that [number] should not fall under [threshold]. It even comes back highlighted in red on the result sheet if it falls under that number. And I have clear instruction on what to do if that happens.
There is no real medical need for an ‘annual physical’ it is a creation of the American medical-industrial complex and creates more problems than it solves.
Having said that seeing a doctor occasionally for blood pressure etc is useful, but the interval for someone young and otherwise not experiencing any symptoms doesn’t need to be annually
Isn't there catch-it-early type diseases? Like breast cancer, testicular cancer, colon cancer, etc... that prove this wrong?
The funny thing is, the older you get, you are likely to have some sort of symptom. Such is life.
For blood pressure, I would expand and add general bloodwork for health conscious individuals or people with a family history for certain issues -- diabetes, liver, androgen, heart health markers.. Here in Canada you just need to mention you are interested for health reasons and a doctor refers you -- not sure how costly it is in USA -- but apparently private clinics are a choice to build custom panels.
For ‘catch it early’ you are talking screening. That’s why there’s cervical cancer screening (pap smear/the new cytology test), mammograms, faecal occult blood tests, in australia skin cancer screening, etc.
And that’s why people should have a regular doctor and that’s why as you get older you see your doctor more frequently. But for young(ish) otherwise healthy people, the whole concept of something ther occurs annually doesnt make sense.
In the other hand, since most screening and medical engagement is with females, you are left with lots of men who get into their 40s without ever having seen a doctor.
So - if thats you - go and see one, build a relationship, and if everything is good ask when you need to come back for prostate screening, FOBT, cholesterol or anything else. All across the board is unnecessary.
With regards to your last point, I’m all for devolving autonomy and power to the patient, but frankly across the board wide ranging blood testing (especially regularly) just doesn’t make sense for a significant percentage of people, unless there is a high pre test probability or a significant family history. All blood results are managed at the 95% CI so if you go in and have 20+ blood tests then more than likely at least one is going to be out of order. All you need to do is visit the askdocs subreddit to see the immense anxiety and flow down effects that has on a population who have absolutely no way of understanding a slightly out of bounds result. Those private clinics trying to spin up and do ‘wellness checks’ are frankly in my opinion, and until the evidence proves otherwise, a parasite on the worried well
If a person is otherwise healthy, no. Or at least, there is no medical indication to do so. But a person with pre diabetes is not generally otherwise healthy. T2DM is not a condition of a healthy person, it is a lifestyle disease caused by lack of exercise, poor diet and obesity. This person should see a doctor, but they’re not a healthy person. They should be aiming to exercise and reduce body mass.
I've heard many experts talk about issues with "catching disease early", one being that what doctors find might have never developed far enough to cause harm and so the treatment might actually be more harmful.
I don't want to risk trying to explain it from memory since I have zero medical knowledge, but there's a YouTube video by "MedlifeCrisis" about this that also has sources cited in the description. The title is something like "the problem with screening".
> one being that what doctors find might have never developed far enough to cause harm and so the treatment might actually be more harmful.
This is not a reason to not screen regularly. If treating very early is the problem then you should still aim to detect it early and then closely monitor it until you have enough information to decide whether to act or not. There are many people that will simply not go in for testing until there is a major problem if you advise against regular testing. A close family member of mine just passed away recently because he didn't go in for regular testing and they caught the cancer way too late.
> There is no real medical need for an ‘annual physical’ it is a creation of the American medical-industrial complex and creates more problems than it solves.
What problems does it create? Isn't preventive care a good thing? Also Japan does annual physicals much more rigorous that in the US. I wish what is done in the US was more rigorous because it would have caught the autoimmune disease that caused my kidney failure. Unfortunately by the time there are visible symptoms, the damage cannot be reversed.
Medicine can hurt as well as heal. A concrete example. Many doctors will advise you not to get a full body MRI scan. You can pretty easily buy such a service, and hire some radiologists to pour over every cubic millimetre of your body. But it's a really bad idea.
Because they will almost certainly find something ambiguous or troubling. And they're gonna biopsy. And then, well, maybe that's ambiguous. Another biopsy. You're terrified, the doctor's now worried about something they would never have known about otherwise, and maybe you have surgery to get it early. In the end the complications of all that quite potentially add up to a shorter life expectancy than simply not getting scanned in the first place. On average. Though of course, if you had a giant treatable tumour that shows up, well, you'd want the scan. But most people don't have one, and all those interventions can cause harm.
