Always Question Your Doctor – Three Stories Why

These three stories may help save your life someday and I hope they will help you make the best possible medical decisions.

Gall Bladder Surgery

12 years ago at age 25, a doctor diagnosed me with gallstones and she recommended that I have my gall bladder removed. The first inaccurate thing they told me was that the procedure was safe. It isn’t. They didn’t tell me that 1 in 50 patients have an injury that results in serious complications like death or lifelong pain. They also didn’t tell me gallbladder surgery increases the chance of colon cancer. And they didn’t tell me that over 1 in 10 patients are not satisfied with the surgery. Is that the doctor’s fault? No, some of this stuff they didn’t even know in 1994. It was my responsibility to ask more questions and do more research about the procedure. I should have asked – What does low risk mean? What exactly are the possible complications and how would they affect my life? Is it possible there are long-term complications with this procedure that nobody knows about yet?

The day of my gall bladder surgery, they wanted to perform an ERCP to remove a stone from my bile duct. The ERCP was in addition to my gall bladder removal surgery. It involved inserting a tube down my throat while I was conscious and rooting around in my bile duct. ERCP risks are high – 1 in 5 cause pancreatitis, which can result in death or lifelong pain. Just before I was about to have the procedure done, I asked the doc, “why do you think there is a stone caught in my bile duct?”

He said, “because your liver tests indicated it.”

I asked, “what else could give you that result?”

He said, “alcohol consumption.”

I asked, “how much?”

He said, “anything more than two beers.”

I said, “I had six last night.”

He said, “Six beers would give these results”, and he called off the procedure. I avoided a 20% chance of serious internal injury by asking questions!

My gall bladder removal surgery was flawless and I am grateful for that, because three years later my brother’s gall bladder removal did not go so well. The surgeon nicked his intestine and it leaked bacteria causing septic shock. He nearly died. He would have left two children under five behind. After several weeks in ICU he snapped out of his coma. A doctor told him that 70% of people with septic shock die.

Kidney Stones

At 4 A.M. Thanksgiving morning 2006 (a few days ago), I awoke to a searing pain in my lower left back. An hour later, I landed in the ER. They diagnosed me with a kidney stone, told me it was one of the most painful sensations know to man (renal colic), shot me up with narcotics, and gave me a CAT scan. The scan confirmed I was passing a kidney stone. They sent me home with a bottle of painkillers and told me it would take a few days to pass. Thank God for opiates. The ER doctor and staff were fabulous.

The ER doc referred me to an urologist, but it took five days to get an office visit. During this visit, I asked him what I could do to prevent kidney stones from forming in the first place. He said I could eat less calcium in my diet, but other dietary changes would have no effect. I said, “what about pop, coffee, or water?” He said that stones were genetic and changing my intake of those items wouldn’t have an effect. He was wrong.

Many medical researchers believe calcium deficiency causes kidney stones not a calcium surplus.

People who form calcium stones used to be told to avoid dairy products and other foods with high calcium content. But recent studies have shown that foods high in calcium, including dairy products, may help prevent calcium stones. Taking calcium in pill form, however, may increase the risk of developing stones.

From: http://kidney.niddk.nih.gov/kudiseases/pubs/stonesadults/#the

Reduced calcium diet is an old inaccurate preventative treatment:
http://www.ccjm.org/pdffiles/HALL1102.PDF
My urologists information was out of date.

Diet does affect risk

Foods and Drinks Containing Oxalate

People prone to forming calcium oxalate stones may be asked by their doctor to cut back on certain foods if their urine contains an excess of oxalate:

  • beets
  • chocolate
  • coffee
  • cola
  • nuts
  • rhubarb
  • spinach
  • strawberries
  • tea
  • wheat bran

People should not give up or avoid eating these foods without talking to their doctor first. In most cases, these foods can be eaten in limited amounts.

From: http://kidney.niddk.nih.gov/kudiseases/pubs/stonesadults/#the

Water intake does affect risk:

A simple and most important lifestyle change to prevent stones is to drink more liquids—water is best. If you tend to form stones, you should try to drink enough liquids throughout the day to produce at least 2 quarts of urine in every 24-hour period.

From: http://kidney.niddk.nih.gov/kudiseases/pubs/stonesadults/#the

He doesn’t return my calls, goes on vacation without a backup, and gives dated advice. It’s time to find a new urologist.

Arthritis

Three months after our second child was born my wife began to develop pain in all the distal joints on her left hand. She was 35 years old. After several more months, the pain increased and her joints began to swell. She visited a doctor. He told her that is was Osteoarthritis and modern medicine couldn’t help. She’d just have to live with it. She believed him for the next year as her joints became worse and the disfigurement progressed.

