Or, “How I became even more disappointed in the medical practice in the USA than I already was”.
I’m getting older—half a century now—and have recently been having health problems. It started with soreness in my right hip about four years ago, gradually getting worse and worse over time. At one point I damaged it by sitting in a funny position for too long; later on, I did what I thought was a very normal set of lunges in the gym that made me almost unable to walk for months afterward.
Then, about a year ago, I started having issues with my feet. At first, they were a little sore. They got worse and worse, eventually getting to the point where I again couldn’t walk comfortably. They just would not heal, no matter how much time off I gave them.
In the past three years, I’ve seen half a dozen doctors. Hypotheses ranged from early onset arthritis, to joint damage, to tendon damage, to disc compression in my back. Physical therapy helped a small amount, but the gains tapered off quickly and did not last. I was making no progress, and had simply restricted activity in my life to the point where things were tolerable. None of the doctors had any idea what was going on, and every visit was hundreds of dollars to be told things I already knew. One doctor prescribed exercises for the elderly to build muscle tone, without even bothering to ask about my current exercise regime or current state of fitness. (At the time I could do sets of 40 push-ups and one-legged squats to the floor and back.) To say that I was frustrated is an understatement.
A bit over six months ago, I began to wonder if perhaps this was a side effect of the low dose statin I had started taking. The problems started prior to my taking the statin, but I found reports of statin side effects that looked vaguely similar to my issues. Perhaps I had fouled my cholesterol metabolism?
I concocted an experiment to stop taking the statin for a few weeks, and eat a ton of eggs to try to get more cholesterol in my system. I didn’t know at the time that dietary cholesterol makes very little contribution to total cholesterol levels, but that turned out to be a good thing: I saw what seemed to be noticeable improvement. The next couple of months I learned about cholesterol metabolism and ran more experiments, eventually narrowing things down to the point that I knew statin use was not responsible. The eggs were the active ingredient.
But how does that make any sense?
At some point it occurred to me that eggs also contain protein, that bodybuilders supplement protein in order to build muscle, and that vegetarians could get protein deficiency. With ten minutes of investigation, I discovered that my preferred diet is pretty close close to vegetarian, and had slowly been shifting to become more vegetarian over time. Did I have a protein deficiency?
Lacking any other options, I used the power of “moar dakka” and tripled the amount of animal protein in my diet. Since then, both of my long-term multi-year health problems have gone away, all in the space of the last three months. I can hike for miles again, I can lift heavy weights, and I heal after taking damage. It’s amazing.
What has not healed is my opinion of medical practice in the USA. How on earth could something like this go undiagnosed for years? How could something as fundamental as protein deficiency not be a standard, ordinary thing we test for? How could half a dozen smart, capable, and highly trained doctors miss something like this repeatedly? How is it that the best modern medicine can do is say “go to physical therapy and hope it gets better”?
To say that I am disappointed quite undersells my change in opinion. I previously took what doctors said with a grain of salt but largely believed them. Now, I take what doctors say and run it through the same sanity check filters I use when surfing random web sites. Diagnoses and recommendations from my doctors are now strictly advisory: it’s clear that the person closest to my problems is me, and it’s clear that doctors know at best only fractionally more about what’s going on in my body than I do. And further, I have more incentive to figure it out, more time I can spend digging into it, and I can run experiments to collect data instead of guessing.
(If only we had a dedicated fraction of the population that were trained experts we could rely on to help us understand, fix, and manage problems with our bodies!)
This is not how an effective society runs its medical system. This is not how medicine needs to be, if it’s going to be effective. This is Moloch in action; this is institutional failure. I don’t know how to fix it, but at least I know enough now to begin protecting myself from it.
Another medical miracle
Or, “How I became even more disappointed in the medical practice in the USA than I already was”.
I’m getting older—half a century now—and have recently been having health problems. It started with soreness in my right hip about four years ago, gradually getting worse and worse over time. At one point I damaged it by sitting in a funny position for too long; later on, I did what I thought was a very normal set of lunges in the gym that made me almost unable to walk for months afterward.
Then, about a year ago, I started having issues with my feet. At first, they were a little sore. They got worse and worse, eventually getting to the point where I again couldn’t walk comfortably. They just would not heal, no matter how much time off I gave them.
In the past three years, I’ve seen half a dozen doctors. Hypotheses ranged from early onset arthritis, to joint damage, to tendon damage, to disc compression in my back. Physical therapy helped a small amount, but the gains tapered off quickly and did not last. I was making no progress, and had simply restricted activity in my life to the point where things were tolerable. None of the doctors had any idea what was going on, and every visit was hundreds of dollars to be told things I already knew. One doctor prescribed exercises for the elderly to build muscle tone, without even bothering to ask about my current exercise regime or current state of fitness. (At the time I could do sets of 40 push-ups and one-legged squats to the floor and back.) To say that I was frustrated is an understatement.
A bit over six months ago, I began to wonder if perhaps this was a side effect of the low dose statin I had started taking. The problems started prior to my taking the statin, but I found reports of statin side effects that looked vaguely similar to my issues. Perhaps I had fouled my cholesterol metabolism?
I concocted an experiment to stop taking the statin for a few weeks, and eat a ton of eggs to try to get more cholesterol in my system. I didn’t know at the time that dietary cholesterol makes very little contribution to total cholesterol levels, but that turned out to be a good thing: I saw what seemed to be noticeable improvement. The next couple of months I learned about cholesterol metabolism and ran more experiments, eventually narrowing things down to the point that I knew statin use was not responsible. The eggs were the active ingredient.
But how does that make any sense?
At some point it occurred to me that eggs also contain protein, that bodybuilders supplement protein in order to build muscle, and that vegetarians could get protein deficiency. With ten minutes of investigation, I discovered that my preferred diet is pretty close close to vegetarian, and had slowly been shifting to become more vegetarian over time. Did I have a protein deficiency?
Lacking any other options, I used the power of “moar dakka” and tripled the amount of animal protein in my diet. Since then, both of my long-term multi-year health problems have gone away, all in the space of the last three months. I can hike for miles again, I can lift heavy weights, and I heal after taking damage. It’s amazing.
What has not healed is my opinion of medical practice in the USA. How on earth could something like this go undiagnosed for years? How could something as fundamental as protein deficiency not be a standard, ordinary thing we test for? How could half a dozen smart, capable, and highly trained doctors miss something like this repeatedly? How is it that the best modern medicine can do is say “go to physical therapy and hope it gets better”?
To say that I am disappointed quite undersells my change in opinion. I previously took what doctors said with a grain of salt but largely believed them. Now, I take what doctors say and run it through the same sanity check filters I use when surfing random web sites. Diagnoses and recommendations from my doctors are now strictly advisory: it’s clear that the person closest to my problems is me, and it’s clear that doctors know at best only fractionally more about what’s going on in my body than I do. And further, I have more incentive to figure it out, more time I can spend digging into it, and I can run experiments to collect data instead of guessing.
(If only we had a dedicated fraction of the population that were trained experts we could rely on to help us understand, fix, and manage problems with our bodies!)
This is not how an effective society runs its medical system. This is not how medicine needs to be, if it’s going to be effective. This is Moloch in action; this is institutional failure. I don’t know how to fix it, but at least I know enough now to begin protecting myself from it.
I just wish I didn’t have to.