I agree in principle, but health literacy is so appallingly low - globally - that more often than not people are not equipped to deal with this information. As I said in an earlier post on this thread, look at the askdocs subreddit. 90% of the posts there are worried well asking for clarification of some unnecessary test they went and specifically asked a doctor for, the result of which they don’t understand and which is causing a cascade of health anxiety.
If every person understood enough to realise how many ‘abnormalities’ enough investigations would show up, and how in 99% of people they mean absolutely nothing, then it would be fine. But that’s not our current situation. And if you’re one of those people who are capable of parsing the dense health literature and understanding the implications (or not) of ‘normal abnormal’ findings, then go for it. But for the population as a whole? It’s not viable or helpful
Preventative care is different from the concept of all round comprehensive annual physical as it has been propagated through the culture from the American experience (I practice in Australia, so am talking from what I see from time working there, and the trickle through effect culturally of Australians thinking this is something they ‘have’ to have).
Preventative care consists of positive health messages (smoking cessation, moderate alcohol consumption, healthy diet, exercise), early identification of at risk individuals through family history, obesity, and then population wide cancer screening. Preventative care does not mean take a dozen tubes of blood and a pot of urine on every person every year.
I’m really sorry to hear about your kidney failure
Annual checkups are just that.
1) Body weight measurements.
2) The doctor talking to you about whether you have any medical or life concerns.
3) The doctor sharing advice on diet improvements, smoking improvements, exercise plans, including providing resources for them.
4) Recommended screenings based on age.
5) 1-2 vials of blood to get basic health information such as glucose levels, vitamin levels, etc.
6) Urine samples are only required if you're sexually active with multiple partners to screen for STDs and is completely optional.
That's been my experience. Through the annual physical I've been able to handle several minor issues, which have materially improved my life, and identified a major diagnosis that goes undiagnosed in the majority of people throughout their lives, and leads to them living significantly worse lives than they would have otherwise. By identifying it early, I have a chance for a much better lifestyle, and reducing the odds of an early death greatly.
Let me be really clear, everyone should have a doctor. But the concept of an annual checkup, as though there is a process to it and if you haven’t been to the doctor in the last 12 months is something you have to go through, is not part of general medical care. For the average under 30, and even under 40 male, with no family history, you are literally just pissing money away ordering annual vitamin, hormone and at some level lipid levels (although occasional checks are definitely useful).
The most invasive part is that they send the results to your employer. I initially balked at this, but you effectively don't have a choice if you want to work at a big company in Japan, although it's worth noting the legal requirement is on the employer to get the tests done, not on the employee to do it.
Having trouble taking satisfactory breaths while laying flat? See a doctor. Feeling out of breath abnormally while working out? See a doctor. Got an Apple Watch? Just for kicks take your ekg. It is crude but can detect abnormal heart rhythms.
You probably know this, but for anyone else reading - I have an Apple watch that has the EKG. It is a two-contact EKG, so it's limited in what it can see. It also requires you to actively look at it (you have to touch the crown while it's reading).
It did successfully diagnose a bout of bigeminy that I had, but unfortunately my cardiologist didn't think it was important, and I ended up having a heart attack anyway. But I lived, and now I have a new cardiologist, so there's that.
Not a lawyer so this is only anecdotal but It is actually very hard to sue a doctor unless its egregious to my understanding and your rewards are limited to the point where most lawyers are hesitant to take the case due to that. Have a family member that got a colonoscopy and the doctor commented after that there was a bit of a tough time getting it in but he just pushed a little harder and all was fine. That push actually perforated the bowel and he got sepsis and spent 3 weeks in the hospital and many months with a coloscopy bag. No lawyer would take the case.
Maybe in the US, probably not anywhere else. You'd have to prove actual negligence, and in this case, it's quite possible the doctor's decision was reasonable. Benign abnormal heart behavior is pretty common.
I’m not american and thought this would be a good generic word to convey “getting some answers/justice”.
I’ve had so many infuriating encounters with dismissive doctors, that I fear I’ll get into a similar situation.
The healthcare system is really strained, but does it have to give them the right to not take your “only annoying, not life threatening” level of simptoms seriously?
I do not have the resources to go for three different doctors to really make sure they are right about telling me “just don’t worry about it..”
How would you apply this to a child, or convey it to their parents?
The procedure has a profound effect on the family that receives the heart and on the donor family. Hearing donor family members describe what it’s like knowing their child’s heart is still beating somewhere is something you don’t forget.