Then it began to spread to her right hand. After Googling arthritis, my wife and I discovered that Osteoarthritis generally did not progress this fast. This time she skipped the whole HMO referral process and went straight to a top tier rheumatologist. This doctor was better and more empathic than the first doctor was. He did tests to ruled out Rheumatoid Arthritis. Then he guessed it might be Psoriatic Arthritis (a rare form of progressive arthritis that can be disabling within five years) and put her on several medications. One medication was Methotrexate – a chemotherapy drug with significant life altering side affects. After taking this drug for several weeks, she returned to the doctor telling him that it wasn’t working and it made her sick.

Then she got a third opinion. This doctor determined that she had DJD (degenerative joint disease) which is another name for Osteoarthritis and put her on a NSAID drug that seems to be working. But the truth is not one of them knows what is happening in her hands. They are all guessing. It was up to her to tell them what was and wasn’t working. It was up to her to question their diagnosis. It was up to her to get second and third opinions.

The second doctor encouraged her to do her own research on Google and learn as much as possible about arthritic conditions. He was wonderful. He admitted he didn’t know what was happening and recommended the third opinion.

Owning her own health care decisions and challenging the doctors saved her joints from further destruction and saved her from years of life threatening side affects from Methotrexate. Her current NSAID treatment seems to be working well.

Remember, ultimately, you own you own health care. You are the decision maker. So ask a lot of questions.

Read the 10 part series on the 10 things I wish I had never believed:

#1 Why People Believe Money is the Root of All Evil
#2 Why Getting a Good Job isn’t the Best Way to Earn Money
#3 The Secret Great Leaders Know About Emotions
#4 Success is 99% Failure
#5 10 Tips to Secure a Management Position without a College Degree
#6 Always Question Your Doctor – Three Stories Why
#7 How the Public School System Crushes Souls
#9 Give Me 3 Minutes and I’ll Make you a Better Decision Maker

21 thoughts on “Always Question Your Doctor – Three Stories Why”

  1. I close friend of mine (who coincidentally is studying to become a doctor) used to have a philosophy called “Distrust and Verify”. It means what it says – don’t trust anything until you’ve checked it out yourself. Sadly, I think there’s a lack of caring, honesty, and courtesy in today’s society. When someone asks “How are you doing?”, half the time there’s no real need to actually know how someone is doing – it’s just a formality. And in situations like the one’s you describe, all it takes is someone being straight up with you and letting you know that they may not have all the answers. But more often than not, someone won’t actually take the initiative to let you know that things aren’t as they seem – and instead take the easy way out. Hopefully what I’m saying makes some sense, but yes – at times the only person who is ultimately responsible for your health and well being is you.

  2. Relying solely on allopathic doctors can be dangerous and frustrating. (Oh yeah, and life threatening) I have taken to the habit of googling a condition with the term “naturopathic treatment” as well. I will also use various other terms: “ayurvedic treatment”, “tcm treatment” etc. This has worked out very well in many cases. My wifes mother has a degenerative eye disease. According to the specialist she is seeing for laser treatment, the best she can hope for is to halt the progression (vision loss). We googled and set up an adjunct to her doctors treatment using herbs, specific foods and supplements. This started in september. She just had a check up and the doctor was very surprised to find that her condition had in fact improved. He said that improvement was almost unheard of. She is very happy as are we.

  3. What you described (about questioning the doctors) is sound advice. Internet sites are available worldwide and medical care (and their set-up) differs widely. Where I am writing this, the first appointment is often a 3 month wait, so following up such an appointment with a second opinion may easily take 6 months. I agree with a better option I think the medical profession in general wields too much power, a lot of other professions could not get away with some of the stuff. Yes, I have examples but like to keep this short(er)…

  4. Not questioning your doctors can definitely kill you.

    My girlfriend’s cousin’s new husband just got a death sentence from the doctors, and he’s only 42.

    He was going to the doctor for over a year for bowel problems, and the doctor was treating him for Inflammatory Bowel Disease.

    They just found out that he has Stage IV bowel cancer, and it has spread to his liver and his bones. They are not going to even try treating him because it is so advanced; they are recommending hospice care and predict that he has 6 months left to live.

    He will also be leaving behind 3 young daughters, the oldest is 7.

    Someone else told me that the doctors were recommending that they get their gallbladder removed, but they found a natural remedy on the ‘net that took care of the gallstones and saved them the loss of an internal organ. The surgery alone could have killed her.

