> What disappoints me the most here is now that I feel like it's all on me to determine what my real risk levels are and what's appropriate to treat this.
A convoluted set of circumstances led me to a quick detour in grad school, to sit in on Anatomy at Harvard Med. This included the dissection portion, in which four med students hunch over the cadaver for 3-4 hours at a time. It lead to some of the best medical conversation I've had in my life.
The best topic was summarized as: When you visit a doctor, odds are that he/she has about 15 minutes to an hour to evaluate you before moving onto the next case (often because there are bills to pay.) If you are not an expert on your particular medical history and circumstances, then you are basically screwed, because there is nobody human who can digest all of your medical history and circumstances in the allotted amount of time. It still essentially holds true if you have some serious condition: Consider all of the other patients on the doctor's plate.
That, combined with several other stories and experiences, had a big effect on me: It became obvious that it is worth enormous amounts of time and money to keep fit. When it comes to the med community, the only way to win is not to play.
I was having frequent acid reflux and 2-3 nights a week, I'd wake up choking on it. This lead to issues with difficulty breathing and shortness of breath.
My doctor treated me with an inhaled steroid for the breathing difficulty and a PPI for the reflux. This helped but it didn't fix the problem. I'd wake up choking once every couple of weeks and this was not acceptable to me.
I started googling for my symptoms and I found someone who had a stomach infection that was causing his reflux, when he treated that infection, the reflux stopped.
I tried to get my doctor to run tests and he wouldn't. I went to a gastroenterologist and began asking him to test me for infections. He stated that the only possible thing that could survive in the acidic environment of my stomach was H. Pylori and since a gastroscopy didn't find any evidence of ulcers, I couldn't possibly have an H. Pylori infection.
I was insistent that I be tested for it... Two days later, I got a call that I did have an H. Pylori infection and the doctor would call in a prescription.
I took a ten day course of antibiotics and a PPI. Almost miraculously, I was cured. No more stomach discomfort. Almost no night time reflux. I wake up choking maybe once in 6-8 months. I am breathing better. I was damaging my lungs for years and it's taking time to recover from that damage but things are constantly improving.
Basically, I would be in much worse health if I hadn't sought out the experiences of other people and if I hadn't pushed back against the advice of my doctors.
You still probably have sleep apnea if you are ever waking up fully without the ability breathe. The human mind can wake up from deep sleep to stage 1 sleep in order to breathe better dozens of times an hour without you perceiving a thing. It only wakes up all the way when it's really bad. In fact, the acid reflux is often a symptom of sleep apnea, attempted inspiration with a sealed off airway literally sucks acid out of your stomach. Get yourself a sleep study. If I'm right, get new doctors and dentists, they all should have caught it by now. Good luck.
Agree 100%. The corollary is that, if you must play, make sure that you yourself are the best expert of your medical history, symptomology, and candidate hypotheses about what may be going on with your health. This is difficult, and perhaps futile, but the sad truth is that due to time issues (and probably information overload) it's your job to a) bootstrap the MD with whatever is relevant about your condition, and b) sanity-check the MD's decisions.
Failure to do either of those things is likely to result in either suboptimal care in the best case, actively misleading care in the worst. I guess the silver lining is that Google + intelligent and motivated person >= most MD diagnoses in my experience.
Since few MDs can actually stay on top of the latest developments for all the different items that cross their desks, UpToDate serves as a curated summary of many medical conditions, and is updated every 6 months (? maybe 9, it's been a while) for each topic.
It is a subscription service, and if you are dealing with anything in between problematic-to-serious, it is well worth subscribing for a month. If the language is difficult in whatever article seems relevant to you, it is worth figuring out the language because it will provide a good jumping-off point to go examine the literature on which it is based (which is likely your next stop, for serious conditions.)
I second this. In fact, the big secret is that all doctors use this as reference these days in clinical practice settings, while in the backroom on a computer. It is literally the doctor's goto wikipedia.
A convoluted set of circumstances led me to a quick detour in grad school, to sit in on Anatomy at Harvard Med. This included the dissection portion, in which four med students hunch over the cadaver for 3-4 hours at a time. It lead to some of the best medical conversation I've had in my life.
The best topic was summarized as: When you visit a doctor, odds are that he/she has about 15 minutes to an hour to evaluate you before moving onto the next case (often because there are bills to pay.) If you are not an expert on your particular medical history and circumstances, then you are basically screwed, because there is nobody human who can digest all of your medical history and circumstances in the allotted amount of time. It still essentially holds true if you have some serious condition: Consider all of the other patients on the doctor's plate.
That, combined with several other stories and experiences, had a big effect on me: It became obvious that it is worth enormous amounts of time and money to keep fit. When it comes to the med community, the only way to win is not to play.