About ten years after being diagnosed with a non-aggressive prostate cancer and narrowly escaping the surgeon’s knife by finding a real prostate oncologist who shared all the treatment alternatives with me, then undergoing non-invasive yet pretty darn effective treatment, something entirely unrelated happened, or so it seemed.
Self-Serving Medical Practice
I recall the urologist who had diagnosed the cancer with strong distain. He was a surgeon and had glibly said, “Don’t worry, it’s not that aggressive; give me a call and we can schedule surgery in the next couple of weeks.” His conflict of interest coincided with a complete lack of objectivity as well as indifference to the risks for the patient – me. He failed even to mention alternatives to surgery. I was lucky to find a prostate oncologist, escape the knife, and find an effective non-invasive treatment.
Then, once again, a decade after that narrow escape from unnecessary surgery, by finding the right information and dodging routine medical practice – the so-called “standard of care” – I was able to choose a better path than passive acceptance of self-serving medical “authority” would have allowed.
After a few years living in Northern New Mexico, what had been rather ordinary springtime allergies gradually morphed into full-blown year-round allergy symptoms. I was tested, and sure enough, I had become allergic to most grass and tree pollens in the area. After about four years of weekly allergy shots, my symptoms seemed moderately reduced, but far from eliminated. Then, following a particularly strong winter flu, I sustained a major sinus infection. My sinuses had become almost fully blocked. Sinus surgery followed; the result was wonderful. I was breathing clearly through my nose for the first time in years. And my allergy symptoms were reduced to occasional minor irritations.
The Arrogance of Authority
However, during the pre-op testing, EEG and EKG measures revealed a small heart valve anomaly. Of course, nobody tells you why you are getting extra tests or what the findings are. Finally, after the pre-op physician’s assistant sent me for a full abdominal ultrasound in search of a non-existent aneurysm, she scheduled me to see a cardiologist. “I don’t know why they did the ultrasound; maybe they thought you had an aneurism. But the good news is, you don’t,” said the cardiologist standing over me with a smug air of authority. He said the heart valve anomaly was minor and simply should be checked once a year. If it didn’t change, no problem.
But the cardiologist insisted that I begin taking Lipitor to keep my cholesterol numbers below their slightly elevated level. When I began to inquire about the “side effects” of statin drugs, he became indignant. “I’ve heard all those arguments. You need to take it to prevent more plaque buildup in your coronary arteries to prevent a heart attack or stroke.” He thereupon wrote a prescription for a strong dose of the generic form – Lipitor’s brand-name patent had expired. The man was over-the-top arrogant. To discuss a patient’s concern was apparently below his self-defined authoritarian dignity. I resolved to never see him again.
I was more concerned about the heart valve anomaly and didn’t like what I knew about statin drugs. So, I decided to visit the cardiologist in Beverly Hills that my oncologist had sent me to for a checkup and stress test over a decade before. He was a very bright guy, affiliated with Cedars-Sinai Hospital, and clearly part of what I would call the “high-end” medical establishment. Back then I’d had stress tests and imaging a year apart and the year of regular gym workouts with a trainer in the interim had made the initially difficult stress test easy. All clear back then.
Knowledge Overcomes “Standard of Care”
“Oh, we saw that heart-valve anomaly ten years ago; it’s nothing to worry about.” He reported that I’d done perfectly on the stress test. “But you are off the charts on your arterial plaque. You must begin strong doses of Crestor immediately.” He gave me a handful of samples, insisting that I was in serious danger, based on such a strong score on arterial plaque. I did wonder why, if it was so bad, I had performed perfectly on the stress test and the imaging showed no obstructions at all.
Well, as it turned out with further research on my part and consulting with a lipidologist, my puzzlement with the inconsistency between the stress test and the “plaque score,” was well founded. Things were not as they seemed to the high-end cardiologist. So, next time I will report, as Paul Harvey used to say, “the rest of the story.”