  5. I hate to be picky here, but I noticed that you said that your cholecystectomy took place 12 years ago, and that you were upset because your doctor didn’t know that gallbladder surgery increased the risk of colon cancer. Then you linked to a large population study published in 2005 (one year ago, not 12) showing only a modest increase and only correlation, not causation.

    Then you mentioned that 10% of patients are not satisfied with their gallbladder surgery but fail to link to any studies – only an unreferenced web-page from a surgeon who makes his living doing laparoscopic surgery (which was available 12 years ago, by the way). Why were those patients unsatisfied? Was it because their expectations were not realistic? Were they unhappy with the anesthesia?

    You also link to an unsubstantiated claim of a 2% (1 in 50) risk of serious complication like death or lifelong pain. What population was that in? 80 year olds with multiple medical problems or healthy 25 year olds? Again, no data.

    You go on to describe your having 6 beers the night before an ERCP which shows incredibly poor judgement on your part (as well as whoever did your procedure – I wouldn’t have touched you with a 10-foot pole if you had 6 beers the night before an ERCP).

    Maybe I should write an article about always questoning what you read on the web …

  6. Hey, I’m a first time 35 y.o. mom and I developed symptoms that sound a lot like what happened to your wife… I am also seeing a rheumatologist but as of yet have no diagnosis other than “inflammatory arthritis” and have also been put on an NSAID, which sometimes helps, sometimes doesn’t.

    My OB/GYN recently said the arthritis could have been brought on/aggravated by nursing – the hormones that control lactation cause retention of fluids which in turn aggravate joints… I haven’t had time to follow up on this tidbit myself, but thought I’d pass it on since what your wife is going through sounds so similar. It makes sense to me…

    FWIW, hope everyone has a happier, healthier new year in 2007
    All the best,
    S

  7. Wilson,
    Thanks for reading,

    But everything I said was factual.

    I hate to be picky here, but I noticed that you said that your cholecystectomy took place 12 years ago, and that you were upset because your doctor didn’t know that gallbladder surgery increased the risk of colon cancer. Then you linked to a large population study published in 2005 (one year ago, not 12) showing only a modest increase and only correlation, not causation. – I didn’t say I was upset. But they may not have known, but it still increases your risk for cancer. They didn’t know smoking increased your risk for cancer in 1940, but it still increased your risk for cancer, didn’t it?

    Then you mentioned that 10% of patients are not satisfied with their gallbladder surgery but fail to link to any studies – only an unreferenced web-page from a surgeon who makes his living doing laparoscopic surgery (which was available 12 years ago, by the way). Why were those patients unsatisfied? Was it because their expectations were not realistic? Were they unhappy with the anesthesia? – Scroll down on the site I liked to. It cites over a half dozen studies on satisfaction. Some studies showed a much worse rate than 10%. It was 12 years ago and my Gall Bladder was scoped. They’ve been doing laparoscopic cholecystectomy since the early 90s. I think I read they even did it in the 80s.

    You also link to an unsubstantiated claim of a 2% (1 in 50) risk of serious complication like death or lifelong pain. What population was that in? 80 year olds with multiple medical problems or healthy 25 year olds? – Again, no data. – You didn’t read the site I linked to, it has these facts and references. What is the result of a bile duct injury?

    You go on to describe your having 6 beers the night before an ERCP which shows incredibly poor judgement on your part (as well as whoever did your procedure – I wouldn’t have touched you with a 10-foot pole if you had 6 beers the night before an ERCP). – I was twenty five and I wouldn’t do that today. But I called my surgeon the night before my surgery and he said alcohol was fine, even in that amount.

    Thanks
    Steve

  8. I took Methotrexate for a month and had to stop because I felt sick all the time, and each dose was making it worse. My doctor said that was really rare, but I’m starting to wonder.

    All of the good kidney stone advice you cited was given to me by my urologist, and I haven’t had a stone since I cut back on cola and started drinking 3/4 gallons of water every day. So, I guess I lucked out there (although he seemed pretty unsure that any of it would actually make a difference).

  9. Say… your Urologist wasn’t in Geneva, IL by any chance, was he?

    Because it sounds like the same guy I had for my kidney stones.

    All in all, a good article. After my had a broken knee (fractured tibular plateau), her doctor failed to mention that for some people the restrictive nature of a leg cast can cause clots to form… and then lead to a pulmonary embollism. And that is just what she had a week later.

    She was one of the lucky 10% that walk away without a stroke, or permanent heart or lung damage. But, if we had known this was a possibility, we wouldn’t have dithered at home for 30 minutes trying to figure out what was wrong before we called the ambulance.

