Doctored Up

If you are lucky enough to be “healthy”—aka free of terminal diseases—but saddled with the more usual chronic problems, you might just find yourself Doctored Up. By Doctored Up, I mean spending more time and money in the offices of “health providers” than you ever imagined possible. First, there’s running the gauntlet of annual check-ups with your internist, eye doctor and dermatologist; then (if you’re female), the gynecologist the radiologist (if you’re over 40), and the pediatrician (if you have kids).

And let’s not forget all of those delightful visits to the family dentist and hygienist simply to maintain optimum dental health. And that’s just the baseline. Once you have a cavity, sinus infection or any lumps, bumps, aches or pains, you can start the rounds of seemingly endless appointments with physicians and specialists—sometimes alone and sometimes with loved ones.

Take this week for example. Yesterday I went with my husband to an orthopedic back surgeon for a consultation. For many years Henry has had chronic lower back pain from several herniated disks. About once a year he goes to a physiatrist for an epidural, and that usually does the trick. But not this time. Henry has had multiple shots in various disks over the past six months, practically turning himself into a pin cushion. Not that he’s anxious for surgery, mind you. He’s gone for multiple rounds of physical therapy. Desperate for relief, he even sees a chiropractor. My husband is not crippled or bent over, but his quality of life has been compromised. He can’t walk more than eight blocks, has to choose his chairs carefully, and remember never lean to the left. And, did I mention that he sometimes feels like there’s a knife in his back?

Yesterday, after we waited nearly an hour to see the doctor, we learned—surprise, surprise—that Henry’s not a candidate for spinal fusion. His symptoms are insufficiently severe He doesn’t have a dropped foot or sciatica, and he doesn’t lean on walls or walk like a hunchback. (!!) Besides, the success rate for spinal surgery is only about 50%.

“We’ll cure cancer before we cure back pain,” the surgeon told Henry.

Not liking this answer, Henry decided to seek a second opinion from a neurosurgeon. After looking at the x-rays, MRIs, and giving Henry the same physical exam he’d experienced the day before, the second surgeon came to the same conclusion as the first one: Surgery is out. He advised Henry to try more injections into S4 and S5 and continue seeing the chiropractor. In other words: try to live with the current pain and don’t come back unless it gets significantly worse. I’m no doctor, but I’ve been giving this same advice to Henry all along. Unless I’m in a casino, I don’t like 50/50 odds.

Henry might be finished with doctors this week, but I’m not. My daughter Samantha has an infection in one of her pierced ears, so I made an appointment for her to see our dermatologist.

“Please DON’T come with me,” she demands. “I’m NOT a baby. I can go myself.”

“Of course you can,” I assure her. I need a day off from doctors and I know she’s capable of dealing with an infected earlobe. This has happened so many times before I know she can handle it. But I WILL have to call the doctor’s office, remind them of her disability, explain why she’s going, and arrange payment. I’m beginning to think it might be easier (and cheaper) to give up on Sarah having pierced ears.

After my one day off from doctors this week, I must go with Samantha down to NYU Langone to visit her diet doctor. Those pesky last few pounds are sticking to her like glue. Plus my daughter has just come off Abilify—the drug that made her gain all the weight in the first place—and I’d like to see her start to come off the stimulant drugs used to offset the metabolic side effects of Abilify. Now that Samantha is off Abilify, she’s more anxious and sometimes gets “stuck,” or chatters too much. I’m hoping maybe the best solution is no drugs at all.

Next week it will be my turn to go to the dermatologist for a mole check because my mom had melanoma in her 50s. Just around the corner in July is the appointment that every woman dreads— my yearly mammogram and sonogram. Perhaps the only thing worse than seeing my radiologist is going for a colonoscopy (but at least that’s every three years).

What are the 20 leading primary diagnosis groups for office visits? Other than routine health check-ups, gynecological exams and heart disease, a few of the leaders surprised me. According to the U.S. Department of Health and Human Services, spinal disorders (like Henry’s) and metabolic issues (like Samantha’s) are right up there with cancer, diabetes, asthma and cataracts, all contributing to 1 billion office visits per year!

How much time will you spend in a doctor’s waiting room? The average waiting time is 21 minutes, but can easily run over an hour (as recently happened to Henry and me). Obviously, the answer depends on where you live, who you’re seeing, and whether a particular physician accepts insurance. A doctor who accepts many insurance plans will usually have a crowded waiting room.

Here are a few tips to shorten your wait: book earlier in the day before emergencies are squeezed in and the doctor falls behind schedule; call ahead to find out if the doctor is backed up. If you can’t get an appointment as a new patient, go on a waitlist and check each day for a cancellation.

I know my family is lucky to have health insurance so we can afford to see all of our fine doctors, and luckier still that we’re all basically healthy. As much as I might complain about the time and money we spend on doctors, we can’t live without them. If we want to have the best chance to “live long and prosper” as Mr. Spock in “Star Trek” once said, better to be Doctored Up.

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