I don't mean to be callous by this comment but if you mean "live differently" as living unhealthy well I have a problem with this. People that live in unhealthy ways cause all sorts of grief to others as well as financial loss. It is not right that I have to pay for people that decide to essentially eat themselves to death; it is not right that my wife and I had to care for my mother for months because she decided to eat herself to death. Heart disease and diabetes are all too common "paid" for by others - they should choose differently and while we can't make them choose differently we should for sure tell them that their choices are not "o.k.".
There are a whole host of heart diseases not spurred on by unhealthy living. Particularly diseases affecting younger folk who would inordinately benefit from a longer lifespan if we got better at transplanting.
As a selfish example, I have ARVC. I was diagnosed at 24 while training for my first marathon. Lifestyle treatments for my disease are to explicitly avoid exercise as it exacerbates the deterioration of my heart muscle. As I age, I expect to be at a much greater risk for the heart diseases that you would recommend "healthy living" for, as I will be categorically barred from one of the most important pillars of that, exercise.
I realize we're talking about the margins here, but as a margin, I would love more advancement in transplants.
Living is unhealthy. It’s universally fatal. In a free society we (should) retain autonomy over our bodies. This isn’t purely philosophical, it is practical. Who decides what is healthy? What if they are wrong?
How many eggs should I eat today to meet your personal definition of healthy living? And what do I do when it differs from someone else?
This is kinda an extremist straw man, though. I don't think anyone is claiming that the fields of nutrition and physical fitness are settled and that we know everything about what people need to do to be healthy.
But if you're obese and eat junk food all day, or if you just sit around on your couch and never get any exercise, and then end up with (for example) heart disease, that is something that was likely preventable, and we have a pretty good idea why and what could have been done differently. I'm force to subsidize these people's health care to some extent, and I think that's unfair.
The whole autonomy thing is tricky. We live in a society where we "care" for each other in collective ways (taxes etc.). People who want to live in that society lose some autonomy as a part of the bargain. I don't think this means we should legally force people not to eat or drink certain things. But I do think that (for example) denying people liver transplants when they won't stop drinking excess amounts of alcohol is fine. They can have their autonomy, but then they have to live with the consequences of their choices.
In all seriousness, I think there's obvious medical definitions for unhealthy in regards to addictions, weight, etc. Let's not philosophize some libertarian defense of something that obviously restricts and constricts one's freedom -- the ability to move an inch without your joints buckling.
I can sympathise with you if you have suffered from anti-fat bullying and adopt defensive attitudes in reaction -- but what the hell am I reading.
I agree - people need to be able to be called out when they are making bad decisions - especially w/regards to their health, and they especially should be called out by their health care providers - many doctors these days won't even broach the subject of a patient's weight, for fear of offending them - and I have seen patients file formal complaints against doctors when the doctor notes in their chart that the patient 'is obese'. It is right to tell them they are obese and it is right to encourage people to live healthier - how can you be a health care provider and not be allowed to call out people who are eating themselves to death?
Welcome to being an adult. People will do all sorts of things you think are not "OK", including people you're attached to. If you have kids, they will, too.
How we choose to deal with watching people do things we think they shouldn't is a matter of character.
I will say that I try hard to listen to people's criticism with an open mind, but people who badger me when they know I have considered their position, well, we tend to spend progressively less time together the more it happens. There's a difference between sharing information and punishing people for not complying, and I see no reason to accept punishment for something I don't intend to change about myself. A second-best fix for the problem, but better for everyone concerned.
It's only one self that can determine if one self is in balance or not. Just like we can lie to ourselves telling "everything is alright" while in truth it's not really the case.
But yes, as adults we can determine for ourselves. But it's a poor character trait not to be responsible for how you feel.
Well, we certainly do set up people for [heart] failure in our culture. Standard American diet is atrocious and I often day-dream about what it might take to transition to a culture around healthy, whole foods.
It's hard to imagine. And looking at the westernizing diet of the rest of the world, maybe that's a ship that never sails back. Maybe tech breakthroughs are the only hope we have if major cultural reform around health and food never arrives.
I wish the effect smoking has on the heart was advertised more.
People are terrified of cancer and that's all they think about with smoking, but actually far more people die from heart and stroke related illness after smoking than from cancer. I don't know the exact number, but it's a multitude.
David Bennett was only 57. Heart disease, and related issues are a big problem.
While I’m hopeful for this technology, I wish there was a way for people to see heart issues coming much earlier in life so they can attempt to treat, or delay, the problem.