    That doctor and I had a long, serious discussion about his responsibility to alert patients to potential hazards in the treatments he prescribes.

  10. Here’s a story with a twist.

    My wife is a doctor, and she told me how a few months ago a patient came in to get some blood tests done. Since she didn’t know the patient, she asked what the tests were for. The patient said that her naturopath requested them.

    My wife advised that she does not order blood tests this way, and said that if she performed the blood test the patient would have to agree to be followed up.

    Now it turns out that the patient had an abnormal platelet count. The patient was recaledl, but the patient refused to be referred to an oncologist for further investigation. Luckily for the patient, another doctor gave this person the same advice and the patient is in hospital for treatment of late stage cancer.

    While one should take a doctor’s advise with due care, one should never be entirely dismissive of a doctor’s opinion. Given so much information is available on the internet, it’s important for one to do a bit more research on their own and then discuss with their practitioner what one’s concern is.

  11. I agree with the last comment 100%. Never dismiss a doctor outright either, that could be as big a mistake as taking bad advice. Maybe bigger, I don’t know. I don’t know anyone that has ever done that.

    I did hear a rumor once that a guy I know had symptoms of colon cancer for over a year and he tried as slew of herbal remedies without seeing a doc. By the time he got to the doctor his cancer had progressed so far that it killed him. I don’t know if it’s true, but I heard it from a few people that knew him.

    SO that goes with the theme that the key to your life lies within you. You make the decisions, so you must take resposibility for them. If you take bad medical advice, who pays the price? You do. If you fail to take good medical advice, who pays the price? You do. It’s up to you to determine what is good advice and what is bad advice.

  12. You should have your wife try out a juice called Xango for her arthritis. My mom’s been taking it for a year and it’s taken the symptoms away. It’s all natural. I didn’t believe it would work at all in the beginning because some sales person had sold it to my mom. But I guess it’s working. She’s not taking any meds anymore.

    here’s the site: jilliankay.natureswellnesssecret.com

  13. This is a good post.

    My mother was treated for IBS for years. Her doctors never even considered that it might be cancer in her intestines. It was. In fact, it was a rare and hard-to-treat form. Now she has terminal cancer, because it metasticized to the liver, ovaries, and the rest of the abdomen.

    They did an emergency hysterectomy and took out the worst part of the bowel cancer, but they can’t fix the liver, the whole thing is infested with tumors.

    However, Mom remains strong (mentally) and in control. Her cancer’s a rarer form (her oncologist has only seen 3 cases), so she’s researched it, had meetings with specialists, talked to other people with the same disease online, even gone to conferences (these were geared at both patients and doctors). And so far she’s made it almost 3 years since the crisis. She’s probably had it for 6. Right now there’s an experimental treatment she found which is doing her a lot of good. Lucky for us, since the other methods weren’t working.

    She makes a great role mode as a patient. She listens to her doctors, collects information, reads up on her condition, researches treatments, gets second opinions, finds the best specialists, she’s a trooper!

    -MM

  14. If you are interested in this topic check out the book “How Doctors Think” in your local bookstore now. The author, a highly published MD researcher tells you a lot more about how to interact with your doctor, what to ask etc. Also what thinking errors doctors are prone to. The stories, including the authors own quest for treatment of his painful hand condition, are very informative.

  15. Great post and very interesting topic. I always make sure things are clear when I see my doctor because it’s only the safe thing to do. I have never had any confusion between what I need to do medically because I already keep safe. It saves me a lot of money and trips to the doctor as well.

  16. Ugh unfortunately I can relate. Six months ago my breathing became shallower and I had a slight pain in the upper right area of my back. It progressed until my right chest hurt whenever I drove or bumped up and down and I was sleeping perfectly upright because it hurt to lay down. I went to my general practitioner, insisting that something was really off and I could just feel it. He couldn’t hear anything in my lungs and didn’t seem concerned that I couldn’t breathe. He told me to come back in a week if I didn’t feel better and gave me an inhaler.

    Two days later I was in a horrible state and was just barely able to breathe. After researching online about what could be wrong with me, I learned that most of the possible afflictions that I had were very serious and potentially fatal, so I rushed to the ER. After I got an xray of my chest the ER doctors unanimously determined that I had a horrible case of pneumonia. It was so horrible that they couldn’t hear the fluid in my lungs because my lung was nearly full of fluid, which was why my doctor missed it. I was lucky and got there just in time to avoid a hospital stay, but if I had not insisted that something was wrong and gotten help on my own, I could have been in the hospital in a bad state or even dead.

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